Infectious Disease in the Community and Hospital Setting

Module details

Title

Infectious Disease in the Community and Hospital Setting

Type

Specialist

Module code

SLS220

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with advanced knowledge and understanding of the aetiology, clinical presentation and management of infection in the community and of hospital-acquired infection (HAI). In the work-based module they will be expected to apply this knowledge as they gain experience of infection control and perform methods used in the diagnosis and monitoring of community infection. To provide the trainee with experience and development in the clinical and laboratory investigation and management of a wide range of infectious disease in the hospital and community setting. This will include the selection of relevant techniques, performance of investigations, interpretation of results and working within the required quality system. The trainee will also experience working in partnership between the clinical microbiology laboratory and other clinical specialisms and agencies.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1,2,3,5	Competency Control infection in the laboratory setting.	Action View
# 2	Learning outcome 1	Competency Select appropriate technique to investigate the frequency and clinical presentation of the following community-based infections: genitourinary tract, including sexually transmitted and urinary tract infections respiratory tract gastrointestinal tract skin and soft tissue eye liver (hepatitis) postoperative/inoculation.	Action View
# 3	Learning outcome 1	Competency Investigate the frequency and clinical presentation of the following community-based infections: genitourinary tract, including sexually transmitted infections and bacterial urinary tract respiratory tract gastrointestinal tract skin and soft tissue eye liver (hepatitis) postoperative/inoculation.	Action View
# 4	Learning outcome 7	Competency Interpret and report the results of the laboratory investigation of the following community-based infections: genitourinary tract, including sexually transmitted and urinary tract infections respiratory tract gastrointestinal tract skin and soft tissue eye, liver (viral hepatitis) postoperative/inoculation.	Action View
# 5	Learning outcome 4	Competency Select techniques for the investigation of the following range  of healthcare-acquired infections: hepatitis B virus hepatitis C virus HIV influenza virus varicella-zoster virus (VZV) herpes viruses methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, glycopeptide-resistant enterococci (GRE), resistant Gram negatives.	Action View
# 6	Learning outcome 2	Competency Investigate the source/cause of common pathogens in food and water specimens.	Action View
# 7	Learning outcome 3	Competency Investigate the source/causes of the following healthcare infections: hepatitis B virus hepatitis C virus HIV influenza virus VZV herpes viruses MRSA, C. difficile, GRE, resistant Gram negatives.	Action View
# 8	Learning outcome 4	Competency Interpret and report the results of the laboratory investigation of food, water and environmental samples.	Action View
# 9	Learning outcome 5	Competency Perform quality assurance and quality control tasks within the laboratory in the investigation of the following community-based infections: genitourinary tract, including sexually transmitted and urinary tract infections respiratory tract gastrointestinal tract skin and soft tissue eye liver (hepatitis) postoperative/inoculation.	Action View
# 10	Learning outcome 4	Competency Perform quality assurance and quality control tasks within the laboratory in the investigation of food, water and environmental samples.	Action View
# 11	Learning outcome 4	Competency Interpret and report the results of the laboratory investigation of HAIs, including: MRSA difficile GRE.	Action View
# 12	Learning outcome 5	Competency Fulfil the requirements and mechanisms for reporting of HAIs within healthcare organisations, locally and nationally, including mandatory surveillance and ‘serious untoward incidents’ of infection.	Action View
# 13	Learning outcome 5	Competency Perform quality assurance and quality control tasks within the laboratory for methods associated with HAIs, including for the following micro-organisms: MRSA difficile GRE.	Action View

Assessments

You must complete:

• 2 case-based discussion(s)
• 2 of the following DOPS/ OCEs:

Set up and read identification tests e.g. API of common pathogens in this module	DOPS
Set up, read and iterpret antimicrobial susceptibility tests of suitable pathogens in this module, including for appropriate resistant organisms	DOPS
Perform and interpret serological molecular identification of appropriate viral pathogens	DOPS
Perform the analysis of an appropriate IQA or EQA e.g. NEQAS sample	DOPS
Analyse samples for the detection of C. difficile infection by different methods e.g. ELISA, PCR, culture	DOPS
Perform serological identification of Salmonella spp. using Kauffmann White scheme	DOPS
Participate in an infection control meeting ward round where healthcare acquired infection prevention and control is discussed	OCE
Under supervision obtain a patient history from a normal volunteer or typical patient referred to your service and present the findings to a colleague or peer	OCE
Under supervision, provide advice on the management of an MRSA colonised patient	OCE
Under supervision, provide advice on the management of an C. difficile positive patient	OCE

Learning outcomes

1. Perform the clinical and laboratory investigations that are required for the management of infectious disease in the community, including with older people and in care homes.
2. Perform the clinical and laboratory investigations that are required for the management of common pathogens in food, water and environmental samples.
3. Perform the clinical and laboratory investigations that are required for the management of healthcare-acquired infection.
4. Interpret and report on the full range of investigations specified in this module in the correct clinical context.
5. Perform quality assurance and control tasks across the range of investigations associated with infection in the community and hospital setting.

Learning outcomes

1. Discuss the aetiology, pathogenesis and presentation of infectious disease in the community, including older people and care homes.
2. Describe the methods used in the investigation and management of infectious disease in the community, including treatment of commonly associated microorganisms.
3. Describe the methods used in the application of microbiology testing to food, water and environmental samples in community and hospital settings.
4. Explain the sources and routes of transmission of hospital-acquired infections and the risks caused to patients.
5. Explain and justify the legal framework and the role of guidelines and the hospital infection team in reducing hospital-acquired infections.
6. Describe and evaluate the role of the clinical microbiology laboratory and the infection control team in surveillance, decontamination, disinfection and sterilisation in the hospital and primary care settings and the contribution to patient care.
7. Describe the partnership between the clinical microbiology and other clinical specialisms and agencies in the investigation of infectious disease in the community and hospital setting.

Indicative content

• Aetiology and presentation, including sources and routes of transmission of infectious disease in the community and hospital-acquired infection (HAI)
• Pathophysiology of commonly occurring infections in hospital and community settings
• Epidemiological consequences of hospital-acquired and community disease control with reference to tuberculosis, viral hepatitis, HIV and genitourinary disease
• The laboratory investigation of infection in the community, including testing at the point of care
• Guidelines for the optimum treatment of hospital-acquired and community based infection
• Microbiological testing of food, water and environment samples in hospital and community settings (e.g. endoscopy rinse water, hydrotherapy water, settle plates)
• Current legislation and guidelines on the microbiological testing of food, water and environmental samples
• Local, national and international standards and guidelines in relation to occupational exposure to infectious agents
• Management of needlestick injuries in the clinical setting
• Legislation and guidelines for the diagnosis and management of common HAI (e.g. meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C Diff), glycopeptide-resistant enterococci (GRE))
• Decontamination, disinfection and sterilisation in the hospital and primary care setting
• The role of surveillance in reducing HAI
• The role of the hospital infection control team
• Investigation protocols and patient pathways relevant to hospital-acquired and community infection
• Diagnostic tools for the detection and identification of causes of microbial outbreaks (e.g. culture, enzyme-linked immunosorbent assay [ELISA], molecular techniques, automation, point-of-care testing [POCT])
• Interpretation and reporting of results, including notification (e.g. CoSURV)

Activities

• Participate in multidisciplinary review meetings at which patients with community-based infection are discussed. Reflect on your experiences in relation to the key factors affecting patient care and how this will inform your future practice.
• Review the legislation, regulation and testing requirements to assure microbiological safety of food and water in the UK. Demonstrate how this impacts on your laboratory practice.
• Review previous data on the clinical presentation and common causative agents of infection resulting from contaminated food and water and from the environment, to include spoilage organisms and indicator organisms. Give examples of the role of your laboratory in the investigation of such infections.
• Visit community-based health centres (e.g. GP surgery, care home) and produce a report to describe how medical, nursing and other staff are involved in the control of infection and the impact on patient care in these settings.
• Identify at least one patient undergoing investigation for a healthcare-acquired infection (HAI). Participate in multidisciplinary review meetings at which this patient is discussed and follow progress. Report on your experience and the learning points for your future practice.
• Attend ward rounds that involve patients with HAI and produce a report to describe the investigation and management of at least two patients.
• Participate in a multidisciplinary review meeting at which the epidemiological surveillance of an outbreak of infection is discussed. Produce a report with learning points that inform your future practice.
• Use a published case history, produce a report including the epidemiological surveillance and investigation of a major national or international outbreak of infection. Produce a report with learning points relating to the importance of the multidisciplinary team, the impact on the community/public and the implications for your future practice.
• Perform an audit on an aspect of HAI in your hospital(s). Report on results in the context of outcomes, their significance for the organisation, for patient care and for your own future practice.
• Produce a report on the national statutory and advisory requirements for infection control in the hospital and its implementation.

 

• Become familiar with the laboratory quality management system and perform examination and other audits as part of the laboratory accreditation process (applies to all specialist modules).