Iinfection Control Concepts and Principles 1

8/14/2019 Iinfection Control Concepts and Principles 1

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Infection controlInfection control

DEFINITION :DEFINITION :

Infection control is aInfection control is a

discipline that appliesdiscipline that applies

epidemiology andepidemiology andscientific principles andscientific principles and

statistical analysis to thestatistical analysis to the

prevention or reductionprevention or reduction

in rates of nosocomialin rates of nosocomialinfectionsinfectionsInfection Control TeamInfection Control Team

HCWsHCWs


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Objective of IC inbjective of IC inHospital Setting:ospital Setting:The main objective of the infection control team is toThe main objective of the infection control team is toprevent and reduce nosocomial infections.prevent and reduce nosocomial infections.

By following intervention:By

following intervention:

1. Take responsibility for major decision e.g. outbreak1. Take responsibility for major decision e.g. outbreak

2. Be given reports on current problems and on the2. Be given reports on current problems and on theincidence of infection.incidence of infection.

3. Arrange interdepartmental co-ordination and3. Arrange interdepartmental co-ordination andeducation in control of infection.education in control of infection.

4. Introduce, maintain and when necessary,4. Introduce, maintain and when necessary,

modify policies (e.g. disinfectant, isolation)modify policies (e.g. disinfectant, isolation)5. Advise on the selection of equipment for the5. Advise on the selection of equipment for the

prevention of infection (e.g. sharp boxes)prevention of infection (e.g. sharp boxes)

6. Make recommendations to other committees and6. Make recommendations to other committees anddepartments on infection control techniquesdepartments on infection control techniques..


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mpor anpor anComponents ofomponents ofInfection Control:nfection Control:Universal PrecautionsUniversal Precautions

Hand washingHand washing Isolation PrecautionsIsolation PrecautionsCleaning, Disinfections & SterilizationCleaning, Disinfections & Sterilization Linen Management and WasteLinen Management and Waste

DisposalDisposalNeedle Stick Injury and Hep BNeedle Stick Injury and Hep B

VaccinationVaccination


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PrecautionsrecautionsDefinition:Definition:

Universal Precautions conceptUniversal Precautions concept

should stress that all clientsshould stress that all clients

should be assumed to beshould be assumed to beinfectious for blood borneinfectious for blood borne

disease such as HIV ordisease such as HIV or

Hepatitis B and gram positiveHepatitis B and gram positive

and negative rods colonizedand negative rods colonizedi.e. MARO & MRSA.i.e. MARO & MRSA.


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Recommendationsecommendations Barrier PrecautionsBarrier Precautions Invasive ProceduresInvasive Procedures Wash contaminated body partWash contaminated body part

Proper sharp disposalProper sharp disposal Avoid Re-cappingAvoid Re-capping Masks, eye protectionMasks, eye protection Cleaning of Patients equipmentCleaning of Patients equipment

Environmental cleaning and terminal cleaningEnvironmental cleaning and terminal cleaning Linen ManagementLinen Management Hand washingHand washing


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Hand washingand washing ::Definition :Definition :

Hand washing isHand washing is

define as a vigorous,define as a vigorous,brief rubbingbrief rubbingtogether of alltogether of allsurfaces of latheredsurfaces of lathered

hands, followed byhands, followed byrinsing under arinsing under astream of water.stream of water.


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Classification of Handlassification of Handwashingashing

Handwashing

handwashedScrubbinghand rub


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Recommendationsecommendations Hand must be washed thoroughly with soap andHand must be washed thoroughly with soap and

water when visibly soiled.water when visibly soiled. Hands must be cared by hand washing with soap andHands must be cared by hand washing with soap and

waterwater

* Before and after contact.* Before and after contact.* After contact with a source of microorganisms e.g.* After contact with a source of microorganisms e.g.

contamination object.contamination object.

* After removing gloves.* After removing gloves. Wet hands with running H2O. Apply hand-washingWet hands with running H2O. Apply hand-washing

agent and thoroughly distribute over hands, rubagent and thoroughly distribute over hands, rubhands thoroughly together for 10 15 seconds,hands thoroughly together for 10 15 seconds,covering all surfaces of the hands and fingers.covering all surfaces of the hands and fingers.


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Recommendationsecommendations(cont..)cont..)

For general patient care, a plain, nonantimicrobial soapFor general patient care, a plain, nonantimicrobial soapis recommended.is recommended.

Hand antisepsis achieved by HW with antimicrobialHand antisepsis achieved by HW with antimicrobialcontaining soap or use of alcohol based antiseptic handcontaining soap or use of alcohol based antiseptic handrubs.rubs.

* Before performing invasive procedure* Before performing invasive procedure

* When it is important to reduce numbers of resident skin* When it is important to reduce numbers of resident skinflora in addition to transient microorganism.flora in addition to transient microorganism.

In setting where hand washing facilities are inadequateIn setting where hand washing facilities are inadequate

or in accessible and hands are not soiled with dirty oror in accessible and hands are not soiled with dirty orheavily contaminated with blood or other organicheavily contaminated with blood or other organicmaterial, alcohol based hand rubs are recommended.material, alcohol based hand rubs are recommended.


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IsolationsolationDefinition :Definition :

Isolation refers to theIsolation refers to the

precautions that are takenprecautions that are takenin the hospital to preventin the hospital to preventthe spread of an infectiousthe spread of an infectiousagent from an infected oragent from an infected orcolonized patient tocolonized patient tosusceptible personssusceptible persons


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Purpose of Isolationurpose of Isolation Isolation practices are designed to minimizeIsolation practices are designed to minimize

the transmission of infection in the hospital,the transmission of infection in the hospital,using current understanding of the wayusing current understanding of the wayinfectious can transmit. Isolation should beinfectious can transmit. Isolation should be

done in a user friendly, well accepted,done in a user friendly, well accepted,inexpensive way that interferes as little asinexpensive way that interferes as little aspossible with patient care, minimizes patientpossible with patient care, minimizes patientdiscomfort and avoids unnecessary usediscomfort and avoids unnecessary use..


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Isolation Precautionssolation PrecautionsIsolation precautions are designed to preventIsolation precautions are designed to prevent

transmission of microorganisms by following rootstransmission of microorganisms by following rootsin hospital.in hospital.

1.1. Contact transmissionContact transmission

b.b. Direct contact e.g. between two patientsDirect contact e.g. between two patientsc.c. Indirect e.g. needles, dressing, contaminated instrumentsIndirect e.g. needles, dressing, contaminated instruments

2. Droplet transmission e.g. generated by coughing, sneezing,2. Droplet transmission e.g. generated by coughing, sneezing,talkingtalking

3. Airborne transmission e.g. droplet containing microorganism that3. Airborne transmission e.g. droplet containing microorganism thatremain suspend in the air or dust part.remain suspend in the air or dust part.

4. Common vehicle transmission e.g. food, water, medication ,4. Common vehicle transmission e.g. food, water, medication ,devices , equipmentsdevices , equipments

5. Vector-borne transmission e.g. by mosquitoes, flies, rats5. Vector-borne transmission e.g. by mosquitoes, flies, rats


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Recommendationsecommendations Hand washing.Hand washing. Use of latex or other protective gloves.Use of latex or other protective gloves. Masks, eye protection, face shield.Masks, eye protection, face shield. Gowns.Gowns. Proper handling of soiled patient careProper handling of soiled patient care

equipment.equipment. Proper environment cleaning.Proper environment cleaning. Minimal handling of soiled linen.Minimal handling of soiled linen. Proper disposal of needles and otherProper disposal of needles and other

sharp equipment such as scalpels.sharp equipment such as scalpels. Placement in a private room for patientsPlacement in a private room for patients

who cannot maintain appropriatewho cannot maintain appropriate

cleanliness or contain body fluids.cleanliness or contain body fluids.


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Cleaning, Disinfectantleaning, Disinfectantand Sterilization.nd Sterilization. CLEANINGCLEANING

Definition :Definition :

Cleaning is a processCleaning is a processintended to remove anyintended to remove anysubstances (soil) that issubstances (soil) that isnot part of the structurenot part of the structure

or designated to assistor designated to assistthe function of item beingthe function of item beingcleaned.cleaned.


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CleaningleaningRequirement :Requirement :

Cleaning is usually adequate for anyCleaning is usually adequate for anyitem that does not come intoitem that does not come into

prolonged close contact withprolonged close contact with

susceptible individualssusceptible individuals


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DisinfectionsisinfectionsDefinition :Definition :

Disinfections involvesDisinfections involvesthe destruction ofthe destruction of

microbes but notmicrobes but not

necessarily bacterialnecessarily bacterial

sporesspores


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DisinfectionsisinfectionsRequirement:Requirement:

Cleaning contaminated spillage.Cleaning contaminated spillage.

Decontamination of environment.Decontamination of environment. The treatment of items to be broughtThe treatment of items to be brought

indirect contact with patient.indirect contact with patient.

Routine cleaning of high-risk areas.Routine cleaning of high-risk areas.


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SterilizationterilizationDefinition :Definition :

Sterilization is usuallySterilization is usually

described as thedescribed as the

complete destruction orcomplete destruction or

removed of allremoved of all

microorganisms.microorganisms.

Requirement :Requirement :

Surgical InstrumentsSurgical Instruments


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and Wastend WastemanagementanagementDefinition :Definition :

The methods for handling,The methods for handling,transporting and laundering oftransporting and laundering ofsoiled linen are determined bysoiled linen are determined byhospital policy and anyhospital policy and anyapplicable regulations.applicable regulations.

An important element ofAn important element ofinfection control is appropriateinfection control is appropriatedisposable of waste. Hospitaldisposable of waste. Hospitalgenerally used a color-coded baggenerally used a color-coded bagsystem for waste disposal.system for waste disposal.


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ee e c n urye e c n uryand Hepatitis Bnd Hepatitis BVaccinationaccinationNSI are an important andNSI are an important and

continuing cause of exposure tocontinuing cause of exposure toserious and fatal disease amongserious and fatal disease among

health care worker.health care worker.

These injuries can be avoided byThese injuries can be avoided byeliminating the unnecessary useeliminating the unnecessary use

of needles, using devices withof needles, using devices withsafety features and promotingsafety features and promotingeducation and safe work practiceseducation and safe work practicesfor handling needles and relatedfor handling needles and related

systemssystems


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According to CDC..ccording to CDC..

HIV : 0.3%HIV : 0.3%

HBV : 6% to 30%HBV : 6% to 30%

HCV : 1.8%HCV : 1.8%


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Referenceseferences1.1. Ayliffe, G., Fraise, A., Geddes, A. Michele, K. (2000), Control of Hospital Infection: A PracticalAyliffe, G., Fraise, A., Geddes, A. Michele, K. (2000), Control of Hospital Infection: A Practical

Handbook (4th edition) London: Arnold.Handbook (4th edition) London: Arnold.

2.2. Hammersmith Hospitals NHS Trust, Infection Control Policy,2002Hammersmith Hospitals NHS Trust, Infection Control Policy,2002

3.3. Center of disease control (CDC), Division of tuberculosis elimination (July 2000)Center of disease control (CDC), Division of tuberculosis elimination (July 2000)

4.4. Rotter M. Hand washing and hand disinfection [Chapter 87]. In: Mayhall CG, ed. Hospital epidemiologyRotter M. Hand washing and hand disinfection [Chapter 87]. In: Mayhall CG, ed. Hospital epidemiologyand infection control. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 1999.and infection control. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins, 1999.

5.5. Hepatitis B infected health care workers guidance on implementation of health service circular 2000/020Hepatitis B infected health care workers guidance on implementation of health service circular 2000/020

6.6. Infection control manual of AKUH (2003)Infection control manual of AKUH (2003)

7.7. AKUH, Infection control Newsletter, volume1, July, 2002.AKUH, Infection control Newsletter, volume1, July, 2002.

8.8. Needle Stick Injuries. Available online atNeedle Stick Injuries. Available online at http://wwwhttp://www.Hospital.be/hospital1212002/features/needle. html.Hospital.be/hospital1212002/features/needle. html

9.9. Wang S.H.et al. (2003) health care associated out break due to pan-drug resistant AcinetobacterWang S.H.et al. (2003) health care associated out break due to pan-drug resistant AcinetobacterBaumanii in a surgical intensive care unit journal of hospital infection 53:97-102.Baumanii in a surgical intensive care unit journal of hospital infection 53:97-102.
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Iinfection Control Concepts and Principles 1

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