Infection control

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1. INFECTION CONTROL
MEASURES ,
STANDARD SAFETY
PRECAUTIONS

2. Infection-Definition
•Definition:Infectionisaninvasion&
multiplicationofpathogenicmicroorganisms
thatoccurinbodytissuesandresultin
cellularinjury

3. •Bacteria
•Virus
•Fungi
•Protozoa(Parasites)
Agents

4. •Man
•Animals
•Insects
•Soil
•Water
•Contaminatedfood
Source of infection

5. •Skinandmucousmembranes
•Respiratorytract
•Urinarytract
•G.I.Tract
•Reproductivetract
•Blood
Portal of exit

6. •Directtransmission
-Directcontact
-Dropletinfection
-Contactwithsoilorsurface
-Inoculation
-Transplacental
Mode of transmission

7. •Indirecttransmission
-Vehicleborn
-Vectorborn
-Airborn
-Formiteborn
-Uncleanhandsandfingers
Mode of transmission (contd…)

8. •Gastrointestinaltract
•Genitourinarytract
•Skin
•MucousMembrane
Portal of entry

9. •Age
•Immunestatusofthepatient
•Chronicdiseases
•Malnutrition
•Life-style
•Surgery
Host factors

10. Chain of infection
•Agent
Agent
Reservoir
Agent
Reservoir
Portal of exit
Mode of transmission
Portal
of entry
Host

11. •FollowStandardprecautions
•Transmissionbasedprecautions
•Formulateainfectioncontrolpolicy
•Formahospitalinfectioncontrolcommittee
•Haveagoodsurveillanceprogramme
•Conducttrainingprogrammes
Infection prevention methods

12. •Elements:
-Aninfectioncontrolcommittee
-SurveillanceofNosocomialinfection
-Employeehealthprogram
-Isolationpolicies
-Infectioncontrolin-serviceeducation
-Procedureforenvironmentsanitation
-Microbiologylaboratory
-Infectioncontrolproceduresforclientcare
Infection control plan

13. STANDARD PRECAUTIONS
INTRODUCTION:
•Standard Precautions combine the major features
of Universal Precautions and Body Substance
Isolation and are based on the principle that all
blood, body fluids, secretions, excretions except
sweat, nonintact skin, and mucous membranes
may contain transmissible infectious agents.
Standard Precautions include a group of infection
prevention practicesthat apply to all patients,
regardless of suspected or confirmed infection
status, in any setting in which healthcare is
delivered.

14. •These include: hand hygiene; use of gloves,
gown, mask, eye protection, or face shield,
depending on the anticipated exposure; and safe
injection practices. Also, equipment or items in
the patient environment likely to have been
contaminated with infectious body fluids must be
handled in a manner to prevent transmission of
infectious agents (e.g., wear gloves for direct
contact, contain heavily soiled equipment,
properly clean and disinfect or sterilize reusable
equipment before use on another patient).

15. Standard Precautions and Infection Control
Measures:
Assume that every person is potentially infected
or colonized with an organism that could be
transmitted in the healthcare setting and apply
the following infection control practices during the
delivery of health care.

16. Personal Protective Equipment (PPE)
Observe the following principles of use:
•Wear PPE, when the nature of the anticipated
patient interaction indicates that contact with
blood or body fluids may occur.
•Prevent contamination of clothing and skin during
the process of removing PPE.
•Before leaving the patient's room or cubicle,
remove and discard PPE.

17. Infection control practices for special lumbar
puncture procedures
Wear a surgical mask when placing a catheter
or injecting material into the spinal canal or
subdural space (i.e., during myelograms, lumbar
puncture and spinal or epidural anesthesia.
Worker safety
•Adhere to federal and state requirements for
protection of healthcare personnel from exposure
to bloodborne pathogens

18. Textiles and laundry
•1. Handle used textiles and fabrics with minimum
agitation to avoid contamination of air, surfaces
and persons.
•2. If laundry chutes are used, ensure that they
are properly designed, maintained, and used in a
manner to minimize dispersion of aerosols from
contaminated laundry.

19. Gloves:
Wear gloves when it can be reasonably anticipated that
contact with blood or other potentially infectious
materials, mucous membranes, nonintact skin, or
potentially contaminated intact skin (e.g., of a patient
incontinent of stool or urine) could occur.
Wear gloves with fit and durability appropriate to the task.
•i. Wear disposable medical examination gloves for
providing direct patient care.
•ii. Wear disposable medical examination gloves or
reusable utility gloves for cleaning the environment or
medical equipment.

20. •Remove gloves after contact with a patient and/or
the surrounding environment (including medical
equipment) using proper technique to prevent
hand contamination. Do not wear the same pair
of gloves for the care of more than one patient.
Do not wash gloves for the purpose of reuse since
this practice has been associated with
transmission of pathogens.
•Change gloves during patient care if the hands
will move from a contaminated body-site (e.g.,
perineal area) to a clean body-site (e.g., face).

21. Mouth, Nose, Eye Protection
•Use PPE to protect the mucous membranes of the eyes, nose and
mouth during procedures and patient-care activities that are likely
to generate splashes or sprays of blood, body fluids, secretions
and excretions.
•Select masks, goggles, face shields, and combinations of each
according to the need anticipated by the task performed.
•During aerosol-generating procedures (e.g., bronchoscopy,
suctioning of the respiratory tract [if not using in-line suction
catheters], endotracheal intubation) in patients who are not
suspected of being infected with an agent for which respiratory
protection is otherwise recommended (e.g., M. tuberculosis, SARS
or hemorrhagic fever viruses), wear one of the following: a face
shield that fully covers the front and sides of the face, a mask with
attached shield, or a mask and goggles (in addition to gloves and
gown).

22. Safe Injection Practices
•The following recommendations apply to the use of
needles, cannulas that replace needles, and, where
applicable intravenous delivery systems
•Use aseptic technique to avoid contamination of sterile
injection equipment.
•Do not administer medications from a syringe to multiple
patients, even if the needle or cannula on the syringeis
changed. Needles, cannulas and syringes are sterile,
single-use items; they should not be reused for another
patient nor to access a medication or solution that might
be used for a subsequent patient.

23. •Use fluid infusion and administration sets (i.e.,
intravenous bags, tubing and connectors) for one
patient only and dispose appropriately after use.
Consider a syringe or needle/cannula
contaminated once it has been used to enter or
connect to a patient's intravenous infusion bag or
administration set

24. •Use single-dose vials for parenteral medications
whenever possible.
•Do not administer medications from single-dose
vials or ampules to multiple patients or combine
leftover contents for later use.
•If multidose vials must be used, both the needle
or cannula and syringe used to access the
multidose vial must be sterile

25. •Do not keep multidose vials in the immediate
patient treatment area and store in accordance
with the manufacturer's recommendations;
discard if sterility is compromised or questionable.
•Do not use bags or bottles of intravenous solution
as a common source of supply for multiple
patients.

26. •StandardprecautionsareacombinationofUniversal
PrecautionandBodySubstanceIsolation
-Allclientsaspotentiallyinfectedwithbloodborne
pathogens
-Standardprecautionsapply
(i)Blood
(ii)Allbodyfluidssecretionsandexcretions
(iii)Nonintactskinandmucousmembrane
Standard precautions-CDC
guidelines

27. Itistherubbingofallsurfacesandcrevicesofthe
handsusingasoaporchemicalandwater
followedbyrinsinginaflowingstreamofwater.
•Purposes
-Reducethenumberofresidentandtransient
bacteriafromthehands
-Preventtransferofmicro-organismsfromthe
clienttohealthpersonnelandviceversa
Hand washing

28. •Routinehandwashing
•Surgicalhandwashing
•Usingalcoholicrub
Articlerequiredforhand
washing
-Soap/antimicrobial
chemicals
-Streamofwater
-Autoclavedtowels
Types of hand washing

29. •Removealljewellaryofthehands
•Filenailsshort;avoidnailpaints
•Turnonthewarmwater
•Wethandsunderrunningwaterincludingarmsandelbow
•Applysoap
•Rubpalms,wristandbackofthehandfirmlywithcircular
movement.Interlaceinterestfingersandthumbs,moving
handsbackandforth.Continueusingplentyoflatherand
frictionfor15to30secondsoneachhand(dependson
hospitalpolicyandsettings)
•Usenailbrushtocleanunderfingernail
•Rinsehandsandwriststhoroughlywithwater
•Dryhandswithautoclavedtowel
•Turnoffthewater
Procedure

30. Hand Hygiene
•1. During the delivery of healthcare, avoid
unnecessary touching of surfaces in close
proximity to the patient to prevent both
contamination of clean hands from environmental
surfaces and transmission of pathogens from
contaminated hands to surfaces.
•2. When hands are visibly dirty, contaminated with
visibly soiled with blood or body fluids, wash
hands with either a nonantimicrobialsoap and
water or an antimicrobial soap and water.

31. •3. If hands are not visibly soiled, or after
removing visible material with nonantimicrobial
soap and water, decontaminate hands. The
preferred method of hand decontamination is with
an alcohol-based hand rub. Alternatively, hands
may be washed with an antimicrobial soap and
water. Frequent use of alcohol-based hand rub
immediately following handwashing with
nonantimicrobial soap may increase the frequency
of dermatitis.

32. Cont…
•4. Wash hands with non-antimicrobial soap and
water or with antimicrobial soap and water if
contact with spores (e.g., C. difficile or Bacillus
anthracis) is likely to have occurred.
•5. Do not wear artificial fingernails or extenders if
duties include direct contact with patients at high
risk for infection and associated adverse outcomes
(e.g., those in ICUs or operating rooms).

33. Perform hand hygiene:
•Before having direct contact with patients.
•After contact with blood, body fluids or
excretions, mucous membranes, non intact skin,
or wound dressings.
•After contact with a patient's intact skin (e.g.,
when taking a pulse or blood pressure or lifting a
patient).
•If hands will be moving from a contaminated-
body site to a clean-body site during patient care.
•After removing gloves.

34. GLOVES:Usegloveswhenanticipatinganycontact
withclientsbloodorbodyfluids,nonintactskin,
mucousmembrane
•Eachpatientsininteractionrequiresacleanpairof
gloves
•Changeglovesbetweendifferenttasksand
procedures
•Usegloveswhenhealthworkerhasnonintactskin
•Removestheglovesbeforeleavingthepatientsroom
•Weargloveswhilegivinginjection,handlinglab
specimen,doingdressing
Personnel protective equipments

35. GOWNS
•Wear a gown, that is appropriate to the task, to protect skin and
prevent soiling or contamination of clothing during procedures and
patient-care activities when contact with blood, body fluids,
secretions, or excretions is anticipated.
i.Wear a gown for direct patient contact if the patient has
uncontained secretions or excretions.
ii.Remove gown and perform hand hygiene before leaving the
patient’s environment.
•Do not reuse gowns, even for repeated contacts with the same
patient.
•Routine donning of gowns upon entrance into a high risk unit
(e.g., ICU, NICU, HSCT unit) is not indicated.

36. •Maskpreventthewearerfrominhalinglarge
particleaerosolswhichusuallytravelshort
distances(about3feet)smallparticlenuclei
whichremainsuspendedintheair
•Everyonewhocomesincontactwiththeclient,
includingvisitors
•Theclientmaybetheonlyonetowearmask
outsidetheroom
Mask

37. •InOTornursery,mask
protectsclientfrompossible
Nosocomialinfection
•Masksshouldbedisposed
afterusedonce
•Ifnotinuseshouldnothang
aroundtheneck
Mask

38. Eye protection Gown and mask

39. •Eyeprotection
-Weargogglesorforeheadshieldtoavoid
splash
-Usedisposablegoggleswhencaringforclients
inisolation
•Headcaps
-Tobepreventfallingofhairinsterileareas
•BootsandShoeCovers
-TobeworninareaslikeOTandICU

40. Patientcareequipment:
•Decontamination:Itistheprocessbywhichall
reusablemedicaldevicesaremadefreeof
microorganismallequipmentsusedintheclinical
areasmustbedecontaminatedwithoutexception
•Dis-infection:Itistheprocessbywhich
pathogenicmicroorganismintheinanimate
objects,withtheexceptionofbacterialsporesare
eliminated
Patients environment

41. •Isolationprecautionsaredesignedtoreduce
transmissionofmicroorganismsinhospitals.
Appropriatepatientplacementisasignificant
componentofisolationprecautions.
•Typesofisolation:
-Sourceisolation
-Cohortisolation
Isolation

42. Common disinfectants used in hospitals
Name/preparation Uses
Bacillocid
•10% solution (4.5 lttap water
+500 ml bacillocid)
•2% solution (20 ml bacillocid
+1lt H
2O))
For disinfection of floor + and
instruments
Bleaching powder
•0.1% solution
•1% solution (100 ml bleach in 1
lt H
2O)
For routine disinfection and
carbonization
Carbolic acid
•5% solution (5 ml carbolic +
100 ml H
2O))
•10% solution (10 ml
carbolic+100 H
2O)
For carbonization of room, beds
floor etc.

43. Common disinfectants used in
hospitals
Name/preparation Uses
Savlon
•5% solution (5 ml in 100 ml
distilled water)
•2% solution (2 ml in 100 ml
distilled water )
For surgical dressing and
disinfecting thermometers
For perineal care
Formaline
•40% solutions (30ml+ 90ml H
2o
for 1000 cub feet double
fumigation for highly infected
area or 1:1)
For fumigation keep the OT care
for 30 mins, open the room after 6
hrs clean and wash the area
thoroughly
Korsolox
•10% solution (dilute 1 part of
Korsolox 9 parts of water)
For emergency disinfection
immersion for 15 mts for sporicidal
activity (sterilization for 5 hours)

44. •Physicalagents
-Steamsterilization
-Boiling
-Radiation
•Chemicalagents
-Gas-ethyleneoxide
-Liquid-gluteraldehyde
Sterilization

45. •Infectiouswaste:
-laboratorywastes
-Blood,bloodproducts,allotherbodyfluids
-Clientcareitems
-Disposableinstruments
-Medicationandsoileditems
-Surgicalwastes
•Bloodspillage:Incaseofbloodspillage,pour1%
sodiumhypochloritesolutionoverthespillandwipeafter
20minutes
Disposal of infections material

46. •Theseprecautionsareclassifiedas:
-Airborneprecautions
-Dropletprecautions
-Contactprecautions
Transmission based precautions

47. •Followthehealthcarefacilitiespoliciesfor
handlingthedeadbody
•Wrapthebodywhileyouareintheroom
placeitinaplasticzipperedbag.
•Transferthebodytoacartthathasbeen
drapedwithacleanbathblanketorsheet.A
cleanpersonoutsidetheroomwillwrapthe
cleanblanketaroundthebody
Caring for body of a client on
isolation after death

48. •Decontaminatetheroomaccordingtothe
facility’sprocedures.
•Washyourhandswhenleavingtheroom.
Afterwardyoumaytouchonlyoutside
wrappingorshould
•Labelthebodyproperly,handleallbodies
asiftheyhaveinfectiousdisease
Caring for body of a client on
isolation after death (Contd…)

49. FUNCTIONS OF INFECTION CONTROL NURSE
•Regular visit to all wards & high risk unit
•Checking records& reports
•Collect sample from different areas & sent it to
lab
•Compile statistics of HAI from different areas
•Monitor infection among hospital staff
•Training other personnel on hygiene & aseptic
precautions

50. PREVENTION IS
BETTER THAN CURE

51. BIBLIOGRAPHY:
•Black.M.Joyce, “Medical Surgical Nursing”7th edition, published by Elsevier
•Perry P, “Fundamentals of Nursing”6th edition, published by Elsevier
•Taylor.C, Lillis, “Fundamentals of Nursing-The art and science of nursing care”
1st edition, published by Lippincott Williams and Wilkins
•www.google.com
•Gowda SN Nonjunde, “foundations of nursing” edition Ist, Jaypee brothers
medical publishers
•F.Craven Ruth, “fundamentals of nursing” 4th edition, Lippincott publication
•Lillis Tylor, Lynn LeMone, “fundamentals of nursing, “Lippincott publication, sixth
edition