Infection control in Hospital

Hospital is main source of many infection therefore it is important to use some measures to control cross infection to the patients.

1. Infection control R.N. Ankita Ashok Kadam PGDHA (2019-20) Roll no. 04

2. introduction Hospital infection, also called Nosocomial infection, is the single largest factor that adversely affects both the patient & the hospital. The English word “Nosocomial” is derived from the Greek Nosokomeion , both meaning “hospital”. Nosocomial infection is the infection that develops in admitted patients after more than 48 hours of hospitalization.

3. HIGH risk areas in hospitals Some areas carry a greater risk of Hospital- acquired infection than others. Such areas are as follows: Nurseries Intensive care unit Dialysis unit Organ transplant unit Burn unit Isolation ward Cancer ward Operation theatres Delivery rooms Post operative ward

4. Hospital infection control programme The main aim of the infection control programme is to lower the risk of an infection during the period of hospitalization. The three thrust areas for the infection control programme are as follows. Development of an effective surveillance system. Surveillance implies that observed data are regularly analysed & reported to those who are in position to take appropriate actions. Development of policies & procedures to reduce the risk of hospital-acquired infection. Maintenance of a continuing education programme for hospital-acquired personnel.

5. Basic Elements Of A Control Programme Providing a system of identification & reporting of infections, & providing a system for keeping records of infection in patients & personnel. Providing for good hospital hygiene, aseptic techniques & sterilization & disinfection practices. Providing for personnel orientation & continuing prevention & control. Providing for coordination with all departments & with medical audit committee in quality assurance .

6. Infection control committee (icc) The infection control committee (ICC) will have the responsibility for monitoring the occurrence of hospital infection & recommend corrective action. Members : Hospital Administrator- Chairman. Microbiologist- Secretary. Clinical representative from major clinical specialists. Chief Nursing Superintendent . Housekeeping/ Maintenance. ICC must meet at regular intervals at least once a month.

7. ICC Committee Scope & Functions Prepare policy & procedures for -Use of antiseptics & disinfectants for Hand washing, General hospital cleanliness (walls, floors, toilets, furniture's, fixtures etc.), instrumentation. -Ensure proper sterilization of instruments (right methods for right categories of instruments.) -Follow proper guide lines for reusing of single use devices. -Single use devices to be discarded properly. - Prepare & implement safe regulatory procedures for hospital waste disposal - Periodic testing of high risk sites for Microbiological flora. -Deciding antibiotic policy based on microbiological surveillance and in-vitro sensitivity reports

8. -Supervision to ensure Implementation -Routine Rounds -Surprise Policing -Identification of Infection Source by Microbiologist -Proper reporting to appropriate authority -Recommend Corrective Measures -Training & orientation of all staff -Continuous monitoring -Audit of infection incidence -Guidelines for universal precautions -Guidelines for staff immunization -Issuing of regular circulars mentioning & reminding desired practices.

9. Infection control nurse Surveillance activities can best be handled by a sufficiently senior & experienced full-time nurse, with special training in Hospital infection control activities. In very large hospitals, there should be at least one infection control nurse for every 250 beds.

10. Tasks Of Infection Control Nurse Daily visit to all the wards & patient holding units. Checking ward sister’s report register for records suggestive of infection. Collection & tabulation of daily data of incidence of hospital infection. Ensuring that specimens of patients are collected & dispatched to the laboratory in time. Initiating the hospital infection control form while documenting for nosocomial infections. Compilation of ward wise, discipline wise or procedure wise statistics. Daily visit to laboratory to ascertain results of previous days samples. Monitoring & supervision of infection among hospital staff Training of nursing aides & paramedical personnel on correct use of hygiene practices & aseptic techniques. Assist in bacteriological studies of all cases.

11. Effective control measures People Aseptic techniques Isolation facilities Antibiotic Policy Precautions for Staff Outpatient department Sterilization practices

12. Dietary service Careful Handling of soiled Linen Good Housekeeping Terminal Disinfection Air hygiene in Operation Theatres Developing a sense of Awareness Segregation of waste/ Biomedical Waste

13. Biomedical Waste Management Bio-medical waste is the waste that is generated during the diagnosis, treatment or immunization of human beings or animals, or in research activities pertaining there to, or in the production or testing of biological . Specimens.

14. Categories Of Waste Cat 1 -- Human anatomical waste Cat 2 – Animal waste Cat 3 – Microbial & Biotech waste Cat 4 – waste Sharps Cat 5 – Discarded Medicines & Cytotoxic drugs Cat 6 – Solid waste (dressings, swabs, cottons) Cat 7 – Solid waste (Disp. items but not sharps) Cat 8 -- Liquid waste ( wash cleaning, HK, Lab) Cat 9 – Incineration ash Cat 10 – Chemical waste(insecticides, Bio prod)