Infection control protocol and its importance

1. INFECTION CONTROL
SHEHZAD HUSSAIN
04-03-2015

2. Introduction to Patient Safety:
•This unit of patient safety will focus on
Infection Control

3. Global Infection Problems
According to WHO (2005),
•On average, 8.7% of hospital patients suffer
health care-associated infections (HAI).
•In developed countries: 5-10%
•In developing countries:
–Risk of HAI: 2-20 times higher
–HAI may affect more than 25% of patients
•At any one time, over 1.4 million people
worldwide suffer from infections acquired
while in hospital.

4. Health Care-Associated Infections
(HAI)
According to WHO:
•HAI is also called “nosocomial”.
•HAI is defined as:
–an infection acquired in hospital by a patient
who was admitted for a reason other than
that infection.
–an infection occurring in a patient in a
hospital or other health-care facility in whom
the infection was not present or incubating
at the time of admission.

5. Preventing infections
Requires health care providers who have:
–Knowledge of common infections and their
vectors
–An attitude of cooperation and commitment
–Skills necessary to provide safe care

6. Required Knowledge
•Knowledge of the extent of the problem;
•Knowledge of the main causes, modes of
transmission, and types of infections.

7. Required Skills
•Apply universal precautions*
•Use personal protection methods
•Know what to do if exposed
•Encourage others to use universal
precautions
•Report breaks in technique that increase
patient risks
•Observe patients for signs and symptoms of
infection

8. Initiation:
•Purpose:
•To ensure that all health care workers (HCWs) involved in patient management or
working in a clinical environment are
•aware of the use of standard precautions and to prevent transmission of
microorganism/infection in hospital.
•2. Applicable to: All health care staff
•3. Standard Precautions consist of:
Hand hygiene
Appropriate use of personal protective equipment (PPE).
Respiratory hygiene/cough etiquette
Decontamination
Handling of linen
Safe disposal of sharps and waste

9. One more important thing!
Protect YourselfProtect Yourself
Be sure you have been immunized against
Hepatitis B since it is very easy to
transmit!

10. Main Sources of Infection
•Person to person via hands of health-care providers,
patients, and visitors
•Personal clothing and equipment (e.g. Stethoscopes,
flashlights etc.)
•Environmental contamination
•Airborne transmission
•Hospital staff who are carriers
•Rare common-source outbreaks

11. Main Routes for infections
•Urinary tract infections (UTI)
–Catheter-associated UTIs are the most frequent,
accounting for about 35% of all HAI.
•Surgical infections: about 20% of all HAI
•Bloodstream infections associated with the use
of an intravascular device: about 15% of all HAI
•Pneumonia associated with ventilators:
about15% of HAI

13. Four Ways to Prevent HAI
1.Maintain cleanliness of the hospital.
2.Personal attention to hand washing
before and after every contact with a
patient or object.
3.Use personal protective equipment
whenever indicated.
4.Use and dispose of sharps safely.

14. Your 5 moments for HAND HYGIENE

15. How to Clean Hands
•Remove all wrist and hand jewelry.
•Cover cuts and abrasions with waterproof
dressings.
•Keep fingernails short, clean, and free
from nail polish.

16. Five moments for hand hygiene
•Before patient contact
•Before an aseptic task
•After body fluid exposure even if wearing
gloves!
•After patient contact
•After contact with patient surroundings

17. Effective Hand washing Technique
•Steps in hand washing:
•Remove jewelry (rings, bracelets) and watches before washing hands
•Ensure that the nails are clipped short (do not wear artificial nails)
•Ensure that sleeves are up to the elbow before planning for hand washing
•Wet hands and wrists, keeping hands and wrists lower than the elbows
•Apply soap (plain or antimicrobial) and lather thoroughly.
•Use firm circular motions to wash the hands and arms up to the wrists,
covering
•all areas including palms, back of the hands, fingers, between fingers and
lateral
•side of fifth finger, and wrists. Rub for minimum of 10-15 seconds.
•Repeat the process if the hands are very soiled.
•wash hands with soap and water before using hand rubs/ gel/alcohol
swabs.

18. •Clean under the fingernails.
•Rinse hands thoroughly, keeping the hands lower than the forearms.
•Dry the hands thoroughly with disposable paper towel.
•Discard the towel in a dustbin without touching the bin lids.
• Use a fresh paper towel or your elbow/foot to turn off the faucet, to
prevent
•recontamination of hands.
•Steps using antiseptics, hand rubs, gels or alcohol swabs for hand
antisepsis:
•Apply the product to the palm of one hand.
• Rub hands together, covering all surfaces of hands and fingers, until
hands are dry. Do not rinse.

20. How to use waterless handrub
•Apply a palmful of product in cupped hand
•Rub hands palm to palm
•Right palm over left hand with interlaced fingers
•Palm to palm with fingers interlaced
•Backs of fingers to opposing palms with fingers
intelocked
•Rub between thumb and forefinger
•Rotational rubbing, backwards and forwards with
clasped fingers of right hand in left palm and vice versa
•Once dry your hands are safe.

22. Personal Protective Equipment
Personal Protective Equipment (PPE):
PPEs are clothing, items used to prevent cross
transmission from patients to staff or from
staff to patients. It includes gloves,
gown/apron, masks, eye shield/goggles etc.
NOTE: Remove and discard PPE before
leaving the patient’s room or cubicle

23. Gloves
Wear gloves when contact with blood or body fluids (BBF),
mucous membranes, non-intact skin, or
potentially contaminated intact skin (e.g., of a patient
incontinent of stool or urine) is anticipated.
Wear disposable medical examination gloves for providing
direct patient care.
 Do not wear the same pair of gloves for the care of more
than one patient.
 Perform hand hygiene before and immediately after
removing gloves.
 Polythene gloves are not suitable for use when dealing with
blood and/or blood and body fluids, i.e. in a clinical setting.

24. Cont…
 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 another
patient.
 Never leave the patient care area without removing
gloves and don’t move around with gloved hands.

25. Gowns/Apron:
Wear a gown, to protect skin and clothes to prevent
contamination during patient-care activities when
contact with BBF, secretions/excretions is
anticipated.
Remove gown and perform hand hygiene before
leaving the patient’s environment.
Gowns may be reused by the same HCW for the
same patient.
If the gown is visibly soiled then it should be
replaced.

26. Masks/Eye Shield/Goggles:
Use masks and/or eye shield to protect the mucous
membranes of the eyes, nose and mouth during
procedures that are likely to generate aerosols.
During aerosol-generating procedures e.g.
bronchoscopy, suctioning, intubation; HCWs should
wear
Mask & Eye Shield.
For suspected or proven cases of open TB, H1N1,
VHF wear N95 mask with other PPE.

27. Caps and boots/shoe covers:
 Along with above mentioned PPE, wear cap and shoe cover where there is
likelihood of major spillage of
BBF.
 Do not reuse disposable caps/shoe covers.
 Clean and disinfect reusable boots.
•
Respiratory Hygiene/Cough Etiquette:
 Cover the nose/mouth with inside of elbow when coughing or sneezing.
 Use tissues to contain respiratory secretions and dispose of them in the
nearest waste receptacle after use.
Perform hand hygiene after having contact with respiratory secretions and
contaminated objects/materials.

28. Handling of linen:
•Used linen should be handled and disposed of
appropriately as per institutional policy
•All soiled linen should be placed in water
soluble and then in red bag (double bagged)
immediately by the end user.

29. Handling of sharps
•
Discard sharp in designated puncture-resistant containers. All
needle stick injuries/exposure to BBF
•should be reported immediately to infection control through
IRF link. http://portal.aku.edu/irf/
• Never recap or bend needles.
• Replace the sharps disposal container when two-third (2/3)
filled.
• Cutting of needle is prohibited.
• All BBF spillages should be dealt immediately.
•All BBF should be considered potentially infectious.

30. Environmental cleaning
•Use adequate procedures for the routine
cleaning and disinfection of environmental
and other frequently
•touched surfaces.
• Proper environmental interventions required
such as daily cleaning and disinfection of,
doctors & staff
•changing areas, toilets, doctor’s room and
lounges.

31. Encourage Others to
Participate in Infection Control
Students may routinely observe staff who:
–apply inadequate technique in handwashing
–fail to wash hands
–routinely violate correct infection control
procedures