Objectives Main Objective: To provide participants with a comprehensive understanding of Infection Prevention and Control (IPC) principles and practices to reduce the incidence of hospital- acquired infections. Specific Objectives: Participants will learn what hospital-acquired infections are, their causes, and their impact on patient safety and healthcare outcomes. Participants will identify the components of the infection transmission chain and understand how infections spread within healthcare settings, including the significance of breaking the chain. Participants will be trained on standard and additional precautions, including the IPC pillars, to effectively prevent and control infections in the hospital environment.
Introduction ةمدقم Safe delivery of care is a right of every patient and a key responsibility for any health program/organization. MSF strives towards ensuring patient and healthcare worker safety and in particular comply with the duty to provide care while minimizing harm to individuals or groups. Successful infection prevention and control (IPC) measures are important tools in the management of diseases, and good IPC practices must be equally available to all. ضيرم لكل قح وه نمآ لكشب ةياعرلا ميدقت نإ . ةيحص ةمظنم / جمانرب يأل ةيساسأ ةيلوؤسمو ةمالس نامض ىلإ دودح الب ءابطأ ةمظنم ىعست ،ةيحصلا ةياعرلا لاجم يف نيلماعلاو ىضرملا ليلقت عم ةياعرلا ميدقت بجاول لاثتمالا ةصاخو تاعومجملا وأ دارفألاب قحلي دق يذلا ررضلا ةحجانلا اهتحفاكمو ىودعلا نم ةياقولا ريبادت نإ . نأ بجيو ،ضارمألا ةرادإ يف ةمهم تاودأ يه ةديجلا اهتحفاكمو ىودعلا نم ةياقولا تاسرامم نوكت . ةاواسملا مدق ىلع عيمجلل ةحاتم
Health Care Associated Infections (HAIs) (HAIs) are the most frequent and most severe complications in healthcare structures and a great concern for patient safety. HAI rates range from 5-7% in high income countries in Europe to an estimated 10-20% in low-resource settings. HAI are responsible for death, prolonged hospital stays, creation of long-term disability and increase of the antimicrobial resistance (AMR) burden. The most frequent HAI are: Surgical Site Infections (SSI). Catheter- Related Bloodstream Infections (CR- BSI). Hospital- Associated pneumonia (HAP), including tuberculosis. Catheter- Associated Urinary Tract Infections (CAUTI). Gastro- enteritis.
The most frequent Hospital Acquired Infection The global increase of microbial multi-drug resistance urges all healthcare facilities to improve on infection prevention and control practices to reduce preventable morbidity, mortality and financial expenditure. An era where patients are colonized or infected with bacteria resistant to all antibiotics is approaching fast and is already present in certain facilities. IPC is a practical, evidence- based approach preventing patients and health care workers from being harmed by avoidable infections and hospital outbreaks. Effective IPC programs can lead to more than a 30 % reduction in HAI rates, surveillance contributes to a 25- 57% reduction in HAI and a safety culture and prevention program reduced surgical site infections risk in African hospitals by 44%.
Nosocomial infection The term “nosocomial infection, refers to infections acquired in health- care settings, which are not present or incubating at admission. Infections appearing more than 48 hours after admission are considered nosocomial. Depending on the pathogen involved and the incubation period, some nosocomial infections do not become apparent for up to 14 days after discharge from hospital. Infections occurring within 30 days after a surgical operation (within 1 year if implant) are also considered as nosocomial infections. Nosocomial infections can occur in patients, health care workers, or visitors/attendants.
Microorganisms involved in the transmission of nosocomial infections. Bacteria : Commensal bacteria are part of the normal flora of healthy persons (mouth, nose, intestines). Pathogenic bacteria are not part of the normal flora but could be present in the commensal flora. e.g. Escherichia coli, Pseudomonas, Staphylococcus aureus, Clostridium, Legionella, shigella, meningococcus, etc.) . Viruses : Hepatitis B, C, HIV, RNA1 viruses (VHF1 viruses). Hepatitis A, measles, yellow fever, dengue, etc. Fungi : (e.g. Candida albicans, Aspergillus, Crytococcus) Parasites : (giardia, scabies or body lice outbreaks)
Standard Precautions (ةيرايعملا) ةيسايقلا تاطايتحالأ A- STANDARD PRECAUTIONS: Hand hygiene. Use of personal protective equipment (PPE). Respiratory hygiene/cough etiquette. Injection safety. Cleaning and disinfection of surfaces. Handling of patient care equipment and linen. Waste management. Prevention of accidental exposure to bodily fluids B- SPECIFIC PRECAUTIONS: Contact precautions Airborne precautions Droplet precautions Droplet + Contact precautions Airborne + Contact precautions
IPC PILLARS HAND HYGIENE Cleaning and Disinfection TRANSMISSION BASED PRECAUTIONS
INFECTION PREVENTION AND CONTROL COMMITTEE اهتحفاكمو ىودعلا نم ةياقولا ةنجل
Infection Prevention and Control Committee The Infection Prevention and Control (IPC) Committee provides a forum for interdisciplinary input and cooperation, and information sharing to promote good Infection Prevention and Control practices and monitoring. All issues related to IPC, including hygiene, water and sanitation should be included in an annual action plan . Every member of the core group of the IPC committee is equally important. The IPC supervisor/manager has his own job description and is not equal to the IPC committee.
IPC Committee Core group members Core group (not more than 15 people): Nursing Care Management Representative (Nurse activity manager or Head nurse or Project medical referent or Nursing director). Medical Care management Representative (Medical director or medical activity manager or Doctors’ Representative). IPC supervisor/manager. WATSAN representative. Cleaners’ Supervisor or Representative. Pharmacist. Laboratory supervisor. Sterilization supervisor. Representative of the hospital administration (Hospital Director or Administrator). Facilities management/logistics representative. ددع ديزي ال ) ةيساسألا ةعومجملا :( اصً خش 15 نع اهئاضعأ ريدم ) ضيرمتلا ةياعر ةرادإ لثمم ◄ . ( ضيرمتلا ةطشنأ ريدملا ) ةيبطلا ةياعرلا ةرادإ لثمم ◄ لثمم وأ ةيبطلا ةطشنألا ريدم وأ يبطلا .( ءابطألا . ةلماكتملا ةياعرلا ريدم / فرشم ◄ . يحصلا فرصلاو هايملا لثمم ◄ . ةفاظنلا لامع لثمم / فرشم ◄ . ةلديصلا فرشم / ريدم ◄ . ربتخملا فرشم ◄ . ميقعتلا فرشم ◄ ىفشتسملا ريدم ) ىفشتسملا ةرادإ لثمم ◄ .( يرادإلا لوؤسملا وأ . تايتسجوللا / قفارملا ةرادإ لثمم ◄
Responsibilities of the IPC Committee Develop an annual IPC action plan based on the IPC policy, including (SIPCA) elements Organizational aspects. Ensure and monitor the implementation of the action plan. Reporting of activities : Outbreaks: Staff health and protection : ةيونس لمع ةطخ عضو ضارمألا نم ةياقولل ةسايس ىلع ءً انب اهتحفاكمو ضارمألا نم ةياقولا كلذ يف امب ،اهتحفاكمو بناوجلا SIPCA) ) رصانع . ةيميظنتلا ةطخ ذيفنت ةبقارمو نامض . لمعلا نع ريراقتلا دادعإ . ةطشنألا . ضارمألا يشفت . مهتيامحو نيفظوملا ةحص
Organization of the Committee At the beginning of each year, the committee elects from among its members to handle some roles: The role of the Chair will be to preside over the IPC meetings and ensure effective external relations. The role of the Vice Chair will be to assume the duties of the chair in case of absence. The role of the secretary will be to organize meetings and draft minutes. بختنت ،ماع لك ةيادب يف اهئاضعأ نيب نم ةنجللا : راودألا ضعبب مايقلل وه سيئرلا رود نوكي ةنجللا تاعامتجا ةسائر نامضو تاسايسلل ةيلودلا . ةلاعفلا ةيجراخلا تاقالعلا سيئرلا بئان رود نوكي يف سيئرلا ماهم يلوت وه . هبايغ ةلاح وه ريتركسلا رود نوكي تاعامتجالا ميظنت . رضاحملا ةغايصو
Basic structural requirements for IPC in a Healthcare Facility Organizational aspects IPC supervisor or IPC manager. IPC committee. IPC facility- based action plan. Guidelines, protocols and tools. Training programs. Patient per bed ratio < or =1. Policy for visitors and caretakers. Policy for staff health. ةيميظنتلا بناوجلا . يودعلا ةحفاكم ريدم وأ فرشم . يودعلا ةحفاكم ةنجل ةحفاكمب ةصاخ لمع ةطخ . يودعلا تالوكوتوربلاو ئدابملا . تاودألاو . بيردتلا جمارب وأ < ريرس لكل ىضرملا ةبسن .1= . ةياعرلا يمدقمو راوزلا ةسايس . نيفظوملا ةحص ةسايس
Hospital built environment (infrastructure and hospital design), material and equipment Essential WaSH requirements (health structure including disposal of bodily fluids). Ward layout and bed spacing. Design of the flow of material, patient, waste and staff. Dedicated space for clean storage. Dedicated space for dirty room and sluice area. Capacity to isolate patients with communicable diseases. Materials should be able to be cleaned and disinfected. Sufficient supply and quality of material and equipment (ABHR, PPE, detergents, cleaning material) Dedicated patient equipment for high- risk wards. Hospital area clearly bounded. Ancillary services. Sterilization. Laundry. Kitchen
References عجارملا Hygiene_OCP_EN_July2013. IPC in health care settings first edition 2006. 1.0.2. Guide_IPC_Committee_Guidance _En_V01_201809. 1.0.1. Guide_IPC_Policy_En_V01_201803.