Infection Control in Health Care Settings

What is Infection Control? Identifying and reducing the risk of infections developing or spreading

What is Infection Control? Patient to Worker Visitor Patient Worker to Worker Visitor Patient Visitor to Worker Visitor Patient

Definitions Infection Is invasion and multiplication of microorganisms in a host, with an associated host response (e.g. fever, pain, edema, purulent drainage). Infection may be local or generalized. Infections may require antibiotic treatment. Infection is preceded by colonization.

Definitions Colonization Whereby microorganisms are present in the host but do not invade or cause an associated host response, is distinct from infection. No treatment is needed. Contamination The presence of microorganism on inanimate objects (Clothing, surgical instruments, water, food, milk ) or in substances

Disease Transmission Leave original host Survive in transit Be delivered to a susceptible host Reach a susceptible part of the host Escape host defenses Multiply and cause tissue damage To cause disease, a pathogenic organism must: Disease

Chain of Infection Infectious agent Reservoir Host Portal of exit Route of transmission Portal of entry Susceptible host

Chain of infection 1.Infectious agent: a pathogen must be present 2. Reservoir host: the pathogen must have a place to live and grow – the human body, contaminated water or food, animals, insects, birds, dead or decaying organic material. Humans who can transmit infection but show no signs of the disease are called carriers. Person may be unaware they are a carrier.

Chain of infection 3. Portal of exit: the pathogen must be able to escape from the reservoir host where it has been growing. Examples of portals of exit are blood, urine, feces, breaks in the skin, wound drainage, and body secretions like saliva, mucus and reproductive fluids

Chain of infection 4. Route of transmission: When the pathogen leaves the reservoir host through the portal of exit, it must have a way of being transmitted to a new host. Examples of routes of transmission are air, food, insects, and direct contact with an infected person

Chain of infection 5. Portal of entry: The pathogen must have a way of entering the new host. Common ports of entry are the mouth, nostrils, and breaks in the skin 6. Susceptible host: An individual who has a large number of pathogens invading the body or does not have adequate resistance to the invading pathogen will get the infectious disease

Breaking the chain of infection Breaking at least one link stops the spread of infectious disease The infectious agent – early recognition of signs of infection – Rapid, accurate identification of organisms Reservoir host Medical asepsis Standard precautions Good employee health Environmental sanitation Disinfectant/sterilization

Breaking the chain of infection Portal of exit from the host – Medical asepsis – Personal protective equipment – Hand washing – Control of excretions and secretions – Trash and waste disposal – Standard precautions

Breaking the chain of infection Portal of entry – Wound care – Catheter care – Medical asepsis – Standard precautions Susceptible Host – Treating underlying diseases – Recognizing high-risk patients

Community acquired infection An infection Present or Incubating at the time of admission to a health care facility without any association to previous hospitalization at the same facility

What are Hospital Acquired Infections ? (Nosocomial Infections, Health Care Associated Infections) Any infection that is not present or incubating at the time the patient is admitted to the hospital infections that appear more than 48 hours after admission This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility

Basics of Infection Control Prevention of nosocomial infection is the responsibility of all individuals and services provided by healthcare setting. To practice good asepsis, one should always know: what is dirty, what is clean, what is sterile and keep them separate. Hospital policies & procedures are applied to prevent spread of infection in hospital.

Aiming at preventing spread of infection Standard precautions: These measures must be applied during every patient care, during exposure to any potentially infected material or body fluids as blood and others. Components: A. Hand washing. B. Barrier precautions. (PPE) C. Sharp disposal. D. Handling of contaminated material.

Hand Washing Hand washing is the single most effective precaution for prevention of infection transmission between patients and staff. Hand washing with plain soap is mechanical removal of soil and transient bacteria (for sec.) Hand antisepsis is removal & destroy of transient flora using anti-microbial soap or alcohol based hand rub (for 60 sec.)

When to Wash our Hands 1. Before & after an aseptic technique or invasive procedure. 2. Before & after contact with a patient or caring of a wound or IV line. 3. After contact with body fluids & excreta removal. 4. After handling of contaminated equipment or laundry.

Hand washing is a Priority 5. Before the administration of medicines 6. After cleaning of spillage. 7. After using the toilet. 8. Before having meals. 9. Between different procedures on the same patient 10. Gloves cannot substitute hand washing which must be done before putting on gloves and after their removal.

Barrier precautions Gloves: Sterile gloves are used for invasive procedures. Gloves must be of good quality, suitable size and material. Never reused.

Barrier precautions Disposable gloves must be worn when: a)Direct contact with B/BF is expected. b)Examining a lacerated or non-intact skin e.g wound dressing. c)Examination of oropharynx, GIT, UIT and dental procedures. d)Working directly with contaminated instruments or equipment's e)Health care worker has skin cuts, lesions and dermatitis

Masks & Protective eye wear Must be used when: engaged in procedures likely to generate droplets of B/BF or bone chips. During surgical operations to protect wound from staff breathings. Masks must be of good quality, properly fixed on mouth and nasal openings.

Gowns and Aprons are needed Spraying or spattering of blood or body fluids is anticipated e.g surgical procedures. Gowns must not permit blood or body fluids to pass through. Sterile linen or disposable ones are used for sterile procedures.

Sharp Precautions Needle stick and sharp injuries carry the risk of blood born infection e.g AIDS, HCV,HBV and others. Sharp injuries must be reported and notified NEVER TO RECAP NEEDLES Dispose of used needles and small sharps immediately in puncture resistant boxes (sharp boxes). Sharp boxes: must be easily accessible, must not be overfilled, labeled or color coded. Needle incinerators can be another safe way of disposal. Reusable sharps must be handled with care avoiding direct handling during processing.

DO NOT re-cap needles. In the event recapping is unavoidable, the one-handed scoop technique or a needle recapping device shall be used.

Sharps containers shall be labeled as “sharps waste” and biohazardous with international biohazardous symbol.

Sharp containers shall be filled up to three quarters and taped closed or tightly lidded. Sharps containers are placed in yellow bags by housekeeping personnel for storage and then processing.