1. Topic 9 Minimizing infection through improved infection control

2. LEARNING OBJECTIVE Demonstrate the devastating effects of inadequate infection control and know how to minimize the risks of contamination

3. KNOWLEDGE REQUIREMENTS know the extent of the problem of infection know the main causes and types of infection

4. PERFORMANCE REQUIREMENTS apply universal precautions be immunized against Hepatitis B use personal protection methods know what to do if exposed encourage others to use universal precautions

5. WHAT IS THE URGENCY? can no longer rely on antibiotics increased rates of nosocomial infections infected patients: –stay longer in hospital –die –treated with more toxic and less effective drugs –prone to surgical site infections

6. CAMPAIGNS TO DECREASE INFECTION RATES WHO “Clean hands are safer hands” campaign Centers for Disease Control and Prevention campaign to prevent antimicrobial resistance in health-care settings Institute for Healthcare Improvement “5 million lives” campaign

7. MAIN CAUSES OF INFECTION person-person via hands of health-care providers patients and visitors personal equipment (e.g. stethoscopes, personal digital assistants) and clothing environmental contamination airborne transmission carriers on the hospital staff rare common-source outbreaks

8. MAIN TYPES OF INFECTIONS urinary track infections usually associated with catheters Surgical infections blood stream infections associated with the use of an intravascular device pneumonia associated with ventilators other sites

9. MAIN TYPES OF INFECTIONS Burke J Infection control-a problem for patient safety New Eng Journal of Medicine

10. PREVENTION IN HOSPITALS visibly clean increased cleaning during outbreaks use hypochlorite and detergents during outbreaks

11. PREVENTION THROUGH HANDWASHING how to clean hands rationale for choice of clean hand practice technique for hand hygiene protecting hands from decontaminates promoting adherence to hand hygiene guidelines

12. PROTECTIVE EQUIPMENT gloves aprons face masks

13. SAFE DISPOSAL OF SHARPS keep handling to a minimum do not recap needles; bend or break after use discard each needle into a sharps container at the point of use do not overload a bin if it is full do not leave a sharp bin in the reach of children

14. PERFORMANCE REQUIREMENTS apply universal precautions be immunized against Hepatitis B use personal protection methods know what to do if exposed encourage others to use universal precautions

15. ACT TO MINIMIZE SPREAD OF INFECTION before contact with each and every patient: –clean hands before touching a patient –clean hands before an aseptic task after contact with each and every patient: –clean hands after any risk of exposure to body fluids –clean hands after actual patient contact –clean hands after contact with patient surroundings

16. 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

17. SUMMARY know the main guidelines in each of the clinical environments you are assigned accept responsibility for minimizing opportunities for infection transmission let staff know if supplies are inadequate or depleted educate patients and families/visitors about clean hands and infection transmission ensure patients on precautions have same standard of care as others –frequency of entering the room –monitoring vital signs