infection control practices part 1
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This document discusses infection control and the importance of hand hygiene in healthcare settings. It notes that while hospitals treat patients, they can also introduce risks of infection. Hand hygiene is the most important way to prevent transmission of pathogens between patients and healthcare workers. Proper handwashing and alcohol-based hand rub techniques are described that should be used before and after contact with patients according to the Five Moments for Hand Hygiene. Compliance with hand hygiene is low globally and barriers include time constraints and skin irritation.
![The nature of infection
Micro-organisms -
bacteria, fungi, viruses,
protozoa and worms
Most are harmless [non-
pathogenic]
Pathogenic organisms can
cause infection
Infection exists when
pathogenic organisms
enter the body,
reproduce and cause
disease
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infection control practices part 1
- 1. 1 Dr. Priyadarshini Patro Microbiologist VY Hospital
- 2. The nature of infection Micro-organisms - bacteria, fungi, viruses, protozoa and worms Most are harmless [non- pathogenic] Pathogenic organisms can cause infection Infection exists when pathogenic organisms enter the body, reproduce and cause disease 2
- 3. 3 Why do we need Infection Control?? Hospitals and clinics are complex institutions where patients go to have their health problems diagnosed and treated But, hospitals, clinics, and medical/surgical interventions introduce risks that may harm a patient’s health
- 4. The risk of infection is always present. Patient may acquire infection before admission to the hospital = Community acquired infection. Patient may get infected inside the hospital = Nosocomial infection / Hospital acquired infections (HAI). It includes infections not present nor incubating at admission, infections that appear more than 48 hours after admission, those acquired in the hospital but appear after discharge also occupational infections among staff.
- 5. What is Nosocomial Infection Any infection that is not present or incubating at the time the patient is admitted to the hospital 5
- 6. Common Health-Care Associated Infections Urinary Tract Infection Surgical/Traumatic Wound Infection Respiratory Tract infection Bloodstream infection
- 7. 7 Additional morbidity Prolonged hospitalization Long-term physical, developmental and neurological sequelae Increased cost of hospitalization Death Consequences of Nosocomial Infections
- 8. Objectives : To prevent health care workers & the environment from transmission of infections. To reduce :- Pt’s morbidity & mortality length of hospital stay Cost associated with hospital stay
- 9. What are Universal Precautions Universal precaution are control guidelines designed to protect workers from exposure to Diseases spread by Blood and other Body fluids.
- 10. Why Universal health Precautions The concept of Universal Health Precautions emphasizes that all our patients should be treated as infectious for blood born infections such as HIV, Hep-B, C, and can infect the caring health care workers. ( CDC )
- 11. Human materials/Tissues considered Highly Infectious 1 Blood 2 Semen 3 Vaginal secretions 4 C S F 5 Synovial fluids 6 Amniotic fluid 7 All other body fluids
- 12. Not Infectious unless contaminated with Blood or Body fluids. Faeces, Nasal secretions, Sputum, Sweat, Tears, Urine / Vomitus, Saliva unless blood stained.
- 13. Standard precautions Applied to all pts. at all times ( regardless of diagnosis & infectious status ). Aim : To prevent transmission of infections from Pt Health care worker (HCW) HCW Pt. Pt. Pt. (cross transmission ) Hospital environment Pt. Hospital waste community
- 14. Components Hand hygiene Personal protective equipment (PPE). Handling of pt. care equipments & soiled linen. Prevention of needle stick injuries. Environmental cleaning & spills management. Appropriate handling of waste.
- 16. Hand transmission Hands are the most common vehicle to transmit health care- associated pathogens Transmission of health care-associated pathogens from one patient to another via health-care workers’ hands requires 5 sequential steps .
- 17. 5 stages of hand transmission Germs present on patient skin and immediate environment surfaces Germ transfer onto health- care worker’s hands Germs survive on hands for several minutes Suboptimal or omitted hand cleansing results in hands remaining contaminated Contaminated hands transmit germs via direct contact with patient or patient’s immediate environment one two three four five
- 18. protect the patient against harmful germs carried on your hands or present on his/her own skin protect yourself and the health-care environment from harmful germs Why should you clean your hands?
- 19. Your Unwashed Hand a Great Concern to Your Patient 19
- 20. Hand hygiene Hand washing Antiseptic handwash Alcohol-based handrub Surgical hand hygiene/antisepsis
- 21. Our Hands are Threat to LIFE Just Washing can Save Many LIVES
- 22. There is no Health precaution like Hand washing. Washing with simple toilet soap - reduces the rate of transmission of common infections including the HIV. Proper hand washing is the single most important way to prevent and reduce infections.
- 23. Hands should be washed: Before and after patient contact Before putting on gloves and after taking them off After touching blood and body substances (or contaminated patient-care equipment), broken skin, or mucous membranes (even if you wear gloves) Between different procedures on the same patient. Before leaving the ward. Before handling food. 23
- 24. The “5 Moments for Hand Hygiene” approach
- 25. How to Wash our hands How to Wash our hands To effectively reduce the growth of germs on hands, handwashing must last 40–60 seconds and should be performed by following all of the illustrated steps.
- 26. Hand washing – Areas Missed Research indicates: poor techniques - not all surfaces cleaned frequency diminishes with workload/distance poor compliance with guidelines/training Taylor (1978) identified that 89% of the hand surface was missed and that the areas of the hands most often missed were the finger-tips, finger- webs, the palms and the thumbs. 26
- 27. How to handrub To effectively reduce the growth of germs on hands, handrubbing must be performed by following all of the illustrated steps. This takes only 20–30 seconds!
- 28. Alcohol-based hand-rub formulation Contain 60 to 80% ethanol as isopropanol or n-propanol. Emollients to protect the skin. Available as – Liquid solutions Gels Sprays Foams
- 29. Choosing hand hygiene technique Hand wash • If there is visible contamination with blood or body fluids. • Visible contamination with proteinaceous material. • Exposure to spore forming organisms. • After using toilet. Hand rub • When there is no visible solid contamination on hands. Longtin Y, Sax H, Allegranzi B, et al.Hand hygiene. N Engl J Med. 2011;364;13: e24.
- 30. Advantages of Alcoholic Hand Wash Require less time Can be strategically placed Readily accessible Multiple sites All patient care areas Acts faster Excellent bactericidal activity Less irritating (??) Sustained improvement 30
- 31. Time constraint = major obstacle for hand hygiene Adequate hand washing with water and soap requires 40–60 seconds Average time usually adopted by health- care workers: <10 seconds Alcohol-based handrubbing: 20–30 seconds
- 32. Compliance with hand hygiene Compliance with hand hygiene differs across facilities and countries, but is globally <40% Main reasons for non-compliance reported by health-care workers: Too busy Skin irritation Glove use Don’t think about it
- 33. Words of Wisdom on Hand Washing Soap, water and Common sense are still be Best Antiseptics William Osler
- 34. Cut / abrasion – should be covered with Waterproof dressing. • Finger nail – should be short and clean ((less than 0.2 inches or ½ cm in length). • Avoid artificial nails. • Avoid wearing rings, watches, any jewellery during health care. • In high risk areas (OT rooms)- avoid any jewellery, even a plain band.