WINTERTemplateINFECTION

CONTROLyoyen

• 40% of entire p&p

• DOH and PhilHealth put so much importance on I.C.

• every health care institution they inspect

• come inspection time…

• how can we give something we don’t have?

Why Infection Control?

Objectives

• At the end of this session, the participants will be able to:– Verbalize definitions related to infection control– List modes of transmission of infections and portals of

entry of bacteria– Explain precautions– Explain the worker’s role in preventing spread of

infections– Demonstrate proper hand washing technique

What is Infection Control?

• concerned with preventing nosocomial or healthcare-associated infection

Nosocomial Infection

• Develops when a patient is staying at a health care facility and was not present when the paitnet was admitted to the facility

• At least 5% of patients hospitalized each year in the US develop nosocomial infections. Many are preventable.

04Chain of Infection

Organisms

Causative Agents

Causative Agents

Causative Agents

Elimination

• Sterilizing surgical intsruments• Proper food preparation• Vaccination• Treatment• Good hand hygiene practice

Reservoir

• Human beings

• Animals

• Inanimate objects (fomites)

Portal of Exit

• Sputum• Vomitus• Stool• Blood

• Cover cough and sneezes• PPE’s• Appropriate dressing for wounds

Transmission

• Contact– Direct contact – most frequent– Indirect contact – bet. Susceptible host and contaminated inanimate

object

• Droplet – large droplets containing microorganisms propelled at a short distance through the air (usu. <1 m)

• Airborne – evaporated droplets; suspended in air• Vector-borne – mosquitoes, flies, rats

Portal of Entry

• Membrane• Skin break• GIT• GUT• Respiratory

Susceptible Host

• People have better resistance to to disease when they are well rested, well fed and relatively stress free.

• Immuncompromised: w/ chronic disease, w/ invasive devices (tubes, catheters), malnourished, very old, very young, tired, under high stress, skin breaks, steroid therapy, HIV

Hand Hygiene

• Still the single most effective way to prevent the spread of infection.

Hand Hygiene

Hand Hygiene

Handwashing – areas missed

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.

Four Moments of Hand Hygiene

Standard Precautions (ma’am sheltex)

• First tier of precaution– Those designated for the care of all hospital patients regardless of their

diagnosis or presumed infection.– Primary strategy for reducing the risk of and controlling nosocomial

infections.– Apply to: blood, all body fluids, secretions, and excretions except sweat,

non intact skin and mucous membrane– All patient fluids can be infectious: concept– PPE

Standard Precautions

Transmission-Based Precautions

• Second tier of precaution• Instituted for patients who are known to be or suspected of

being infected with a highly transmissible infection

Contact Precaution

• To reduce risk of transmitting infectious agents by direct or indirect object

• Gloves, gown, dedicated patient care equipment (thermometer, stethoscope, BP cuff)

• eg. Scabies, lice, MRSA, VRE, C. diff

Droplet Precaution

• To reduce the risk of transferring infectious agents through large particle (5 micrometer or more) droplets

• Eg. Influenza, meningitis, diphtheria, rubella, neisseria meningitidis, some pneumonias, mumps, pertussis

• Large particles do not remain in air and travels 3 feet or less• Requires mask

Airborne Precaution

• To reduce the risk of airborne transmission infectious agents• Eg. Measles, TB, varicella• Include special air handling and ventilation procedures to

prevent spread of infection.• Requires respiratory protection such as particulate respirator (

fits to a face and filters out organisms as small as 1 micrometer

• Negative air pressure isolation room• Doors closed

Isolation and Universal Precautions

• Isolation precautions – special precautionary measures, practices and procedures used in the care of patients with contagious or communicable disease

• Universal precaution – refers to the practice of avoiding contact with patients’ body fluids, by means of wearing nonporous articles such as gloves and mask. All patients are considered possible carriers of blood-borne pathogens.

• Mask during duty hours• ROD – will assess the patients whether

admission or transfer is needed• Isolation room – meningococcemia, SARS,

etc• Vital signs to be done in the isolation room• Handwashing

Isolation Technique

• Prepare the isolation room• Laundry hamper and waste basket inside the room• Separate thermometer, sphymomanometer and

stethoscope inside the room• Put on gown and gloves if needed• Mask• Double bagging• Dishes and food trays

Key Points about PPE

• Don before contact with the patient• Use carefully• Remove and discard carefully either at doorway

or outside room• Immediately perform hand hygiene• Discard if torn or damaged

Sequence for Donning PPE

• Gown• Mask• Goggles• Gloves

Sequence for RemovingPPE

• Gloves• Goggles• Gown• Mask

What to do if exposed to blood/body fluids

• Puncture wounds should be washed immediately and the wound should be caused to bleed

• If skin contamination should occur, wash the area immediately

• Splashes to the nose or mouth should be flushed with water

• Eye splashes require irrigation with water or saline

• Complete an incident report. Report exposure to supervisor immediately.

PPE

Uniform and Work Clothing

Safe Handling of Sharps (ma’am jasmin)

Single-handed scooping method

1. Place the needle cap on a hard, flat surface and remove your hand.

2. With one hand, hold the syringe and use the needle to scoop up the cap.

3. When the cap completely covers the needle, use the other hand to place the cap firmly on the hub of the needle.

4. Remove the capped needle from the hub.

5. Discard capped needle to sharp container.

Sharps Container

• Empty container if ¾ full• 70% Zonrox

30% water

Waste Segregation

• Black• Yellow• Green

Gradual Phase-out of Mercury

Gradual Phase-out of Mercury

Gradual Phase-out of Mercury

Gradual Phase-out of Mercury

Nosocomial Infection

• Are infections that present themselves in hospitalized patients in whom the infection was not present nor incubating at the time of admission

Prevention of Nosocomial Infection

• Frequent handwashing• PPE’s• Sanitation of surfaces after every shift• Isolation of pt (if necessary)• Health education• Sterilization of equipment• Limit duration of hospital stay as much as possible• Ongoing training

Control of Nosocomial Infection

• All infectious materials (linen, clinical waste, lab waste, sharps) should be safely contained, destroyed or decontaminated

• Clean and dry instruments and equipment• Disinfect items in contact with mucous membranes, fluid and

potentially infectious materials• Environment = clean, dry, well-lighted and well-ventilated• Immunization• Isolation techniques• Reverse isolation• Proper food preparation• Control of vectors (insects, rodents)

Isolation of Nosocomial Infection

• Isolation room @ the end of corridor

• PPE

• Handwashing

• Utensils: ?

• Room always closed

• Limit visitors

• During transport: pt must wear mask

Asepsis

• A set of specific practices and procdeures performed under carefully controlled conditions with the goal of minimizing contamination by pathogens.

• OR technique/sterility

Sterile single technique

• Single use syringes and needles for each injection only• Discard needle of syringe if package had been punctured, torn

or damaged• Discard bent or damaged needles• Never leave a needle inserted in the vial to withdraw multiple

doses

Prevent contamination of injection

• Prepare each injection in clean area• Alcohol swab to clean vial cap or neck of ampule

Treatment of Needlestick Injuries

• Do not apply pressure. Allow to bleed freely.• Wash with soap and water.• Any exposed mucous membranes should be flushed with large

amounts of water• Medical assessment• Blood tests, vaccination, medications• ATS, antibiotics• Report injury to supervisor• Counseling, periodic monitoring• Document (details, name, dept, date, etc..)• Sentinel report before end of shift• Advice from ICC

Reuse and Recycle of Equipment

Questions?

Thank you!