INFECTION

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WINTER

CONTROL
yoyen

Why Infection Control?

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 dont have?

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 workers role in preventing spread of infections Demonstrate proper hand washing technique

What is Infection Control?

concerned with preventing nosocomial or healthcareassociated 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.

Chain of Infection

04

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 PPEs 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 fingertips, finger-webs, the palms and the thumbs.

Four Moments of Hand Hygiene

Standard Precautions (maam 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 Removing PPE

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 (maam 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 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 PPEs 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!