10 a prevention of infection 16 sept
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10 a prevention of infection 16 sept

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    10 a prevention of infection 16 sept 10 a prevention of infection 16 sept Presentation Transcript

    • 1Prevention of InfectionMaternal Health DivisionMinistry of Health & Family WelfareGovernment of IndiaBEMoC - Presentation 10 (a)Session 10a
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India2Session Objectives Understand the concept and importance ofinfection prevention Know and practice the standard proceduresto be undertaken in the facility andspecifically the labour room
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India3WHY? Minimise the risk of HIV, Hepatitis B, C andstreptococcal/staphylococcal infections Appropriate prevention practices to:• reduce post-procedure infection• prevent infection of health care personnel• protect the community• lower the costs of healthcare
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India4Sources of InfectionWhat are the common sources of infection? Environment: Blood, body fluids, secretions,excretions, placenta, contaminated sharpsand other equipments. Other clients People in the community Health care delivery personnel
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India5Infection prevention principles All objects that come in contact with a patientare potentially contaminated Every person must be considered potentiallyinfectious If an object is disposable - discard appropriately If an object is reusable - decontaminate
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India6Universal (Standard) Precautions“Precautions to protect against exposuremust be taken when there is anypotential for exposure to bodily fluids. Itis assumed that all bodily fluids havethe potential to transmit disease”The Universal Precaution Rule:Treat all human blood, bodily fluids and other potentiallyinfectious materialsas if they are infectious.
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India7Components of universal precautions Hand washing Careful handling of sharps Safe techniques Sterilization and Disinfection Disposal of waste in a proper manner Use of Personal barrier precautionsASSUME ALL BODY FLUIDS FROM ALL PERSONSARE POTENTIALLY INFECTIOUS
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India8Standard Precautions: Hand WashingLongAntibacterialsoap, AlcoholicsolutionsPre-operativedisinfectionSurgical handdisinfectionDisinfectionAlcoholDisinfection aftercontaminationHygienichand rubShortNon medicatedsoapCleansing afterclient contactCareful handwashingShortNon medicatedsoapCleansingRoutine handwashingResidualeffectAgentsMain PurposeTechnique
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India9Specific Indications for Hand HygieneBefore: Patient contact Inserting urinary catheters, peripheral vascular,I/V cannula ,catheters, or other invasive devicesthat don’t require surgeryAfter: Contact with a patient’s skin Contact with body fluids or excretions, non-intact skin, wound dressings Removing gloves
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India10Steps of hand washingStep 1Wet the hands and wrists.Apply soap.Step 2Right palm over left,left over right.Step 3Palm to palm,Fingers interlaced.Step 4Back fingers to opposingFingers interlocked.Step 5Rotational rubbing of rightThumb clasped in left palmand vice versa.Step 6Rotational rubbing backwardsand forwards with top offingers and thumb of rightHand in left and vice versa.
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India11Missed Spots when Hand-washing
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India12Standard Precautions: Protective attire Gloves Masks Eye-covers Gowns Caps Footwear*use once then change
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India13Standard Precautions: Processing of useditemsA. DecontaminationB. CleaningC. Sterilization or high level disinfection(HLD)D. Storage
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India14Processing of used items Decontamination: kills pathogens• Place instrument in 0.5% chlorine for 10min• Wipe contaminated surfaces Cleaning: with soap and water – scrubequipment Sterilization: for surgical instruments anddrapes
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India15Standard Precautions: Maintaining cleanenvironmentFor cleaning areas –operation theatres,procedure rooms, latrinesDisinfectantcleaning solutionTo clean up spills of blood orother body fluidsDisinfectant 0.5 %chlorine solutionTo remove dirt & organicmaterial such as grease, oilPlain detergentand waterUsesType of cleaningsolution
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India16Steps of Decontaminnation Monitor vitals Take steps to stabilize woman’s condition If condition worsens, assess the level of shock Treat accordingly & refer the patient to an FRUwith basic life support Specific treatment: as mentionedaccording to the type of abortion
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India17Missed Spots when Hand-washing
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India18Recommended Disinfectants .5 to 1% bleach 2% glutaraldehyde 70% ethyl and isopropyl alcohol. 4% formaldehyde. .5-1% sodium hypochlorite.
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India19Processing of used itemsSterilization: Sterilization ensures that items are free of allmicroorganisms (bacteria, viruses, fungi andparasite) including endospores.Three methods of sterilisation: Steam sterilisation / Autoclaving / Pressurecooker autoclaving Dry heat sterilisation Chemical / cold sterilisation
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India20Processing of used itemsSterilization: High level Disinfection HLD eliminates bacteria, viruses, fungi andparasites, but does not kill all endospores whichcause diseases such as tetanus and gas gangrene. HLD only acceptable alternative to sterilisation. There are 3 methods of HLD:• Boiling• Chemical HLD• Steaming
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India21Processing of used itemsStorage: To prevent contamination after processing Do not store instruments or other items such asscalpel blades and suture needles in solution,always store them dry Follow the guidelines written on the container,instructed by the manufacturer
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India22Standard Precautions: Proper Handling andDisposal of sharpsNeedles and syringes Use disposable needle and syringe ONLY ONCE. Always wear utility gloves while handling sharps Do not recap, bend or break needles before disposal. Make needles unusable after single use by burningthem in a needle destroyer Never burn syringes Do not reuse disposable gloves
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India23Standard Precautions: Proper Handling andDisposal of sharpsNeedles and syringes Dispose off needles and syringes in a puncture-proofcontainer such as metal box, cardboard box or anempty plastic box. Syringes to be cut with hub cutters and chemicallydisinfected at source of generation before final disposalinto sharps pit located at the PHC Finally dispose as follows:• Dispose the needles and broken vials in pit / tank,(made according to the GOI guidelines)• Send the syringes and unbroken vials forrecycling or landfill
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India24Standard Precautions: Maintaining cleanenvironmentFor cleaning areas – operationtheatres, procedure rooms,latrinesDisinfectant cleaning solutionTo clean up spills of bloodor other body fluidsDisinfectant0.5 % chlorine solutionTo remove dirt & organicmaterial such as grease, oilPlain detergent and waterUsesType of cleaning solution
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India25What are the colour codes for segregation? Yellow for infectious waste such as anatomical &pathological wastes, such as body parts and animalcarcasses, soiled dressings such as gauze, cotton,linen, etc. contaminated with blood or other body fluids Red for infectious plastics such as gloves, IV sets,tubings, catheters, canulas, microbiological waste, etc. Translucent/puncture proof containers for metalsharps Blue for glass Black for cytotoxic drugs, incinerator ash, chemicalwaste, etc. White for recyclable non-infected general waste Green for collecting and transporting food waste fromwards, canteens, and dining halls.
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India26Standard Precautions: Biomedical WasteDisposalIt is the waste that is generated during diagnosis,treatment or immunization of human beingsPurpose of waste disposal Minimize/Prevent the spread of infection tohospital personnel who handle waste Prevent the spread of infection to the localcommunity
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India27Standard Precautions: Biomedical WasteDisposalSteps of waste disposalA. SegregationB. Collection and StorageC. TransportationD. Treatment and disposal
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India28Biomedical Waste Disposal: Collection andStorageWrong Correct
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India29How to dispose of placenta In a yellow bag Not to be left in open places To be buried in a deep trench away from thewater source
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India30Biomedical Waste Disposal: TransportationWrong Correct
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India31Biomedical Waste Disposal: Treatment andDisposalDo’s Disinfect and destroy the waste before its finaldisposal. Remember• Biological waste to be buried deep at thefacility
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India32Key Messages Hand-washing is essential for preventinginfections Always wear gloves especially where there isa risk of touching blood, body fluids,secretions, excretions or contaminated items Decontamination: 0.5% bleach solution is theleast expensive and the most rapid acting andeffective agent to use for decontamination Proper handling of contaminated wasteminimizes the spread of infection to healthcarepersonnel and to the local community
    • PREVENTION OF INFECTIONMaternal Health DivisionMinistry of Health & Family WelfareGovernment of India33Key Messages (contd...)Proper handling means: Wearing utility gloves Transporting solid contaminated waste to thedisposal site in covered containers Disposing of all sharp items in puncture-resistantcontainers Carefully pouring liquid waste down a drain orflushable toilet Burning or burying contaminated solid waste Washing containers, gloves and hands afterdisposal of infectious waste
    • 34Preparation of ChlorineSolution
    • IP: Instructions for Preparing Dilute ChlorineSolutionsTo make a 0.5% chlorine solution from 5%bleach, mix 1 part bleach to 9 parts water.Dilute%eConcentrat%Total parts (TP) (H2O) =- 1Total parts (TP) (H2O) = Dilute.5%eConcentrat5%- 1= 9 Total parts (TP) (H2O)
    • IP: Instructions for Preparing a ChlorineSolution from a PowderTo make a 0.5% chlorine solution froma 35% chlorine powder,mix 14.2 grams of powder to 1 liter of water.eConcentrat%Dilute%Gram/Liter = X 1000eConcentrat35%Dilute.5%Gram/Liter = X 1000 = 14.2 Gram/Liter
    • ?
    • 38Thank you
    • EXCERSIZE1. Which is the most important of thestandard precautions practices?2. Which is the first step in instrumentprocessing and what is its purpose?3 What are the key differences betweensterilisation and high level disinfection?4 What are the types of contaminatedwastes produced in your HCF?
    • EXCERSIZE cont…5. How are you managing yourwaste?6. How are you processing reusableitems in your facility?7. Name the chemical disinfectantsavailable at your facility?8. How is 0.5% hypochlorite solutionprepared?