2. Learning Objectives
By the end of this session, students are expected to be able to:
• Describe contact based transmission precautions
• Describe disease transmission cycles
• Define the terms waste and hazardous material
• Describe different types of hospital (health care) wastes
• Describe sources of hospital wastes and hazardous materials
• Explain dangers of indiscriminate disposal of hospital wastes and hazardous
materials
3. Contact Based Transmission Precautions
• Reduces the risk of transmission of organisms from infected or colonized
patient through
direct or indirect contact, (e.g. Herpes Simplex, hemorrhagic fever virus –Ebola
and
multi-drug or antibiotics resistance organisms)
4. Airborne Precautions
Patient Placement
• Private room with the door closed
• Room air is exhausted to the outside (negative air
pressure) using fan, air
conditioner or other filtration system
• If private room not available, place patient in room
(negative air pressure as
above) with patient having active infection with the same
disease, but with no
other infection.
Respiratory Protection
• Wear a mask.
• If Severe Acute Respiratory Syndrome (SARS) or bird flu
is known or suspected,
wear a particulate respirator (N95 mask) if available, or a
mask
- Susceptible persons—do not enter room.
• Remove mask after leaving the room and place in a
plastic bag or waste
Container. Patient Transport
• Limit transport of patient to essential purposes only
• During transport, patient must wear mask
• Notify area receiving patient
5. Droplet Precautions
Use in addition to standard precautions for a patient
known or suspected to be infected with
microorganisms transmitted by large-particle droplets
(larger than 5 μm).
Patient Placement Private room; door may be left open.
• If private room not available, place patient in room with
patient having active
infection with the same disease, but with no other infection
(cohorting).
• If neither option is available, maintain separation of at
least 1 meter (3 feet)
between patients.
Respiratory and Eye/Mucous Membrane Protection
• Wear a mask and goggles or face shield if within 1
meter of patient.
CMT 04103 Environmental Health NTA L4 Semester 1 Student Manual
Session 13: Fundamentals of Infection Prevention Control (IPC) 104
Patient Transport
• Limit transport of patient to essential purposes only
• During transport, patient must wear a mask
• Notify area receiving patient.
6. Contact Precautions
Use in addition to standard precautions for a patient known or suspected to be infected
or
colonized with microorganisms transmitted by direct contact with the patient’s
secretions/excretions or indirect contact with environmental surfaces or patient care
equipment.
Patient Placement
• Private room; door may be left open
• If private room not available, place patient in room with patient having
active infection with the same microorganism, but with no other infection
(cohorting)
Gloving
• Wear clean, non-sterile examination gloves when entering room
• Change gloves after contact with infectious material (e.g., feces, wound
drainage)
• Remove gloves before leaving patient room
Hand washing
• Wash hands with soap and water or an antibacterial agent, or use a
waterless, alcohol-based antiseptic hand rub, after removing gloves
• Do not touch potentially contaminated surfaces or items before leaving the
room
Gowns and Protective Apparel
• Wear clean, non-sterile gown when entering patient room if patient contact
is anticipated or patient is incontinent, has diarrhea, an ileostomy, colostomy
or wound drainage not contained by a dressing
• Remove gown before leaving room
• Do not allow clothing to touch potentially contaminated surfaces or items
before leaving the room
Patient Transport
• Limit transport of patient to essential purposes only
• During transport, ensure precautions are maintained to minimize risk of
transmission of organisms
Patient Care Equipment
• Reserve non-critical patient care equipment for use with a single patient if
possible
• Clean and disinfect any equipment shared among infected and non-infected
patients after each use
7.
8. Description of Terms and Types of Hospital
(Health Facility) Waste
• Waste: Any worthless material that is to be disposed of.
• Wastes can be classified as either liquid or solid waste.
• Hospital waste: Wastes from all types of health
facilities, whether private or publically
owned.
• Health facilities can include health posts, dispensaries,
health centres, hospitals, maternal
waiting homes, physician offices, research institutes
(animal and human health), homes
(especially diabetic homes, and HIV and AIDS patients in
homes) and specialized clinics.
• Hazardous materials: Wastes which contain organic or
inorganic elements that, due to
their toxicological, physical, chemical, carcinogenic or
those with persistency properties,
may cause detrimental cumulative effects to humans,
animals and other living organisms.
9. Figure 1: Types of Healthcare Waste
Type Examples
Non-infectious waste
Similar in nature to domestic/office waste like kitchen
waste, food
remains, office papers, packing materials, etc
Infectious waste
Contains pathogens in sufficient quantity so that they pose
a serious threat,
such as cultures from laboratories, waste from surgeries
and autopsies on
patients with infectious diseases, waste from patients in
isolation wards
Pathological wastes
Tissues, organs, body parties, human foetuses, placentas,
animal carcasses
and most blood and body tissues
10. Radioactive waste
Solids, liquids, and gases from analysis procedures, body
organ imaging
and tumours localization, radioactive materials for
treatment (e.g. cobalt
60, uranium, lithium etc)
Chemical waste
Solid, liquid or gaseous waste may be hazardous or non
hazardous
Hazardous wastes are toxic, corrosive, flammable,
reactive or geno toxic
Sharps Any items that could cause a cut or puncture
(especially syringes with
needles, blades, broken glass)
Pharmaceutical waste
Drugs whether surplus, spilled, damaged, expired or
contaminated and
pressurized receptacle
11. Sources of Health Care Wastes and Hazardous
Materials
• Health care wastes are generated in a wide variety of
sources, starting from hospital,
human and animal clinics, health centres and
dispensaries
• Sources of hazardous waste include:
o Agricultural land and agro-industry pesticides
Rat poisons, veterinary product waste
o Domestic
Batteries, dry cell, furniture polishes, wood
preservatives, mosquito repellents,
paints, disinfectant, fuel
o Mines and mineral processing sites
o Health care facilities
Pathological waste, human blood, contaminated needle,
specific source from
dentists, morticians, blood banks, hospital clinic and
medical laboratories
o Commercial wastes
Gasoline stations, dry cleaners and automobile repair
shops
12. Dangers of Indiscriminate Disposal of Hospital
Wastes and Hazardous
Materials
Dangers of Indiscriminate Disposal
• Presence of waste or combination of waste may pose a
substantial hazard to humans or
other living organisms
• Non degradable wastes are persistent in nature, can be
biologically magnified and may
cause a detrimental cumulative effect to humans, animals
and other living organisms
• Possible other effects of waste may include:
o Explosion
o Infection
o Chemical instability, reaction or corrosion
o Cancer, mutation or birth defects
o Acute or birth defects
o Damage to ecosystem or natural resources or
Cumulative effects
13. Disease Transmission Cycle
Components of the Disease Transmission Cycle
• Infectious agent
o Microorganisms that can cause infection or disease
• Reservoir
o A source of infection
• Place of exit
o The infective agents can come out through one of the body
organs or openings
• Modes of transmission
o Describes the mechanism by which an infectious agent is
spread
• Places of entry
o Can be broken skin, puncture wound, surgical site, and mucous
membranes
• Susceptible host
o Human a risk for acquisition or resistance to the disease
14.
15. Description of the Components
• Infectious agent
o The micro-organisms that can cause infection or
disease
o These include bacteria, viruses, fungi and parasites
• Reservoir
o People, water and solutions, instruments and other
items, equipment, soil and air
• Place of exit
o Respiratory, genitourinary, vascular systems, GIT, skin,
mucous membranes, placenta
• Modes of transmission
o Contact
(e.g. Haemorrhagic fever virus, enteric pathogens, and
Multi-Drug Resistance
(MDR) Bacteria)
o Droplet
(e.g. Influenza & Rubella viruses, Corynebacterium
diphtheria)
o Airborne
(e.g. Tb, chicken pox and measles)
o Common vehicle
(e.g. salmonella (food), HBV, HIV (blood))
o Vector borne.
16. o Vector borne
Malaria, yellow fever and filariasis
• Places of entry:
o Broken skin, puncture wound, surgical site, mucous
membranes
• Susceptible host:
o Clients/patients, service providers’ ancillary staff,
community members
