BIOSAFETY IN THE HOSPITAL by Dr.T.V.Rao MD

1. BIOSECURITY FOR
HOSPITALS AND CLINICS
Dr.T.V.Rao MD

2. Biosecurity
What is the best definition of biosecurity?
Biosecurity is a strategic and integrated
approach to analye and managing relevant
risks to human, animal and plant
life and associated risks for the
environment.

3. What Wikipedia defines
Biosecurity
•Biosecurity refers to measures aimed at
preventing the introduction and/or spread
of harmful organisms (e.g. viruses,
bacteria, parasitic fungal etc.) to humans
animals and plants in order to minimize the
risk of transmission of infectious disease.

4. Includes pandemics and
Bio terrorism
•The term includes
biological threats
to people,
including those
from pandemic
diseases and
bioterrorism

5. Biosafety / Biosecurity definitions
varies to different contests
•The definition has
sometimes been
broadened to
embrace other
concepts, and it is
used for different
purposes in
different
contexts.

6. How is India dealing with this
issue?
• The various aspects of biosecurity in India are managed by
ICMR (Indian Council of Medical Research), CSIR (Council of
Scientific and Industrial Research) and DRDO (Defence Research
and Development Organization).
• Biosecurity is considered as a health and agriculture matter in
India- hence it is largely dealt with by the states. The centre
issues guidelines which the states modify to suit their local
needs.
• The biosecurity bill drafted in India has been pending approval
since 2014. Also, it does not take zoonosis (like Coronaviruses)
into account
• Ref Biosecurity in India – Need, Challenges, Solutions

7. Draft on Biosecurity
• A 2016 draft handbook on biosecurity education produced
by the Bradford Disarmament Research Centre at
Bradford University in the UK, where the focus is on the
dangers of "dual-use" research, defines the term as
meaning "successful minimizing of the risks that the
biological sciences will be deliberately or accidentally
misused in a way which causes harm for humans, animals,
plants or the environment, including through awareness
and understanding of the risks"

8. THE PURPOSE WE LEARN ABOUT
BIOSECURITY / BIOSAFETY AND INFECTIONS
IN HEALTH CARE
•The very first
requirement in a
hospital is that it
should do the sick
no harm
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9. WHAT IS BIOSAFETY?
Biosafety is defined as, “
The discipline addressing the safe handling and
containment of infectious microorganisms and
hazardous biological materials”
The practice of safe handling of pathogenic micro-
organisms and their toxins in the biological
laboratory is accomplished through the application
of containment principles and the risk
assessment.

10. Biosafety means in
• Biosafety is order to
prevent worker exposure
to potentially infectious
agents or biohazards. The
differences in use of
universal precautions by
HCWs are influenced by
their level of knowledge.

11. Bio safety Included
as the component of Biosecurity
• Infection control methods
• Cross infections
• Nosocomial infections
• Universal health precautions
• Waste Management
• Vaccinations and
implementations
• Laboratory safety

12. BIOSAFETY INCLUDES
•This includes how
we handle animals,
plants, cell culture,
bacteria, viruses,
fungi, parasites and
public health crisis
such as CoVID-19.

13. Preventing Infections in the
Hospitals
• The goal of biosafety is to
reduce or eliminate
exposure of lab personnel,
the community and the
environment to potentially
infectious or hazardous
agents and this is achieved
via the principles of
containment and risk
assessment

14. Approach to Biosecurity?
• It is based on recognition that
hazards have the potential to be
deliberately or accidentally
misused resulting in harm.
Specifically, laboratory
biosecurity is a set of systems
and practices employed in
research facilities to protect
microbial agents from loss,
theft, diversion or intentional
misuse.

15. PRACITISING BIOSAFETY
• Biosafety is the application
of safety precautions that
reduce risk of exposure to
a potentially infectious
material and limit
contamination of the work
environment , preventing
spread of infections to
patients and health care
workers and ultimately the
community

16. The Scenario in Developing
Countries
• Very few studies from developing countries assessed
HCAI impact and no report provided national
estimates. Increased length of stay associated with
HCAI varies between 6 and 23 days in non-critically
ill patients. In developing countries, crude excess
mortality in adult critically ill adults affected by
ventilator-associated pneumonia is reported to be as
high as 27.5%.
• (Source WHO )
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17. Impact of HCAI
•According to the available evidence, the impact
of HCAI implies prolonged hospital stay, long-
term disability, increased resistance of
microorganisms to antimicrobials, massive
additional financial burden for health systems,
high costs for patients and their family, and
unnecessary deaths.
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18. What are Nosocomial Infections
• A nosocomial infection, also known
as a hospital-acquired infection or
HAI, is an infection whose
development is favored by a
hospital environment, such as one
acquired by a patient during a
hospital visit, or one developed
among hospital staff. Such
infections include fungal and
bacterial infections, and are
aggravated by the reduced
resistance of individual patients.

19. Nosocomial infections and
Threat to patients
• Some well known nosocomial infections include:
ventilator-associated pneumonia,
Methicillin resistant Staphylococcus aureus,
Candida albicans, Acinetobacter baumannii, Clostridium
difficile, Tuberculosis, Urinary tract infection,
Vancomycin-resistant Enterococcus and Legionnaires’
disease.
• Methicillin-resistant Staphylococcus aureus ( MRSA ) is a
bacterium responsible for several difficult-to-treat
infections in humans.

20. Most common Nosocomial
infections
• Urinary tract infection is
the most common) and
accounts for 15-20% of
the total.
• Hospital acquired
pneumonia is the second
most common
nosocomial infection

21. Infection control Methods in
Hospitals
• While hospitals maintain
strict protocols for
minimizing infections and
the spread of microbes,
facility managers may be
overlooking a prime area of
concern. Indentations in
flooring and hard-to-clean
places are areas where
bacteria, viruses, and fungi
can grow.

22. 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 fluid

23. Not Infectious unless contaminated
with
Blood or Body fluids
• Faeces,
• Nasal secretions,
• Sputum,
• Sweat,
• Tears,
• Urine / Vomitus,
• Saliva unless blood stained

24. Hygiene
begins with hand washing

25. DEFINING HYGIENE
• Hand hygiene Performing hand
washing, antiseptic hand wash,
alcohol-based hand rub, surgical
hand hygiene/antisepsis
• Common Hand washing
Washing hands with plain soap
and water
• Antiseptic hand wash
• Washing hands with water and
soap or other detergents
containing an antiseptic agent

26. HAND WASHING THE TRUE BEGINING
FOR INFECTION CONTROL
• Practicing hand hygiene is a
simple yet effective way to
prevent infections. Cleaning
your hands can prevent the
spread of germs, including
those that are resistant to
antibiotics and are
becoming difficult, if not
impossible, to treat.
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29. Cross Infection
• Because cross-infections
are one of the greatest
threats to hospital
patients, pathogens cannot
be allowed to travel and
multiply. Fortunately, there
are ways to help mitigate
the risks of microbial
spread.

30. Environment needs great
attention
• In all healthcare settings,
administrative, staffing
and scheduling activities
should prioritize the
proper cleaning and
disinfection of surfaces
that could be implicated
in transmission.

31. Cleaning during suspected
outbreaks
•During a suspected or
proven outbreak where
an environmental
reservoir is suspected,
routine cleaning
procedures should be
reviewed, and the need
for additional trained
cleaning staff should be
assessed.

32. Healthcare flooring hygiene –
areas of concern
Microbes tend to proliferate
on the floor surface in hard-to-
clean seams, sharp angles or
corners, depressions in the
floor, divots, punctures, or
anywhere the finish has been
breached. Microbes can
infiltrate the actual floor
covering itself, should it
become compromised or
susceptible to damage

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34. UNIVERSAL PRECAUTIONS CDC
• .Current
recommendations from
the Centers for Disease
Control and Prevention
are to follow universal
precautions, that is, to
treat all human samples
of blood and body fluid
as infectious.

35. Standard
precautions
• 1) Work practices
• hand hygiene
• no eating, drinking in
areas with risk of
transmission
• no re-capping of used
needles
• 2) Engineering controls
• safety devices on sharp
medical devices
• sharps containers
• hand washing facilities
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36. It is a necessity to wash hands
when
• In prolonged contact with patient.
• Before taking care of Immune supressed,New born infants,
patients in ICU / ICCU, Dialysis Units, Burn’s Units.
Before and after touching wounds.
• When Microbial contamination of Hands, likely to occur
when in contact with mucous membranes, body fluids, and
other secretions contaminated with
• Blood, and serous fluids

37. We made a Progress
but not adequate
• Although healthcare
facilities and infection
control experts have made
significant progress in
preventing some types of
infections, there is still a
great deal of work to do
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38. India at a Glance
WHAT IS MORE RISKY
OUR LIVING OR HOSPITALS
• Population:
1,314,097,616
• Per capita income: $5,760
• Life expectancy at birth
women/men: 69/68 yrs
• Infant mortality rate:
42/1,000 live births
5/1/2018
Dr.T.V.Rao MD 38

39. Components of Infection control and
Biosecurity tools
• Routine practices essential
to infection control such as
aseptic techniques, use of
single use devices,
reprocessing of
instruments and
equipment, antibiotic usage,
management of blood/body
fluid exposure, handling and
use of blood and blood
products, sound
management of medical
waste;
11/25/2023 Dr.T.V.Rao MD @Education in infection control- 39

40. Promoting a collaborative approach to
protecting the safety of clients and staff,
• The Infection Prevention
and Control Standards
contain the following
sections:
• Planning and Developing
the IPC Program
• Implementing the IPC
Program
• Evaluating the Impact of
the IPC Program
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41. PATIENT SAFETY IS THE TOPIC
PRIORITY
•Surveillance of
healthcare associated
infections and infection
prevention and control
programmes not only
help tackle AMR but also
contribute to overall
patient safety.
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42. Infection Control a Top Priority
•What is the key to
improving hand hygiene
and other infection-
control practices in long-
term care homes? it’s
“education,
education,
education.”
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43. PATIENT SAFETY IS THE GRWOING
RESPONSIBILITY EVERY ORGANIZION
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44. OUR GOAL TO ACHIEVE THE
SAFETY
•Working safely is
important for your
own protection as
well as the protection
of fellow employees,
hospital staff,
patients, and visitors.

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47. Health care workers are at great risk
think how many doctors nurses and paramedics died with
CoVid 19
• Health care workers (HCWs) are
among those at highest risk of
occupational biohazards, as
they are exposed to human
body fluids daily. They are
exposed to blood-borne
infections by pathogens, such as
human immunodeficiency virus
(HIV), hepatitis B (HBV), and
hepatitis C (HCV) and other
blood-borne pathogens
• More alarming Covid 19

48. Needle stick injuries
• Needle stick and sharps injuries
(NSSIs) have been one of the
major issues in theprotection of
health care workers, and
vigorous preventive action
hasbeen practiced worldwide in
recent decades. NSSIs are an
important occupational hazard
in health care, and the
distribution of riskdoes not
occur at random .

49. Dealing with Needle stick
Injuries
• Consider all Needle stick injuries as a serious health hazard in the
era of AIDS
• All events of Needle stick injuries to be reported to the supervisory
staff. Wash the injured areas with soap and water.
• Encourage bleeding if any.
• Prophylaxis for prevention of HIV/HBV is top priority.
• Anti retroviral prophylaxis, if necessary should
started within 2 hours, ( if injury is from HIV positive or high risk
group)

50. HOW YOU PROTECT WHEN YOU ARE
DEALING WITH BIOHAZARD MATERIALS
• Special precautions have to be followed when dealing with
materials contaminated with blood or other bodily fluids
• Blood or other bodily fluids may contain disease causing
micro-organisms (pathogens) that can be transmitted to
others that come in direct contact.
• The Blood borne pathogens act was implemented to
protect workers from potentially infectious diseases
contracted from contaminated blood or other bodily fluids.
• Examples of Blood borne pathogens:
Hepatitis B Virus HIV-1 Virus (AIDS Virus)

51. Training Health care
professionals in Biosafety
• Providing statutory and
mandatory training is a key
investment of healthcare
employers, and despite
budget constraints and time
concerns, it can play a
crucial role in ensuring a
high level of care to
patients.

52. Mandatory training a good
investment
• Mandatory training is that
determined essential by an
organization for the safe and
efficient running in order to
reduce organizational risks and
comply with policies,
government guidelines. For the
purposes of this article, we will
be using mandatory training as
the catch all phrase throughout.

53. Role of the Microbiology
Laboratory in Infection Control
• Specimen Collection????
• Accurate Identification and Susceptibility Testing
• Laboratory Information Systems
• Rapid Diagnostic Testing
• Reporting of Laboratory Data
• Outbreak Recognition and Investigations-Molecular
• Typing
• Organism Storage
• Cultures of Specimens from Hospital Personnel and the
Environment MRSA and Settle plates

54. Infection Control Current issues
•Shift toward focused
surveillance
ICUs
Devices
Antimicrobial
resistance
Control strategies are
more proactive
Active intervention
Control of resistance
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55. Critical concerns with Dressing rooms
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56. Reliable Data Created with Optimal surveillance is the
greatest component of Biosecurity for effective decisions
• The main purpose of
conducting routine
surveillance of healthcare
associated infections is to
provide data that can lead to
the implementation of
effective prevention
strategies to reduce the
incidence of drug resistant
infections
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57. Ethics and Research in
Biosecurity
• Healthcare Ethics and
Training: Concepts,
Methodologies, Tools, and
Applications is a
comprehensive source of
academic research material
on methods and techniques
for implementing ethical
standards and effective
education initiatives in clinical
settings.

58. HAND HYGINE SAVES MANY LIVES THAN MANY OTHER
METHODS
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59. Hospital Waste
Management
• Effective work
practices and
procedures, such as
environmental
management practices
including management
of hospital/clinical
waste, support services
(e.g., food, linen), use of
therapeutic devices;
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60. BIOSECURITY COOPERTATION
OF EVERYONE
•The future
Biosecurity requires
the cooperation of
scientists,
technicians, policy
makers, security
engineers, and law
enforcement officials]

61. Biosecurity threats Newer
challenges in be Bioterrorism
• The emerging nature of newer
biosecurity threats means that
small-scale risks can blow up
rapidly, which makes the
development of an effective policy
challenging owing to the
limitations on time and resources
available for analyzing threats and
estimating the likelihood of their
occurrence

62. Policy Implementation in
Biosecurity
• Some uncertainties about
the policy implementation
for biosecurity remain for
future. In order to carefully
plan out preventive policies,
policy makers need to be
able to somewhat predict
the probability and assess
the risks;

63. Worlds great challenge with Covid19
opened the Pandora box of our
preparedness
• The Covid-19 pandemic
has thrown open
multiple issues that
question the
preparedness of not just
India, but the world as
such to fight challenges
like the one we are faced
with, today.

64. National Biosafety and
Biosecurity
•National biosafety and bio-waste activities
are governed by legislation through state
health ministries and environment
ministries (Pollution Control Boards).
Under the Integrated Disease Surveillance
Programme, a network of public
laboratories with biosafety practices and
infrastructure is being set up.

65. •Biosecurity has sadly
remained a stepbrother
of Biosafety.

66. COVID 19 TEACHING THE
IMPORTANCE OF BIOSECURITY
The crisis should serve as a reminder of the
importance of the doctrine of universal bio-
deterrence. India, for its part, should
strengthen its biosecurity system while
mobilizing international cooperation to
strengthen international biosecurity

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68. Thank you all Ominicuris and all the
Professionals involved in Health care