Hand Hygiene and Prevention of Infections in icu care

1. Hand Hygiene and
Prevention of Infections
in
icu care
DR.T.V.RAO MD
Dr.T.V.RaoMD
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2. Health care Associated
Infections
 Healthcare-associated infections
affect 1.4 million patients at any
time worldwide, as estimated by
the World Health Organization. In
intensive care units, the burden of
healthcare-associated infections is
greatly increased, causing
additional morbidity and
mortality.
Dr.T.V.Rao MD
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3. Multi Drug Resistant Microbes can be reduced
with Hand hygiene
 Multidrug-resistant pathogens
are commonly involved in such
infections and render effective
treatment challenging. Proper
hand hygiene is the single most
important, simplest, and least
expensive means of preventing
healthcare-associated infections
Dr.T.V.Rao MD
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4. CDC Says
 According to the Centers for Disease Control and Prevention and
World Health Organization guidelines on hand hygiene in health
care, alcohol-based hand rub should be used as the preferred
means for routine hand antisepsis. Alcohols have excellent in vitro
activity against Gram-positive and Gram-negative bacteria,
including multidrug-resistant pathogens, such as methicillin-
resistant Staphylococcus aureus and vancomycin-resistant
enterococci
Dr.T.V.Rao MD
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5. Our Hands are always
Contaminated with
Microbes
Dr.T.V.Rao MD
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6. OPTIMAL HAND HYGEINE
 Correct hand hygiene includes
washing hands with soap and
water or using alcohol-based
hand sanitizers (preferred).
Hand hygiene procedures
should be performed before and
after any and all direct patient
contact – even when gloves are
used.
Dr.T.V.Rao MD
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7. OPTIMAL HAND HYGEINE
 Direct patient contact includes:
examination of patient, specimen
collection, and all procedures. Hands
should be cleaned before and after
contact with the patient’s immediate
environment or medical equipment.
Hand hygiene practices should be
performed before and after eating,
sneezing, coughing, and using the
restroom.
Dr.T.V.Rao MD
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8. Every bed should have
 Every bed should have
attached alcohol based anti-
microbial instant hand wash
solution source, which is used
before caregiver
(doctor/Nurse/relative/Param
edical) handles the patient
Dr.T.V.Rao MD
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9. Water basin
 Water basin at all bedside
has not proven popular and
successful because of poor
compliance by one and all
and also for reasons of
space constraints and
maintenance issues.
Dr.T.V.Rao MD
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10. An operation room style sink
 An operation room style sink
with Elbow or foot operated
water supply system with
running hot and cold water
supply with antiseptic soap
solution source should be there
at a point easily accessible and
unavoidable point, where two
people can wash hands at a
time
Dr.T.V.Rao MD
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11. How you enter a ICU
 All entrants (Irrespective
of Doctors or nurses
should don mask and
cap in ICU and ideally
an apron which should
be replaced daily)
Dr.T.V.Rao MD
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12. No dirty/soiled linen
 No dirty/soiled linen/material
should be allowed to stay in
ICU for long times for fear of
spread of bad odour, infection
and should be disposed off as
fast as possible. Dirty linen
should be replace regularly at
fixed intervals.
Dr.T.V.Rao MD
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13. All surrounding to be clean
All surroundings of
ICU should be kept
absolutely clean and
green if possible for
obvious reasons
Dr.T.V.Rao MD
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14. Care of the Catheters
 While the epidemiology of catheter infections is well described
in western literature, data from Indian hospitals is scarce.
Though one study of intermediate-term central catheters in
children reports rates of catheter associated bloodstream
infection of 1.3/1000 catheter days. The definitions of catheter
infections are very variable in the published studies and need
to be standardised
Dr.T.V.Rao MD
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15. Catheters as source of
Infection
The high frequency of fungal
colonisation of catheter tips
and candidemia (about 45%)
in a paediatric study is also
unusual and requires further
evaluation.
Dr.T.V.Rao MD
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16. Surveillance of Catheter associated
Infections
 All Institutions and
intensive care units
should measure CABSI
rates (A) 2. For purposes
of surveillance all BSIs
count as CABSI
Dr.T.V.Rao MD
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17. Indication for culturing Blood
 Blood cultures are to be
drawn only when BSI is
clinically suspected (and
preferably before antibiotics
are started) (A) Routine
cultures of vascular catheter
tips are not recommended
Dr.T.V.Rao MD
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18. Implementation of Standard Operating
procedures
 Standard methodology
for blood culture,
vascular catheter-tip
culture and calculation
of CABSI rates are
encouraged
Dr.T.V.Rao MD
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19. Hand washing a great
priority
 Practical approaches to promote
hand hygiene in the intensive
care unit include provision of a
minimal number of hand rub
dispensers per bed, monitoring
of compliance, and choice of the
most attractive product. Lack of
knowledge of guidelines for
hand hygiene,
Dr.T.V.Rao MD
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20. Increased use of Alcohol in
Health care
 Multidisciplinary programs to
promote increased use of
alcoholic hand rub lead to an
increased compliance of
healthcare workers with the
recommended hand hygiene
practices and a reduced
prevalence of nosocomial
infections.
Dr.T.V.Rao MD
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21. Give everyone a
Clean Hand
Dr.T.V.Rao MD
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22. Program file Created by Dr.T.V.Rao
MD for Medical and Paramedical
Professionals for improving the
health care in Intensive care Units
 Email
doctortvrao@gmail.com
Dr.T.V.Rao MD
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