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P4 INFECTION CONTROL HOUSEMANSHIP MALAYSIA
- 1. INFECTION PREVENTION & CONTROL Patient Safety Unit Quality in Medical Care Section Ministry of Health Malaysia @ Secretariat, Patient Safety Council Malaysia In Collaboration with : Patient Safety Module Technical Committee 1
- 2. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL PART 1: INFECTION PREVENTION & CONTROL Healthcare Associated Infection (HCAI) Cause of Infection and Transmission Route Hand Hygiene Standard Precaution Transmission Based Precaution Needle Stick Injury HCAI Preventive Bundle 2
- 3. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL OBJECTIVES 3 Demonstrate the devastating effects of inadequate infection prevention & control in health-care settings Apply required knowledge in preventing and/or minimizing infection Perform appropriate behaviors required to prevent health care associated infections
- 4. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL Definition of Health Care Associated Infection (HCAI) This includes infections that are acquired in the hospital, but appear only after discharge, as well as occupational infections among health-care staff 4 What it is HCAI? Infection acquired in a hospital by a patient who was admitted for a reason other than that infection and/or infection occurring in a patient in a hospital or other facility in whom the infection was not (latently) present at admission.
- 5. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 5 Impact of Healthcare Associated Infection
- 6. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL MOST FREQUENT SITES OF INFECTION AND THEIR RISK FACTORS (Distribution based on MOH data) PNEUMONIA Mechanical ventilation, Aspiration and Nasogastric tube Central nervous system depressants Antibiotics and anti-acids Prolonged health-care facilities stay Malnutrition Advanced age Surgery Immunodeficiency 37% BLOOD STREAM INFECTIONS Vascular catheter Neonatal age Critical care Severe underlying disease Neutropenia Immunodeficiency New invasive technologies Lack of training and supervision 30% SURGICAL SITE INFECTIONS Inadequate antibiotic prophylaxis Incorrect surgical skin preparation Inappropriate wound care Surgical intervention duration Type of wound Poor surgical asepsis Diabetes Nutritional state Immunodeficiency Lack of training and supervision 17% URINARY TRACT INFECTIONS Urinary catheter Urinary invasive procedures Advanced age Severe underlying disease Urolitiasis Pregnancy Diabetes 7% LACK OF HAND HYGIENE 6
- 7. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL Direct contact transmission Indirect transmission Droplet transmission Airborne transmission Percutaneous exposure CAUSES OF INFECTION AND TRANSMISSION ROUTE 7
- 8. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 5 WAYS TO PREVENT HCAI 8 Hand Hygiene •Hand washing •Hand rubbing PPEs •Gloves •Goggle/ Face Shield •Gown & Mask Sterilization/ disinfection of equipment, devices & instruments ‘Single use’ medical devicesEnvironmental Cleanliness •increased levels of cleaning during outbreaks
- 9. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL THE “MY 5 MOMENTS FOR HAND HYGIENE” APPROACH 9
- 10. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 10
- 11. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 11
- 12. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL STANDARD PRECAUTIONS • Set of infection control practices used to prevent transmission of diseases that can be acquired bt contact with blood, body fluids, non-intact skin (including rashes) , and mucous membranes. •Meant to reduce risk of transmission of bloodborne and other pathogens from both recognized and unrecognized sources. 12
- 13. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 13 ELEMENT OF STANDARD PRECAUTIONS Hand hygiene Wearing gloves Wearing gown or apron Mask, eye protection and face shield Waste Management 1 2 3 4 5
- 14. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 14 ELEMENT OF STANDARD PRECAUTIONS Needles and other sharps Respiratory hygiene Patient care equipment Linen Management Management of spills 6 7 8 9 10
- 15. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL TRANSMISSION-BASED PRECAUTIONS •When treating patients who are known or suspected of being infected or colonized with infectious agents. •Applied according to the clinical syndrome and the likely etiologic agents, and then modified based on test results. •These precaution are to be implemented in conjunction with standard precaution 15
- 16. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 16 • Herpes Zoster • Measles • Mycobacterium Tuberculosis • Varicella Pneumonia TYPE OF TRANSMISSION-BASED PRECAUTIONS 1
- 17. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 17 •Diphtheria - Pharyngeal •Epiglotittis -Haemophilus Influenza •Meningitis (haemophilus influenza, meningococcal, fungal) •Pneumonia •Mumps •Influenza •MersCoV TYPE OF TRANSMISSION-BASED PRECAUTIONS 2
- 18. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 18 TYPE OF TRANSMISSION-BASED PRECAUTIONS 3 •Herpes Simplex •Herpes Zoster •Methycillin-Resistance Staphylococcus Aureus (MRSA) •Extended Spectrum Beta Lactamase (ESBL) •Carbapenem Resistance Enterobacteriaceae (CRE) •Streptococcal Disease – skin, wound, burns •Typhoid (Salmonella Typhii) •Varicella Zoster
- 19. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 19 Role of Junior Doctors Be immunized against Hepatitis B Practice standard precaution including Hand Hygiene Act as role model for good clinical practice and patient safety and encourage others to use appropriate precautions Take appropriate precaution when you are ill to avoid infecting patients/ contaminating environment 1 2 3 4
- 20. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL 20 Know What To Do After Needle Stick/Sharp/Splash Injury Wash the injury site under running water DO NOT SQUEEZE – causing hyperaemia and inflammation If splash injury from body fluids or blood to wash under running water (i.e eyes, nostrils, eczematous skin 5
- 21. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL HCAI PREVENTIVE CARE BUNDLE 21 Ventilator Associated Pneumonia Care Bundle Catheter Associated UTI Care Bundle Surgical Site Infection Care Bundle Central Venous Catheter Care Bundle
- 22. PATIENT SAFETY UNIT MEDICAL CARE QUALITY SECTION MEDICAL DEVELOPMENT DIVISION ADOPTED FROM THE WHO PATIENT SAFETY CURRICULUM GUIDE (MULTIPROFESSIONAL ACKNOWLEDGEMENT • DR SURAYA AMIR HUSIN • DR ISMALIZA ISMAIL • DR SYAMHANIN ADNAN • DR AFAF AZIZAN • MATRON SUHAILY OTHMAN 22