Healthcare associated infections (HAI) are infections acquired during medical care in hospitals or other healthcare facilities. Some key points: - HAI affect around 10% of hospital patients and costs are doubled compared to patients without infections. Common sites of infection include urinary, surgical and pneumonia. - Risk factors for HAI include crowded hospital conditions, patients with compromised immune systems, increasing antibiotic resistance in bacteria. Procedures like catheterization and ventilation also increase risk. - HAI can be prevented through proper hand hygiene, sterilization of equipment, isolation of infected patients, and avoiding unnecessary medical procedures. Surveillance by infection control teams is also important to reduce infection rates.

1. HEALTHCARE
ASSOCIATED
INFECTION (HAI)

2. HEALTHCARE ASSOCIATED
INFECTION (HAI)
2
Also known as Nosocomial infection /
/Hospital acquired infection
/ Hospital associated infection
Also occupational infections among staff
For patients : Infections that first
appear 48hrs or more after hospital
admission or within 30 days after
discharge.

3. Some Statistics for HAI:
Affects ~ 10% of all in-patients
Delays discharge
Costs 2 x more than if there is
no infection
Show increasing
trend among patients
and staff
3

4. 4
Crowded hospital conditions
New microorganism
Increasing people with
compromised immune system
Increasing Bacterial resistance
(MRSA,resistant Gram negatives)
HAI reducible by 10-
30%
RISE IN HAI AS A RESULT OF 4 FACTORS

5. HAI - EPIDEMIOLOGY
5
Can be exogenous (external organism) and
endogenous (opportunist normal flora)
Host susceptibility : important factor in
development of HAI
MEDICAL EQUIPMENTS AND
PROCEDURES (surgery) are often responsible
for infections

6. HAI :Mode of Transmission
 Contact/hand borne (most common)
 Air borne

 Oral route
 Parenteral route
 Vector borne
6

7. 1. Contact (most common)
Direct (physical contact)
◦ eg when a staff turns a
patient, gives patient a
bath , examination of
patient
7

8. 8
Indirect-contact Transmission
Involves contact of a host with a contaminated
intermediate object ， eg:
 Contaminated instruments / needles/dressings
 Contaminated gloves that are not changed
between patient.
 Contaminated surface by needles (Jarum diletak
atas permukaan selepas ambil darah ! ）》》》
 Dried blood can transmit HEPATITIS B/C

9. 9
RISIKO HAI
Hep B virus can live outside d body
at least 7 days
Hep C virus can live outside d body
for 16h - 4 days

10. 10
2.VECTOR TRANSMISSION
Transmitted through insects
eg mosquitoes and fleas.
( eg Denggi)
3.AIR BORNE TRANSMISSION
Tiny droplet nuclei that
remain suspended in air.
（ Eg TB)

11. 11
4.DROPLET TRANSMISSION
Droplet generated by sneezing,
coughing or respiratory tract
procedures eg suction
EX : Influenza,TB

12. AGENTS OF HA INFECTIONS
12
VIRUS
BACTERIA
FUNGI

13. Hospital Procedure Pose Many
Risks to HAI
Nebuliser mask
Catheterization
IV Procedure
Dressing
Bedpans
Urinals
Dirty couch etc.
13

14. Predisposing Factors fOR
HAI
Age （ Young children ，
Elderly ）
Severity of Illness
Medical conditions
Immuno compromised
Malnutrition
Obesity
14

15. COMMON SITES OF HAI
 Patients in Labour Room / ICU
 Patients undergoing invasive
procedures /operation.
 Areas of hospital with poor ventilation
15

16. 5 COMMON TYPES OF HAI
1. Urinary Tract Infections (UTI)
2. Surgical Wounds Infections (SWI)
3. Pneumonia
4. Skin
5. Blood stream infection/
Bacteremia
 Staff : URTI/ Conjunctivitis
/Pertussis/TB etc
16

17. COMMON SITES OF INFECTION
17

19. URINARYTRACT INFECTIONS
19
Most common cause of HAI
80% of UTI are associated
with indwelling catheters.

20. SURGICAL SITE INFECTIONS
20
Frequent
Definition is mainly clinical
(purulent discharge around wounds
or at insertion site of drain, or
spreading cellulites from wounds)
The infections can be exogenously
or endogenously

21. NOSOCOMIAL PNEUMONIA
21
Most important are patients
on ventilators in ICU.
Recent and progressive
radiological opacities of
pulmonary parenchyma,
purulent sputum and recent onset
fever.

22. PREVENTION & CONTROL OF HAI
1. Observance of aseptic technique
2. FREQUENT HAND WASHING
esp. between patients
3. Cleaning, and disinfection of
linen and furniture etc)
22

23. 23
PPE:Wear Gloves
For two reasons:
Provide a protective barrier
and prevent contamination of
hands
Reduce likelihood that
microorganism present on
hands will be transmitted
to patients during procedure.

24. 3.

25. HAND HYGIENETO PREVENT HAI
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 You can get 100s to 1000s of bacteria on your
hands by doing simple tasks like:Assisting pt
up in bed /Touching pt’s gown or bed sheets
HandWashing is Important Because…
80% of disease is spread by your hands.
Hand Hygiene : single most effective
intervention to reduce the cross
transmission of HAI

26. PREVENTION & CONTROL OF HAI
4. Sterilization of instrument eg
nebulizer/oxygen mask/Use of
single-use disposable items
5. Patient isolation eg Pertussis/TB
etc
6. Avoidance of medical
procedures that can lead to HAI
( eg. urinary catheter)
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27. HAI :What is most Important
 Effective surveillance and
action by infection control
team to reduce infection
rates.
 Important role of team :
monitor compliance and
practices to prevent HAI

28. EXAMPLE OF HAI
TB in HCW
28

29. HCW - TB Cases & Notification Rate, Malaysia 2003-
2014
Control & Prevention Measures of TB among HCWs
Risk for TB among HCWs is consistently higher than
general population worldwide (Joshi, 2006)
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30. ii. ADMINISTRATIVE CONTROL
• Periodic TB Screening for HCWs
Control & Prevention Measures of TB among HCWs
30

31. iii. PPE
• N95 (respirator) must be used in high risk TB
areas
 TB ward, chest clinic
 Isolation room
 Procedure room
eg. sputum induction room
• HCW to use N95
• Patient to use Surgical Mask
Control & Prevention Measures of TB among HCWs
31

32. Control & Prevention Measures of TB among HCWs
Conclusion
In addition to having TB guidelines with
environmental / engineering;
administrative; and respiratory-
protection controls;
HCWs must change their behaviour
towards healthy and safer work culture
in order to prevent & control TB at the
workplace.
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33. Thank YouThank You33