The document discusses hospital acquired infections, also known as nosocomial infections. It defines nosocomial infections as infections acquired during or after hospitalization. It discusses the epidemiological interaction between host factors, infectious agents, and the hospital environment. It also summarizes common bacterial, viral, and fungal agents that cause nosocomial infections and how they are transmitted. Prevention and control methods like isolation precautions, hand hygiene, and surveillance programs are also outlined.
1. Aarti Sareen
MSPT Honours I
Roll No. 8
HOSPITAL ACQUIRED INFECTIONS
2. Hospital acquired infection is also
called Nosocomial infection or
Healthcare-associated infections.
"nosus" = disease
"komeion" = to take care of
Nosocomial infections can be defined
as infection acquired by the person
in the hospital, manifestation of
which may occur during
hospitalization or after discharge
from hospital. The person may be a
patient, members of the hospital
staff and/ or visitors.
3.
4. EPIDEMIOLOGICAL INTERACTION
HOST FACTORS
Suppresed immune system due to Age, Poor
nutritional status, severity of underlying
disease, complicated diagnostic & therapeutic
procedure,therapeutic,
NCI
THE ENVIRNOMNET
Everything that surrounds the patient
THE AGENT
in the hospital is his environment.
Varieties of organisms
Other patients
Institutional and human Hospital staff and visitors
Eatables
Reservoirs & their virulence Dust and other contaminated articles
5. SOURCE OF INFECTION
Exogenous/indirect
Endogenous/direct: Caused by organisms acquiring by
exposure to hospital personnel, medical
Caused by the devices or hospital environment, cross-
infection from medical personnel
organisms that are • hospital environment- inanimate
objects
present as part of – air
normal flora of the – dust
– IV fluids & catheters
patient – washbowls
– bedpans
– endoscopes
– ventilators & respiratory equipment
– water, disinfectants etc
14. TYPES OF INFECTIONS
– Urinary tract infections (UTI)
– Surgical wound infections (SWI)
– Lower respiratory infections
– Traumatic wounds and burns infections
– Primary bacteraemia
– Gastrointestinal tract
– Central nervous system
15. Major Types of Nosocomial Infections
35
30
25
UTI
20 Pneumonia
15 SWI
Bloodstream
10 Other
5
0 Richards, MJ. 1999.
Overall ICU Crit Care Med 27; 887.
20. The hands are the most important
vehicle of transmission of
HCAI
21. Why
Don’t Staff Wash
their Hands
(Compliance estimated at less than 50%)
22. Why Not?
• Skin irritation
• Inaccessible hand washing facilities
• Wearing gloves
• Too busy
• Lack of appropriate staff
• Being a physician
(“Improving Compliance with Hand Hygiene in Hospitals” Didier Pittet. Infection
Control and Hospital Epidemiology. Vol. 21 No. 6 Page 381)
23. Hand Hygiene Techniques
1. Alcohol hand rub
2. Routine hand wash 10-15 seconds
3. Aseptic procedures 1 minute
4. Surgical wash 3-5 minutes
29. Why surveillance?
• NCI cause of morbidity and mortality
• One third may be preventable
• Surveillance = key factor
– an infection control measure
– overview of the burden and distribution of NCI
– allocate preventive resources
• Surveillance is cost-efficient!!
30. Objectives
• Reducing infection rates
• Establishing endemic baseline rates
• Identifying outbreaks
• Identifying risk factors
• Persuading medical personnel
• Evaluate control measures
• Satisfying regulators
• Document quality of care
• Compare hospitals’ NCI rates
31. The surveillance loop
Health care Surveillance centre
system
Reporting
Event Data
interpretation
Analysis,
Action Information
Feedback,
recommendations
32. Considerations when creating a
surveillance system
• Goal of the surveillance system (why)
• Engage the stakeholders (who)
• Surveillance method (what, how, when)
– definition
– what to collect
– how to collect (operation of system)
• Available resources
34. Stakeholders
Central
adm. Local
…..
adm.
Public
Health ICP
instituteI
It-
Directorat
Surveillance of dep.
surgical site infections
Ministry Surgical
Of health wards
Service Surgical
dep. ward. 2
Lab Patients
37. Goals for infection control and hospital
epidemiology
There are three principal goals for hospital infection
control and prevention programs:
1. Protect the patients
2. Protect the health care workers, visitors, and others
in the healthcare environment.
3. Accomplish the previous two goals in a cost
effective and cost efficient manner, whenever
possible.
.
39. Prevention & control of nosocomial
infections
– observance of aseptic technique
– frequent hand washing especially between
patients
– careful handling, cleaning, and disinfection of
fomites
– where possible use of single-use disposable
items
– patient isolation
– avoidance where possible of medical procedures
that can lead with high probability to nosocomial
infection (urinary catheter)
40. Prevention & control of nosocomial infections
(cont.)
– Various institutional methods such as air filtration
within the hospital
– Appropriate isolation precautions to protect
patients, visitors, and HCWs.
– Surveillance for common infections, monitoring of
high risk patients, and hospital area to identify
outbreaks, document incidence and prevalence
rate of specific infections and set goal for
improvement.
41. Uttermost care should be taken in following
services:
• House keeping
• Dietary services
• Linen and laundry
• Central sterile supply department
• Nursing care
• Waste disposal
• Antibiotic policy
• Hygiene and sanitation
42. Isolation & barrier precautions
Decontamination of equipment
Prudent use of antibiotics
Hand washing
Decontamination of environment
The 5 pillars of infection control
44. Infection control Committee (ICC):
The hospital ICC is charged with the
responsibility for the planning, evaluation of
evidenced-based practice and
implementation, prioritization and resource
allocation of all matters relating to infection
control.
46. Role of infection control teams
• Education and training
• Development and dissemination of
infection control policy
• Monitoring and audit of hygiene
• Clinical audit