Hospital acquired infections

1. HOSPITAL
ACQUIRED
INFECTION
& its prevention
By Dr.Sara ( PG 1’st Year, SIMS)

2. Content
○Hospital acquired infections
○Sources of infection
○Routes of spread
○Hospital Infection Prevention and Control Guidelines
○Universal and standard precautions

3. Hospital acquired infections (HAI)
○HAI are infections acquired during hospital care which
are not present or incubating at admission.
○Infections occurring more than 48 hours after admission
are usually considered nosocomial.

4. Hospital acquired infections (HAI)
○An infection acquired in hospital by a patient who was
admitted for a reason other than that infection.
○An infection occurring in a patient in a hospital or other
healthcare facility in whom the infection was not present
or incubating at the time of admission.
○This includes infections acquired in the hospital but
appearing after discharge, and also occupational
infections among staff of the facility

5. HAI - burden
○HAI occur worldwide and affect both developed and
resource-poor countries.
○Over 1.4 million people worldwide suffer from such
infectious
○Most frequent of these are:
 infections of surgical wounds
 urinary tract infections
 lower respiratory tract infections

6. Why do patients in hospital acquire
infection?
○Patients with infectious diseases are frequently admitted
to hospital.
○Some of these patients are able to spread their
organisms to other patients and they provide one source
of infection in hospital patients admitted for other causes

7. Why do patients in hospital acquire
infection?
○When such patients require admission to hospital, the
risk has to be assessed for other patients.
○Appropriate measures have to be taken to contain the
infection with isolation procedures of varying degrees of
strictness depending on the infection

8. Why do patients in hospital acquire
infection?
○ The commonest forms of HAI are due to invasive
procedures carried out on patients such as:
 surgical operations
 intravenous therapy
 intubation
 catheterization

9. Why do patients in hospital acquire
infection?
○Immunodeficiency of varying degrees is seen in many of
the patients admitted to hospital. These include:
 patients at the extremes of age
 patients with diabetes
 receiving immunosuppressive drugs
 patients with cancer, in particular those undergoing
chemotherapy
These patients are prone to infection with bacteria which
have little threat for healthy persons.

10. Chain of
infection
There are six
elements in the cycle
of infection, and all six
must be present
before the
transmission of
infection can take
place.

11. Chain of
infection

12. Sources of infection in the hospital
Other
patients
Visitors
Water /
food
Air
Surgical
procedu
res
Hospital
persons
Devices,
drains
and
catheter
Fomite
contami
nation
Pt’s
normal
flora

13. Sources of infection in the hospital
Exogenous source
○ Other patients (cross-infection)
○ Health care workers
○ Inanimate objects (fomites) vehicle
○ Inanimate environment of the hospital:
 Contaminated air, water, food
 Contaminated equipment and instruments
 Soiled linen
 Hospital waste (Biomedical waste)

14. Sources of infection in the hospital
Endogenous sources
○ source is the normal intestinal flora or colonizers of skin
and other epithelial surfaces

15. Routes of
infection in the
hospital
○IV line

16. Routes of
infection in the
hospital
Catheter

17. Common infections in ICU

18. Common
pathogens
in
ICU

19. Prevention of HAI

20. Universal/Standard Precautions
for Infection Control
1. Hand hygiene
2. Personnel protective equipment
3. Safe handling and disposal of sharps
4. Follow needle stick injury protocol
5. Safe handling and disposal of wastes
6. Managing blood and body fluids
7. Disinfection of equipment
8. Environmental disinfection
9. Immunization
10.Isolation

21. Hand hygiene: hand washing technique

23. Personal Protective equipment
Must be used whenever high risk patient is being handled
 Gloves
 Disposable plastic Apron
 Masks.
 Eye protection

24. Safe handling and
disposal of sharps
The main hazards of a sharps injury are:
 Hepatitis B,
 Hepatitis C,
 HIV.
Ensure that:
 Sharps are not passed from hand to hand.
 Needles are not broken or bent before use.
 Sharps are disposed of at the point of use.
 Sharp containers are not filled more than two third.
 Staff are aware of inoculation injury policy.

25. Follow needle stick
injury protocol
1. Irrigate mucous membranes by washing under running
water
2. Do not suck/ Squeeze the injury site
3. Wash with soap and water
4. Apply antiseptic lotion to the injury site.
5. Contact emergency room-medical officer for
management
6. Complete the incident report & inform to ICN

26. Safe handling and disposal of waste
 Segregate the waste at source.
 Know the policies and protocols of the state.
 Safe disposal.
 Safe handling of spillage.

28. Managing blood and bodily fluids
○Handle specimens safely: Collection → Labeling → Transfer
○Dealing with spillage:
 Small spill/ spotted Spill
 Large Spill

29. Managing blood and
bodily fluids
Management of small spill:
 Wear gloves and eye protection
 Contamination should be wiped up with paper towels
soaked in freshly prepared Hypochlorite solution (1%)
 If broken glasses are present, first treat the spillage
with Hypochlorite, then carefully remove the glass
piece with disposable forceps and wipe it up
 Towel and glasses should be disposed off in a yellow
clinical waste bag for Incineration
 Wash hands.

30. Managing blood and
bodily fluids
Management of large spill:
 Mark that area as large spill
 Wear PPE
 Liquid spill should be covered up with Hypochlorite
solution and left for 2 min.
 Use absorbent to absorb
 Wipe that with water and detergent
 Allow that to dry
 Put all the towels, gloves to yellow bin for incineration

31. Infection control checklist
1. Have you washed your hands?
2. Do you need to use personal protective equipment?
3. Are you preventing sharp injuries?
4. Are you disposing off waste safely?
5. Do you deal promptly with spillages?
6. Do you thoroughly decontaminate equipment?
7. Are you maintaining a clean environment?
8. Do you know what to do in the event of an accident?
9. Do you know your workplace's procedures?

32. GET INVOLVED
AND
HOSPITAL
ACQUIRED
INFECTIONS