2. Infection- Definition
• Definition: Infection is an invasion &
multiplication of pathogenic microorganisms
that occur in body tissues and result in
cellular injury
11. • Follow Standard precautions
• Transmission based precautions
• Formulate a infection control policy
• Form a hospital infection control committee
• Have a good surveillance programme
• Conduct training programmes
Infection prevention methods
12. • Elements:
- An infection control committee
- Surveillance of Nosocomial infection
- Employee health program
- Isolation policies
- Infection control in-service education
- Procedure for environment sanitation
- Microbiology laboratory
- Infection control procedures for client care
Infection control plan
13. STANDARD PRECAUTIONS
INTRODUCTION:
• Standard Precautions combine the major features
of Universal Precautions and Body Substance
Isolation and are based on the principle that all
blood, body fluids, secretions, excretions except
sweat, nonintact skin, and mucous membranes
may contain transmissible infectious agents.
Standard Precautions include a group of infection
prevention practices that apply to all patients,
regardless of suspected or confirmed infection
status, in any setting in which healthcare is
delivered.
14. • These include: hand hygiene; use of gloves,
gown, mask, eye protection, or face shield,
depending on the anticipated exposure; and safe
injection practices. Also, equipment or items in
the patient environment likely to have been
contaminated with infectious body fluids must be
handled in a manner to prevent transmission of
infectious agents (e.g., wear gloves for direct
contact, contain heavily soiled equipment,
properly clean and disinfect or sterilize reusable
equipment before use on another patient).
15. Standard Precautions and Infection Control
Measures:
Assume that every person is potentially infected
or colonized with an organism that could be
transmitted in the healthcare setting and apply
the following infection control practices during the
delivery of health care.
16. Personal Protective Equipment (PPE)
Observe the following principles of use:
• Wear PPE, when the nature of the anticipated
patient interaction indicates that contact with
blood or body fluids may occur.
• Prevent contamination of clothing and skin during
the process of removing PPE.
• Before leaving the patient's room or cubicle,
remove and discard PPE.
17. Infection control practices for special lumbar
puncture procedures
Wear a surgical mask when placing a catheter
or injecting material into the spinal canal or
subdural space (i.e., during myelograms, lumbar
puncture and spinal or epidural anesthesia.
Worker safety
• Adhere to federal and state requirements for
protection of healthcare personnel from exposure
to bloodborne pathogens
18. Textiles and laundry
• 1. Handle used textiles and fabrics with minimum
agitation to avoid contamination of air, surfaces
and persons.
• 2. If laundry chutes are used, ensure that they
are properly designed, maintained, and used in a
manner to minimize dispersion of aerosols from
contaminated laundry.
19. Gloves:
Wear gloves when it can be reasonably anticipated that
contact with blood or other potentially infectious
materials, mucous membranes, nonintact skin, or
potentially contaminated intact skin (e.g., of a patient
incontinent of stool or urine) could occur.
Wear gloves with fit and durability appropriate to the task.
• i. Wear disposable medical examination gloves for
providing direct patient care.
• ii. Wear disposable medical examination gloves or
reusable utility gloves for cleaning the environment or
medical equipment.
20. • Remove gloves after contact with a patient and/or
the surrounding environment (including medical
equipment) using proper technique to prevent
hand contamination. Do not wear the same pair
of gloves for the care of more than one patient.
Do not wash gloves for the purpose of reuse since
this practice has been associated with
transmission of pathogens.
• Change gloves during patient care if the hands
will move from a contaminated body-site (e.g.,
perineal area) to a clean body-site (e.g., face).
21. Mouth, Nose, Eye Protection
• Use PPE to protect the mucous membranes of the eyes, nose and
mouth during procedures and patient-care activities that are likely
to generate splashes or sprays of blood, body fluids, secretions
and excretions.
• Select masks, goggles, face shields, and combinations of each
according to the need anticipated by the task performed.
• During aerosol-generating procedures (e.g., bronchoscopy,
suctioning of the respiratory tract [if not using in-line suction
catheters], endotracheal intubation) in patients who are not
suspected of being infected with an agent for which respiratory
protection is otherwise recommended (e.g., M. tuberculosis, SARS
or hemorrhagic fever viruses), wear one of the following: a face
shield that fully covers the front and sides of the face, a mask with
attached shield, or a mask and goggles (in addition to gloves and
gown).
22. Safe Injection Practices
• The following recommendations apply to the use of
needles, cannulas that replace needles, and, where
applicable intravenous delivery systems
• Use aseptic technique to avoid contamination of sterile
injection equipment.
• Do not administer medications from a syringe to multiple
patients, even if the needle or cannula on the syringe is
changed. Needles, cannulas and syringes are sterile,
single-use items; they should not be reused for another
patient nor to access a medication or solution that might
be used for a subsequent patient.
23. • Use fluid infusion and administration sets (i.e.,
intravenous bags, tubing and connectors) for one
patient only and dispose appropriately after use.
Consider a syringe or needle/cannula
contaminated once it has been used to enter or
connect to a patient's intravenous infusion bag or
administration set
24. • Use single-dose vials for parenteral medications
whenever possible.
• Do not administer medications from single-dose
vials or ampules to multiple patients or combine
leftover contents for later use.
• If multidose vials must be used, both the needle
or cannula and syringe used to access the
multidose vial must be sterile
25. • Do not keep multidose vials in the immediate
patient treatment area and store in accordance
with the manufacturer's recommendations;
discard if sterility is compromised or questionable.
• Do not use bags or bottles of intravenous solution
as a common source of supply for multiple
patients.
26. • Standard precautions are a combination of Universal
Precaution and Body Substance Isolation
- All clients as potentially infected with blood borne
pathogens
- Standard precautions apply
(i) Blood
(ii) All body fluids secretions and excretions
(iii) Non intact skin and mucous membrane
Standard precautions-CDC
guidelines
27. It is the rubbing of all surfaces and crevices of the
hands using a soap or chemical and water
followed by rinsing in a flowing stream of water.
• Purposes
- Reduce the number of resident and transient
bacteria from the hands
- Prevent transfer of micro-organisms from the
client to health personnel and vice versa
Hand washing
28. • Routine hand washing
• Surgical hand washing
• Using alcoholic rub
Article required for hand
washing
- Soap/antimicrobial
chemicals
- Stream of water
- Autoclaved towels
Types of hand washing
29. • Remove all jewellary of the hands
• File nails short; avoid nail paints
• Turn on the warm water
• Wet hands under running water including arms and elbow
• Apply soap
• Rub palms, wrist and back of the hand firmly with circular
movement. Interlace interest fingers and thumbs, moving
hands back and forth. Continue using plenty of lather and
friction for 15 to 30 seconds on each hand (depends on
hospital policy and settings)
• Use nail brush to clean under finger nail
• Rinse hands and wrists thoroughly with water
• Dry hands with autoclaved towel
• Turn off the water
Procedure
30. Hand Hygiene
• 1. During the delivery of healthcare, avoid
unnecessary touching of surfaces in close
proximity to the patient to prevent both
contamination of clean hands from environmental
surfaces and transmission of pathogens from
contaminated hands to surfaces.
• 2. When hands are visibly dirty, contaminated with
visibly soiled with blood or body fluids, wash
hands with either a nonantimicrobial soap and
water or an antimicrobial soap and water.
31. • 3. If hands are not visibly soiled, or after
removing visible material with nonantimicrobial
soap and water, decontaminate hands. The
preferred method of hand decontamination is with
an alcohol-based hand rub. Alternatively, hands
may be washed with an antimicrobial soap and
water. Frequent use of alcohol-based hand rub
immediately following handwashing with
nonantimicrobial soap may increase the frequency
of dermatitis.
32. Cont…
• 4. Wash hands with non-antimicrobial soap and
water or with antimicrobial soap and water if
contact with spores (e.g., C. difficile or Bacillus
anthracis) is likely to have occurred.
• 5. Do not wear artificial fingernails or extenders if
duties include direct contact with patients at high
risk for infection and associated adverse outcomes
(e.g., those in ICUs or operating rooms).
33. Perform hand hygiene:
• Before having direct contact with patients.
• After contact with blood, body fluids or
excretions, mucous membranes, non intact skin,
or wound dressings.
• After contact with a patient's intact skin (e.g.,
when taking a pulse or blood pressure or lifting a
patient).
• If hands will be moving from a contaminated-
body site to a clean-body site during patient care.
• After removing gloves.
34. GLOVES: Use gloves when anticipating any contact
with clients blood or body fluids, non intact skin,
mucous membrane
• Each patients in interaction requires a clean pair of
gloves
• Change gloves between different tasks and
procedures
• Use gloves when health worker has non intact skin
• Removes the gloves before leaving the patients room
• Wear gloves while giving injection, handling lab
specimen, doing dressing
Personnel protective equipments
35. GOWNS
• Wear a gown, that is appropriate to the task, to protect skin and
prevent soiling or contamination of clothing during procedures and
patient-care activities when contact with blood, body fluids,
secretions, or excretions is anticipated.
i. Wear a gown for direct patient contact if the patient has
uncontained secretions or excretions.
ii. Remove gown and perform hand hygiene before leaving the
patient’s environment.
• Do not reuse gowns, even for repeated contacts with the same
patient.
• Routine donning of gowns upon entrance into a high risk unit
(e.g., ICU, NICU, HSCT unit) is not indicated.
36. • Mask prevent the wearer from inhaling large
particle aerosols which usually travel short
distances (about 3 feet) small particle nuclei
which remain suspended in the air
• Everyone who comes in contact with the client,
including visitors
• The client may be the only one to wear mask
outside the room
Mask
37. • In OT or nursery, mask
protects client from possible
Nosocomial infection
• Masks should be disposed
after used once
• If not in use should not hang
around the neck
Mask
39. • Eye protection
- Wear goggles or forehead shield to avoid
splash
- Use disposable goggles when caring for clients
in isolation
• Head caps
- To be prevent falling of hair in sterile areas
• Boots and Shoe Covers
- To be worn in areas like OT and ICU
40. Patient care equipment:
• Decontamination: It is the process by which all
reusable medical devices are made free of
microorganism all equipments used in the clinical
areas must be decontaminated without exception
• Dis-infection: It is the process by which
pathogenic microorganism in the inanimate
objects, with the exception of bacterial spores are
eliminated
Patients environment
41. • Isolation precautions are designed to reduce
transmission of microorganisms in hospitals.
Appropriate patient placement is a significant
component of isolation precautions.
• Types of isolation:
- Source isolation
- Cohort isolation
Isolation
42. Common disinfectants used in hospitals
Name/preparation Uses
Bacillocid
• 10% solution (4.5 lt tap water
+500 ml bacillocid)
• 2% solution (20 ml bacillocid
+1lt H2O))
For disinfection of floor + and
instruments
Bleaching powder
• 0.1% solution
• 1% solution (100 ml bleach in 1
lt H2O)
For routine disinfection and
carbonization
Carbolic acid
• 5% solution (5 ml carbolic +
100 ml H2O))
• 10% solution (10 ml
carbolic+100 H2O)
For carbonization of room, beds
floor etc.
43. Common disinfectants used in
hospitals
Name/preparation Uses
Savlon
• 5% solution (5 ml in 100 ml
distilled water)
• 2% solution (2 ml in 100 ml
distilled water )
For surgical dressing and
disinfecting thermometers
For perineal care
Formaline
• 40% solutions (30ml+ 90ml H2o
for 1000 cub feet double
fumigation for highly infected
area or 1:1)
For fumigation keep the OT care
for 30 mins, open the room after 6
hrs clean and wash the area
thoroughly
Korsolox
• 10% solution (dilute 1 part of
Korsolox 9 parts of water)
For emergency disinfection
immersion for 15 mts for sporicidal
activity (sterilization for 5 hours)
45. • Infectious waste:
- laboratory wastes
- Blood, blood products, all other body fluids
- Client care items
- Disposable instruments
- Medication and soiled items
- Surgical wastes
• Blood spillage: In case of blood spillage, pour 1%
sodium hypochlorite solution over the spill and wipe after
20 minutes
Disposal of infections material
46. • These precautions are classified as:
- Airborne precautions
- Droplet precautions
- Contact precautions
Transmission based precautions
47. • Follow the health care facilities policies for
handling the dead body
• Wrap the body while you are in the room
place it in a plastic zippered bag.
• Transfer the body to a cart that has been
draped with a clean bath blanket or sheet. A
clean person outside the room will wrap the
clean blanket around the body
Caring for body of a client on
isolation after death
48. • Decontaminate the room according to the
facility’s procedures.
• Wash your hands when leaving the room.
Afterward you may touch only outside
wrapping or should
• Label the body properly, handle all bodies
as if they have infectious disease
Caring for body of a client on
isolation after death (Contd…)
49. FUNCTIONS OF INFECTION CONTROL NURSE
• Regular visit to all wards & high risk unit
• Checking records& reports
• Collect sample from different areas & sent it to
lab
• Compile statistics of HAI from different areas
• Monitor infection among hospital staff
• Training other personnel on hygiene & aseptic
precautions
51. BIBLIOGRAPHY:
• Black.M.Joyce, “Medical Surgical Nursing”7th edition, published by Elsevier
• Perry P, “Fundamentals of Nursing”6th edition, published by Elsevier
• Taylor.C, Lillis, “Fundamentals of Nursing-The art and science of nursing care”
1st edition, published by Lippincott Williams and Wilkins
• www.google.com
• Gowda SN Nonjunde, “foundations of nursing” edition Ist, Jaypee brothers
medical publishers
• F.Craven Ruth, “fundamentals of nursing” 4th edition, Lippincott publication
• Lillis Tylor, Lynn LeMone, “fundamentals of nursing, “Lippincott publication, sixth
edition
