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INFECTION CONTROL IN CLINICAL
SETTING
The invasion of bodily tissue by
pathogenic microorganisms that
proliferate, resulting in tissue injury that
can progress to disease.
DEFINITION OF INFECTION
Infection prevention refers to policies and
procedures used to minimize the risk of spreading
infections, especially in hospitals and human or animal
health care facilities.
Infection prevention:
KEY TERMS:
Antiseptic: An Agent That Will Inhibit The Growth
And Development Of Microorganisms Without
Necessarily Killing Them.
Asepsis: Freedom From Infection Or Prevention Of
Contact With Microorganisms.
Autoclaving: sterilization Of Articles By Steam Under
Pressure By Using Autoclave.
Biohazardous waste: items contaminated with blood,
body fluids, secretion, or excretions.
• Contamination: process of becoming unclean.
• Cross infection: infection transmitted between
individual infected with different pathogenic organisms.
• Decontamination: process of removing the foreign
material such as blood, body fluids or radioactivity.
• Disinfection: process of destroying pathogens.
• Infection: a disease state resulting from the invasion and
growth of microbes in the body.
Infection control: practices and procedures
that prevent the spread of infection.
• Isolation: separation of infected persons from non-
infected persons which will prevent the transmission
of infection to others.
• Medical asepsis: the state of being free of living
pathogenic microorganisms.
• Microorganisms: living organisms such as bacteria,
fungi and viruses.
Nasocomial infection: an infection whose
development is favoured by a hospital environment.
• Pathogen: a microbe that is harmful and can
cause an infection.
• Phagocytosis: the ingestion of bacteria or other
material by phagocytes and amoeboid
protozoans.
• Precaution: an action taken in advance to
protect against possible danger, failure or injury.
Prophylactic: a medicine or course of action
used to prevent disease.
• Purulent: containing, discharging or causing the
production of pus.
• Reservoir: the environment in which an infectious
agent normally lives and multiplies.
• Segregation: to separate or isolate from others or
from a main body or group.
• Sterile field: the area declared free from micro
organisms or other infective agents.
Sterilization: destruction of all the microorganisms,
both pathogenic and non –pathogenic including their
spores.
• Susceptibility: the condition of being vulnerable to
a disease or disorder.
• Surgical asepsis: the practices that keep items free
of all microbes, sterile technique.
• Transmission: a transfer e.g.: transmission of
disease from one person to another.
 Bacteria
 Viruses
 Fungi
 Protozoa
NATURE OF INFECTION
• Microorganisms exist everywhere: in water, in soil, and on
body surfaces such as the skin, intestinal tract and other areas
open to the outside (e.g mouth, upper respiratory tract,
vagina and lower urinary tract)
• Most of the microorganisms are harmless and some are even
beneficial in that they perform essential functions in the body.
(e.g enterobacteria) produce substances called bacteriocins,
which are lethal to related strains of bacteria.
Chain Of Infection Transmission
• An infection: is an invasion of body tissue by
microorganisms and their proliferation there. six
links made up the chain of infection. these are as
follows:
Causative
Agent
Reservoir
Portal of
Exit
Mode of
Transmis
sion
Portal of
Entry
Susceptible
Host
 Causative Agent - the microorganism (for example
bacteria, virus or fungi).
 Reservoir (source) - a host which allows the
microorganism to live, and possibly grow, and multiply.
Humans, animals and the environment can all be
reservoirs for microorganisms
Portal of Exit - a path for the microorganism to escape from
the host. The blood, respiratory tract, skin and mucous
membranes, genitourinary tract, gastrointestinal tract, and
transplacental route from mother to her unborn infant are
some examples.
Common escape routes are as follows:
• The skin and mucus membrane
• Respiratory tract
• Gastrointestinal tract
• Genito urinary tract
• Reproductive tract
• Blood and serum
 Mode of Transmission - since microorganisms cannot travel
on their own; they require a vehicle to carry them to other
people and places.
Infectious diseases and even certain contagious
diseases spread through the following agencies. Their ways of
spreading is also given along with these agencies.
Direct transmission
-Direct Contact
-Droplet Infection
-Contact With Soil
-Inoculation into skin or mucosa
Transplacental (vertical)
 Portal of Entry - a path for the microorganism to
get into a new host, similar to the portal of exit.
 Susceptible Host - a person susceptible to the
microorganism
 Staff: service provide are at significant risk for
infection because they are exposed to potentially
infectious blood and other body fluids on daily
basis.
 Clients: they are at risk of post procedural
infection when, e.g. service providers do not
wash hands between client and procedure,
when they do not adequately prepare client for
procedure and when used instruments and
other items are not cleaned and processed
correctly.
 Community: it is also at risk of infection,
particularly from inappropriate disposal of
medical waste.
Breaking chain of infection:
 As health professional, we cannot provide
health care services without some exposure to
potentially infectious materials, but we can
prevent transmission in many cases. The only
way to prevent infection is to break the chain
of infection. The nurse must follow certain
principle and procedures to prevent infection
and control its spread.
1. Rapid and accurate identification of
organism:
 Routinely send blood cultures, urine culture,
skin swabs, throat swabs, tracheal aspirate
culture.
 Send endotracheal tube tip, urinary catheter
tip and central line tip for culture after
removal.
Breaking the chain 1 of infection:
2. Control or elimination of infectious
agents including:
 Proper cleaning by the water and
mechanical action with or without
detergents.
 Disinfection.
 Sterilization of contaminated objects.
High level of disinfectants:
 Activated glutaraldehyde (cidex 2%)
 Sodium hypochloride 1%
 Carbolic solution 5%
 Bleaching powder 1%
Low level of disinfectant:
 Methylated spirit 70%
 Betadine solution 10%
 Savlone 1%
 Measures to control or eliminate of reservoir of
infection.
 Employee health:
 Immunization of health personnel’s e.g.
hepatitis B vaccine
 Regular checkup for early detection of any
communicable disease
 Restriction from work of patient contact when
infected with communicable disease.
Breaking the chain 2 of infection:
Environmental disease:
 Cleaning with hospital approved clear
disinfectant, e.g. phenol
 Through cleaning of bed and bedside
equipments before admitting new patient.
 Separate mops should be used for cleaning
of unit. (Twice a day).
 Damp dusting should be done.
 Drains should be patent.
Handling of linen:
 Keep bed sheets dry and clean.
 Change sheets every day.
 Do not shake blankets and linen.
 Do not throw them on floor.
 Soiled linen counting should be done in
separate place.
Pest control:
 Measures to be taken to avoid their entry
into unit. E.g. proper cleaning, sealing and
draining.
 Patient’s diet should be kept in covered
containers.
 Keep fly trappers on each bedside
of patient.
 Pesticide spray should be used weekly.
 Visitors control:
 Traffic should be restricted except for doctor,
nurse and supportive staff.
 Allow only one attendant (3-4 hours).
 Keep the doors and windows closed.
 Mobile phones should not be allowed inside
the area.
 Machines (X-rays, echo machines, ultrasound
machine) from outside should be cleaned with
spirit before their use.
Portal of exit:
 Practice aseptic precaution.
 Avoid talking directly into the client’s mouth to
prevent the droplet infection.
 Wearing of mask is compulsory if the nurse is
infected or she is dealing with the patients who are
infected.
 Careful handling of waste like urine, faeces,
emesis and blood is important.
 Disposable gloves should be worn to prevent direct
contact with wastes or infected materials.
Breaking the chain 3 of infection:
Breaking the chain 4 of
infection:
Mode of transmission:
Contact Precautions;
 Single patient room.
 Staff to perform hand hygiene, put on gown/apron
and gloves prior to entering patient room and when
anticipating contact with the patient or their
surroundings is.
 Remove gown/apron and gloves and perform
hand hygiene after leaving room.
 Clean and disinfect non-disposable equipment and
items when removed from patient room.
 Droplet Precautions;
 Single patient room.
 Staff to put on surgical mask when entering
room and remove and dispose of mask after
leaving room and perform hand hygiene.
 Instruct patient about respiratory hygiene
and cough etiquette.
 Limit patient movement outside the room to
medically-necessary purposes.
 Patient to put on a surgical mask when
leaving room.
 Airborne Precautions;
 Single negatively pressured room.
 Door to remain closed.
 Staff to put on N95/P2 mask when entering
patient room and remove and dispose of
mask and perform hand hygiene after
leaving room.
 Instruct patient about respiratory hygiene and
cough etiquette.
 Patient to put on surgical mask when
leaving room.
Portal of entry:
 Maintain integrity of skin and mucous
membrane.
 Prepare position of tubing, etc. may
prevent injuries and skin breakdown.
 Turning and positioning of debilitated
clients.
Breaking the chain 5 of
infection:
 Ensure the personal hygiene of client
regularly.
 Proper disposal of contaminated syringe
and needles.
 Proper handling of catheters and
drainage set etc. care should be taken
while collecting and handling specimen.
Breaking the chain 6 of
infection:
Protecting susceptible host:
 Protecting the normal defense mechanism by,
 Regular oral hygiene.
 Maintaining adequate intake.
 Encouraging deep breathing exercise.
 Encouraging proper immunization of
children and adult client.
Maintaining healing process:
 Promotion of intake of well-balanced diet
containing essential protein, vitamins, fats
and carbohydrates.
 Institution measures to improve appetite of
patient.
 Helping the client to identify methods to
relieve stress.
 Pathogens fall into two broad categories,
blood borne (carried in the body fluids) and
airborne.
 Standard precaution contains following
things;
 Hand washing
 Gloving
 Gowning
 Mask/ protective eye wear/ cap
 Shoe cover
Infection control in clinical settings

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Infection control in clinical settings

  • 1. INFECTION CONTROL IN CLINICAL SETTING
  • 2. The invasion of bodily tissue by pathogenic microorganisms that proliferate, resulting in tissue injury that can progress to disease. DEFINITION OF INFECTION
  • 3. Infection prevention refers to policies and procedures used to minimize the risk of spreading infections, especially in hospitals and human or animal health care facilities. Infection prevention:
  • 4. KEY TERMS: Antiseptic: An Agent That Will Inhibit The Growth And Development Of Microorganisms Without Necessarily Killing Them. Asepsis: Freedom From Infection Or Prevention Of Contact With Microorganisms. Autoclaving: sterilization Of Articles By Steam Under Pressure By Using Autoclave.
  • 5. Biohazardous waste: items contaminated with blood, body fluids, secretion, or excretions. • Contamination: process of becoming unclean. • Cross infection: infection transmitted between individual infected with different pathogenic organisms. • Decontamination: process of removing the foreign material such as blood, body fluids or radioactivity. • Disinfection: process of destroying pathogens. • Infection: a disease state resulting from the invasion and growth of microbes in the body.
  • 6. Infection control: practices and procedures that prevent the spread of infection. • Isolation: separation of infected persons from non- infected persons which will prevent the transmission of infection to others. • Medical asepsis: the state of being free of living pathogenic microorganisms. • Microorganisms: living organisms such as bacteria, fungi and viruses.
  • 7. Nasocomial infection: an infection whose development is favoured by a hospital environment. • Pathogen: a microbe that is harmful and can cause an infection. • Phagocytosis: the ingestion of bacteria or other material by phagocytes and amoeboid protozoans. • Precaution: an action taken in advance to protect against possible danger, failure or injury.
  • 8. Prophylactic: a medicine or course of action used to prevent disease. • Purulent: containing, discharging or causing the production of pus. • Reservoir: the environment in which an infectious agent normally lives and multiplies. • Segregation: to separate or isolate from others or from a main body or group. • Sterile field: the area declared free from micro organisms or other infective agents.
  • 9. Sterilization: destruction of all the microorganisms, both pathogenic and non –pathogenic including their spores. • Susceptibility: the condition of being vulnerable to a disease or disorder. • Surgical asepsis: the practices that keep items free of all microbes, sterile technique. • Transmission: a transfer e.g.: transmission of disease from one person to another.
  • 14. NATURE OF INFECTION • Microorganisms exist everywhere: in water, in soil, and on body surfaces such as the skin, intestinal tract and other areas open to the outside (e.g mouth, upper respiratory tract, vagina and lower urinary tract) • Most of the microorganisms are harmless and some are even beneficial in that they perform essential functions in the body. (e.g enterobacteria) produce substances called bacteriocins, which are lethal to related strains of bacteria.
  • 15. Chain Of Infection Transmission • An infection: is an invasion of body tissue by microorganisms and their proliferation there. six links made up the chain of infection. these are as follows:
  • 17.  Causative Agent - the microorganism (for example bacteria, virus or fungi).  Reservoir (source) - a host which allows the microorganism to live, and possibly grow, and multiply. Humans, animals and the environment can all be reservoirs for microorganisms
  • 18. Portal of Exit - a path for the microorganism to escape from the host. The blood, respiratory tract, skin and mucous membranes, genitourinary tract, gastrointestinal tract, and transplacental route from mother to her unborn infant are some examples. Common escape routes are as follows: • The skin and mucus membrane • Respiratory tract • Gastrointestinal tract • Genito urinary tract • Reproductive tract • Blood and serum
  • 19.  Mode of Transmission - since microorganisms cannot travel on their own; they require a vehicle to carry them to other people and places. Infectious diseases and even certain contagious diseases spread through the following agencies. Their ways of spreading is also given along with these agencies. Direct transmission -Direct Contact -Droplet Infection -Contact With Soil -Inoculation into skin or mucosa Transplacental (vertical)
  • 20.  Portal of Entry - a path for the microorganism to get into a new host, similar to the portal of exit.  Susceptible Host - a person susceptible to the microorganism
  • 21.  Staff: service provide are at significant risk for infection because they are exposed to potentially infectious blood and other body fluids on daily basis.
  • 22.  Clients: they are at risk of post procedural infection when, e.g. service providers do not wash hands between client and procedure, when they do not adequately prepare client for procedure and when used instruments and other items are not cleaned and processed correctly.  Community: it is also at risk of infection, particularly from inappropriate disposal of medical waste.
  • 23. Breaking chain of infection:  As health professional, we cannot provide health care services without some exposure to potentially infectious materials, but we can prevent transmission in many cases. The only way to prevent infection is to break the chain of infection. The nurse must follow certain principle and procedures to prevent infection and control its spread.
  • 24. 1. Rapid and accurate identification of organism:  Routinely send blood cultures, urine culture, skin swabs, throat swabs, tracheal aspirate culture.  Send endotracheal tube tip, urinary catheter tip and central line tip for culture after removal. Breaking the chain 1 of infection:
  • 25. 2. Control or elimination of infectious agents including:  Proper cleaning by the water and mechanical action with or without detergents.
  • 26.  Disinfection.  Sterilization of contaminated objects. High level of disinfectants:  Activated glutaraldehyde (cidex 2%)  Sodium hypochloride 1%  Carbolic solution 5%  Bleaching powder 1% Low level of disinfectant:  Methylated spirit 70%  Betadine solution 10%  Savlone 1%
  • 27.  Measures to control or eliminate of reservoir of infection.  Employee health:  Immunization of health personnel’s e.g. hepatitis B vaccine  Regular checkup for early detection of any communicable disease  Restriction from work of patient contact when infected with communicable disease. Breaking the chain 2 of infection:
  • 28. Environmental disease:  Cleaning with hospital approved clear disinfectant, e.g. phenol  Through cleaning of bed and bedside equipments before admitting new patient.  Separate mops should be used for cleaning of unit. (Twice a day).  Damp dusting should be done.  Drains should be patent.
  • 29. Handling of linen:  Keep bed sheets dry and clean.  Change sheets every day.  Do not shake blankets and linen.  Do not throw them on floor.  Soiled linen counting should be done in separate place.
  • 30. Pest control:  Measures to be taken to avoid their entry into unit. E.g. proper cleaning, sealing and draining.  Patient’s diet should be kept in covered containers.  Keep fly trappers on each bedside of patient.  Pesticide spray should be used weekly.
  • 31.  Visitors control:  Traffic should be restricted except for doctor, nurse and supportive staff.  Allow only one attendant (3-4 hours).  Keep the doors and windows closed.  Mobile phones should not be allowed inside the area.  Machines (X-rays, echo machines, ultrasound machine) from outside should be cleaned with spirit before their use.
  • 32. Portal of exit:  Practice aseptic precaution.  Avoid talking directly into the client’s mouth to prevent the droplet infection.  Wearing of mask is compulsory if the nurse is infected or she is dealing with the patients who are infected.  Careful handling of waste like urine, faeces, emesis and blood is important.  Disposable gloves should be worn to prevent direct contact with wastes or infected materials. Breaking the chain 3 of infection:
  • 33. Breaking the chain 4 of infection: Mode of transmission: Contact Precautions;  Single patient room.  Staff to perform hand hygiene, put on gown/apron and gloves prior to entering patient room and when anticipating contact with the patient or their surroundings is.  Remove gown/apron and gloves and perform hand hygiene after leaving room.  Clean and disinfect non-disposable equipment and items when removed from patient room.
  • 34.  Droplet Precautions;  Single patient room.  Staff to put on surgical mask when entering room and remove and dispose of mask after leaving room and perform hand hygiene.  Instruct patient about respiratory hygiene and cough etiquette.  Limit patient movement outside the room to medically-necessary purposes.  Patient to put on a surgical mask when leaving room.
  • 35.  Airborne Precautions;  Single negatively pressured room.  Door to remain closed.  Staff to put on N95/P2 mask when entering patient room and remove and dispose of mask and perform hand hygiene after leaving room.  Instruct patient about respiratory hygiene and cough etiquette.  Patient to put on surgical mask when leaving room.
  • 36. Portal of entry:  Maintain integrity of skin and mucous membrane.  Prepare position of tubing, etc. may prevent injuries and skin breakdown.  Turning and positioning of debilitated clients. Breaking the chain 5 of infection:
  • 37.  Ensure the personal hygiene of client regularly.  Proper disposal of contaminated syringe and needles.  Proper handling of catheters and drainage set etc. care should be taken while collecting and handling specimen.
  • 38. Breaking the chain 6 of infection: Protecting susceptible host:  Protecting the normal defense mechanism by,  Regular oral hygiene.  Maintaining adequate intake.  Encouraging deep breathing exercise.  Encouraging proper immunization of children and adult client.
  • 39. Maintaining healing process:  Promotion of intake of well-balanced diet containing essential protein, vitamins, fats and carbohydrates.  Institution measures to improve appetite of patient.  Helping the client to identify methods to relieve stress.
  • 40.  Pathogens fall into two broad categories, blood borne (carried in the body fluids) and airborne.  Standard precaution contains following things;  Hand washing  Gloving  Gowning  Mask/ protective eye wear/ cap  Shoe cover