The document details infection control measures in critical care settings, focusing on definitions of infection types, stages of infection, and guidelines for hygiene practices and isolation protocols. It emphasizes prevention strategies for nosocomial infections, including ventilator-associated pneumonia, catheter-associated urinary tract infections, and central line-associated bloodstream infections. Key recommendations include proper use of personal protective equipment, stringent hand hygiene, and specific management bundles for different infection risks.

1. College of nursing and
midwifery fjmu lahore
Submitted to: Madam naeema
Submitted by : Anmol Arshad
Aqsa Ashfaq
Topic: infection control in critical care setting

2. Objectives:
• By the end of this session leaners will be able to:
• Define infection and its types.
• Discuss the stages and chain of infection.
• Explain Guidelines for Infection Control in Critical Care Settings.
• Discuss types of isolation and its importance.
• Describe steps and importance of Hand hygiene.
• Recognize the significance of standard and transmission-based isolation and
when to use
• Discuss the strategies to reduce Ventilated Associated Pneumonia (VAP), Central
Line A Blood Stream Infection (CLABSI), and Catheter Associated Urinary Tract
Infection (CA.
• Explain the personal protective equipment (PPE).
• Understand the appropriate techniques of Donning and doffing of PPE.
• Enlist Aerosol-Generating Procedures performed in critical care settings.

3. Infection:
• The invasion and multiplication of microorganisms
such as bacteria, viruses, and parasites that are not
normally present within the body.

4. Types of infection:
• Localized infection Vs. Systemic Infection
• Localized infection: An infection that is restricted to a
specifie location or region within the body of the host.
• Systemic Infection: An infection that has spread to
several regions or areas in the body of the host.
• Clinical Vs. Sub-clinical Infection
• Clinical Infection: An infection with obvious observable
or
• detectable symptoms, Sub-clinical Infection: An
infection with few or no obvious symptoms.

5. Nosocomial infection:
• Nosocomial infections are infections patients
acquire while admitted to a health-care facility and
generally develop 48 hours or later after admission.

6. Types of nosocomial infection:
• MOST COMMON STAPHYLOCOCCUS AUREUS
• OTHER COMMON PATHOGENS: ESCHERICHIA COLI
• ENTEROCOCCI CANDIDA
• PREVENTION
• COSMOSIS
• ANTIME RIRIAL USE
• SOUTHE DOMFECTION
• CAUSES
• URINARY CATHETERS URINARY TRACT INFECTIONS
• SURGICAL PROCEDURES
• SURGICAL SITE SRECTO
• CENTRAL VENOUS CATHETERS
• MECHANICAL VENTILATION
• DEVICES ASAP

7. Stages of infectious process:
• Incubation phase
• From introduction of microbe to host until onset of initial
symptoms
• Establishment of microbe within host system
• Overcome host innate defenses
• Days to months/years
• Average 1-2 weeks
• Prodromal phase
• Non-specific symptoms
• Fatigue Headache and/or malaise
• 1-2 days before onset of true symptoms

8. Continue:
llness period
• Actual disease onset
• Most severe signs and symptoms
• Specific for that disease
• Decline period
• The number of infectious particles decreases Symptoms will
gradually improve
• Convalescent phase
• Recovery from disease
• May be long slow or quick process
• Time of antibody peak

10. Recommended guidlines for infection
control critical care setting:
. Assess the need for isolation. Screen all intensive care unit (ICU) patients for
the following:
• Neutropenia and immunological disorder
• Diarrhea
• Skin rashes
• Known communicable disease
• 2. Identify the type of isolation needed.
• Protective isolation for neutropenic or other immunocompromised patients to
reduce the chances of acquiring opportunistic infections.
• Source isolation of colonized or infected patients to minimize potential
transmission to other patients or staff.
• Isolation rooms should have tight-fitting doors, glass partitions for observation
and both negative-pressure (for source isolation) and positive- pressure (for
protective isolation) ventilations.

11. Continue:
• 3. Observe hand hygiene
• Hands are the most common vehicle for
transmission of organisms and "hand hygiene" is
the single most effective means of preventing the
horizontal transmission of infections among
hospital patients and health care personnel.

13. Continue:
4.Standard Precautions
are used for all patient care, regardless of status of
infection.
⚫PPE are considered as one of the major actions
which prevents the transmission of infection and
protects healthcare professionals and patients from
Healthcare- Acquired Infection.

14. Continue
• 5. Follow transmission-based precautions
• • In addition to standard precautions, the following
should be observed in those patients known or
suspected to have airborne, contact or droplet
infections.

15. Contact precautions:
• Methods used to contain diseases.
• Patients at risk of contaminating their environment.
• Gown and gloves at entry point, before contact
with a patient or patient's environment.
• Potentially contaminated objects include:
• Objects, such as tray tables and bedrails.
• Medical equipment (e.g., Blood Pressure cuff).
• • PPE removed at the point of exit, prompt hand
hygiene.

16. Droplet precautions :
• • Prevents transmission of diseases spread by large
respiratory droplets through coughing. sneezing, or talking.
• Examples of conditions requiring Droplet Precautions
include seasonal influenza and B. pertussis.
• A face mask is worn upon entry into the patient room.
• • Use Standard Precautions when handling items.
• Contaminated with respiratory secretions.
• • PPE must be removed at the point of exit; do not reuse
face masks.
• Hand hygiene follows PPE removal.

17. Airborn precautions:
• Prior to entering the room":
• • Prevents transmission of infectious agents that are very
small and remain viable and suspended in the air over long
distances.
• • Examples include measles, M. tuberculosis, chicken pox.
• Particulate respirator (e.g., N95) or powered air purifying
respirator (PAPR) worn before entry.
• With a particulate respirator, perform a fit-check before
entering an area where they may be airborne infectious
disease.

18. Recommended Guidelines for Infection
Control in Critical Care Settings
• 6. Use specific strategies focused on prevention of
specific nosocomial infections.
• In addition to the standard and transmission-based
precautions, there are several strategies focused on
prevention of specific nosocomial infections in
critically ill patients that includes:
• Ventilator-Associated Pneumonia (VAP)
• Central Line-Associated Blood Stream Infection
(CLABSI)
• Urinary Tract Infection (UTI)

19. Ventilator Associated Pneumonia
• in a person who is on a ventilator.
• Ventilator Associated Pneumonia Prevention Bundle:
• 1. Daily assessment regarding the need for continuing ventilator.
• 2. The head of bed is kept at 30-45 degrees.
• 3. Patient is given spontaneous breath at least per day.
• 4. Sedation vacation is initiated atleast per day.
• 5. Mouth wash has been done by 0.12% chlorhexidine 2-4 hourly
• 6. Respiratory accessories are kept clean and dry.
• 7. EET cuff pressure is between 20-29 cm of H2O for adults.
• (

20. Catheter Associated Urinary Tract
Infection
• Among UTIs acquired in the hospital, approximately 75% are associated with a
urinary catheter, which is a tube inserted into the bladder through the urethra to
drain urine.
• Catheter Associated Urinary Tract Infection Prevention Bundle:
• 1. Daily assessment regarding the need for continuing catheter.
• 2. Closed drainage system is maintained.
• 3. Collecting bag is placed below the level of bladder.
• 4. Catheter bag is not touching the floor or dustbin.
• 5. Perineal care with soap and water is provided per shift.
• 6. Hand hygiene is done PRIOR AND AFTER to any manipulation of urinary catheter.
• 7. Clean latex gloves is worn while emptying the bag.
• (Dellinger, 2016)
• 22
• 8. Separate clean collecting container is used for Each Patient

21. Central Line associated Blood
Stream Infection
A central line bloodstream infection (CLABSI) occurs when bacteria or other germs
enter the patient's central line and then enter their bloodstream
Central Line Maintenance Bundle:
1. Daily assessment regarding the need for continuing Central venous catheter (CVC)
line..
2. Dressing is clean and intact.
3. All central line (CVP,PICC lines, Joe-Cath) dressing changed according to guideline.
Transparent dressing in 7 days
Gauze dressing in 2 days
Changed dressing as required
Catheter Hub, needless connectors and injection ports are disinfected with 2%
chlorhexidine in 70%
alcohol wipe before accessing the catheter. Hand Hygiene is done PRIOR and AFTER
the manipulation of the central line or IV administration set.