1. 1
Dr. Priyadarshini Patro
Microbiologist
VY Hospital

2. The nature of infection
 Micro-organisms -
bacteria, fungi, viruses,
protozoa and worms
 Most are harmless [non-
pathogenic]
 Pathogenic organisms can
cause infection
 Infection exists when
pathogenic organisms
enter the body,
reproduce and cause
disease
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3. 3
Why do we need Infection
Control??
Hospitals and clinics are complex
institutions where patients go to have
their health problems diagnosed and
treated
But, hospitals, clinics, and medical/surgical
interventions introduce risks that may harm a
patient’s health

4. The risk of infection is always
present.
Patient may acquire infection before admission to
the hospital = Community acquired infection.
Patient may get infected inside the hospital =
Nosocomial infection / Hospital acquired
infections (HAI).
It includes infections
not present nor incubating at admission,
infections that appear more than 48 hours after admission,
those acquired in the hospital but appear after discharge
also occupational infections among staff.

5. What is Nosocomial Infection
Any infection
that is not
present or
incubating at
the time the
patient is
admitted to the
hospital
5

6. Common Health-Care
Associated Infections
 Urinary Tract
Infection
 Surgical/Traumatic
Wound Infection
 Respiratory Tract
infection
 Bloodstream
infection

7. 7
 Additional morbidity
 Prolonged
hospitalization
 Long-term physical,
developmental and
neurological sequelae
 Increased cost of
hospitalization
 Death
Consequences of Nosocomial
Infections

8.  Objectives :
To prevent health care workers & the environment
from transmission of infections.
To reduce :-
Pt’s morbidity & mortality
length of hospital stay
Cost associated with hospital stay

9. What are Universal Precautions
Universal precaution are control guidelines
designed to protect workers
from exposure to Diseases spread by Blood and
other Body fluids.

10. Why Universal health Precautions
The concept of Universal Health Precautions
emphasizes that all our patients should be treated
as infectious for blood born infections such as HIV,
Hep-B, C, and can infect the caring health care
workers.
( CDC )

11. Human materials/Tissues considered Highly
Infectious
 1 Blood
 2 Semen
 3 Vaginal secretions
 4 C S F
 5 Synovial fluids
 6 Amniotic fluid
 7 All other body fluids

12. Not Infectious unless contaminated with
Blood or Body fluids.
 Faeces,
 Nasal secretions,
 Sputum,
 Sweat,
 Tears,
 Urine / Vomitus,
 Saliva unless blood stained.

13. Standard precautions
 Applied to all pts. at all times ( regardless of diagnosis
& infectious status ).
 Aim : To prevent transmission of infections from
 Pt  Health care worker (HCW)
HCW  Pt.
Pt.  Pt. (cross transmission )
Hospital environment  Pt.
Hospital waste  community

14. Components
 Hand hygiene
 Personal protective equipment (PPE).
 Handling of pt. care equipments & soiled linen.
 Prevention of needle stick injuries.
 Environmental cleaning & spills management.
 Appropriate handling of waste.

16. Hand transmission
 Hands are the most common vehicle to transmit health care-
associated pathogens
 Transmission of health care-associated pathogens from one
patient to another via health-care workers’ hands requires
5 sequential steps .

17. 5 stages of hand transmission
Germs
present on
patient skin
and
immediate
environment
surfaces
Germ transfer
onto health-
care worker’s
hands
Germs survive
on hands for
several
minutes
Suboptimal or
omitted hand
cleansing
results in
hands
remaining
contaminated
Contaminated
hands
transmit
germs via
direct contact
with patient
or patient’s
immediate
environment
one two three four five

18.  protect the patient against harmful germs carried on your
hands or present on his/her own skin
 protect yourself and the health-care environment from
harmful germs
Why should you clean your hands?

19. Your Unwashed Hand a Great
Concern to Your Patient
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20. Hand hygiene
 Hand washing
 Antiseptic handwash
 Alcohol-based handrub
 Surgical hand hygiene/antisepsis

21. Our Hands are Threat to LIFE
Just Washing can Save Many
LIVES

22.  There is no Health precaution like Hand washing.
 Washing with simple toilet soap - reduces the rate
of transmission of common infections including
the HIV.
 Proper hand washing is the single most important
way to prevent and reduce infections.

23. Hands should be washed:
 Before and after patient contact
 Before putting on gloves and after taking them off
 After touching blood and body substances (or
contaminated patient-care equipment), broken skin,
or mucous membranes (even if you wear gloves)
 Between different procedures on the same patient.
 Before leaving the ward.
 Before handling food.
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24. The “5 Moments for Hand Hygiene” approach

25. How to Wash our hands
How to Wash our hands
To effectively reduce the
growth of germs on hands,
handwashing
must last 40–60 seconds
and should be performed by
following all of the
illustrated steps.

26. Hand washing – Areas Missed
 Research indicates:
 poor techniques - not
all surfaces cleaned
 frequency diminishes
with
workload/distance
 poor compliance with
guidelines/training
Taylor (1978) identified
that 89% of the hand
surface was missed and
that the areas of the hands
most often missed were
the finger-tips, finger-
webs, the palms and the
thumbs.
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27. How to handrub
To effectively reduce the growth
of germs on hands,
handrubbing must be
performed by following all of
the illustrated steps.
This takes only 20–30
seconds!

28. Alcohol-based hand-rub
formulation
 Contain 60 to 80% ethanol as
isopropanol or n-propanol.
 Emollients to protect the skin.
 Available as –
Liquid solutions
Gels
Sprays
Foams

29. Choosing hand hygiene technique
Hand wash
• If there is visible
contamination with blood or
body fluids.
• Visible contamination with
proteinaceous material.
• Exposure to spore forming
organisms.
• After using toilet.
Hand rub
• When there is no visible solid
contamination on hands.
Longtin Y, Sax H, Allegranzi B, et al.Hand hygiene. N Engl J Med. 2011;364;13: e24.

30. Advantages of Alcoholic Hand Wash
 Require less time
 Can be strategically placed
 Readily accessible
 Multiple sites
 All patient care areas
 Acts faster
 Excellent bactericidal
activity
 Less irritating (??)
 Sustained improvement
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31. Time constraint =
major obstacle for hand hygiene
Adequate hand washing with
water and soap requires
40–60 seconds
Average time usually adopted by health-
care workers:
<10 seconds
Alcohol-based
handrubbing: 20–30 seconds

32. Compliance with hand hygiene
 Compliance with hand hygiene differs across
facilities and countries, but is globally <40%
 Main reasons for non-compliance reported by
health-care workers:
 Too busy
 Skin irritation
 Glove use
 Don’t think about it

33. Words of Wisdom on Hand
Washing
Soap, water and
Common sense are still
be Best Antiseptics
William Osler

34.  Cut / abrasion – should be covered with
Waterproof dressing.
• Finger nail – should be short and clean
((less than 0.2 inches or ½ cm in length).
• Avoid artificial nails.
• Avoid wearing rings, watches, any jewellery during health
care.
• In high risk areas (OT rooms)- avoid any jewellery, even a
plain band.

35. Let’s Practice!!!