Infection
Control &
Prevention
PRESENTED BY:
HARSH RASTOGI,
Ph.D. STUDENT,
AEC, PGIMER, CHANDIGARH
Introduction
 Hospital infections are a primary cause of
unnecessary deaths.
 Millions of preventable hospital infections cause
unnecessary deaths, according to the CDC.
 All health providers worry about organism
transmission. Asepsis helps achieve this.
 Asepsis is the state of being free from living
pathogenic organisms.
Introduction (Cont.)
 Infection control addresses factors related to the spread of infections within the
healthcare setting:
Patient to
Patient
From Patients
to Staff
From Staff to
Patients
Among Staff
Introduction (Cont.)
 Hand hygiene/handwashing
 Cleaning
 Disinfection
 Sterilization
 Vaccination
 Surveillance
 Monitoring/investigation of
demonstrated or suspected spread
of infection within a particular
health-care setting (surveillance and
outbreak investigation),
 And management (interruption of
outbreaks).
Infection control also includes prevention via:
Definition
 Pathogenic microorganisms proliferate and invade bodily tissue, causing tissue harm
and disease.
 The invasion and multiplication of microorganisms such as bacteria, viruses, and
parasites those are not normally present within the body.
 An infection may cause no symptoms and be subclinical, or it may cause symptoms and
be clinically apparent.
Definition (Cont.)
 An infection may remain localized, or it may spread through the blood or lymphatic
vessels to become systemic (body wide).
 Microorganisms that live naturally in the body are not considered infections.
 For example, bacteria that normally live within the mouth and intestine are not
infections.
Infection
prevention
 Infection prevention policies and
practices are used in hospitals
and other health care facilities
to reduce the spread of
infections.
This Photo by Unknown Author is licensed under CC BY-NC-ND
Infectious diseases
 Infectious diseases kill the most people
worldwide.
 Germs cause infections.
 Germs are microscopic organisms found in air,
soil, and water.
 Germs can spread by touching, eating, drinking,
or breathing.
 Kissing, sexual contact, and animal bites transfer
germs.
 Vaccination, handwashing, and medicines can
prevent illnesses.
Four main kinds of germs
Bacteria Fungi Virus Protozoa
Type of infections
Primary infection
Initial infection with an organism to host
constitutes primary infection.
Secondary infection
When in a host whose resistance is
lowered by pre-existing infection, a
new organism may set up a new
infection.
Local infection
Infection that is limited to a defined
area or single organ with symptoms
that resemble inflammation (redness,
tenderness and swelling.)
Type of infections
Systemic infection
• Infection that spreads to whole
body resulting in a septicemia.
Acute infection
• It appears suddenly or lasts for
a short time.
Chronic infection
• May occur slowly over a long
period and may last months to
years.
Type of infections
Iatrogenic infection
• Infection resulting due to therapeutic
and diagnostic procedures.
Nosocomial infection
• Aka Hospital-acquired infection
(HAI) is an infection that is
contracted from the environment or
staff of a healthcare facility.
Chain of infection
 The presence of a pathogen does not mean that an infection will begin.
 For infectious disease to spread, several necessary steps must occur.
 These steps are known as “chain of infection”.
 An infection will develop only if chain remains intact.
 These links are:
Causative
agent
Reservoir
Portal of exit
Mode of
transmission
Portal of
entry
Susceptible
Host
A. Causative agent
 The microorganism (for example bacteria, virus, protozoa or fungi).
B.Reservoir
 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
 Path for the microorganism to escape
from the host.
 Examples: blood, respiratory tract, skin
and mucous membranes, genitourinary
tract, gastrointestinal tract, and
transplacental pathway from mother to
unborn infant.
Mode of infection
 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:
Modes of
infection (Cont.)
 Air-borne transmission
 Contact transmission-direct and
indirect
 Vehicle transmission (Water,
milk, food etc.)
 Vector-transmission
 Transplacental transmission
Portal of
entry
A PATH FOR THE
MICROORGANISM TO GET INTO
A NEW HOST.
Susceptible
host
A PERSON SUSCEPTIBLE TO
THE MICROORGANISM
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.
 Breaking the cycle is the only way to prevent infection.
 Health personnel must follow protocols to prevent and control infection.
Breaking chain 1 of
infection
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 chain 1 of infection(Cont.)
2. Control or elimination of infectious agents including:
 Proper cleaning by the water and mechanical action with or without detergents.
Breaking chain 1 of infection(Cont.)
 Disinfection
 Sterilization of
contaminated
objects.
High level of disinfectants:
• Activated glutaraldehyde (Cidex 2%)
• Sodium hypochlorite 1%
• Carbolic solution 5%
• Bleaching powder 1%
Low level of disinfectant:
• Methylated spirit 70%
• Betadine solution 10%
• Savlone 1%
Breaking chain 2 of infection
 Measures to control or eliminate of
reservoir of infection are:
1. 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 chain 2 of infection (cont.)
2. Environmental disease:
 Cleaning with hospital approved clear disinfectant, e.g., phenol
 Through cleaning of bed and bedside equipment's 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.
Breaking chain 2 of
infection (cont.)
3. 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.
Breaking chain 2 of infection (cont.)
4. 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.
Breaking chain 2 of infection (cont.)
5. Visitors control:
 Traffic should be restricted except for Health Care Provider.
 Allow only one attendant (3-4 hours).
 Keep the doors and windows closed.
 Cell 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.
Breaking chain 3 of infection
Portal of exit:
 Practice aseptic precaution.
 Avoid talking directly into the client's mouth to avoid
droplet infection.
 Infected HCPs or dealing with the patients who are
infected & must wear masks.
 Urine, faeces, emesis, and blood must be handled
carefully.
 Avoid waste and infection by wearing disposable
gloves.
Breaking chain 4 of infection
1. Contact Precautions
 One-patient room.
 Hand hygiene, gown/apron, and gloves before entering
patient room and before interacting with patient or
surroundings.
 Remove gown/apron and gloves and perform hand
hygiene after leaving room.
 Remove non-disposable articles from patient room and
disinfect.
This Photo by Unknown Author is licensed under CC BY
Breaking chain 4 of
infection (Cont.)
2. Droplet Precautions;
 One-patient room.
 Staff must wear surgical masks when entering
rooms, remove them when exiting, and wash
their hands.
 Instruct patient about respiratory hygiene
and cough etiquette.
 Only allow medically necessary patient
mobility outside the room.
 Leave room with a surgical mask.
Breaking chain 4 of infection (Cont.)
3. 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
Breaking chain 5 of
infection
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.
 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 chain 6 of infection
1. 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.
Breaking chain 6 of infection (Cont.)
2. 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.
Universal/Standard
precaution
 Standard precaution is “a set of
precautionary measures comprising
appropriate hand hygiene practices and
use of protective barriers during routine
patient care by health care workers
(HCW)”.
 Standard precaution contains following
things:
 Hand washing
 Gloving
 Gowning
 Mask/ protective eye wear/ cap
 Shoe cover
Any
Questions
???
Thank You!

Infection Control & Prevention

  • 1.
    Infection Control & Prevention PRESENTED BY: HARSHRASTOGI, Ph.D. STUDENT, AEC, PGIMER, CHANDIGARH
  • 2.
    Introduction  Hospital infectionsare a primary cause of unnecessary deaths.  Millions of preventable hospital infections cause unnecessary deaths, according to the CDC.  All health providers worry about organism transmission. Asepsis helps achieve this.  Asepsis is the state of being free from living pathogenic organisms.
  • 3.
    Introduction (Cont.)  Infectioncontrol addresses factors related to the spread of infections within the healthcare setting: Patient to Patient From Patients to Staff From Staff to Patients Among Staff
  • 4.
    Introduction (Cont.)  Handhygiene/handwashing  Cleaning  Disinfection  Sterilization  Vaccination  Surveillance  Monitoring/investigation of demonstrated or suspected spread of infection within a particular health-care setting (surveillance and outbreak investigation),  And management (interruption of outbreaks). Infection control also includes prevention via:
  • 5.
    Definition  Pathogenic microorganismsproliferate and invade bodily tissue, causing tissue harm and disease.  The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites those are not normally present within the body.  An infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent.
  • 6.
    Definition (Cont.)  Aninfection may remain localized, or it may spread through the blood or lymphatic vessels to become systemic (body wide).  Microorganisms that live naturally in the body are not considered infections.  For example, bacteria that normally live within the mouth and intestine are not infections.
  • 7.
    Infection prevention  Infection preventionpolicies and practices are used in hospitals and other health care facilities to reduce the spread of infections. This Photo by Unknown Author is licensed under CC BY-NC-ND
  • 8.
    Infectious diseases  Infectiousdiseases kill the most people worldwide.  Germs cause infections.  Germs are microscopic organisms found in air, soil, and water.  Germs can spread by touching, eating, drinking, or breathing.  Kissing, sexual contact, and animal bites transfer germs.  Vaccination, handwashing, and medicines can prevent illnesses.
  • 9.
    Four main kindsof germs Bacteria Fungi Virus Protozoa
  • 10.
    Type of infections Primaryinfection Initial infection with an organism to host constitutes primary infection. Secondary infection When in a host whose resistance is lowered by pre-existing infection, a new organism may set up a new infection. Local infection Infection that is limited to a defined area or single organ with symptoms that resemble inflammation (redness, tenderness and swelling.)
  • 11.
    Type of infections Systemicinfection • Infection that spreads to whole body resulting in a septicemia. Acute infection • It appears suddenly or lasts for a short time. Chronic infection • May occur slowly over a long period and may last months to years.
  • 12.
    Type of infections Iatrogenicinfection • Infection resulting due to therapeutic and diagnostic procedures. Nosocomial infection • Aka Hospital-acquired infection (HAI) is an infection that is contracted from the environment or staff of a healthcare facility.
  • 13.
    Chain of infection The presence of a pathogen does not mean that an infection will begin.  For infectious disease to spread, several necessary steps must occur.  These steps are known as “chain of infection”.  An infection will develop only if chain remains intact.  These links are:
  • 14.
    Causative agent Reservoir Portal of exit Modeof transmission Portal of entry Susceptible Host
  • 15.
    A. Causative agent The microorganism (for example bacteria, virus, protozoa or fungi).
  • 16.
    B.Reservoir  A hostwhich allows the microorganism to live, and possibly grow, and multiply.  Humans, animals and the environment can all be reservoirs for microorganisms.
  • 17.
    Portal of exit Path for the microorganism to escape from the host.  Examples: blood, respiratory tract, skin and mucous membranes, genitourinary tract, gastrointestinal tract, and transplacental pathway from mother to unborn infant.
  • 18.
    Mode of infection 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:
  • 19.
    Modes of infection (Cont.) Air-borne transmission  Contact transmission-direct and indirect  Vehicle transmission (Water, milk, food etc.)  Vector-transmission  Transplacental transmission
  • 20.
    Portal of entry A PATHFOR THE MICROORGANISM TO GET INTO A NEW HOST.
  • 21.
  • 22.
    Breaking chain ofinfection  As health professional, we cannot provide health care services without some exposure to potentially infectious materials, but we can prevent transmission in many cases.  Breaking the cycle is the only way to prevent infection.  Health personnel must follow protocols to prevent and control infection.
  • 23.
    Breaking chain 1of infection 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.
  • 24.
    Breaking chain 1of infection(Cont.) 2. Control or elimination of infectious agents including:  Proper cleaning by the water and mechanical action with or without detergents.
  • 25.
    Breaking chain 1of infection(Cont.)  Disinfection  Sterilization of contaminated objects. High level of disinfectants: • Activated glutaraldehyde (Cidex 2%) • Sodium hypochlorite 1% • Carbolic solution 5% • Bleaching powder 1% Low level of disinfectant: • Methylated spirit 70% • Betadine solution 10% • Savlone 1%
  • 26.
    Breaking chain 2of infection  Measures to control or eliminate of reservoir of infection are: 1. 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.
  • 27.
    Breaking chain 2of infection (cont.) 2. Environmental disease:  Cleaning with hospital approved clear disinfectant, e.g., phenol  Through cleaning of bed and bedside equipment's 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.
  • 28.
    Breaking chain 2of infection (cont.) 3. 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.
  • 29.
    Breaking chain 2of infection (cont.) 4. 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.
  • 30.
    Breaking chain 2of infection (cont.) 5. Visitors control:  Traffic should be restricted except for Health Care Provider.  Allow only one attendant (3-4 hours).  Keep the doors and windows closed.  Cell 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.
  • 31.
    Breaking chain 3of infection Portal of exit:  Practice aseptic precaution.  Avoid talking directly into the client's mouth to avoid droplet infection.  Infected HCPs or dealing with the patients who are infected & must wear masks.  Urine, faeces, emesis, and blood must be handled carefully.  Avoid waste and infection by wearing disposable gloves.
  • 32.
    Breaking chain 4of infection 1. Contact Precautions  One-patient room.  Hand hygiene, gown/apron, and gloves before entering patient room and before interacting with patient or surroundings.  Remove gown/apron and gloves and perform hand hygiene after leaving room.  Remove non-disposable articles from patient room and disinfect. This Photo by Unknown Author is licensed under CC BY
  • 33.
    Breaking chain 4of infection (Cont.) 2. Droplet Precautions;  One-patient room.  Staff must wear surgical masks when entering rooms, remove them when exiting, and wash their hands.  Instruct patient about respiratory hygiene and cough etiquette.  Only allow medically necessary patient mobility outside the room.  Leave room with a surgical mask.
  • 34.
    Breaking chain 4of infection (Cont.) 3. 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
  • 35.
    Breaking chain 5of infection 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.  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.
  • 36.
    Breaking chain 6of infection 1. 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.
  • 37.
    Breaking chain 6of infection (Cont.) 2. 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.
  • 38.
    Universal/Standard precaution  Standard precautionis “a set of precautionary measures comprising appropriate hand hygiene practices and use of protective barriers during routine patient care by health care workers (HCW)”.  Standard precaution contains following things:  Hand washing  Gloving  Gowning  Mask/ protective eye wear/ cap  Shoe cover
  • 41.
  • 42.