infection control biomedical waste management

1. INFECTION CONTROL
SUPRIYA PATKAR

2. DEFINITION
 Infection Control—The process by which
health care facilities develop and implement
specific policies and procedures to prevent
the spread of infections among health care
staff and patients.

3. INFECTION
It is an invasion of body tissue by
microorganisms and their proliferation there.

4. NATURE OF INFECTION
 ASYMPTOMATIC :- no clinical evidence of
disease.
 SYMPTOMATIC :- clinical sign & symptom
presents.
 COMMUNICABLE :- transmits from one
person to another.

7. Chain of Infection
Pathogen
Reservoir
Portal of Exit
Mode
of
Transmission
Portal of
Entry
Susceptible
Host
Why Isolation?.. because transmission is
easier to control than the source / host!

9. How Microorganisms Spread
 Direct Contact
 transmitted directly from one person to another
 Indirect contact
 transferred from one object to another
 Airborne
 carried in the air
 Oral route
 enters body through water, food dirty hands
 Insects and Pests
 picked up on insects and pests and transferred

11. DEFENSES AGAINST INFECTION
 NATURAL
 ACQUIRED

12. Asepsis
 Asepsis
 free from or keeping away disease producing
microorganisms
 Medical Asepsis
 to destroy the environment that allows pathogens to
live, breed, and spread
 Aseptic technique
 methods used to make the environment, worker, and
as germ free as possible

13. Asepsis
 Surgical Asepsis
- to destroy disease producing
microorganisms including spore forming &
create & maintain sterile field.

14. Universal Precautions
 Universal Precautions Techniques
 Wear gloves when
 touching blood
 touching mucous membranes
 performing veinipuncture
 touching body fluids of any kind
 Body Fluids
 vaginal fluids or semen
 cerebrospinal fluid
 pleural fluid (fluid around lung)
 pericardial fluid (fluid around heart)
 synovial fluid (fluid in the joints)
 amniotic fluid (fluid around the fetus)
 placenta tissue
 saliva with blood in it

15. Universal Precautions
 Wash hands after glove removal
 Protect clothing with apron or gown when
splashing of blood or body fluids is possible
 Discard needles or other sharps in puncture-
resistant container
 Do not recap needles or work with needles
before disposal
 Waste and soild linen must be handled with
care

16. Key Points About PPE
Don before contact with the patient,
generally before entering the room
Use carefully – don’t spread contamination
Remove and discard carefully, either at the
doorway or immediately outside patient
room; remove respirator outside room
Immediately perform hand hygiene

17. Sequence for Donning PPE
Gown first
Mask or respirator
Goggles or face shield
Gloves

18. How to Safely Use PPE
Keep gloved hands away from face
Avoid touching or adjusting other PPE
Remove gloves if they become torn;
perform hand hygiene before donning new
gloves
Limit surfaces and items touched

19. “Contaminated” and “Clean”
Areas of PPE
Contaminated – outside front
• Areas of PPE that have or are likely to have been in contact with
body sites, materials, or environmental surfaces where the
infectious organism may reside
Clean – inside, outside back, ties on head
and back
• Areas of PPE that are not likely to have been in contact with the
infectious organism

20. Sequence for Removing PPE
Gloves
Face shield or goggles
Gown
Mask or respirator

21. Where to Remove PPE
At doorway, before leaving patient room or
in anteroom*
Remove respirator outside room, after
door has been closed*
* Ensure that hand hygiene facilities are available at the point needed,
e.g., sink or alcohol-based hand rub

22. Removing Isolation Gown
Unfasten ties
Peel gown away from
neck and shoulder
Turn contaminated
outside toward the
inside
Fold or roll into a
bundle
Discard

23. Removing a Mask
Untie the bottom, then
top, tie
Remove from face
Discard

24. Hand Hygiene
Perform hand hygiene immediately after
removing PPE.
• If hands become visibly contaminated during PPE removal, wash hands
before continuing to remove PPE
Wash hands with soap and water or use an
alcohol-based hand rub
* Ensure that hand hygiene facilities are available at the point needed,
e.g., sink or alcohol-based hand rub

25. HOSPITAL ACQUIRED INFECTION
 Nosocomial Infection—An infection
contracted by a patient or staff member
while in a hospital or health care facility (and
not present or incubating on admission)

26. HOSPITAL ACQUIRED INFECTION
 Most common sites for nosocomial infections
 Surgical incisions
 Urinary tract (i.e., catheter-related)
 Lower respiratory tract
 Bloodstream (i.e., catheter-related)

27. HOSPITAL ACQUIRED INFECTION
Common microorganisms
 Aerobic gram-positive cocci
(Staphylococcus aureas [MRSA],
enterococci [vancomycin-resistant]),
 Aerobic gram-negative bacilli (Escherichia
coli, P. aeruginosa, Enterobacter spp., and
Klebsiella pneumoniae)

28. HOSPITAL ACQUIRED INFECTION
Nosocomial transmission of community
acquired, multidrug-resistant organisms
 M. tuberculosis
 Salmonella spp.
 Shigella spp.
 V. cholerae

29. Isolation and Standard
Precautions
 Whenever possible, avoid crowding wards.
 Implement specific policies and procedures for
patients with communicable diseases:
 Private rooms and wards for patients with specific
diseases
 Visitation policies
 Hand washing and use of gloves
 Gowns, when appropriate
 Masks, eye protection, gowns
 Precautions with sharp instruments and needles

30. Standard Precautions
 Establish policies and procedures to prevent food
and water contamination
 Establish a regular schedule of hospital cleaning
with appropriate disinfectants in, for example,
wards, operating theaters, and laundry
 Dispose of medical waste safely
 Needles and syringes should be incinerated
 Other infected waste can be incinerated or autoclaved
for landfill disposal
 Bag and isolate soiled linen from normal hospital
traffic

31. Standard Precautions
 Written policies and procedures are needed
 All objects to be disinfected or sterilized should first be
thoroughly cleaned
 Use stream sterilization whenever possible
 Quality control in reprocessing is essential
 Monitor and record sterilization parameters (i.e., time, temperature,
pressure)
 Biological indicators should be used to ensure sterilization
 Chemical indicators are necessary for chemical sterilization
 Sterilized items must be stored in enclosed clean areas
 Items or devices that are manufactured for single use should
not be reprocessed (e.g., disposable syringes and needles)

32. What to do if exposed to
blood / body fluids
 Puncture wounds should be washed immediately
and the wound should be caused to bleed
 If skin contamination should occur, wash the
area immediately
 Splashes to the nose or mouth should be flushed
with water
 Eye splashes require irrigation with clean water,
saline, or a sterile irritant
 Most importantly: Complete a GBMC
Employee Incident Report. Report exposure to
charge nurse and Agency immediately

33. DISINFECTION
 Disinfection—The process of microbial
inactivation that eliminates virtually all
recognized pathogenic microorganisms, but
not necessarily all microbial forms (e.g.,
spores)

34. STERILIZATION
 Sterilization—The use of physical or chemical
procedures to destroy all microbial life, including
large numbers of highly resistant bacterial
endospores. Procedures include—
 Steam sterilization
 Heat sterilization
 Chemical sterilization

35. Methods of Sterilization
Microbial
Control
Methods
Physical
Agents
Chemical
Agents
Mechanical
Removal
Methods

36. Chemical
Agent
Gas
Sterilization Disinfection
Liquids
Animate
Chemotherapy Antiseptics
Inanimate
Sterilization Disinfection

38. Mechanical
Removal
Methods
Filtration
Air
Disinfection
Liquids
Sterilization

39. Physical Methods of Sterilisation
Sterilisation By Dry Heat:
Hot Air Oven
• Kills by oxidation effects
•The oven utilizes dry heat to
sterilize articles
• Operated between 50oC to
250/300oC.
•A holding period of 160oC for 1 hr
is desirable.
• There is a thermostat controlling
the temperature.
•Double walled insulation keeps the
heat in and conserves energy,

40. Uses:
 To sterilise Forceps, Scissors, Scalpels, Swabs.
 Pharmaceuticals products like Liquid paraffin, dusting
powder, fats and grease.

41. FLAMING
 Inoculation loop or
Wire, the tip of
Forceps and
spatulas are held in
a bunsen flame till
they are red hot.

42. INCINERATION
This is an excellent method of
destroying materials such as
contaminated cloth, animal
carcasses and pathological
materials.

43. MOIST HEAT STERILIZATION
Kills microorganisms by coagulating their
proteins.

44. MOIST HEAT STERILISATION IS CARRIED OUT WITH
FOLLOWING METHODS
 Temp below 100oC: “Pasteurisation”, Inspissator.
 Temperature at 100oC: Boiling.
 Steam at atmospheric pressure: Koch/Arnold’s
steamer.
 Steam under pressure: Autoclave.

45. Steam Sterilizer

46. AUTOCLAVE

59. HOSPITAL WASTE MANAGEMENT