infection prevention control for health staff

1. Provincial Health Services Academy
Infection Prevention and Control

2. Provincial Health Services Academy
Infection Prevention and Control
• Measures adopted to:
– Prevent or reduce the rates of Health
care-associated infections (HAIs)
– Control and decrease the morbidity
and cost
– Ensure the protection of those who
might be vulnerable to acquiring an
infection

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Infection
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• An infection is the invasion of tissues by
pathogens, their multiplication, and the reaction of
host tissues to the infectious agent and the toxins
they produce.

4. Provincial Health Services Academy
Components of IPC
Disinfection and
Sterilization
Isolation Precautions
Health care Waste
Management
Environmental Infection
Control

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Hand Hygiene
Injection safety & Device-
associated Infection Prevention
Respiratory Hygiene/Cough
Etiquette
Immunization of Health-Care
Workers
Infection Control in Critical Care
Components of IPC…..

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Implementation of
Infection Control Programs
Infection Control
Committee
(ICC)
Infection Control
Team (ICT)

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Infection Control Committee (ICC)
Chair: Infectious Diseases Specialist/Surgeon/Microbiologist/Physician/Medical
Superintendent /Administrator (coordinator)
Members:
• Medical Superintendent/Administrator (coordinator)
• Epidemiologist
• Member from Surgical & Allied Departments
• Member from Nursing/Matron’s office.
• Member from Medical & Allied Departments
• Incharge of O.Ts and sterilization section.
• Member from Stores/Purchase.
• Member from Canteen/Food Supplies.
• Chief of Sanitary Services and house keeping.
• Biomedical Engineer/Civil Engineer

8. Provincial Health Services Academy
Infection Control Committee (ICC)
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Infectious Diseases Specialist/ Surgeon/ Microbiologist/
Physician/ Medical Superintendent/ Administrator
Chair
(coordinator)
Medical Superintendent/Administrator (coordinator)
Epidemiologist
Member from Surgical & Allied Departments
Member from Nursing/Matron’s office.
Member from Medical & Allied Departments
Incharge of O.Ts and sterilization section.
Member from Stores/Purchase.
Member from Canteen/Food Supplies.
Chief of Sanitary Services and house keeping.
Biomedical Engineer/Civil Engineer
Members

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• To have monthly meetings
• To develop Protocol/Guidelines
• To monitor activities.
• Generate Resources (Human, Financial & Logistic)
• To plane and approve the annual plan
• To implement infection control policies and strategies.
• To direct resources to address any additional issue/problem when
identified.
• To ensure availability of appropriate supplies and logistics
• To encourage communication among the involved disciplines and
different departments.
• To report outbreaks of nosocomial infections and incidents

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Infection Control Team (ICT)
• Chair: Infectious Diseases Specialist/
Senior Surgeon/ Microbiologist/ Physician.
• Members:
• Infection Control Nurse/ Technician
• Infection Control Doctor/ Microbiologist
• Sanitary Inspector & housekeeping staff
representative

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• Meet at least weekly (daily in case of an outbreak)
• Implementation of IPC- program
• Day to day surveillance of infections
• Identify gapes and organize trainings programs for staff
• Ensure uninterrupted availability of PPE eg., ……………
• Advise the staff on all aspects of infection control needed to maintain a
safe environment for patients and staff
• Monitor Nosocomial infection and report any incident
• Identify problems in implementation of infection control activities
• Develop an annual training plan for the health care workers.
• Investigate outbreaks within the health care facility
• Submit monthly reports on activities to the ICC

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Key Administrative Recommendations
Develop and maintain infection
prevention and occupational health
programs
Assure sufficient and appropriate
supplies necessary for adherence to
Standard Precautions
Assure at least one trained person on
duty
Develop written infection prevention
policies and procedures

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Prevention of Nosocomial infection
• Standard Infection Control Precautions (SICP)
• Hand Hygiene
• Respiratory Hygiene/ cough etiquette
• Personal Protective Equipment
• Injection Safety/ safe injection practices
• Occupational Exposure management including Sharps
• safe handling of potentially contaminated equipment
• Management of Care Equipment
• Safe Care of Linen including Uniforms
• Control of Environment
• Safe Waste Disposal

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IPC Precautions
Standard Precautions
 Routine precautions to be applied in all situations for all
patients
Additional Precautions (based on route of transmission)
 For specific patients/diseases
 Contact Precautions
 Droplet Precautions
 Airborne Precautions

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Standard Precautions….
• Hand washing
• PPEs: Wear gloves, Mask, Eye Protection, Face Shield, gown
• Patient-care equipment
– Ensure that single-use items are discarded properly
– Ensure that reusable equipment be used after sterilization/cleaning
• Environmental Control:
– cleaning, and disinfection of environmental surfaces, beds,
bedrails, bedside equipment, and other frequently touched
surfaces
• Linen: Handle, transport, and process used linen with care
• Occupational Health
• Patient Placement

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Personal Protective Equipment
Head protection
Eye and Face protection
Respiratory protection
Foot protection
Protective clothing
Gloves

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Five Moments for Hand Hygiene

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How do I Practice
Hand Hygiene Correctly?

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Biomedical Waste Management

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BMW Management….
• Management of health-care waste is an integral part of hospital
hygiene and infection control
• Health-care waste should be considered as a reservoir of
pathogenic microorganisms
• Infectious waste contributes in this way to the risk of nosocomial
infections, putting the health of hospital personnel, and patients, at
risk.
• a comprehensive and systematic approach to hospital hygiene and
infection control.

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Waste classification

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Real picture

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What to do?

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Segregation

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Management

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Summary

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Discharging the Patient
• Ensure patient and family have been educated as to what
precautions are to be taken (children < 12 years may shed
the virus for prolonged time)
• Self health monitoring (fever, signs of influenza), reporting
• Ensure that appropriate cleaning and disinfection of the
room takes place, no spraying of disinfectant
• Ensure appropriate cleaning, disinfection and/or sterilization
of medical equipment

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Care of the Deceased
• Use standard precautions for routine care of the body
• PPE to be used by HCWs
• waterproof gown
• surgical or procedure mask
• Non-sterile, ambidextrous gloves: cover cuffs of gown
• If splashing of body fluids is anticipated:
• Hair-cover
• face shield (preferably) or goggles
• After removing PPE, perform hand hygiene
• Family should wear gloves, gowns & perform hand hygiene
• Seal body in impermeable body bag prior to transfer to the mortuary
• Cultural sensitivity should always be considered

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of Infection
Portal of exit
Reservoir
Mode of
transmission
Susceptible host
Infectious Agent
Portal of entry

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Transmission

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General historical perspective on
infection control in
home and community
• History of advice on hygiene, cleaning & infection control
dates back at least to the mid 19th century
• Today - renewed interest :
– emerging infections: e.g. SARS, influenza,
– cross-contamination & person-person transmission,
– antibiotic resistance,
– viral agents
– immuno-compromised groups in the community

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The home is central to the community
with a constant movement of pathogens
Home
school
daycare
residential
care
hospital
retail-
food
leisure workplace

36. Provincial Health Services Academy
Why Infection Control in Home?
 Click to edit Master text styles
 Second level
 Third level
 Fourth level
 Fifth level

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Sources of Pathogens into Home
• HUMANS: Enteric bacterial pathogens, Staph. aureus (MRSA),
norovirus, rotavirus, rhinovirus, influenza, hepatitis A, SARS
etc.
• PETS: Enteric pathogens, protozoa, herpes B, toxoplasma,
MRSA
• FOOD: Salmonella, Campylobacter, E.coli O157, Listeria,
Bacillus cereus, enteric viruses
• AIR: Fungi, respiratory agents, aerosols from food preparation
& toilet flush etc (bacteria & viruses).
• WATER: Enteric pathogens, Cryptosporidium, Legionella

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Targeted hygiene
• Aim: to reduce the numbers of pathogens to a level where
there is no longer a threat to health
• Targeted hygiene involves identifying the sites, surfaces and
situations in the home where pathogens are most likely to be
found, as well as considering whether the pathogen
represents an infectious dose and the probability of human
exposure to the pathogen

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Summary
• The home is a multifunctional setting with scenarios of increased
risk.
• Infectious disease continues to be a significant threat.
• Transmission of infection occurs throughout a range of community
settings, including the home.
• Throughout the community, hand hygiene is a primary defense
against infectious disease.
• Home & community hygiene practices offers benefits in terms of
reducing the level of cross-contamination.

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Summary (continued)
• Hygiene practice becomes even more important in an age of
antibiotic resistance
• Hygiene promotion raises standards of hygiene awareness
and practice, both in the home and in the general
community.
• Effective home & community hygiene practice includes the
targeted use of antimicrobial agents.

41. Provincial Health Services Academy
Hospital Hygiene and Infection
Control