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Presented
by
DR . Soha El-Hady
Professor of Medical Microbiology &
Immunology,
Faculty of Medicine, Ain Shams University
1
Standard Precautions include
• Hand Hygiene
• Personal Protective Equipment (PPE) (e.g. gloves, gowns,
masks, eye goggles and face shields)
• Proper handling and processing of patient care
equipment
• Environmental surfaces control
• Respiratory hygiene
• Safe injection

4/2021 IPC 2
4/2021 IPC 47
Safe waste disposal

• Segregation at work place (sharp waste & infectious or regulated

medical waste)
• Color coding of receptacles
• Puncture-resistant containers with a lid for sharp waste

4/2021 IPC 48
Infectious or regulated medical waste
•Fluid waste (Blood & body fluids ).
•Contaminated items with blood or other potentially infectious
materials e.g. contaminated dressings.
•Microbiology laboratory waste e.g. stock cultures, discarded
diagnostic samples (e.g. urine, stool).
•Pathological and anatomical waste.
•Sharps e.g. used syringes, needles, disposable scalpels and
blades.

4/2021 IPC 5
4/2021 IPC 6
Respiratory Hygiene

• It applies to any person with signs of illness

including cough, congestion, rhinorrhea, or
increased production of respiratory secretions
when entering a healthcare facility.

4/2021 IPC 7
 Source Control Measures

•Cover your nose and mouth with a

tissue when you cough or sneeze.

•Throw the tissue in the trash.

•Wash your hands.

•Wear a face mask if tolerated or

maintain a social distance of about 2
meters.
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9
Safe Injection Practices
• What is safe injection???
• It is a set of measures taken to perform injections in
an optimally safe manner for patients, healthcare
personnel, and others

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11
 Safe Injection practices:
• Use a sterile syringe and needle for each injection, dispose
appropriately after use in approved puncture resistant container for
sharps disposal.
•Never use medication in a syringe for more than one patient even if
the needle is changed between patients. Changing the needle but
not the syringe is unacceptable.
•Do not keep multi-dose vials in the immediate patient treatment
area; store in accordance with the manufacture’s recommendations;
discard if sterility is compromised or questionable.
•Check the vial for leaks or cracks.

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Safe Injection practices (cont.)

• The vial access diaphragm should be disinfected with an

approved disinfectant (70% alcohol) immediately prior to
accessing.
•Always use a new needle and syringe every time fluid is
withdrawn from a multidose vial.
•Never leave one needle inserted in the vial cap for multiple
uses.
•Expired medications should be discarded.

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Proper handling of multi dose vials

1. Keep it in a clean place outside patient treatment area

2. It should be labeled with opening date and expiry date
3. Before use: Check the vial for leaks or cracks
4. Prior to access: Disinfect the vial access diaphragm with 70%
alcohol
5. Always use a new needle and syringe every time fluid is
withdrawn from a multidose vial
6. Never leave an inserted needle in a multidose vial

14
4/2021 IPC 15
4/2021 IPC 16
Aseptic techniques

• Aseptic Technique is a general term involving practices that

minimize the transmission of micro-organisms during invasive
procedures

• Invasive procedures
• Surgical procedures
• The placement of device into sterile body spaces such as
intravenous lines and Urinary catheters.
• Wound care
• Intravenous or intramuscular injection

4/2021 IPC 62
Key processes for performing Aseptic Techniques

• Hand antisepsis
• Patient skin antisepsis
• No-touch-technique
• Suitable attire (head cap, mask, strile gown, sterile
gloves)
• Sterile drapes
• Maintaining sterile field during surgical procedures
4/2021 IPC 63
Clean no touch technique
Insertion of PVC

4/2021 IPC 20
Transmission Based Isolation
Precautions

4/2021 IPC 21
Transmission based precautions

•Contact precautions

•Droplet precautions

•Air borne precautions

4/2021 IPC 22
Contact precautions

• Applied for patients infected or colonized with microorganisms

transmitted by direct or indirect contact
Examples :
• Skin Infections: impetigo, scabies, pediculosis
• Respiratory syncytial virus.
• Disseminated herpes simplex, Zoster
• MRSA, VRE and multi drug resistant Gram negative bacteria.
• Clostridium difficile associated diseases.

4/2021 IPC 23
Requirements of Contact precautions

In addition to standard precautions

• Single room if available
• En-suite toilet and HW basin
• Clean gloves and clean gowns during any patient
contact

4/2021 IPC 24
Droplet precautions
Applied for patients with infections transmitted by large Droplets
Examples:
• Influenza
• Rubella
• Meningococcal meningitis
• Streptococcal pharyngitis
• Multi-drug resistance pneumococcal pneumonia
• Pneumonic plague

4/2021 IPC 25
Requirements of droplet precautions
In addition to standard precautions
• Single room if available
• En-suite toilet and HW basin
• A standard surgical mask should be worn before entering the
room or being within one meter from the patient
• Limit patient movement to essential purposes
• Patient can put a surgical standard mask while being outside
the isolation room

4/2021 IPC 26
Airborne precautions
Applied for air borne transmitted infections
e.g.

• Tuberculosis
• Measles
• Varicella-Zoster

4/2021 IPC 27
 Requirements of airborne precautions

• A single room with

negative air flow
ventilation

• A high efficiency mask

should be worn before
entering the room.

4/2021 IPC 72
Requirements of airborne precautions

•En suite toilet and a basin for hand washing.

•The door of the room should be kept closed except
during necessary entrances and exits.
•The patient transport outside isolation room should be
limited to essential purposes
•Patient can put a face mask while being outside the
isolation room

4/2021 IPC 29
Positive air pressure room

4/2021 IPC 30
4/2021 IPC 31
Safety Program

• Education and Training

• Immunization
• Exposure Prevention
• Exposure Management

4/2021 IPC 32
HCW Immunization
• Hepatitis B vaccine: (3-dose vaccine series administered intramuscularly
at 0, 1, and 6 months).

• Influenza vaccine (annual vaccine)

• Measles, Mumps and Rubella vaccines (MMR).

• Varicella-zoster (VZV).

• Tetanus, diphtheria and acellular pertussis(Tdap).

4/2021 IPC 33
Pre-exposure management (for HBV)

• Pre-exposure evaluation for health-care

personnel previously vaccinated with
complete (≥3dose) HepB vaccine series who
have not had postvaccination serologic testing

4/2021 IPC 34
Risk of blood borne pathogens
• Blood borne pathogens include:
• HBV
• HCV
• HIV
• They are often carried by persons
unaware of their infection.
• They can produce chronic infection
and dangerous complications
• Needle stick and other sharp
injuries represent the greatest risk
4/2021 IPC 36
Prevent sharp injuries

• Be careful with sharp instruments

• Do not recap by two hands
• Do not dispose in plastic bags
• Dispose in puncture resistant container

4/2021 IPC 37
Sharps disposal and handling

√ √
4/2021 IPC 38
Exposure Management

• IMMEDIATE response
• REPORTING
• TESTING of source patient (if applicable).
• Specific viruses measures

4/2021 IPC 39
Immediate Response

• Skin wounds should be cleaned with soap and

water.
• Mucous membranes should be flushed thoroughly
with water.
• Eyes should be irrigated with normal saline.

4/2021 IPC 40
Immediate response to exposure incidents

4/2021 IPC 89
Importance of reporting exposure incidents
(Give reasons)
• Assess infection risk according to:
• Type and severity of exposure: e.g. percutaneous or mucous
membrane.
• Type and amount fluid exposure e.g blood or body fluid.
• Administer post exposure prophylaxis (PEP) if indicated.
• Allow follow up for the exposed HCP.

4/2021 IPC 42
 Management of exposures to specific viruses

• Any blood or body fluid exposure to an unvaccinated person should

lead to initiation of the hepatitis B vaccine series.
• Further management of exposure to HBV depends on the HB
vaccination status and the vaccine response status of the exposed
personnel.
• Postexposure management of exposure to HCV is intended to achieve
early identification of infection by base line and follow up testing.
• HCP exposed to HIV should be evaluated within hours after exposure
for administration of antiretroviral medications as soon as possible after
exposure within 72 hours (preferable 24 hours)

4/2021 IPC 43
To sum up
•HAIs are common adverse effects in all health care levels
•Preventive strategy relies upon adherence to standard
and transmission-based isolation precautions
•Aseptic techniques are basis for patient safety in invasive
clinical procedures
•HCP safety depends on vaccination, prevent exposure
and proper management of exposure events

4/2021 IPC 44
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4/2021 IPC 93