Infection Control in Healthcare

1401AHS
Background Reading
• Lee & Bishop, 2015, Microbiology and Infection Control for Health
Professionals Chapter 13: Infection control in healthcare facilities
Learning Outcomes
By the end of this tutorial, you will be able to:
1. Describe the importance of Healthcare-Associated Infections (HAI) and how they
differ from community strains of infection
2. Describe the common types of HAI and where and how they occur
3. List potential sources of infection and routes of transmission of infection in
healthcare facilities
4. Describe risk factors associated with HAI and strategies to minimise these risks
5. Describe methods to control transmission and spread of different types of HAI
6. Describe why hand hygiene is important
Definition: Healthcare Associated Infections (HAI)
• Not present or incubating at time of admission
• Occur 48 hrs after admission to healthcare facility or as a
consequence of a medical procedure
• HAI = Nosocomial (Latin/Greek Hospital) Infections
• Iatrogenic infections = infections caused by a medical procedure
• Contaminated surgical wound → wound infection
• Insertion of urinary catheter → urinary tract infection
 How do infections spread?
Three elements are needed:

1. A source of infectious agent

2. A mode of transmission

3. A susceptible host

We can break the chain by implementing certain precautions to limit

the spread

http://www.rph.org.nz/public-health-topics/early-childhood-centres/keeping-your-centre-healthy/how-do-infections-spread/
History of Healthcare Associated Infections
• Hospitals have existed for over 2000 years

• Initially designed with plenty of fresh air and a focus on hygiene.

• Roman Empire and through the middle ages the emphasis on

hygiene was lost giving way to ignorance and superstition.

• 19th Century reduced mortality and infections:

• Ignaz Phillip Semmalweis (1847): Demonstrated that washing

hands with a chlorinated solution before entering the obstetric
ward reduced mortality
• Joseph Lister (1869): Introduced antiseptics

• Florence Nightingale (1854): Introduced sanitary measures in

English field hospitals during the Crimean War

• 20th Century: antibiotics improved the treatment outcome of

infections but did not decrease the number of HAI’s
 Why are HAIs important?
• People who go to hospital should expect to get better not worse!

• In developed countries - up to 12% patients acquire an infection while

in healthcare facilities

• In developing countries - up to 25% patients

Australia – 165,000 HAI in acute

healthcare facilities each year

https://nhhi.southrock.com/courseware/fad41a790d72b4052e493b54bb17ff60c17773db/NHHI_PB-
INFECTION_CRTL_content/start.html?msecs=85c2e0f60dc74415995262860844b771&assess_url=RunMsAssessStart.cgi%3Fmsecs%3D95298e3e9d85228c56d42243cc369014%26SKIP%3D1%26c
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tps%3A%2F%2Fnhhi.southrock.com%2Fcgi-bin%2FSRAICCHandler.cgi&MS_ID=58860&SCH_ID=2235540
Why are HAIs important?
• Less able to resolve infection – more serious consequences

• Length of hospital stay increases

• Greater costs
Who is at risk of a HAI?
• Many hospitalised patients are more susceptible to infections because of diminished immunity:

• Age extremes - babies, elderly

• Underlying diseases - immune dysfunctions, cancer

• Existing infection – e.g. viral infection can lead to bacterial pneumonia

• Poor nutrition

• Therapies – immunosuppressive drugs, surgery or treatments that break natural barriers and
introduce microbes to normally sterile sites

• Antibiotic therapy – disrupt normal microbial flora and allow pathogenic (disease-causing)
microbes to establish foothold in tissues.

• Medical procedures – e.g. surgery, catheters

Community Acquired Infections
• How are these different to HAI?

• Why are HAI more serious than community acquired infections?

 So how do we manage
hospital-acquired infections?
Part A: Hand Hygiene
• Complete the ‘Hand Hygiene Allied Health Online Learning Module’ using the
following link:

• https://www.safetyandquality.gov.au/hand-hygiene-and-infection-prevention-and-
control-elearning-modules

• You will need to register (this is free) before you can access the online learning
module. Once you have completed and successfully passed all of the exams, a
certificate will be emailed to you.
Part B: Group Activity
• You will be divided into groups by your tutor and each group will
address one of the following aspects of HAI:

1. Organisms of infection

2. Modes of transmission

3. Infection control measures

Part B: Group Activity
1. Organisms of infection

What are the characteristics of bacteria, fungi, parasites and viruses? What is the relationship with each
of these with the host? Why are MRSA and VRE infections a concern for hospitals?

https://vivotesting.com/bacteria_viruses_fungi_and_parasites

2. Modes of Transmission (exogenous and endogenous)

Describe the 3 main modes of transmission and give examples of organisms that are commonly
transmitted under each mode:
• Contact (direct and indirect)

• Droplet/fluid

• Airborne
Give one example of each of these modes of transmission

Describe the difference between exogenous and endogenous HAI

Part B: Group Activity
3. Infection control strategies

• Describe a range of infection control strategies to minimise the spread

of HAIs in terms of contact, droplet and airborne transmission

• List the 5 moments for hand hygiene

• What hand rub delivers the best hygiene?

Part C: Concept Map
• Come back to your original group (each person should have completed a different
question in the above task) and develop a concept map with “HAND WASHING
IS IMPORTANT” at the centre; add all the factors that related to this topic around,
with arrows showing the visual inter-relationship between concepts and ideas. A
concept map is a type of graphic organiser used to help you organise and
represent knowledge of the subject. Concept maps begin with a main idea (or
concept) and then branch out to show how that main idea can be broken down
into specific topics.

Take a photo of your concept map so you can keep this for future reference
THANK YOU