INFECTION CONTROL

INTRODUCTI
• ONrequirement in a hospital
“The very first
that it should do the sick no harm" -
Florence Nightingale

• Health care associated infections(HCAI)-

economic loss, prolonged hospital stay
& adverse patient outcomes.

• In most health care facilities

the average incidence of HCAI
is around 5-10 %
INFECTION CONTROL -
DEFINITION
Measures practiced by health care
personnel to prevent spread,
transmission & acquisition of
infection between clients, from
health care providers to clients &
from clients to HCP.

Standard
precaution
Based on
Additio
 COMMON
ORGANISMS
BACTERIA VIRU
 Staphylococcus S
aureus  HIV
 Enterococcus  HBV
 Pseudomonas  HCV
aeruginosa  CMV
 Klebsiella
 E- coli
FUNGAL
 Candida albicans
 Aspergillus

PARASITES
 Giardia lambia
 RISK DUE
TO
• Low resistance of patient to
infections.
• Invasive
procedures/interventions.
• Inappropriate anti-microbial
usage.
• Drug resistance of endemic
microbes.
• Contaminated environment.
STANDARD
SAFETY
MEASURES
 STANDARD
• Set PRECAUTION
of infection control practices used
to prevent transmission of diseases
that can be acquired by contact with
blood, body fluids, non- intact skin &
mucus membrane
• STANDARD PRECAUTION STEPS
– Hand washing

– PPE

– Decontamination
 HAND
HYGIENE
Hand washing is the single most
effective measure in infection control.

80% of the diseases are spread through

hands.
How to
Handwash?
HOW TO HAND
RUB?
 POINTS TO BE
REMEMBERED
• Covering cuts & wounds

• Gloves is not a substitute for hand

washing
• When a bar soap is used, it should be
kept dry in soap case
• When liquid soaps are used, avoid
topping off of the solution , dispenser
should be kept clean
PERSONAL
PROTECTIVE
• Gloves
EQUIPMENT
• Gown
• Mask
• Protective eye
wear
• Face shield
• Apron
SEQUENCE FOR DONNING
PPE GOWN

MASK

GOGGLES
OR FACE
SHIELD

GLOVES
SEQUENCE FOR
REMOVING
PPE
 SAFE HANDLING OF
SHARPS
 Never pass sharps from one
person to another.
 Always dispose your own
sharps.
 DO NOT RECAP needles.
 Dispose sharps in puncture
proof container.
 DISINFECTI
ON
Reduce the number of
microorganisms on
an object or surface but not the
complete destruction of all
microorganisms or spores.
 TYPE OF
• High DISINFECTANTS
level
disinfectants 2%
glutaraldehyde (cidex)
stabilised hydrogen
peroxide 1% sodium
hypochlorite
• Intermediate level
disinfectants 0.1% sodium
hypochlorite Iodophores &
phenolic solutions
• Low level disinfectants
 STERILIZATI
ON
 Procedures, which would remove all
microorganisms, including spores, from
an object.
Sterilization Methods
• Dry heat sterilization

• Moist heat sterilization

• Chemical sterilization

• Radiation sterilization
 Safety
bundles
• A “bundle” is a group of evidence
based care components for a
given disease that, when
executed together, may result in
better outcomes than if
implemented individually.
 CAUTIs
Bundle
• Avoid unnecessay urinary
catheters
• Insert using aseptic technique
• Maintain catheter using
recommended guidelines
(daily care)
• Review catheter necessity daily
& remove promptly.
 CLABSI
• Hand hygiene
s
• Maximal barrier precautions
• Chlorhexidine skin antisepsis
• Optimal catheter site selection
• Daily review of line necessity with
prompt removal of unnecessary lines
• Line secure with clean & intact
dressing
 SSI
Bundle
• Appropriate use of
antibiotics
• Appropriate hair removal
• Post operative glucose
control
• Peri & postoperative
normothermia
 VAP
Bundle
• DVT prophylaxis
• GI prophylaxis
• Head of bed elevated to
30-45º
• Daily sedation vacation
• Daily spontaneous
breathing trail
BIO MEDICAL
WASTE
MANAGEMENT
DEFINITI
ON
Waste generated during the
diagnosis, testing, treatment,
research or production of
biological products for humans or
animals (WHO)

Waste management is the collection,

transport, processing or disposal,
managing & monitoring of waste
material .
PURPOSES OF WASTE
DISPOSAL
 T o reduce hazardous nature of
waste.
 To reduce volume of waste.

 To prevent misuse or abuse of

waste.
 To ensure occupational safety
& health.
 LEGISLATIO
N
• Ministry of environment & forests
(MOEF) issued guidelines to the
hospitals to ensure proper & safe
disposal of bio medical waste.

– Bio medical waste management &

handling rule came in to effect in
1998
 3 BINS, 01 CONTAINER, O1
BOX
Human Glassw
anatomical are:
waste (Contami Waste Broken
Chemo nated or
Gene drugs Plastic sharp discar
ral Soiled Waste s ded &
waste
wast (Recycla includ contamin
Expired ble
e or ing ated
Discarded Metal glass
s including
Medicines medicine
, soiled vials &
linen ampoules

3
 BMW RULE 2016
CATEGOR TYPE OF TREATMENT &
Y DISPOSAL
WASTE
(a)Human Incineration or plasma
anatomi pyrolysis or deep burial
cal
waste
YELLOW (b)Animal
anatomi
cal
(d)waste
Expired Incineration at tem.
(c)Solied
or >12000C Or Encapsulation
waste
discarded or Plasma Pyrolysis
medicine
(e) Chemical Pre treatment before
liquid mixing with
waste waste water.
(f) Non- chlorinated
Linen chemical
 BMW RULE 2016
CATEGORY TYPE OF TREATMENT &
WASTE DISPOSAL
Contamin
Autoclaving or
ated
RED plastic
waste
micro- waving
followed by
( Recyclable)
shredding,
sterilization &
then sent to
registered
recyclers for energy
recovery or for road
 BMW RULE
CATEGORY 2016
TYPE OF TREATMENT &
WASTE DISPOSAL
White Waste Autoclaving &
( Translucent sharps shredding &
Puncture including sent for final
proof, Metals
containers disposal to iron
) foundries.
consent to operate from
the
State Pollution Control
Boards
or concrete waste sharp
pit.
 BMW RULE
CATEGORY 2016 TYPE OF TREATMENT
WASTE &
DISPOSAL
Cardboard Glassware:Bro Disinfection
boxes with blue ken or discarded then Sent for
& contaminated recycling.
coloured marking
glass Metallic
Body Implants
 WASTE
MANAGEMENT
3R’
s
 WASTE
SEGREGATION
Done at the source of waste
generation

Responsibility of generator of
waste.

segregation as per categories

applicable.
 WASTE
STORAGE
Storage facility should have
sufficient capacity.
 Location - within hospital
premises.

Untreated biomedical waste not

to be kept beyond 48 hrs
(Permission required for
 WASTE
TRANSPORTATION
Points to be remembered:
 Before taking the bags it should
be tied & labeled.
 Waste handlers should not touch
any other articles.
 A covered cart with biohazard
symbol to carry the waste to the
central area of collection.
AIIMS-OUT SOURCING BY
BIOTIC
 TRAINING ON BIOMEDICAL
WASTE
Overall aimMANAGEMENT
of training:
• To develop awareness of
health, safety & environmental
issues relating to health care
waste.
• Roles & responsibilities of
health care personnel in
overall management program
should be highlighted.
STAFF SAFETY
CONSIDERATIONS
• Separate trolleys for transporting
waste within

the hospital.

• All workers involved in the work are

aware of the hazardous nature of

the work.

• Provided with all protective

equipment.
 ROLE OF INFECTION
CONTROL
NURSES
• Visits all wards & high risk units.
• Checking nursing supervisor’s register &
records for cases suggestive of
infection.
• Collection of sample from different
areas of the hospitals & sending
them to the lab.
 ROLE OF INFECTION
CONTROL
NURSES(CONTD..)
• Daily visit to microbiology lab to
ascertain results of sample
collected.
• Monitoring & supervision of
infection among hospital staffs.
• Training of nursing & paramedical
personnel on correct hygiene
practices & aseptic technique.
 SUMMAR
Y
• Infection control
• Chain of infection
• Standard safety
measures
• Safety bundles
• Staff safety
• Role of infection control
nurses
 CONCLUSIO
•This N the time to understand
is
that infection control, standard
precaution, hospital waste
management are of great concern.
•The human element is more
important than technology.
•Well trained, motivated staff can
really work wonders.
•Strict adherence to simple infection
control procedures go long way in
controlling infection.