INFECTION

PREVENTION AND
CONTROL IN
IN

ANTIMICROBIAL
STEWARDSHIP
Module Objectives
At the end of this session, participants should be able to:
• Explain the components of Infection Prevention and Control (IPC).

• Identify predisposing factors to infections.

• Describe transmission of healthcare-associated infections.

• Demonstrate decontamination of equipment.

• Explain the role of hand hygiene in IPC

• Apply the principles and strategies used for IPC.

CONT:

• Demonstrate the appropriate use of Personal Protective Equipment (PPE).

• Discuss WASH strategies.

• Show willingness to participate in vaccination programs in health facilities.

• Advocate for multidisciplinary collaboration in IPC.

DEFINITIONS
• Infection Prevention and Control (IPC) – According to WHO, infection
prevention and control is a scientific approach and practical solution
designed to prevent harm caused by infections to patients and health
workers-Processes, protocols, procedures

• Healthcare-associated infections (HAIs) – these are infections people

get while they are receiving care for another condition.

• WASH (or Watsan, WaSH) – is an acronym that stands for “water,

sanitation and hygiene”.
 PREDISPOSING FACTORS TO
INFECTIONS
Factors that predispose an individual to acquiring infections are many,
and they may include infectious agents, host, and environmental factors.

• Infectious agent factors: infectivity, pathogenicity, virulence, toxicity,

invasiveness and antigenicity.

• Host factors: genetic, anatomical, age and nutrition.

• Environmental factors: climatic changes like fluctuations in

temperatures.
TRANSMISSION OF HEALTHCARE-
ASSOCIATED INFECTIONS
(1 OF 3)
• Healthcare-associated infections (HAIs) are infections that occur while
receiving healthcare.

• However, these infections can be prevented by breaking the chain of

infections.

• The chain of infection can be broken by targeting the following components:

• Causative agent(s): eliminating or inactivating the agent(s) from existing the

reserviour.
TRANSMISSION OF HEALTHCARE-
ASSOCIATED INFECTIONS
(2 OF 3)
Reserviour: treating infectious individuals, vaccination, handling and
disposing of body fluids appropriately, safe food practices and
monitoring water contamination.

Portal of exit: implementing safe practices such as covering coughs

and sneezes, handling body fluids with gloves, and performing
appropriate hand hygiene.

Mode of transmission: ensuring transmission between objects or

people does not occur.
TRANSMISSION OF HEALTHCARE-
ASSOCIATED INFECTIONS
(3 of 3)
Portal of entry: performing appropriate hand hygiene using aseptic
techniques when required, and applying best practices techniques
when handling patients.

Susceptible host: ensuring hosts are not susceptible through

immunization, good nutrition, and treatment of high-risk patients
 Pathogens: Bacteria,
viruses, fungi,
protozoa, etc. People, equipment,
Immuno- water, food, etc.
compromised
, age, acute or
chronic
condition,
etc.

Broken skin, respiratory, GI, Excretions, secretions,

mucous membrane, etc. blood, etc.
Contact, airborne,
vehicle, vector, etc.
UNIT 1: Components of Infection Prevention and
Control (IPC)
WHO 5 elements for IPC multimodal strategies
IPC Minimum Requirements

Starting point for undertaking

the journey to build strong and
effective IPC programmes at the
national and facility level
Decontamination of equipment
(1 of 2)
• Decontamination is one of the ways by
which the chain of infection is broken.

• It refers to a combination of processes

involved in removing to neutralizing
contaminants accumulated on personnel
and equipment – critical to health and
safety at hazardous waste sites.

• The purpose of decontaminating

hazardous materials or equipment is to
limit the spread contaminants.
DECONTAMINATION OF EQUIPMENT
(2 OF 2)
• The 3 most common processes of decontamination are as follows:
1. Cleaning – first step in decontamination process involving immersion
and non-immersion techniques.

2. Disinfection – involves using the correct amount of the disinfectant

(or/and detergent) with water on equipment contaminated with blood
or in contact with known or suspected infection.

3. Sterilization (Autoclaving) – this is a specialized means of

decontamination of equipment using steam.
ROLE OF HAND HYGIENE IN IPC
(1 OF 8)
• The hands are the most common vehicles for the transmission of
pathogens from patient to patient and within the healthcare
environment.

• Hand hygiene is the most important means to consider when

preventing the spread of antimicrobial resistance (AMR) and reducing
HAIs.

• Compliance with optimal practices of hand hygiene by healthcare

workers remains low in most settings
ROLE OF HAND HYGIENE IN IPC
(2 OF 8)
• WHO has set recommended guidelines to enable healthcare workers
to clean their hands at the right time and in the right way, using the 5
moments of hand hygiene.

• The 5 moments of hand hygiene defines the right moments when

healthcare workers should perform hand hygiene.
ROLE OF HAND HYGIENE IN IPC
DIAGRAMMATIC PRESENTATION OF 5 MOMENTS OF HAND HYGIENE
ROLE OF HAND HYGIENE IN IPC
HAND RUBBING TECHNIQUE WITH ALCOHOL-BASED HANDRUB
ROLE OF HAND HYGIENE IN IPC
HAND WASHING WITH SOAP AND RUNNING WATER
USE OF PERSONAL PROTECTIVE
EQUIPMENT (PPE)
• PPE is commonly used in healthcare settings such as hospitals and
clinical laboratories.

• When used properly, PPE acts as a barrier between infectious pathogens

such as viral and bacterial contaminations and one’s skin, mouth, nose,
or eyes (body surfaces covered by mucous membrane).

• Main types of PPE include;

Protective clothing e.g. gowns (for skin protection).

USE OF PERSONAL PROTECTIVE EQUIPMENT (PPE)
• Main types of PPE include;
Protective clothing e.g. gowns (for skin protection).
Respiratory protective equipment e.g. medical masks and respirators (for
respiratory tract protection).
Goggles (for eye protection).
Head cap (for head covering).

Earplugs (for ear protection).

Cap boots (for foot protection)

Gloves (for hand and arm protection)

• Donning and doffing refers to how you put on and remove PPE
• The donning process facilitates the correct application of PPE while doffing procedures
ensure safe removal after the wearer has concluded an encounter with potential
USE OF PERSONAL PROTECTIVE
EQUIPMENT (PPE)
• Proper donning and doffing PPE is critical for reducing the risk of
contamination.
• Donning PPE
1.Perform hand hygiene
2. Put on shoe covers (if applicable)
3. Put on gown
4. Put on mask/respirator (if applicable)
5. Put on eye protection (if applicable)
6. Put on gloves
USE OF PERSONAL PROTECTIVE
EQUIPMENT (PPE)
• Doffing
1. Remove shoe covers (if applicable)
2. Remove gown and gloves together
3. Perform hand hygiene
4. Remove eye protection (if applicable)
5. Remove mask/respirator (if applicable)
6. Perform hand hygiene
WASH STRATEGIES
• WASH strategies ensure that all healthcare facilities provide at least the following:

Sufficient water is available at all times from an improved source located on the
premises.

Access to hand hygiene facilities.

Clean hygienic conditions.

Improved sanitation facilities located on functional premises.

WASH STRATEGIES
Well-lit areas and adequate ventilation and drainage systems.

Adequate power for sterilization, incineration and medical devices.

Adequate supply of appropriate PPE and puncture-resistant sharps’

containers, containers for separating other types of healthcare waste
and cleaning supplies.

Separation, treatment and safe disposal, including autoclaving,

incineration or removal for off-site treatment, of healthcare waste.
Safe management of sewage/faecal waste.
VACCINATION PROGRAMS IN HEALTH
• Healthcare workers are in regular contact with patients suffering from different
types of diseases, hence at high risk of contracting infections.

• Healthcare workers must receive vaccinations for some diseases because

vaccines can play a major role in limiting the impact of infections.

• Vaccination programs should be implemented in healthcare facilities to ensure

that recommended vaccinations are administered to staff who qualify.
• WHO guidelines or their equivalent should be followed to successfully
implement immunization programs.
• Implementation guidelines for vaccination of health workers
https://www.who.int/publication-detail-redirect/9789240052154.
MULTIDISCIPLINARY
COLLABORATION IN IPC
• Effective implementation of IPC in a healthcare facility requires close partnerships
and collaboration between the IPC programme staff.

• IPC staff provide guidance, expertise, data, education, encouragement, support and
communication to their colleagues at all facility levels.

• Multidisciplinary support is also obtained via quality improvement teams.

• Communication should be structured so that the information is readily accessible
and understandable.

• Regular feedback of IPC data is one of the most important communication activities.
UNIT 2: PRINCIPLES AND
STRATEGIES USED IN INFECTION
PREVENTION AND CONTROL (IPC)
UNIT 2: Objectives

• Explain prevention of healthcare-associated infections (HAIs).

• Discuss strategies to prevent HAIs.

• Describe risk assessment and crisis management in IPC

PREVENTION OF HEALTHCARE-ASSOCIATED
INFECTIONS (HAIS)
• Common healthcare-associated infections (HAIs) that frequently occur in healthcare settings are:

 Surgical site infections

 Catheter-associated infections

 Urinary tract infections

• Common healthcare-associated infections (HAIs) that frequently occur in healthcare settings are:

 Surgical site infections

 Catheter-associated infections

 Urinary tract infections

STRATEGIES TO PREVENT HEALTHCARE-
ASSOCIATED INFECTIONS (1 OF 2)
1. Hand hygiene – proper hand hygiene is the most important, simplest and
least expensive means of reducing the prevalence of HAIs and spread of AMR.

2. Environmental hygiene – appropriate hygiene of surfaces and equipment

which patients and healthcare personnel touch is necessary to reduce exposure
to infections.

3. Screening and cohorting patients – early detection of multidrug-resistant

organisms is an important component of any infection control programme.

4. Surveillance for HAIs – surveillance systems allow the evaluation of the local
burden of HAIs and AMR and contribute to early detection of HAIs , including
identifying clusters and outbreaks.
STRATEGIES TO PREVENT HEALTHCARE-
ASSOCIATED INFECTIONS (2 OF 2)
• 5. Antimicrobial stewardship – antimicrobial stewardship
programmes (ASPs) can help reduce antibiotic exposure, lower rates
of clostridium defficile infections.
• 6. Compliance with IPC guidelines – compliance with IPC guidelines
enhances the prevention of infections.
• 7. Patient safety – absence of preventable harm to a patient during
the process of healthcare.
Risk assessment in IPC
 Risk assessment in IPC
• An IPC risk assessment involves:
Identifying tasks or activities that carry the risk of introducing or spreading
the infection.
Identifying people who may be most vulnerable to spread the infection.
Evaluating risks and implementing precautions and controls through low,
medium or high risk ratings.
Keeping thorough and accurate records of every assessment.
Infection Control Assessment Tools developed by CDC assist healthcare
facilities and departments to assess IPC practices and guide quality
improvement activities.
• Tools for healthcare settings/Infection Control/CDC
https://www.cdc.gov/infectioncontrol/tools.