Infection

Prevention and
Control (IPC)

DR NOR ASHIKIN BINTI AB GHANI

PEGAWAI PERUBATAN UD54
UNIT KAWALAN
INFEKSI/PENJAGAAN LUKA
 Contents of presentation:
• Introduction
• Hospital Infection and Antibiotic Control
Committee (HIACC)
• HCAI
• Standard precaution
• Transmission based precautions
• Contact
• Droplet
• Airborne
 INTRODUCTION
• Infection prevention and control (IPC) is a
practical, evidence-based approach preventing
patients and health workers from being
harmed by avoidable infections.
Hospital Infection and Antibiotic Control Committee (HIACC)
 Definition of HCAI
This includes
infections that are
acquired in the
hospital, but appear
only after discharge,
as well as
Healthcare associated infections are infections occupational
that patients acquire 48 or infections among
more hours after admission during the course of health care staff
receiving treatment for
other conditions within a healthcare setting.
Prevalence of HCAI in HTM
 PEMANTAUAN HEALTHCARE ASSOCIATED
INFECTION (HCAI)
Tahun 2022 (Januari-Disember) terdapat 154 kes Healthcare Associated
Infection(HCAI) Survielan HTM.

Kadar infection adalah 0.95 % (Total admission Januari –Disember 2022

adalah 16271) terdapat peningkatan sebanyak 39 kes (0.15%) berbanding
tahun 2021

Standard HPIA KKM adalah ≤ 5%

PERBANDINGAN KADAR HCAI DI HTM

1.20%

1.00%
1.00% 0.95%

0.80%
0.80%
0.70% 0.70%

0.60%

0.40%

0.20%

0.00%
2019 2020 2021 2022 JAN-JUN 2023
 Impact of HCAI
prolonged massive
hospital stays additional costs
for health
systems
long-term
disability high costs for
patients and
their family
increased resistance
of microorganisms
to antimicrobials unnecessary deaths

(WHO, Fact sheet on HCAI endemic burden worldwide)

 Transmission Droplet
Routes of HCAI transmission

Direct Airborne
contact transmission
transmission

Indirect Percutaneous
transmission exposure
Our Goal is to
have Zero
infection Everyone has a
transmission role in Infection
Prevention
It is in our HANDS !
 Standard The minimum
infection prevention
Precaution practices that should
be used in the care of
What is standard ALL patients,
precaution ?
ALL the time.

Standard precautions are a set of infection

control practices used to prevent transmission of
diseases that can be acquired by contact with
blood, body fluids, non-intact skin and mucous
membranes.
 Standard What is standard
precaution ?
Precaution
Standard precautions consist of:
1. Hand hygiene
2. Personal Protective Equipment (PPE)
3. Disinfectant & Sterilisation
4. Environmental Hygiene
5. Linen Management
6. Waste Management
7. Spillage Management
8. Injection safety & Sharps management
9. Respiratory Hygiene & Cough Etiquette
 Standard Element of Standard
Precaution Precaution

Hand hygiene Personal Protective Equipment (PPE)

Disinfectant & Sterilisation Environmental Hygiene

 Standard Element of Standard
Precaution Precaution

Linen Management Waste Management Spillage Management

Injection safety & Respiratory Hygiene &

Sharps management Cough Etiquette
 Hand Hygiene Hand hygiene is
the most basic and
What is the Best Way to important step to
Prevent Infection prevent spread of
Transmission? infection

Hand wash with soap and water Hand rub with alcohol sanitizer
 Hand Hygiene
We should perform hand hygiene :

Before entering and

upon exiting the After using toilets
patient room

Before and after

putting on gloves After sneezing

Before and after

preparing meals After handling
patient
equipment
Before and after eating
Hand Hygiene
Hand hygiene is a
major component of
standard precautions
and one of the most
effective methods to
prevent transmission
of pathogens
associated with
healthcare
 Transmission
Based
Precautions
When treating patients who are known or suspected of being
infected or colonized with infectious agents.

Applied according to the clinical syndrome and the likely

etiologic agents, and then modified based on test results.

These precautions are to be implemented in conjunction with

STANDARD PRECAUTION.
 Transmission
Based
Precautions
Three types :
Contact
Droplet
Airborne
May be combined for diseases
that have multiple routes of
transmission.
• Herpes Simplex
• Herpes Zoster
• Multidrug Resistance
Organisms (MDRO)
• Methycillin Resistance
Staphylococcus Aureus
(MRSA)
• Extended Spectrum Beta
Lactamase (ESBL)
• Carbapenem Resistance
Enterobacteriaceae (CRE)
• Streptococcal Disease – skin,
wound, burns
• Typhoid (Salmonella Typhii)
• Varicella Zoster
 Contact Precautions
Isolate the patient All patient need to be
in a single room , tag for easy
if single room is identification e.g.
not available, medical records,
cohort the patient bedside area
(with same
organism) at a Appropriate
designated area Personal Protective
Equipment (PPE)
Strict hand hygiene
before entering and
Dedicated medical
upon exiting the
equipment
patient room / area
• Diphtheria – Pharyngeal
• Epiglotittis – Haemophilus
Influenza
• Meningitis (Haemophilus
Influenza, Meningococcal)
• Severe Acute Respiratory
Infection (SARI)
• Mumps
• Influenza
• Mers-CoV

** Certain organism requires the

use of N95 mask especially during
aerosol generating procedure
 Droplet Precautions
Health-care facilities (Outpatient and
Emergency Department) should :
Place acute febrile respiratory symptomatic patients at
least 1 meter (3 feet) away from others in common
waiting areas, if possible.

Place visual alerts at the entrance to health-care

facilities instructing persons with respiratory symptoms
to practice respiratory hygiene/cough etiquette.

Consider making hand hygiene resources, tissues and

masks available in common areas and areas used for
the evaluation of patients with respiratory illnesses.
• Herpes Zoster
• Measles
• Mycobacterium
Tuberculosis
• Varicella Pneumonia
• Novel infectious
diseases
Transportation of a patient
who requires isolation
precaution
Restrict the movement whenever possible

To inform the receiving unit / department of

patient’s isolation status prior to transfer or
movement

Appropriate barrier precaution should be maintained

at all times, both by HCW and patient
Transportation of a patient
who requires isolation
precaution
Procedures for these patients should
be scheduled last if feasible

Terminal decontamination of
equipment in contact with
patient and environment MUST
be performed after the procedure
 References
1. CDC : Guideline for Isolation Precautions: Preventing Transmission of
Infectious Agents in Healthcare Settings (2007).

2. Australian Guidelines for the Prevention and Control of Infection in

Healthcare 2019.

3. Malaysian Policies and Procedures on Infection Prevention and Control

2019.
Thank You