2. INFECTION CONTROL
It is the discipline concerned with preventing
nosocomial or health care associated infection.
It is an essential part of the infrastructure of health
care.
Infection control addresses factors related to the
spread of infections within the health care setting,
including prevention, monitoring investigation of
spread of infection within a particular health care
setting and management.
3. Objectives of infection control
To protect the patient and members of the
hospital team from contracting infection
during hospital procedures
To implement a high standard of infection
control when treating every patient
To reduce the numbers of pathogenic micro
organisms to the lowest possible level
4. Strategy to achieve infection control
All patients must be screened
Barriers for personal protection
Careful aseptic technique
Sterilization and disinfection
Disposal of contaminated safely
5. Importance of infection control
Prevents post procedure infection
Provide high quality safe services
Prevents infection in service providers and other
staff
Protects the community from infection that
originate from health care facilities
Prevents the spread of antibiotic resistant MO
Lowers the costs of health care services since
prevention is cheaper than treatment
6. Hospital infection control
programme
Aim:
Dissemination of information
Surveillance activities
Investigation
Prevention and control of nosocomial
infections in the hospital
7. Effectiveness of infection control
program depends on:
Organised surveillance and control
activities
One infection control practitioner for every
major health facility
Appointing a trained hospital
epidemiologist
8. Important components of the infection
control program
Basic measures of infection control i.e
standard and additional precautions
Education and training of HCW
Protection of HCW
Identification of hazards and minimizing risks
Routine practices essential to infection control
such as aseptic techniques
9. Use of single use devices, reprocessing of instruments and
equipments
Antibiotic usage, management of blood and body fluid
exposure
Surveillance
Incident monitoring
Outbreak investigation
Infection control in specific situations
Research
Management of medical waste
10. Role of infection control
Identify, investigate and monitor infections
hazardous practice and procedures
Participate in the preparation of documents
relating to service specifications and quality
standards
Participate in training and educational
programs and in membership of relevant
committees where infection control input is
needed
11. Educate individuals and groups about the risk,
prevention, transmission and control of
infection, disease specific care, appropriate
precautions and appropriate assessments.
Investigate, manage and conduct surveillance
of suspected and confirmed outbreaks of
infection
Maintain infection control standards and
policies
14. Rehabilitation
Any service or activity that can address or
prevent the health related challenges or
disabilities ( HIV)
Research has shown that rehabilitation
interventions like stress management,
maintaining a healthy weight and regular
exercise can prevent or reduce the severity
of many diseases
15. Helps people to manage their problems
Provides support so that people can be
included in their communities while continuing
to live as independently as possible
Services include physiotherapy, occupational
therapy, speech therapy, language therapy,
complimentary and alternative therapies such
as AYUSH, yoga, acupuncture, meditation
massage, and counselling therapies.
16. Nursing procedures
Handwashing techniques
Moments of hand hygiene
Isolation techniques
Sterile techniques
Standard precautions
17. Standard precautions must be used in
the handling of:
Standard precautions apply to all patients regardless of their diagnosis or
presumed infection status
blood (including dried blood)
all other body fluids/substances (except sweat), regardless of whether they
contain visible blood
non-intact skin
mucous membranes.
18. Standard precautions consist of the following
practices:
Hand hygiene before and after all patient contact
The use of personal protective equipment, which may include gloves,
impermeable gowns, plastic aprons, masks, face shields and eye protection
The safe use and disposal of sharps
The use of aseptic “non-touch” technique for all invasive procedures, including
appropriate use of skin disinfectants
Reprocessing of reusable instruments and equipment
Routine environmental cleaning
Waste management
Respiratory hygiene and cough etiquette
Appropriate handling of linen.
19. The following are the routes of
transmission
The type of TBPs applied is based upon the mode of transmission of the
pathogen. For diseases that have multiple routes of transmission, more than
one TBP category is applied.
1. airborne transmission, e.g., pulmonary tuberculosis, chickenpox, measles
2. droplet transmission, e.g., influenza, pertussis (whooping cough), rubella
3. contact transmission (direct or indirect), e.g., viral gastroenteritis,
Clostridium difficile, MRSA, scabies
20. Contact precautions
Ensure appropriate patient placement in a single patient space or room if
available in acute care hospitals. In long-term and other residential settings, make
room placement decisions balancing risks to other patients. In ambulatory
settings, place patients requiring contact precautions in an exam room or cubicle
as soon as possible.
Use personal protective equipment (PPE) appropriately, including gloves and
gown. Wear a gown and gloves for all interactions that may involve contact with
the patient or the patient’s environment. Donning PPE upon room entry and
properly discarding before exiting the patient room is done to contain pathogens.
Limit transport and movement of patients outside of the room to medically-
necessary purposes. When transport or movement is necessary, cover or contain
the infected or colonized areas of the patient’s body. Remove and dispose of
contaminated PPE and perform hand hygiene prior to transporting patients on
Contact Precautions. Don clean PPE to handle the patient at the transport
location.
21. Airborne precautions
Source control: put a mask on the patient.
Ensure appropriate patient placement in an airborne infection isolation room
(AIIR) constructed according to the Guideline for Isolation Precautions. In settings
where Airborne Precautions cannot be implemented due to limited engineering
resources, masking the patient and placing the patient in a private room with the
door closed will reduce the likelihood of airborne transmission until the patient is
either transferred to a facility with an AIIR or returned home.
Restrict susceptible healthcare personnel from entering the room of patients
known or suspected to have measles, chickenpox, disseminated zoster, or smallpox
if other immune healthcare personnel are available.
Use personal protective equipment (PPE) appropriately, including a fit-tested
NIOSH-approved N95 or higher level respirator for healthcare personnel.
22. Limit transport and movement of patients outside of the room to medically-
necessary purposes. If transport or movement outside an AIIR is necessary,
instruct patients to wear a surgical mask, if possible, and observe Respiratory
Hygiene/Cough Etiquette. Healthcare personnel transporting patients who
are on Airborne Precautions do not need to wear a mask or respirator during
transport if the patient is wearing a mask and infectious skin lesions are
covered.
Immunize susceptible persons as soon as possible following unprotected
contact with vaccine-preventable infections (e.g., measles, varicella or
smallpox).
23. Droplet precautions
Source control: put a mask on the patient.
Ensure appropriate patient placement in a single room if possible. In acute care
hospitals, if single rooms are not available, utilize the recommendations for
alternative patient placement considerations in the Guideline for Isolation
Precautions. In long-term care and other residential settings, make decisions
regarding patient placement on a case-by-case basis considering infection risks to
other patients in the room and available alternatives. In ambulatory settings,
place patients who require Droplet Precautions in an exam room or cubicle as soon
as possible and instruct patients to follow Respiratory Hygiene/Cough Etiquette
recommendations.
Use personal protective equipment (PPE) appropriately. Don mask upon entry
into the patient room or patient space.
Limit transport and movement of patients outside of the room to medically-
necessary purposes. If transport or movement outside of the room is necessary,
instruct patient to wear a mask and follow Respiratory Hygiene/Cough Etiquette.
24. Use disposable or dedicated patient-care equipment (e.g., blood pressure
cuffs). If common use of equipment for multiple patients is unavoidable,
clean and disinfect such equipment before use on another patient.
Prioritize cleaning and disinfection of the rooms of patients on contact
precautions ensuring rooms are frequently cleaned and disinfected (e.g., at
least daily or prior to use by another patient if outpatient setting) focusing on
frequently-touched surfaces and equipment in the immediate vicinity of the
patient.