Its related to infection control practices

2. Introduction
Increased outbreaks of disease that were once better
controlled , and infectious agents that can cause incurable
diseases, such as HIV, HCV have become significant cause
of illness and death in many parts of the world.
Without the proper precautions, health care facility can
actually cause the spread infections and diseases.
So it is essential to prevent the transmission of infections at
all times through standard procedures.

3. Each and every patient’s visit is of three – fold
importance.
1. To get right consultation for the ailment caused.
2. To get properly investigated and diagnosed within reasonable time
frame.
3. To get treated with right knowledge and technology.
4. Right choice of antibiotics and controlled use.
• Among above, for the right, treatment, right investigation and
proper diagnosis is compulsory.
• For investigations, the level of getting infected depends upon the
type and nature of investigation.

4. HICC
Members:
The Director
Chiefs of major clinical departments
Microbiologist
Chief nurse
Pharmacists
Head of maintenance and cleaning department
CSSD
Head of infection control team.

5. Cross infection and sterilization in dentistry
Three sources of cross infections in dentistry
Patients suffering from infectious illness
Patient in prodromal phase if disease
Carrier ( Convalescent, asymptomatic)
Transmission of infection
Direct contact of tissues with blood or saline
Droplets containing infectious agents and
Through use of contaminated instruments
Routes of infection
Transdermal
Respiratory

6. Microorganisms commonly causing cross infection in dentistry
Transmitted thr’ skin and blood Transmitted thr’ aerosols
Bacteria
Treponema pallidum
Staphylococcus aureus
Viruses
Hepatitis B, C, d
HIV
Herpes simplex virus
Fungi
Dermaomycoses
Candidiasis
Bacteria
Bordetella pertussis
Mycobacterium tuberculosis
Streptococcus pyogenes
Viruses
Influenza virus
Rhinovirus
Rubella
Mumps
Measles
Epstein – Barr virus

7. Prevention of cross infection
Aseptic technique
Protective clothing
Immunization
Prevention of infection from patient to patient by
proper sterilization of equipments,
Use of disposable material where ever possible
Good environmental hygiene
Proper disposal of waste etc

8. Standard Precautions
1. Wear personal protective equipment
(PPE)
2. Personnel habits
3. Proper waste segregation
4. Immunization

9. MDROs
Methicillin Resistant S. aureus (MRSA)
Extended Spectrum Beta Lactamases (ESBL)
Vancomycin Resistant Enterococci (VRE)
Vancomycin Resistant S. aureus (VRSA)
Pseudomonas and other nonfermenters

10. Waste management plan
Sorting
Handling
Interim storage
Sub disposal
Final disposal

11. Option Waste category Treatment and
disposal
Category
no.1
Human anatomical waste
(Human tissues, organs, body
parts)
Incineration
@deep burial*
Category
no.2
Animal waste
(animal tissues, organ, body
parts carcasses, bleeding parts,
fluids, blood and experimental
animals used in research, waste
generated by veterinary
hospitals, colleges, discharge
from hospitals, animal house)
Incineration
@deep burial*

12. Option Waste category Treatment and
disposal
Category
no.3
Microbiology and biotechnology waste
(wastes from laboratory cultures, stocks
or microorganism live or vaccines,
human and animal cells, culture used in
research and infectious agents from
research and individual laboratories,
wastes from production of biologicals,
toxins, dishes and devices used for
transfer of cultures)
Local autoclaving /
microwaving /
incineration @
Category
no. 4
Waste sharps
(needle, syringes, scalpels, blade, glass
etc. that may cause puncture and cuts.
this includes both used and unused
sharps)
Disinfection by
chemical treatment
@@@ / Autoclaving/
microwaving and
mutilation. shredding
##

13. Option Waste category Treatment and
disposal
Category
no. 5
Discarded medicines and cytotoxic drugs
(waste comprising of outdated,
contaminated and discarded medicines)
Incineration @.
destruction and
drugs disposal in
secured landfills
Category
no.6
Soiled wastes
(items contaminated with blood, and
body fluids including cotton, dressings,
soiled plaster casts, lines, bedding, other
material contaminated with blood)
Incineration @
autoclaving /
microwaving
Category
no. 7
Solid waste (disposable)
(waste generated from disposable items
other than the sharps such as tubing, IV
sets etc)
Disinfection by
chemical treatment
@@ / autoclaving /
microwaving /
shredding ##

14. Option Waste category Treatment and
disposal
Category
no. 8
Liquid waste
(waste generated from laboratory and
washing, cleaning house keeping and
disinfecting activities)
Disinfection by
chemical method @@
and discharge into
drainage
Category
no. 9
Incinerator ash
(ash form incineration of bio medical
waste)
Disposal in municipal
landfills
Category
no. 10
Chemical waste
(chemicals used in production of
biologicals, chemicals used in
disinfection , as insecticides etc)
Chemical treatment
@@ and discharge
into drains for liquids
and secured landfills
for solids

15. INFUSION SETSNEEDLES USED BLADES
BROKEN GLASS
SLIDES
P
U
N
C
T
U
R
E
P
R
O
O
F
C
O
N
T
A
I
N
E
R
BURN AND CUT THE NEEDLE BEFORE
DISCARDING IN PUNCTURE PROOF CONTAINER
CONTAINING 1% HYPOCHLORITE SOLUTION
BROKEN AMPOULES
LANCET

16. EXPIRED
MEDICINES
ALL HUMAN ANATOMICAL WASTE MICROBIOLOGICAL CULTURES
Y
E
L
L
O
W
B
A
G
USED SANITARY
PADS
PLASTER CASTS
BLOOD STAINED COTTON,
DRESSINGS
CYTOTOXIC DRUGS SHOULD
BE DISCARDED IN YELLOW
BAG SEPERATELY BUT WITH
LABEL AS CT

17. USED IV FLUID LINES
AND CATHETERS
USED SYRINGES
(without needles & nozzles)
R
E
D
B
A
G
CUT ALL THE IV LINES, SALINE
BOTTLES,GLOVES & EMPTY BLOOD
BAGS UROSAC BEFORE DISCARDING.
EMPTY SALINE BOTTLES
EMPTY BLOOD
BAG
GLOVES
UROSAC

18. EMPTY BOTTLES
WASTE FOOD FRUIT PEELINGS
BOUQUET
PACKAGING MATERIAL
B
L
A
C
K
B
A
GUSED PENS,
ICE CREAM
CUPS
COCONUT
SHELL

19. @@ Chemical treatment using 1% hypochlorite solution
or any equivalent chemical reagent. It must be ensured
that chemical treatment ensures disinfection.
## Mutilation / Shredding must be such so as to prevent
unauthorized reuse.
@ There will be no chemical pretreatment before
incineration. Chlorinated plastics shall not be incinerated.
* Deep burial shall be an option available only in towns
with population less than five lakh and in rural areas.

20. WHAT TO DO IF EXPOSED TO THE BLOOD OF A PATIENT
Do not put the pricked finger in the mouth reflexly
Squeeze the finger and let blood flow.
Needle stick cuts should be immediately washed with soap and
water
Apply antiseptics
Splashes to the nose, mouth or skin, should be washed with plenty
of water thoroughly
Eyes should be thoroughly irrigated with clean water or saline
Do not use sodium hypochlorite to clean wound as it is caustic to
skin.

21. WHAT TO DO IF EXPOSED TO THE BLOOD OF A PATIENT
Following any blood exposure one should:
Report the exposure to the appropriate authority immediately.
Contact ICU registrars during routine working and emergency
hour.
Treat the condition as an emergency
Prompt reporting

22. Take home message
Always wear personal protective equipments
Get vaccinated for Hepatitis B Virus, Swine flu
Follow aseptic precautions
Strict adherence to HAND HYGIENE before and after touching the
patient
Cough etiquettes
Waste segregation and proper disposal