The document discusses the prevention of hospital-acquired infections through various means. It begins by outlining the prevalence of such infections, ranging from 3-21% globally. It then discusses the major risk factors and modes of transmission, including contact, common vehicles, airborne, and vectors. Key prevention strategies are also highlighted, such as proper hand hygiene, use of protective equipment, safe handling and disposal of sharps, and waste management. Adopting universal precautions and enforcing infection control practices can significantly reduce infection rates and healthcare costs from hospital-acquired infections.

1. PREVENTION OF HOSPITAL
AQUIRED INFECTION
Presented By:
Dr.P.P.Singh
Ex.MEDICAL SUPRINTENDENT HRH &SDN
HOSPITAL
Ex.Director Project IPP-VIII
Municipal Corporation of Delhi

2. Dr. P.P.SINGH

3. WHOLESTIC LIFECYCLE APPROACH TO
WOMEN HEALTH
1. CSSM
3. CARE OF
WOMEN
FOR
RTI/STI(AIDS)
RCH
2. FAMILY
PLANING
4. ADOLESCENT
HEALTH
Dr. P.P.SINGH

4. Definition
• Infection acquired by the patients from hospital facilities
i.e.
- during hospitalisation
- due to any therapeutic / diagnostic
procedures
Dr. P.P.SINGH

5. Sources of Hospital Infections
• Cross Infection
• Self or auto infections
• Environmental
Dr. P.P.SINGH

6. Prevalence of Hospital Acquired Infection
• In early seventies Barrett Connor
Estimated 3-13%
• Estimate in USA
Around 1.5 million cases of 5-20% and operative
infections 4.7 to 21.8% with an average of 9.7%
• WHO
Estimated after study in 47 countries 3-21% with
mean of 8.4%
• India
Authenticated data not available.
Dr. P.P.SINGH
References of few hospitals indicate around 10%

7. Aetiology
• Like any other disease Process Hospital Infection has
also got epidemiological triad i.e. the agent, host and
environment
• Entire spectrum of microbes i.e. bacteria, viruses,
ricketsis, fungi and protozae etc. responsible for hospital
infection
• 20-25% of all Hospital Infections due to Gram +ve
Organisms
• Proteous, e-coli, salmonella, klebsiella, pseudomonas are
on the rise
cont.
Dr. P.P.SINGH

8. Risk Factors
• Patient factors:
•
•
•
•
•
•
Extreme age
Malnutrition
Immune deficiency
Injuries
Diseases like Diabetes, Nephritis, Severe burns
Endogenous infection
cont.
Dr. P.P.SINGH

9. • Microbial factors:
•High conc. Of agent
•High level of virulence
•Emergence of resistant strains
•Presence of new organism
• Environmental factors:
•Level of contamination
•Medical interventions
Dr. P.P.SINGH

10. Pathogenic Organisms
• Gram Positive
• Virus
– Staphylococcus
– Streptococcus
– B.subtalis
–
–
–
–
• Gram Negative
–
–
–
–
–
–
–
–
E.coli
Pseudomonas
Proteus
Klebsiella
Citrobacter
Shigella
Salmonella
Serratia
Hepatitis A,B,C…
HIV/AIDS
Dengue
Japanese encephelitis
• Rickettesial
– Typhus
– Scrub fever
• Protozoal
– Malaria
– Amoebiasis
• Mycobacterial
Dr. P.P.SINGH
– Tuberculosis

11. Modes of transmission
• Contact spread
– Contaminated inanimate objects
• catheters
• Cystoscopes
• Bed pans etc.
– Person to person & Droplet infection
• Infective Hepatitis
• Streptococcal Pharyngitis
Cont.
Dr. P.P.SINGH

12. • Common Vehicle Spread
– Transmission through food
• Salmonella
– through blood and blood products & Injections and
intravenous fluids
•
•
•
•
Hepatitis B & C
HIV / AIDS
Gram -ve Septicemia
Salmonellosis
Cont.
Dr. P.P.SINGH

13. • Airborne spread
– Vaccum cleaners & Dust Particles
• Staphalococcal infection
• Tuberculosis
Dr. P.P.SINGH

14. • Vector Borne Spread
– Body parts of vectors like
•
•
•
•
•
Mosquitoes
Flies
Flea
Bugs
Cockroaches
Transmit Infections like
»
»
»
»
Gastroenteritis
Yersina pestis
Malaria
Dengue
Dr. P.P.SINGH

15. Types of Hospital Acquired Infection
•
•
•
•
•
•
•
•
•
Urinary tract infections
Lower respiratory tract infections
Surgical wound infections
Anaerobic bacteriological infections
Gastroenteritis
Transplant associated infections
Intravenous cannula related infections
Intracardiac & various prosthesis infections
Perpureal infections
Dr. P.P.SINGH

16. High Risk Procedures for HAI
•
•
•
•
•
•
•
Injections
Surgical Procedures
Dressing of wounds
Management of deliveries
Investigative procedures
Laboratory investigations
Dialysis
Dr. P.P.SINGH

17. High Risk Areas for HAI
•
•
•
•
•
•
•
•
Haemodialysis Unit
Intensive Care Unit
Nursery Unit
Pharmacy
Dietetics services
Laundry
Operation Theatre
O.P.D.
Dr. P.P.SINGH

18. Management of HAI
• HAI Control Committee (meeting once a month)
– Chairman
Medical Superintendence
– Member Secretary - Infection Control Officer
(Microbiologist)
– Members
Head of all clinical units
Chief of blood bank
Microbiologist
Medical record officer
Chief of nursing services
Infection control sister
– Invited Members - Chiefs of all supportive services
Dr. P.P.SINGH
Cont.
-

19. •
•
•
•
•
•
•
•
Surveillance of HAI
Sterilisation and high level disinfection
Proper discarding and disposal of hospital waste
Universal blood and body fluid precautions by health
care workers
Dietetics services
Laundry
Antibiotic policy
In-service training
Dr. P.P.SINGH

20. Universal Precautions
•
•
•
•
•
•
•
•
Wash hands before and after patient contact
Wear gloves for contact with blood & body fluids
Wear masks to protect against aerosols & splashes
Wear gowns to protect against splashes
Handle and dispose sharps safely
Disinfect and sterilise critical items
safe disposal of waste
Hepatitis B vaccination
Dr. P.P.SINGH

21. Safe Handling & Disposal of Sharps
• Always dispose of your own sharps
• Never pass sharps directly from one person to other
• The risk of injury in high risk areas should be minimised
by ensuring best possible visibility for operator
• Protect fingers from injuries by using forceps while
suturing
• Locate sharps disposable container close to the point of
use
Dr. P.P.SINGH

22. Infection Control Indicator Checklist
• Handle sharps safely to minimise injury
–
–
–
–
Appropriate puncture proof sharps container
Container less than three quarter full
Sharps not protruding from container
No recapping or one hand recapping of needle & syringe
• Instrument decontaminated fully
– Steriliser available and in good working order
– Equipment thoroughly cleaned after use
– Clean instruments stored in cupboards
Dr. P.P.SINGH

23. • Hands washed appropriately to prevent cross infection
– Soap and clean water available
– Clean towels available
– Staff wash & dry hands after contact with body fluid, removal
of gloves and contact with patients
• Protective barrier worn to prevent blood exposure
Depending on the clinical area and risk of exposure use
•
•
•
•
•
Disposable gloves
Heavy duty gloves
Masks
Aprons
Protective eye wears
Dr. P.P.SINGH

24. • Waste disposal safety
– Evidence of deep burial or incineration regularly
– No contaminated waste visible
Dr. P.P.SINGH

25. Cost related to HAI
• The outbreak infections are expansive. The cost
increased can be summarised as
–
–
–
–
–
–
Prolonged patient stay
Increase consumption of disinfectants
Increase use of protective clothing
Increase in overhead expanses
Cost associated with patient screening
Need for expansive antibiotic therapy
Dr. P.P.SINGH

26. HIV / AIDS
PROBLEM IN DELHI. 35000 HIV +Ve.
780AIDS Cases.
PROBABLE SOURCE
•HETRO SEXUAL
75%
•INJECTABLES
7.3%
•RECIPIENT OF BLOOD
•OTHER
7.5%
11%
Dr. P.P.SINGH

27. AWERNESS
(Education)
A
ACQUIRED
INFORMATION
I
IMMUNO
DRUGS(PRE)
(Disinfectants)
D
DEFFICENCY
SAFE SEX
S
SYNDROME
Dr. P.P.SINGH
ADULT HOOD
INJECTABLES
DRUGS
SEX

28. RNA Virus
Reverse transcription
HIV1 &HIV2
Dr. P.P.SINGH

29. Common cold
5 – 15 years
Anti bodies
Death
6-8 wks
Dr. P.P.SINGH

30. RISKS.
Needle stick/prick injury--- 0.25 to 0.3% for HIV,
9 to 30% for HBV, 3-10% for HCV
0.3% risk through muco -cutanious exposure
 0.6% IN NON SURGICAL.
 4% IN SURGICAL, HIGER IN
GYNAECOLOGIST
 5 / 1000 IN OTHERS
 40% WHILE SUTURING.
 60% RECAPPING.
Dr. P.P.SINGH

31. ANTISEPTICS
HIV1&2
Hp B
H2O2
0.3
3%
ALCOHOL
50%
95%
FORMALINE
0.5%
1%
LYSOL
2%
3%
BLEACH
1%
5%
GLUTERALDEHYDE
2%
2%
ULTRA VIOLET LIGHT- HIGHER DOSE
LAMINAR FLOW, OT, LAB.
DRYCLEANNING MAY NOT INACTIVATE
Dr. P.P.SINGH

32. MISCONCEPTIONS
 MOSQUITO BITE
ANY INSECT BITE
CASUAL CONTACT WITH AIDS pt.
WITH IN HOUSE HOLD
SHARING FOOD, WATER, CLOTHS OR
TOILETS
PROFESSIONAL CONTACT.
Dr. P.P.SINGH

33. METHODS OF PREVENTION AMONGST HEALTH
PERSONNEL
1.
KNOWLEDGE, ATTITUDE,PRACTICE.



1.
2.
3.
4.
5.
6.
Barrier precautions,
Aseptic precautions
Management of parenteral &MM exposure to blood/blood products, tissue
organs.
HAND WASHING WITH SOAP 10 -15 SECONDS
WEAR GLOVES – BOTH HANDS, WASHING HAND AFTER
REMOVING GLOVES.
WEAR EYE GLASSES, FACE SHIELD ,APRON /GOWANS
DECONTAMINATION / DISINFECTING –
INSTRUMENTS,GLOVES,LINEN ALL THINGS WITH BLEACHING
POWDER -15 gms /liter.
- SURFACE – 10% BLEACH
BIO MEDICAL WASTE ( BMW).
P.E.P.
Dr. P.P.SINGH

34. • SALIVA as source.
- Mouth piece.
- Resuscitation Bags
-Ventilation devices
- Suction machines
-Mouth to Mouth Breathing
•
HOSPITAL DISINFECTANT- Chlorine – 1-1.5%
Sod. Hypochlorite 1 gm/L
Calcium hypochlorite 1.4 gm/L
Bleach at least 10 min.
Dr. P.P.SINGH

35. HANDLING SPECIMENS
USE GLOVES
SCREW CAPPED LEAK PRFOOF CONTAINERS
CARE TAKEN WHILE TRANSPORT OF SAMPLES.
SERA CAN BE KEPT - - HEAT 56 0 C FOR 30 MIN.
NO MOUTH PIPETTINGS
ANY SPILLAGE OF BLOOD & OTHER BODY FLUIEDS ON
TABLE TOP OR ANY SURFACE – CLEAN WITH SOD.
HYPOCHLORITE.
ALL OPEN WOUNDS ON HAND & ARMS SHUOLD BE COVERED
Dr. P.P.SINGH

36. ASEPTIC PRECAUTIONS
(IN RELATION TO INJECTION / OTHER SKIN PIERCING
PROCEDURES)
 REDUCE UNECESSARY USE.
SINGLE USE DISPOABLES
REUASBLE SHOULD BE DIS INFECTED ,WASHED ,
& STERILISE
PUNCTURE PROOF CONTAINERS
P E P – ANY NEEDLE STICK , INJURY , CUTS OR
MUCUS MEMBRAIN EXPOSURE.
- WASH PROPERLY
- BLEEDING IS ENCOURAGED
Dr. P.P.SINGH

37. NON INVASIVE PROCEDURES
 VAGINAL & RECTAL EXAMINATION.
INTRA OCCULAR PRESSURE
CONTACT LENSES TRIAL.
TRACHIAL & LARYNGIAL EX.
THROAT & NASAL EX.
X RAY & CT SAN ETC,
- THERE IS CHANCES OF BREAK OF MM.
- BODY FLUIDS / SECRETION MAY ACT AS SOURCE
OF INFECTION.
*** EFFECTIVE USE OF STERILISATION &
DISINFECTANTS
Dr. P.P.SINGH

38. Conclusion
• Prevention of Hospital Infection will cut the wasteful
expenditure. Savings could be re-deployed for
betterment of hospital
• Incidence of Hospital Acquired Infection can be reduced
to great extent by
–
–
–
–
Work culture & attitude of health care providers
Religious observation of universal precautions
Application of antiseptic technique
Proper Disposal of hospital waste
Dr. P.P.SINGH