1. INFECTION CONTROL
SHEHZAD HUSSAIN
04-03-2015

2. Introduction to Patient Safety:
• This unit of patient safety will focus on
Infection Control

3. Global Infection Problems
According to WHO (2005),
• On average, 8.7% of hospital patients suffer
health care-associated infections (HAI).
• In developed countries: 5-10%
• In developing countries:
– Risk of HAI: 2-20 times higher
– HAI may affect more than 25% of patients
• At any one time, over 1.4 million people
worldwide suffer from infections acquired
while in hospital.

4. Health Care-Associated Infections
(HAI)
According to WHO:
• HAI is also called “nosocomial”.
• HAI is defined as:
– an infection acquired in hospital by a patient
who was admitted for a reason other than
that infection.
– an infection occurring in a patient in a
hospital or other health-care facility in whom
the infection was not present or incubating
at the time of admission.

5. Preventing infections
Requires health care providers who have:
– Knowledge of common infections and their
vectors
– An attitude of cooperation and commitment
– Skills necessary to provide safe care

6. Required Knowledge
• Knowledge of the extent of the problem;
• Knowledge of the main causes, modes of
transmission, and types of infections.

7. Required Skills
• Apply universal precautions*
• Use personal protection methods
• Know what to do if exposed
• Encourage others to use universal
precautions
• Report breaks in technique that increase
patient risks
• Observe patients for signs and symptoms of
infection

8. Initiation:
• Purpose:
• To ensure that all health care workers (HCWs) involved in patient management or
working in a clinical environment are
• aware of the use of standard precautions and to prevent transmission of
microorganism/infection in hospital.
• 2. Applicable to: All health care staff
• 3. Standard Precautions consist of:
 Hand hygiene
 Appropriate use of personal protective equipment (PPE).
 Respiratory hygiene/cough etiquette
 Decontamination
 Handling of linen
 Safe disposal of sharps and waste

9. One more important thing!
Protect YourselfProtect Yourself
Be sure you have been immunized against
Hepatitis B since it is very easy to
transmit!

10. Main Sources of Infection
• Person to person via hands of health-care providers,
patients, and visitors
• Personal clothing and equipment (e.g. Stethoscopes,
flashlights etc.)
• Environmental contamination
• Airborne transmission
• Hospital staff who are carriers
• Rare common-source outbreaks

11. Main Routes for infections
• Urinary tract infections (UTI)
– Catheter-associated UTIs are the most frequent,
accounting for about 35% of all HAI.
• Surgical infections: about 20% of all HAI
• Bloodstream infections associated with the use
of an intravascular device: about 15% of all HAI
• Pneumonia associated with ventilators:
about15% of HAI

13. Four Ways to Prevent HAI
1. Maintain cleanliness of the hospital.
2. Personal attention to hand washing
before and after every contact with a
patient or object.
3. Use personal protective equipment
whenever indicated.
4. Use and dispose of sharps safely.

14. Your 5 moments for HAND HYGIENE

15. How to Clean Hands
• Remove all wrist and hand jewelry.
• Cover cuts and abrasions with waterproof
dressings.
• Keep fingernails short, clean, and free
from nail polish.

16. Five moments for hand hygiene
• Before patient contact
• Before an aseptic task
• After body fluid exposure even if wearing
gloves!
• After patient contact
• After contact with patient surroundings

17. Effective Hand washing Technique
• Steps in hand washing:
• Remove jewelry (rings, bracelets) and watches before washing hands
• Ensure that the nails are clipped short (do not wear artificial nails)
• Ensure that sleeves are up to the elbow before planning for hand washing
• Wet hands and wrists, keeping hands and wrists lower than the elbows
• Apply soap (plain or antimicrobial) and lather thoroughly.
• Use firm circular motions to wash the hands and arms up to the wrists,
covering
• all areas including palms, back of the hands, fingers, between fingers and
lateral
• side of fifth finger, and wrists. Rub for minimum of 10-15 seconds.
• Repeat the process if the hands are very soiled.
• wash hands with soap and water before using hand rubs/ gel/alcohol
swabs.

18. • Clean under the fingernails.
• Rinse hands thoroughly, keeping the hands lower than the forearms.
• Dry the hands thoroughly with disposable paper towel.
• Discard the towel in a dustbin without touching the bin lids.
• Use a fresh paper towel or your elbow/foot to turn off the faucet, to
prevent
• recontamination of hands.
• Steps using antiseptics, hand rubs, gels or alcohol swabs for hand
antisepsis:
• Apply the product to the palm of one hand.
• Rub hands together, covering all surfaces of hands and fingers, until
hands are dry. Do not rinse.

20. How to use waterless handrub
• Apply a palmful of product in cupped hand
• Rub hands palm to palm
• Right palm over left hand with interlaced fingers
• Palm to palm with fingers interlaced
• Backs of fingers to opposing palms with fingers
intelocked
• Rub between thumb and forefinger
• Rotational rubbing, backwards and forwards with
clasped fingers of right hand in left palm and vice versa
• Once dry your hands are safe.

22. Personal Protective Equipment
Personal Protective Equipment (PPE):
PPEs are clothing, items used to prevent cross
transmission from patients to staff or from
staff to patients. It includes gloves,
gown/apron, masks, eye shield/goggles etc.
NOTE: Remove and discard PPE before
leaving the patient’s room or cubicle

23. Gloves
 Wear gloves when contact with blood or body fluids (BBF),
mucous membranes, non-intact skin, or
 potentially contaminated intact skin (e.g., of a patient
incontinent of stool or urine) is anticipated.
 Wear disposable medical examination gloves for providing
direct patient care.
 Do not wear the same pair of gloves for the care of more
than one patient.
 Perform hand hygiene before and immediately after
removing gloves.
 Polythene gloves are not suitable for use when dealing with
blood and/or blood and body fluids, i.e. in a clinical setting.

24. Cont…
 Remove gloves after contact with a patient and/or
the surrounding environment (including medical
 equipment) using proper technique to prevent hand
contamination.
 Do not wear the same pair of gloves for another
patient.
 Never leave the patient care area without removing
gloves and don’t move around with gloved hands.

25. Gowns/Apron:
 Wear a gown, to protect skin and clothes to prevent
contamination during patient-care activities when
 contact with BBF, secretions/excretions is
anticipated.
 Remove gown and perform hand hygiene before
leaving the patient’s environment.
 Gowns may be reused by the same HCW for the
same patient.
 If the gown is visibly soiled then it should be
replaced.

26. Masks/Eye Shield/Goggles:
 Use masks and/or eye shield to protect the mucous
membranes of the eyes, nose and mouth during
 procedures that are likely to generate aerosols.
 During aerosol-generating procedures e.g.
bronchoscopy, suctioning, intubation; HCWs should
wear
 Mask & Eye Shield.
 For suspected or proven cases of open TB, H1N1,
VHF wear N95 mask with other PPE.

27. Caps and boots/shoe covers:
 Along with above mentioned PPE, wear cap and shoe cover where there is
likelihood of major spillage of
 BBF.
 Do not reuse disposable caps/shoe covers.
 Clean and disinfect reusable boots.
• Respiratory Hygiene/Cough Etiquette:
 Cover the nose/mouth with inside of elbow when coughing or sneezing.
 Use tissues to contain respiratory secretions and dispose of them in the
nearest waste receptacle after use.
 Perform hand hygiene after having contact with respiratory secretions and
contaminated objects/materials.

28. Handling of linen:
• Used linen should be handled and disposed of
appropriately as per institutional policy
• All soiled linen should be placed in water
soluble and then in red bag (double bagged)
immediately by the end user.

29. Handling of sharps
• Discard sharp in designated puncture-resistant containers. All
needle stick injuries/exposure to BBF
• should be reported immediately to infection control through
IRF link. http://portal.aku.edu/irf/
• Never recap or bend needles.
• Replace the sharps disposal container when two-third (2/3)
filled.
• Cutting of needle is prohibited.
• All BBF spillages should be dealt immediately.
• All BBF should be considered potentially infectious.

30. Environmental cleaning
• Use adequate procedures for the routine
cleaning and disinfection of environmental
and other frequently
• touched surfaces.
• Proper environmental interventions required
such as daily cleaning and disinfection of,
doctors & staff
• changing areas, toilets, doctor’s room and
lounges.

31. Encourage Others to
Participate in Infection Control
Students may routinely observe staff who:
– apply inadequate technique in handwashing
– fail to wash hands
– routinely violate correct infection control
procedures