INFECTION CONTROL

INTRODUCTION:-

Infection is one of the leading causes of preventable deaths in hospital every year. The centre of disease
control and prevention estimates that there are approximately 2 million preventable infections in
hospital everywhere, leading to 90,000 unnecessary deaths. The importance of hospitals clean and
infection free is greater now than ever, as information regarding the patient safety and the effectiveness
of prevention efforts continues to grow.

Infection control prevents or stops the spread of infections in healthcare settings. This site
includes an overview of how infections spread, ways to prevent the spread of infections, and more
detailed recommendations by type of healthcare setting.Hospital infection is also called Nosocominal
infection. It is the single largest factor that adversely affects both the patient and the hospital.
Nosocominal infection is that which develops in the patients after more than 48 hours of hospitalization.

TERMINOLOGIES:-

Infection:- The invasion and growth of germs in the body. The germs may be bacteria, viruses, yeast, fungi, or
other microorganisms.

Nosocominal:- A nosocomial infection is contracted because of an infection or toxin that exists in a

certain location, such as a hospital.

Germicide:- An agent that destroy microorganism

Fumigation:- Fumigation is a method of pest control/ removal of harmful micro-organisms that completely
fills an area with gaseous pesticides or fumigants to suffocate or poison the pests within.

Isolation:- The complete separation from others of a person suffering from contagious or infectious disease.

DEFINITION OF INFECTION:-

An infection is the entry and multiplication of an infectious agent in the tissues of the host. Infectious
agent may be bacteria, viruses, fungus, spirochete or other microorganisms capable of producing
infection under favourable circumstances of host, and the environment.

Role of microorganisms in infection:-

Microorganisms capable of harming people are called pathogens or pathogenic.

When pathogens enter and multiply within body tissues, they disrupt normal physiologic
process and produce infection.
Sepsis a term that means poisoning of tissues is often used to describe the presence of infection.
Transport of an infection or the products of infection throughout the body by the blood is known
as septicaemia.
Once the infection agent enters the host it begins to proliferate an reacts with the defence mechanisms
of the body producing infection symptoms and sign: pain, swelling, redness, functional disorder, rise in
temperature heart rate and leucocytosis.

BASIC OF INFECTION CONTRIOL:-

 Prevention of nosocomial infection is the responsibility of all individuals and services provided
by healthcare setting.
 To practice good asepsis, one should always know: what is dirty, what is clean, what is sterile
and keep them separate.
 Hospital policies & procedures are applied to prevent spread of infection in hospital.

PRINCIPLES OF INFECTION CONTROL:-

 Client safety in the health care environment requires the reduction of microorganism
transmission.
 Infection control practices are directed at controlling or eliminating sources of infection in the
health care agency or home.
 Nurses are responsible for protecting clients and themselves by using infection control practices.
 Nurses and clients must be educated on the types of infections, mode of transmission, risk for
susceptibility, and infection control practices required to control or prevent further transmission.

TYPES OR CLASSIFICATION OF INFECTION:-

Infection can be classified as:

1. Primary and secondary infection

2. Local and systemic infection
3. Acute and chronic infection
4. Nosocomial infection
5. Iatrogenic infection

Primary infection: - Initial infection with an organism to a host constitutes primary infection.

Secondary infection: - when in a host whose resistance is lowered by pre-existing infections, a new
organism may set up a new infection.

Local infection: - infection that is limited to a defined area or a single organ with symptoms that
resemble inflammation (redness, tenderness and swelling)

Systemic infection: - infection that spreads to whole body resulting in septicaemia.

Acute infection: - acute infection appears suddenly or lasts for a short time, e.g.URTI.

Chronic infection: - may occur slowly over a long period and may last months to year.

Nosocomial infection: - It is also known as hospital acquired infections. These encompass all types of
infections acquired by patients while being cared for in acute care institution and those acquired by
health care personnel and visitors.
Iatrogenic infection: - infection results due to therapeutic and diagnostic procedures.

CHAIN OF INFECTION:-

The presence of a pathogen does not mean that an infection will begin. In order for infectious disease to
spread, several steps must occur

 Infectious agent or pathogen

 A reservoir or source for pathogen growth
 A portal of exist
 A mode of transmission
 A portal of entry to host
 A susceptible host

Infectious agent or pathogen:-

The spread of infection requires an infectious agent- A pathogen that has the potential to cause
infection. The pathogen may be viral, bacterial, fungal or parasitic

Reservoir:-

The infectious agent needs a reservoir where it can live, grow and reproduce. Reservoirs are warm,
warm and moist places.

Portal of exist:-

Transfer requires a route for the infectious agent to exist the reservoir. An infectious agent can exit the
reservoir and enters the host through various body systems and through mucous membrane.

Mode of transmission:-

i. Contact transmission
ii. Droplet transmission
iii. Airborne transmission
iv. Vehicle transmission
v. Vector-borne transmission

Portal of entry:-

An infectious agent can exit the reservoir and enters the host through various body systems and through
mucous membrane.

Susceptible host:-

Susceptibility depends on the individual’s degree of resistance and virulence of organisms. The
transmission of infection also requires a susceptible host. Susceptibility to an infectious agent varies
among individuals.
Who is at risk of infection?
Staff
Clients
Community

Breaking the chain of infection:-

As health professionals, we cannot provide health care services without some exposure to potentially
infectious materials, but we can prevent transmission in many cases.

Breaking Chain 1 of Infection:-

 Rapid and accurate identification of organisms

 Control or elimination of infectious agents

Breaking the Chain 2 of the Infection

Measures to control/eliminate reservoir for Infection

 Employee health
 Immunization
 Regular check up
 Preventing contact with infected person
 Environmental cleaning
 Cleaning with hospital approved cleaner disinfectant
 Thorough cleaning of bed and bedside equipments
 Damp dusting
 Drains should be patent
 Handling of linen
 Keep bed sheets dry and clean.
 Do not shake blankets and linen.
Do not throw them on floor.
 Separate soiled linen
 Visitors control
 Pest control
 Avoid their entry
 Fly trapper
 Pesticide sprays

Breaking the Chain 3 of Infection Portal of Exit

 Aseptic precautions
 Use PPE
 Careful handling of waste

Breaking the Chain 4 of Infection Transmission Based Precaution

  Airborne/Droplet precautions
Private room, well-ventilated, & door closed.
Negative air pressure & 6-12 air changes per hour.
Wear masks
Prevent contact with susceptible people
Limit movement of client
 Contact precautions
Client private room
Hand hygiene
Use PPE Remove PPE in client’s room
Limit movement of client
Practice use of non-critical client care equipment to a single client or to clients with same
infecting microorganism

Breaking the Chain 5 of Infection Portal of Entry

 Maintain integrity of skin and mucus membranes.

 Proper positioning of tubing
 Personal hygiene
 Dispose of contaminated syringes and needles properly
 Care should be taken while collecting and handling specimen.

Breaking the Chain 6 of Infection

Protecting Susceptible Host

 Protecting normal defense mechanisms

Oral hygiene
Adequate intake
Deep breathing and coughing exercises
Proper immunization
 Maintaining healing processes
Well-balanced diet
Institution of measures to improve appetite
Promotion of the client's comfort and sleep
Helping to relieve stress

MEDICAL SURGICAL ASEPSIS:-

MEDICAL ASEPSIS:-
Medical asepsis, also known as “clean technique” is aimed at controlling the number of
microorganisms. Medical asepsis is used for all clinical patient care activities.

Principles of Medical Asepsis

 • Perform hand hygiene

• Use of personal protective equipment and hand hygiene if contact with body fluids or
potentially contaminated secretions

• Clean and disinfect shared patient equipment, example-Hep-B,c

• Clean and disinfect the environment

• Healthcare providers free of disease and up to date on immunizations.

Surgical asepsis:-
Surgical asepsis, also known as “sterile technique” is aimed at removing all microorganisms. Surgical
asepsis is used for all surgical/sterile procedures.

Principles of Surgical Asepsis

• The patient should not be the source of contamination

• The operating room (OR) team should not be the source of contamination

• The surgical scrub should be done meticulously

• The OR technique of the surgeon is very important

• Recognize potential environmental contamination

CONTROL OR ELIMINATION OF INFECTIOUS AGENTS

1. Cleansing:- Is the removal of all foreign materials such as soil & organic material from objects.
Generally, cleansing involves use of water & mechanical action with or without detergents.
2. Disinfection:-eliminates pathogenic organisms on inanimate objects with the exception of
bacterial spore. Noninfectious microorganisms may or may not be killed
3. Sterilization:-is the process of eliminating and destroying all microorganisms, including spores
& viruses.

Commonly used disinfectants and germicide:-

Bacillocide: - it contains formaldehyde, glutaraldehyde, alkylurea derivatives

TYPES OF ASEPTIC PRACTICES:-

1. Cleaning:- it includes dusting, sweeping and moping the unit, rinsing and washing the
equipment and patient to remove pathogens.
2. Hand washing:- cleaning hands to remove pathogens.
3. Capping and masking:- capping is covering the head and masking is covering the nose and
mouth to protect the nurse from inhaling pathogens when disease is airborne.
 4. Gowning:-it means covering the uniform to protect the nurse to contaminating herself and
others around her.
5. Gloving:-it means covering the hand to protect the nurse or patient with poor resistance from
pathogens.
6. Bagging:-it means removing the contaminated materials and supplies in bags from isolation
unit.

Hand Hygiene

Practicing hand hygiene is a simple yet effective way to prevent infections. Cleaning your hands can prevent
the spread of germs, including those that are resistant to antibiotics and are becoming difficult, if not
impossible, to treat.

PREVENTION OF CROSS INFECTION

1. Fumigation
2. Isolation
a) Respiratory isolation
b) Enteric isolation
c) Wound and skin isolation
d) Blood isolation
3. Barrier protection
I. Gloves
II. Mask & goggles
III. Apron
IV. Foot wear & eye wear
4. Hand washing
 Social hand washing
 Hygienic hand disinfection
 Surgical hand disinfection

HOSPITAL WASTE MANAGEMENT:-

Hospital waste is “Any waste which is generated in the diagnosis, treatment or immunization of human
beings or animals or in research” in a hospital. This is also called ‘Bio-Medical Waste’ (BMW).

Hospital Waste Management means the management of waste produced by hospitals using such
techniques that will help to check the spread of diseases through.
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HOSPITAL INFECTION CONTROL PROGRAME

The main aim of the hospital infection programme is to lower the risk of an infection during the period
of hospitalization.

Aspects:-

 Development of an effective surveillance system to know the risk of nosocomial infection.

 Development of policies and procedures to reduce risk of nosocomial infection.
 Maintenance of continuing education programme from hospital personnel.

Basic elements:-

 Providing a system of identification and reporting of infections and providing a system for
keeping records of infection.
 Providing for good hospital hygiene, aseptic technique and sterilization and disinfection
practices.
 Providing for co-ordination with all departments and medical/ nursing audit committee in
quality assurance.

Infection control organization in a hospital:-

i. Infection control team (ICT)

ii. Infection control committee (ICC)
iii. Infection control Officer (ICO)
iv. Infection control Doctor (ICD)
v. Infection control Nurse (ICN)
vi. Infection control Manual (ICM)

ROLE OF NURSE FOR PREVENTING NOSOCOMIAL INFECTION:-

 Practical methods for preventing nosocomial infection.

 Hand washing as often as possible use of alcoholic hand spray while hand washing,
removing jewellery before washing.
 Stethoscope: cleaning with an alcohol swab at least daily.
 Gloves: supplement rather than replace hand washing.
 Intravenous catheter: thorough disinfection of skin before insertion changing administration
sets every 72 h.
 Gowning: routine use in neonatal units
 White coats: enforced use in clinical units
SUMMARY:-

Routine practice protects the healthcare providers and community people from the infection. Proper
using of PPE helps to reduce the contamination of infection. Hand hygiene is the most important way to
prevent the spread of infection.

CONCLUSION:-

Nosocominal transmission of pathogenic bacteria creates a major health burden. Proper infection
control needs to include education of patients, their caretakers, and health care personnel about good
preventive measures. These measures should include appropriate hand hygiene, the use of PPE or
isolation.

ABSTRACT:-

ABSTRACT –I

Infection Control Link Nurse Program: An interdisciplinary approach on targeting health care-
acquired infection

Published in-American journal of infection control, April 14 2020

Authors-Madhuri M, Sopirala et.al

Background: a successful interdisciplinary liaison program that effectively reduced health care-acquired
(HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting.

Methods: Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel
with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per
1,000 patient-days (PD) was compared between- baseline and intervention period along with total and
non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage.

Hand hygiene compliance was assessed. The study results showed that total MRSA rate and MRSA
bacteremia rate also showed significant reduction with nonsignificant reductions in overall non-HCA-
MRSA and non-HCA-MRSA bacteremia. Hand soap/sanitizer usage and compliance with hand hygiene
also increased significantly during IP. The study concluded that Link nurse program effectively reduced
HCA-MRSA. Goal-defined metrics with ongoing reeducation for the nurses by IP personnel helped
drive these results.

ABSTRACT II

Infection prevention and control research priorities: what do we need to combat healthcare-
associated infections and antimicrobial resistance? Results of a narrative literature review and
survey analysis

 Published in- Antimicrobial Resistance & Infection Control

 Authors- Lacotte Y, Årdal C, Ploy MC.

 Background: Infection prevention and control (IPC) is one of the most cost-effective
interventions against antimicrobial resistance (AMR). Yet, IPC knowledge gaps often receive little
prominence in AMR research agendas. In this article, we construct IPC research priorities, in order to
draw attention to these critical research needs. Methods: We developed a 4-step framework to identify
IPC knowledge gaps from literature (narrative review).

It also integrates the process with the organization to maintain and improve the effectiveness of
clinical services. It was evident that infection control measures and practices were not up to the mark
because of so many factors such as inadequate biomedical waste management practices, inadequate
practices in spill management, inadequate practices in usage of sodium hypo chloride, recapping of the
needle and document regarding the needle stick injury and inadequate practices on the hand washing
before touching the patient. From the study concluded that there was an inadequate infection control
practice among the health care workers and also compliance percent. Hence there is a need for
continuous and mandatory training, surveillance, infection control program.

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 SEMINAR
ON
INFECTION CONTROL

SUBMITTED TO SUBMITTED BY

MR.ASOKAN R ANITA PANIGRAHI

ASSOCIATE PROFESSOR MSC NURSING 2ND YEAR

KINS, KIIT DEEMED TO BE UNIVERSITY ROLL NO-1988002