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Infection prevention and control for medical students
- 1. INFECTION PREVENTION &CONTROL INTERNAL MEDICINE II GROUP1 GROUP MEMBERS AH/PAS/22/0001 AH/PAS/22/0002 AH/PAS/22/0003 AH/PAS/22/0004 AH/PAS/22/0005 AH/PAS/22/0006 AH/PAS/22/0007 AH/PAS/22/0008 AH/PAS/23/0030 AH/PAS/22/0104 AH/PAS/22/0105
- 2. INFECTION PREVENTION &CONTROL DEFINITION According to the WHO, Infection Prevention & Control is a scientific approach and practical solution designed to prevent harm caused by infection to patients and health workers. Infection Prevention & control (IPC) refers to the evidence-based practices designed to prevent the transmission of infections in the healthcare settings and the community. Effective IPC measures reduce healthcare-associated infections (HAIs), control outbreaks and combat Antimicrobial resistance (AMR).
- 3. THE BURDEN OFHEALTHCARE-ASSOCIATED INFECTIONS (HAI) Globally, 7-15% of hospitalized patients acquire at least one HAI (WHO, 2022). In Low and Middle-Income countries (LMICs), HAIs affect up to 30% of patients in Intensive Care units (ICUs). Common HAIs in Ghana include •Surgical Sites Infections (SSIs) •Catheter-Associated Urinary Tract Infections (CAUTIs) •Bloodstream Infections (BSIs) •Pneumonia (Ventilator-associated, VAP)
- 4. INFECTIONS The invasion andgrowth of pathogen in the body followed by the multiplication and producing it metabolites leading to harmful effects. Infectious Diseases are disorders caused by organisms usually microscopic in size; pathogens, that are passed directly or indirectly from one person to another. Pathogens are organisms causing disease to its host, with the severity of the disease symptoms referred to as virulence. Bacteria Fungi Virus protozoa
- 5. TYPES OF INFECTION Primaryinfection: initial infection with an organism to host constitutes primary infection. Secondary infection: when a host whose resistance is lowered by pre-existing infection, a new organism may set up a new infection. Local infection: infection limited to a defined area or single organ with symptoms that resemble inflammation. Systemic infection: infection that spreads to a whole body resulting in septicemia. Acute infection: it appears suddenly or lasts for a short period of time. Chronic infection: may occur slowly over a long period. Latrogenic infection: infection resulting due to therapeutic and diagnostic procedures. Nosocomial infection: infection that is contracted from the environment or staff of a health facility.
- 6. EPIDEMIOLOGICAL TRIAD The Agent-the microorganism that cause infection. The host- the target of the disease. The environment- the surroundings and external conditions of the host. The agent The host The environment
- 7. GENERAL MECHANISM OFINFECTIONS ENTRY ADHESION- the pathogen attaches to the host cells using adhesins which are molecules on the surface of the pathogen that bind to specific receptors on the host cells. INVASION- after adhesion, the pathogen invades the host cells by using various strategies such as endocytosis, phagocytosis or direct penetration. MULTIPLICATION- once inside the host cells, pathogen multiplies by replicating its genetic material and producing new pathogens. COLONIZATION- the pathogen colonizes the host tissues by establishing a population of pathogens that can persist and cause disease. Evasion- the pathogen evades the host immune system by producing molecules that inhibit the host’s immune system response such as anti-inflammatory cytokines and immune suppressive molecules. Tissue damage- the pathogen causes tissue damage and disease by producing toxins, enzymes and other molecules that damage host tissues and disrupt normal cellular function. Transmission- pathogen is transmitted to other hosts through various contacts such as direct contact, airborne or vector-borne transmission.
- 8. CHAIN OF INFECTION Causative agent reservoir Portalof exit Mode of transmissio n Portal of entry Susceptible host Causative agent: bacteria, virus, protozoa or fungi. Reservoir: humans, animals, environment. Portal of exit: blood, respiratory tract, skin, mucous membranes, genitourinary tract, gastrointestinal tract and transplacental pathway between mother and child. Mode of infection: airborne, contact(direct & indirect), vehicle, vector & transplacental. Portal of entry: conjunctiva, respiratory tract, alimentary tract, skin, urinogenital tract & anus. Susceptible host: humans
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- 13. FIRST AID INCASE OF SHARP INJURY BLEED IT- encourage wound to bleed, hold site under running water WASH IT- wash site with running water and plenty of soap COVER IT- dry wound and cover with waterproof dressing REPORT IT- seek medical advice, report injury to your employer
- 14. INFECTION PREVENTION &CONTROL (IPC) Infection Control refers to the policy and procedures implemented to minimize the spread of infections in hospitals, other healthcare settings and communities to reduce infection rate. The main purpose of infection control: Reduce occurrence of infectious diseases Prevent transmission of communicable diseases Reducing morbidity and mortality Decreasing healthcare costs
- 15. INFECTION CONTROL (IC) Infectioncontrol addresses factors related to the spread of infections within the healthcare setting. Key components of IC Surveillance Isolation Personal Protective Equipment Hand hygiene Disinfection Sterilization Vaccination Education and training of healthcare workers on infection control practices. Patient to patient From patient s to staff From staff to patient s Among staff
- 16. STANDARD INFECTION CONTROLPRECAUTIONS (SICP) SICPs are basic infection prevention and control measures necessary to reduce the risk of transmitting infectious agents from both recognized and unrecognized sources of infection. SICPs are to be used by all staff, in all care settings, at all times, for all patients whether or not infection is present, to ensure safety of those being cared for, staff, and visitors in the care environment. Sources of potential infections include blood and other body fluids, secretions or excretions (excluding sweat), non-intact skin or mucous membranes and any equipment or items in the care environment that could have become contaminated.
- 17. 10 ELEMENTS OFSICPS Patient placement/assessment of infection risk Hand hygiene Respiratory and cough hygiene Personal protective equipment (PPE) Safe management of care environment Safe management of care equipment Safe management of healthcare linen Safe management of blood and body fluids Safe disposal of waste (including sharps) Occupational safety/managing prevention of exposure
- 18. INFECTION CONTROL Hand hygiene Alcohol based hand rub Soap and water 5 moments for hand hygiene Before touching a patient Before clean/aseptic procedures After exposure to body fluids After touching a patient After touching patient surroundings Personal protective Equipment •Gloves •Masks •Gowns & aprons •footwear •Eye/face protection Respiratory hygiene & cough etiquette •Cover mouth/nose with tissue/elbow •Dispose of tissues in touch bins •Wear masks if symptomatic
- 19. INFECTION CONTROL: ELIMINATIONOF INFECTIOUS AGENTS Disinfection Activated glutaraldehyde 2% Sodium hypochlorite 1% Carbolic solution 5% Bleaching powder 1% Methylated spirit 70% Betadine solution 10% Savlone 1% Sterilization of contaminated objects Autoclaving Dry/moist heat sterilization UV light sterilization Fumigation sterilization 5 principles of cleaning Wipe in an “S” pattern Work from top to bottom Wipe from clean to dirty Ensure correct contact time One wipe one surface
- 20. HEALTHCARE WASTE COLORCODING SEGREGATION GUIDELINES COLOUR WASTE DESCRIPTION YELLOW Human tissues, organs, body parts, items contaminated by body fluids, soiled cotton & dressing, soiled plaster casts, etc RED Catheters, tubes, cannulas, syringes, plastic IV bottles & sets, used gloves, infected plastics, specimen containers, lab waste. Microbiology cultures, used or discarded bags of blood/blood products, vaccines, etc BLUE Glass items, needles, syringes, scapels, blades, used & unused sharps BLACK Discarded medicines, discarded cytotoxic drugs, etc GREEN General waste, non-infected plastic materials & papers, disposables, cardboards, metal containers, office waste, food waste, etc
- 21. INFECTION CONTROL: ISOLATIONPRECAUTIONS Isolation precautions are additional precaution measures, practices or procedures designed on patients with known or suspected contagious infectious diseases to prevent transmission of infections in the hospital setting. It requires co-operation and responsibility from various units including administration, education, other clinical services and surveillance. Stringent infection control precautions Highly contagious diseases Diseases with high mortality rate e.g TB Multidrug resistant diseases Infection with multiple routes of infection e.g varecilla virus
- 22. INFECTION CONTROL: QUARANTINE Quarantineis for people who are not sick, but may have been exposed. Isolation separates and restricts the movement of sick people so they can spread the disease to healthy people. Aims: Prevent spread of infection Monitoring the development pf signs and symptoms Duration: 14 days from the first exposure
- 23. GHANA HEALTH SERVICEIPC PRIORITIES Hand hygiene promotion- Clean Care for All campaigns PPE availability- protection of healthcare workers Waste management- proper segregation and disposal Outbreak preparedness- protocols for pandemics, outbreaks and epidemics
- 24. REFERNCES Warrell, D. A.et al(2010) Oxford Textbook of Clinical Medicine. Oxford University Press: Oxford. 5th edition. Kretshmer, J. et al (2012) Harrison’s Principle of Internal Medicine. McGraw-Hill Publishing Company: New York. 18th edition. Standard Treatment Guidelines Ministry of Health. Seventh Edition 2017. ((7th).