INFECTION CONTROL

PRESENTED BY:
SHIVANI
MSC NURSING 2ND YEAR
S.N.G.N.C I.G.M.C SHIMLA
BASICS OF INFECTION CONTROL:
• 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.
INFECTION

DEFINITION:
Infection is the process of bacteria or viruses invading the body or
making someone ill or diseased.
• Infection may be local or generalized and spread throughout the
body.
• Once the infectious agent enters the host it begins to proliferate and
reacts with the defense mechanisms of the body producing infection
symptoms and signs: pain, swelling, redness, functional disorders,
rise in temperature and pulse rate and leukocytosis.
INFECTION CONTROL:

DEFINITION :
Infection control is the discipline concerned with preventing
nosocomial or healthcare-associated infection.
• Infection control addresses factors related to the spread of
infections within the health-care setting, including
prevention, monitoring/investigation of demonstrated health
care setting, and management (interruption of outbreaks)
OBJECTIVES OF INFECTION CONTROL

• To protect the patient and members of the hospital team from

contracting infection during hospital procedures.
• To implement a high standard of infection control while treating
patient (universal precautions).
• To reduce the numbers of pathogenic micro-organisms in the dental
operatory to the lowest possible level
STRATEGY TO ACHIEVE
INFECTION CONTROL

• All patient must be screened.

• Barriers for personal protection.
• Careful aseptic techniques.
• Sterilization and disinfection.
• Disposal of contaminated waste safely.
PRINCIPLES

• Client safety in 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.
PRINCIPLES

• Nurses are responsible for protecting clients and

themselves by using infection control practices.
• Nurses and clients must be educated on the types of
infections, modes of transmission, risks for
susceptibility, and infection control practices required
to control or prevent further transmission.
HOSPITAL INFECTION
CONTROL PROGRAMME

The aim of Hospital Infection Control Program is dissemination of

information, surveillance activities, investigation, prevention and
control of nosocomial infections in the hospital.
• Nosocomial infections affect approximately 2 million patients
annually in acute care facilities in our country and their annual
patient care costs several millions of rupees.
• Studies shows that nearly one-third of nosocomial infections can
be prevented by a well-organized infection control program. But
only less than 10% are actually prevented.
HOSPITAL INFECTION
CONTROL PROGRAMME

To be effective, the infection control program should

include the following:
• Organized surveillance and control activities
• One infection control practitioner for every major
Health Facility.
• A Trained Hospital Epidemiologist
IMPORTANT
COMPONENTS

THE IMPORTANT COMPONENTS OF THE

INFECTION CONTROL PROGRAM ARE:
• Basic measures for infection control, i.e. standard and
additional precautions.
• Education and training of health care workers.
• Protection of health care workers e.g. immunization.
• Identification of hazards and minimizing risks.
IMPORTANT
COMPONENTS
• Routine practices essential to infection control such as aseptic
techniques , use of single use devices, reprocessing of
instruments and equipment ,antibiotic usage, management of
blood/body fluid exposure, handling and use of blood and
blood products.
• Surveillance, incident monitoring; outbreak investigation;
infection control in specific situations; and Research.
• Sound management of medical waste;
ORGANIZATION OF AN
INFECTION CONTROL
PROGRAM

As with all other functions of a health care facility, the

ultimate responsibility for prevention and control of
infection rests with the health administrator.
• The hospital administrator/head of hospital should:
 Establish an infection control committee.
 Provide adequate resources for effective functioning of
the infection control program.
ORGANIZATION OF AN INFECTION
CONTROL PROGRAM

• In the majority of countries Infection control program

(ICP), typically operates on two levels: an executive
body – the infection control team (ICT) – and an
advisory body to the hospital management – the
infection control committee (ICC) – which adopts the
‘legislative’ role of policy making.
ORGANIZATION OF AN
INFECTION CONTROL PROGRAM

 INFECTION CONTROL COMMITTEE

 TEAM MEMBERS OF INFECTION CONTROL

COMMITTEE

 INFECTION CONTROL MANUAL

INFECTION CONTROL
COMMITTEE:-

• It is a multidisciplinary committee responsible for

monitoring program policies implementation and
recommend corrective actions.
• It includes representatives from different concerned hospital
departments & management. They meet bimonthly.
• It establishes standards for patient care, it reviews and
assesses IC reports and identifies areas of intervention.
INFECTION CONTROL COMMITTEE

• The hospital ICC is charged with the responsibility for the

planning, evaluation of evidenced-based practice and
implementation, prioritization and resource allocation of
all matters relating to infection control.
• The ICC must have a reporting relationship directly to
either administration or the medical staff to promote ICP
visibility and effectiveness. The ICC should meet regularly
(monthly) according to local need.
INFECTION CONTROL
COMMITTEE

Team members to be authorized:

• Team should have authority to manage an effective control
program.
• Team should have a direct reporting with senior
administration.
• Infection control team members or are responsible for day-to-
day functions of IC and preparing the yearly work plan.
• They should be expert and creative in their job.
INFECTION CONTROL COMMITTEE

THE ICC HAS THE FOLLOWING TASKS:

• To review and approve the annual plan for infection
control.
• To review and approve the infection control policies.
• To support the IC team and direct resources to address
problems as identified.
• To ensure availability of appropriate supplies.
INFECTION CONTROL
COMMITTEE

• To review epidemiological surveillance data and identify area for

intervention.
• To assess and promote improved practice at all levels of the health
care facility.
• To ensure appropriate training in infection control and safety.
• To review risks associated with new technology and new devices
prior to their approval for use.
• To review and provide input into an outbreak investigation.
INFECTION CONTROL
COMMITTEE

THE ROLE OF ICN:-

• Identify, investigate and monitor infections, hazardous
practice and procedures.
• Participate in the preparation of documents relating to service
specifications and quality standards.
• Participate in training and educational programs and in
membership of relevant committees where infection control
input is needed.
CONT…….

• Educate individuals and groups about the risk,

prevention, transmission, and control of infection,
disease-specific care, appropriate precautions, and
appropriate assessments.
• Investigate, manage and conduct surveillance of
suspected and confirmed outbreaks of infection.
• Training and education under the supervision of ICO.
CONT….

• Increase awareness among patients and visitors about

infection control.
• Maintain infection control standard and policies.
TEAM MEMBERS:-

 INFECTION CONTROL INCHARGE

(Microbiologist )
 SISTER INCHARGE
 INFECTION CONTROL NURSE
(3-4 ICN)
INFECTION CONTROL MANUAL:-

• Every Hospital should have a nosocomial infection prevention

manual or a Hospital associated infection prevention manual
containing recommended instructions and practices for patient
care.
• The manual should be developed and updated by the infection
control team and reviewed and approved by the committee.
• It must be made readily available for health care workers, and
updated in a timely fashion.
INFECTION CONTROL MANUAL:-

IT INCLUDES:-
SURVEILLANCE
PREVENTIVE ACTIVITY
STAFF TRAINING AND
EVALUATION
SURVEILLANCE
 DEFINITION
• It is the outgoing systematic
collection, analysis and
interpretation of health data
essential to the planning,
implementation and evaluation of
health care practices.
PURPOSES
• Reduce infection rates within a
hospital
• Identify outbreak
• Convincing medical personnel
• Evaluating control measures
SURVEILLANCE ACTIVITIES
• Operative Procedures
• Critical Care Units (MICU, SICU,
NICU)
• Targeted Surveillance
• Outbreak Investigation
PREVENTIVE ACTIVITY
• Treating all patients in the health care
facility with the same basic level of
“standard” precautions involves work
practices that are essential to provide a
high level of protection to patients,
health care workers and visitors.
STANDARD SAFETY
PRECAUTIONS
STANDARD SAFETY MEASURES
• Standard Safety measures are the
minimum infection prevention practices
that should be used in the care of all
patients all of the time. These practices
are designed to both protect the
healthcare worker and to prevent the
healthcare worker from spreading
infections among patients.
A. Medical and surgical asepsis
B. Hand washing and personal protective equipment
C. Isolation precautions
D. Sharp precautions
E. Handling of contaminated material
F. Housekeeping routine
G. Sterilization and disinfection
H. Dietary services
I. Environmental control
A. MEDICAL AND SURGICAL ASEPSIS
• Hand washing
• Donning and removing sterile gloves
• Preparing a sterile field by opening a
tray wrapped in a sterile drape
• Preparing a sterile field
• Performing a surgical hand scrub
• Donning a sterile gown and closed
gloving
B. HAND WASHING AND PERSONAL
PROTECTIVE EQUIPMENT
• Hand washing is the single most effective
precaution for prevention of infection
transmission between patients and staff.
• Hand washing with plain soap is mechanical
removal of soil and transient bacteria (for 10-
15 sec.)
• Hand antisepsis is removal & destroys of
transient flora using anti-microbial soap or
alcohol based hand rub (for 60 sec.)
HAND HYGIENE
WHEN?
BARRIER PRECAUTION
A general term referring to any method or
device used to reduce contact with potentially
infectious body fluids, including.
• Face mask, face shield, gloves and fluid
resistant gowns.
• Protective eye wears(goggles)
• Apron
• Boots/shoe cover; and
• Cap/ hair cover
PERSONAL PROTECTIVE EQUIPMENT
 C. ISOLATION PRECAUTIONS
• Availability of adequate number of trained
nurses is crucial for prevention of nosocomial
infection. Isolation facilities for patients with
communicable diseases and those vulnerable to
infection. Such facilities must be made
available in ICU, nurseries, burn unit, transplant
unit, etc. Strict control on wearing of mask,
gown and gloves must be exercised while
attending to such patients. All articles taken for
patient use must be treated appropriately.
D. SHARP PRECAUTIONS
• Never to recap needles
• Dispose of used needles and small
sharps immediately in puncture
resistant boxes. Needle incinerator can
be used for disposal.
E. HANDLING OF CONTAMINATED
MATERIAL
1. Cleaning of blood or body fluid spills:
• Wear gloves.
• Wipe- up the spill with paper or towel
• Apply disinfectant
2. Cleaning & decontamination of
equipment:
• Protective barriers must be worn.
 CONT…..
3. Handling & processing lab specimens:
• Must be in strong plastic bags with biohazard label.
4. Handling & processing linen:
• Soiled linen must be handled with barrier
precautions, sent to laundry in coded bags.
5. Handling & processing infectious waste:
• Must be placed in color coded, leakage proof bags,
collected with barrier precautions
• Contaminated waste incinerated or better autoclaved
prior to disposal in a landfill
F. HOUSEKEEPING ROUTINES
• Dry dusting and sweeping should be avoided; it
is preferable to vacuum cleaner to suck the dust
from the floor, walls and equipment’s.
• Wet mopping of floors with soap and water
containing 3% phenol should be carried out at
least thrice daily
• The waxing of surfaces and use of oil in water
for mopping may limit dissemination of
microorganisms.
 G. STERILIZATION AND DISINFECTION
Sterilization practices
• An efficient CSSD ensures supply of properly sterilized articles
to all users in the hospital. Each sterilization must be monitored
through the use of heat- sensitive tapes.
• All steam and ethylene oxide sterilizers should be checked at
least once each week with a suitable live spore preparation by
the laboratory.
• Instruments which come in contact with mucous membranes but
are disinfected rather than sterilized before use, such as
endoscopes, and anesthesia equipment may be bacteriologically
sampled on a spot check basis to ensure adequacy of
disinfection.
 Disinfection practices
• Different kinds of disinfectants vary in their reaction to
different kinds of micro- organisms. Phenolic compounds
are active against gram-negative organisms. Quaternary
ammonium compounds against staphylococci,
streptococci, and lodophores and Hypochloride’s have a
broad spectrum of action. Selection of appropriate
disinfectant for different purpose is important. The
following should be checked.
• Appropriate choice
• Appropriate concentration
• Appropriate contact time
• Appropriate method of use
H. DIETARY SERVICES
• Storage of food articles and appropriate
temperatures in refrigerators and deep
freezers must be checked. Control of
rodents and insects is a must to prevent
contamination of stored food and
supplies Fruits and vegetables eaten raw
must be thoroughly washed before
consumption.
I. ENVIRONMENTAL CONTROL
• Physical facility plan must meet quality and
infection control measures.
• Cleaning of hospital environment
• Proper air ventilation
• Water pipes examination
• Proper waste collection & disposal
• Cleaning and disinfection of equipment
• Proper linen collection, cleaning, distribution
STAFF TRAINING AND EVALUATION
Staff health promotion and education:
• HCW’s are at risk of acquiring infection,
they can also transmit infection to patients
and other employee.
• Employee health history must be reviewed,
immunizations recommendations to be
considered.
• Release from work if sick, occupation injury
must be notified.
STAFF TRAINING AND EVALUATION

• Continuous education to improve practice,

better performance of new techniques.
• Master institutional infection control
orientation and in service education program-
for all level staff
• Wards/departmental in service training program
• Infection control seminar/workshops and
symposium
Evaluation:
• Measure success of infection
control techniques and compare
patient’s response to actual
outcome
EXAMPLE:
INFECTION CONTROL IN
HOSPITALS
• INFECTION CONTROL INCHARGE
(Microbiologist)
• SISTER INCHARGE
• INFECTION CONTROL NURSE
 MANAGEMENT OF INFECTION CONTROL

• Monthly they have one infection control meeting with all committee members.
• In which they deal with all infection control prevention measures of hospital.
• Also they discuss with all department and infection control nurse about
monthly report of infection control in hospital.
• Also they have in-service education in hospital for staff, 2 times class lecture
for staff and one time class lecture for infection control nurse.
• Also they give education to staff and students at bed sides ICN has duty in 2
shifts.
• They follow all the protocols like universal precaution, BMW etc.
REFERENCES:
 
• Berman A.,synder s.”Kozier and Erb’s fundamental of nursing”
9th edition, pearson publisher, page no.670-708
• Dash Bijaylaskhmi ”A comprehensive textbook of community
health nursing” first edition, jaypee brothers,Ansari Road New
Delhi, page no.777-778
• Park K” Textbook Of Preventive And Social Medicine”21st
edition, banarsidas bhanot publishers, Jabalpur, page no 86-90
• BasheerP. Shebeer.S. Yaseen khan “A Concise Text Book of
Advanced Nursing Practice” 2nd edition, emmess medical
publishers, page no 9-21