FUNDAMENTALS OF NURSING

UNIT 3. INFECTION PREVENTION AND

CONTROL (IPC)
by
MALIZA Nursing staff, RN, BSN, MP
Equipment cleaning Hand Hygiene Compliance / Precautions
Learning outcomes of the unit
At the end of this unit, students should be able to demonstrate
knowledge and understanding of:
• General principles of infection prevention and control in nursing care
• Apply infection control and prevention and safety precaution
measures while caring for patient and their families.
 Contents
3.1 Safe environment
• Hospital environment
• Ward environment, equipment and linen
3.2 Principles of infection control
3.3 Nosocomial infections
3.4 WHO Universal precautions of infection control
Technique: Application of Personal Protective Equipment (PPE)
3.5 Principles of medical and surgical asepsis and maintenance of
hospital equipment
Introduction
• Knowledge of the relationship between micro-organisms and
infectious diseases developed in the late nineteenth century.
• Previously, it was thought infectious diseases were caused by
exposure to ‘bad air’, otherwise known as miasmas.
• As a result of this naïveté, people had little success in
controlling their spread.
• Health care professionals need to understand the roles,
interactions, benefits, challenges, and disadvantages of
humans, micro-organisms, and the environment in which we
live.
Definitions of key terms

• Infection: Invasion of a body part or tissue by pathogens which

may produce subsequent tissue injury and progress to overt
disease. Infectious disease: Any disease caused by the
entrance, growth, and multiplication of microorganisms in the
body.
• Infestation: presence of living infectious agent on the exterior
surface of the body.
• Infective agent: a microorganism (e.g. bacteria, viruses, fungi,
and parasites) capable of producing infection or infectious
disease.
Definitions of some terms
• Communicable diseases: Refer to diseases that can be
transmitted from one host to another and result in damage to
tissues and organs or to altered physiology that results in
clinical signs and symptoms of disease.
• Nosocomial infection: Infection acquired during hospitalization
• Sterilization: This is the process of destroying all
microorganisms and their pathogenic products.
• Asepsis: absence of microbes
• Aseptic technique: This is a set of aseptic practices and
procedures performed under carefully controlled conditions
with the goal of minimizing contamination by pathogens.
Definitions of some terms
• Antiseptic: preventing the growth of disease-causing
microorganisms.
• Disinfection: the destruction of microorganisms, but not
usually spores, on inanimate surfaces or objects.
• Sterilization: describes a process that destroys or eliminates all
forms of microbial life, including spores.
• Disinfectants: chemicals used to destroy or prevent the growth
of pathogens.
3.1. Hospital environment
• Any environment in which a person lives has certain risk
factors that negatively affect him/her.
• Hospitalization is always stressful for the body. Both the
disease itself and the new environment force a person to
change their usual way of life and to satisfy their needs in a
new way.
• A safe hospital is a facility whose services remain accessible
and functioning at maximum capacity and encompasses all
health facilities, regardless of their level of complexity.
Hospital Environment cont’d

• A safe hospital environment is an environment in which the

comfort and safety of both patients and medical staff of a
health facility is provided.
• A hospital is ‘safe’ when:
• It provides the highest level of protection possible,
• Access routes to the health facility are open, and when the
water supply, electric power, and telecommunications can
continue supplying the health facility.
• Ensuring the continuity of operations and the ability to
absorb the additional demand for medical care.
Hospital Environment cont’d
• Currently, a safe hospital environment is one of the most
pressing and at the same time complex problems in the
professional work of medical workers.
• The patient, getting into such an environment, is weakened,
suffers physically and psychologically, both from the disease
itself and from the unusual hospital environment for him.
• Properly organized work of medical personnel will help the
patient quickly adapt to the hospital environment and cope
with the disease without prejudice to his health.
Hospital Environment Cont’d
• Hospitals are representative of complex environments in
which different aspects including patients, staff, equipment,
services, and information are interfaced.
• Maintaining a safe environment reflects a level of competent
healthcare that must be fulfilled for patient safety.
• The clinical engineer plays an important role in providing a
safe environment within the hospital.
Hospital Environment cont’d

• Many factors affect the hospital environment internally and

externally.
• Many internal factors have a significant impact on the
hospital environment such as waste management, noise,
and infection control
• External factors such as sources and treatment of water,
sewage(dirty) treatment, and disposal.
 1. Waste management
• Waste management is crucial to promoting high-quality of
healthcare and a safe environment within hospitals.
• Hospital waste management means the management of waste
produced by hospitals using techniques that will check the
spread of diseases through hospital waste.
• Hospital waste consists of both risk waste and non-risk waste.
• Generally risk waste includes infectious waste, pathological,
pharmaceutical, sharps, chemicals, genotoxic, and radioactive
wastes.
1. Waste management Cont’d
• Chemicals, genotoxic, and radioactive wastes include
cytostatic drugs or vomit, urine, and feces from patients
treated with cytostatic drugs, chemicals, and radioactive
material.
• Non-risk waste includes garbage and general day-to-day
waste produced by foods tuff leftovers and their packaging.
1. Waste management cont’d
• To achieve a sustainable waste disposal system, the three R’s-
“Reduce, Reuse and Recycle” are generally used.
• The principle of reducing waste, reusing, and recycling resources
and products is often called the “3Rs.“
Reducing:
Means choosing to use things with care to reduce the amount of
waste generated.
The unnecessary and unwanted wasteful purchases are
decreased.
Avoiding waste is the preferable option for waste management.
Avoid excessive use of paper, switch to online modes.
• Reusing:
Involves the repeated use of items or parts of items that still
have usable aspects.
Using the same item more than once in either the same way
or a modified way.
It is the way to use the materials or items again.
• Recycle:
It is to make something new from a commodity that has
been used earlier and which could be recycled with a little
polish perhaps.
 Processing older items to produce something new in order
to save energy and resources.
1. Waste management cont’d
• Each hospital should prepare its own health management
plan in accordance with national and international
guidelines, specific to its unique requirements.
• It should be ensured that risks from hospital wastes to
individuals and the environment are minimized to a certain
extent.
1. Waste management cont’d
• The proper management of health-care waste depends on
various factors like proper planning, funding, administration,
and commitment at the policy level.
• If they are implemented properly, they can lead to better
effects for both individuals and the environment.
• Proper waste management can significantly lower the
infectious disease burden especially Hep B, C, and AIDS,
which spreads through I/V routes.
2. Noise

• Noise is defined as unwanted sound

• Hospitals have various sources of noise such as alarms,
paging systems, telephones, computer printers, televisions,
delivery carts, staff conversation, equipment, housekeeping
activities, air conditioning systems, doors opening and
closing, and sounding systems.
• To overcome the problem of noise within hospitals, some
preventive procedures should be carried out.
• One form is to measure the noise level periodically to
reduce patient exposure to such noises.
2.Noise cont’d
• Another approach is to perform regular checks and
maintenance on all systems that are considered sources of
noise including equipment.
• Some practices that could reduce the noise level include:
Handling different alarms
Obligation of instructions in critical areas such as intensive
care units, making clear circulation paths for patients and
staff.
Well-training for service providers such as housekeeping.
3. Infection prevention and control

• Infection prevention and control(IPC) is a practical, evidence-

based approach to preventing patients and health workers
from being harmed by avoidable infections.
• Infection control prevents or stops the spread of infections in
healthcare settings.
• An infection occurs when germs enter the body, increase in
number, and cause a reaction in the body.
• Effective IPC requires constant action at all levels of the
health system, including policymakers, facility managers,
health workers, and those who access health services.
3.Infection Prevention and control cont’d
• IPC is unique in the field of patient safety and quality of care,
as it is universally relevant to every health worker and
patient, at every healthcare interaction.
• Infection prevention and control regarding all aspects of
health care, including hand hygiene, surgical site infections,
injection safety, antimicrobial resistance, and how hospitals
operate during and outside of emergencies.
Infection prevention and control cont’d

• Programs to support IPC are particularly important in low-

and middle-income countries, where healthcare delivery and
medical hygiene standards may be negatively affected by
secondary infections.
• Defective IPC causes harm and can kill.
• Without effective IPC, it is impossible to achieve quality
health care delivery.
Infection Prevention and control cont’d
• Infections associated with the provision of health care affect
patients, consumers, and the health workforce and lead to:
• Considerable harm and may increase the risk of morbidity,
and death.
• Increase in use of health services for example, extended
length of stay, resulting in increased use of health resources
such as inpatient beds, treatment options, investigations,
and greater demands on the health workforce.
Infection prevention and control Cont’d
• An infection occurs when germs enter the body, increase in
number, and cause a reaction in the body.
• Three things are necessary for an infection to occur:
• Source: Places where infectious agents (germs) live (e.g.,
sinks, surfaces, human skin)
• Susceptible Person with a way for germs to enter the body
• Transmission: a way germs are moved to the susceptible
person
The chain of Infection
Breaking the chain of infection
Rapid identification, diagnosis,
Infectious Agent and treatment
Bacteria
Virus
Fungi
Recognition of high risk patients
Treatment of underlying disease
Immunizations

Susceptible Host Reservoir Education

Patient People
Environmental Hygiene
Staff Environment
Disinfection and
Visitor Equipment & Water Sterilization

Chain of
Hand Hygiene,
Personal Hygiene
infection Hand Hygiene
Transmission Based Precautions Control of Excretions &
Aseptic Technique secretions
Portal of Entry
Wound/catheter care Portal of Exit Proper attire
Mucous Membranes
Excretion, secretions, skin, and
Respiratory & GI Tract
droplets
Broken Skin

Means of Transmission
Direct & Indirect Contact
Inhalation Hand Hygiene
Airborne Transmission based precautions
Environmental Hygiene
Breaking the chain of infection transmission

Equipment cleaning Hand Hygiene Compliance /Precautions

Infection prevention and control

• Standard precautions: a set of infection control practices used

to prevent transmission of diseases that can be acquired by
contact with blood, body fluids, secretions, and non-intact skin
(including rashes).
• These measures are to be used when providing care to all
individuals, whether or not they appear infectious or
symptomatic.
Infection Prevention and control cont’d
• Infection control provides a framework for the identification
of a hazard and the development of an action plan to
eliminate the hazard or minimize its effect through control
measures.
• Control has been achieved by recognizing the means of
growth, reproduction, and transmission of pathogenic
microorganisms.
Infection prevention and control cont’d
• The main components of an effective infection prevention
and control program are listed as follows:
 Education and training
 Surveillance of infection
 Policies, procedures, and guidelines
 Audit processes
Documented arrangements
 Monitoring of hospital hygiene
Infection prevention and control
Successful infection control involves five elements:
Applying basic infection control strategies
Adopting quality management practices
Developing effective work practices that prevent the
transmission of infectious agent
Managing specific infectious agents and
Identifying infection control strategies in specialized health care
settings (such as operating rooms, dentistry rooms, and
residential aged care facilities).
Principles of Infection Control cont’d
• The Centers for Disease Control and Prevention (CDC)
recommends two levels in the prevention of infection within
healthcare settings;
• These 2 tiers of recommended precautions to prevent the
spread of infections in healthcare settings:
• Standard Precautions and
• Transmission-Based Precautions.
Standard Precautions

• Standard Precautions are used for all patient care. Used all day, every
day, every patient.
• They are based on a risk assessment and make use of common sense
practices and personal protective equipment that protect healthcare
providers from infection and prevent the spread of infection from
patient to patient.
• Infection prevention actions that apply to all patient/client care and or
interactions, regardless of the suspected or confirmed infection status
of the patient/client
• Are evidence-based practices designed to protect and prevent the
spread of infection
• If followed correctly, minimize the risk of contact with blood and other
body substances.
Transmission-based Precautions
• Transmission-based precautions are the second tier of basic
infection control and are to be used in addition to Standard
Precautions for patients who may be infected or colonized
with certain infectious agents for which additional
precautions are needed to prevent infection transmission.
• Used when standard precautions alone, are not enough to
interrupt the transmission of a pathogenic microorganism
• Used in addition to standard precautions
• Know the route of transmission for the infection of
communicable disease
 Transmission Based Precautions
• Hand Hygiene
Contact Precautions • Gown
• Gloves

• Hand Hygiene
Droplet Precautions • Mask

• Hand Hygiene
Airborne Precautions • Negative pressure room
• N-95 Respirator mask
Transmission Based Precautions
• There are three types of transmission-based precautions,
depending on how transmission occurs
o Contact precautions – used when caring for any
patient/resident known or suspected of being infected with a
microorganism spread by skin-to-skin direct or indirect
contact e.g. Staph aureus, VRE.
o The unwashed hands of Health workers, commonly transfer
pathogenic microorganisms in the health environment.
Transmission Based Precautions
o Droplet precautions – use when caring for any patient/resident
known or suspected of being infected with a microorganism that
can be spread by the respiratory droplet route e.g. coughing,
sneezing, spitting, touching mouth/nose and talking.
o Because they are large and heavy, droplets will travel up to 1 metre
in distance.
o Airborne precautions – used when caring for patients/residents
known or suspected of being infected with a pathogenic
microorganism transmitted by the airborne route.
o Pathogenic microorganisms are small and float in the air travelling
a greater distance than droplets.
 Standard precautions
• Are a set of infection control practices used to prevent transmission of diseases that can be
acquired by contact with blood, body fluids, secretions and non-intact skin (including
rashes), .
• WHO (2006) recommends 10 Health-care facility standard precautions:
1. Hand hygiene
2. Gloves
3. Facial protection (eyes, nose, and mouth)
4. Gown
5. Prevention of needle stick injuries
6. Respiratory hygiene and cough etiquette
7. Environmental cleaning
8. Linens management
9. Waste disposal
10. Patient care equipment handling
 Hand hygiene
• Two possible methods:
• Hand washing (40–60 sec): Wet hands and apply soap; rub
all surfaces; rinse hands and dry thoroughly with a single-use
towel; use a towel to turn off the faucet.
• Hand rubbing (20–30 sec): Apply enough product to cover all
areas of the hands; rub hands until dry.
• Details of procedure to be discussed in basic nursing
procedures.
WHO STEPS OF HAND WASHING
Hand Hygiene
• Hand Hygiene (HH) is the single most important practice to
reduce the transmission of infectious agents in healthcare
settings and is an essential element of Standard Precautions.
• The term “hand hygiene” includes:
 Handwashing with soap and water
 Use of alcohol-based products that do not require the use of
water (>60% alcohol)
 No artificial nails for those having contact with (high-risk)
patients
Standard Precautions
Apply to all patients receiving care in hospitals, regardless of their
diagnosis or presumed infection status
 Designed to reduce the risk of transmission of microorganisms from
both recognized and unrecognized sources of infections
 Under standard precautions, blood and body fluids of all patients
are considered potentially infectious
 Antiseptics
• An effective antiseptic hand cleanser will contain any of
the following antiseptics:
• Chlorhexidine gluconate 2–4%
• 70% ethyl alcohol and 70–90% isopropyl alcohol
• Iodophor 2.5%; 2–3.5% chloroxylenol (PCMX) 1.5–3.5%;
triclosan 0.3–1%
 Indications for hand washing
• Before and after any direct patient contact and between patients,
whether or not gloves are worn.
• Immediately after gloves are removed.
• Before handling an invasive device.
• After touching blood, body fluids, secretions, excretions, non-intact skin,
and contaminated items, even if gloves are worn.
• During patient care, when moving from a contaminated to a clean body
site of the patient.
• After contact with inanimate objects in the immediate vicinity of the
patient.
The WHO 5 critical moments of hands washing
Gloves
• Wear gloves when touching blood, body fluids, secretions,
excretions, mucous membranes, non-intact skin.
• Change between tasks and procedures on the same patient
after contact with potentially infectious material.
• Remove after use, before touching non-contaminated items
and surfaces, and before going to another patient.
 Facial protection (eyes, nose, and mouth)

• Wear a surgical or procedure mask and eye protection

(face shield, goggles) to protect mucous membranes of
the eyes, nose, and mouth during activities that are
likely to generate splashes or sprays of blood, body
fluids, secretions, and excretions.
 Gown
• Wear gown to protect skin and prevent soiling of clothing
during activities that are likely to generate splashes or sprays
of blood, body fluids, secretions, or excretions.
• Remove soiled gown as soon as possible, and perform hand
hygiene.
Prevention of needle stick injuries
Use with care when:
• Handling needles, scalpels, and other sharp instruments or
devices
• Cleaning used instruments
• Disposing of used needles (safety boxes).
 Respiratory hygiene and cough etiquette
Persons with respiratory symptoms should apply source control measures:
• Cover their nose and mouth when coughing/sneezing with tissue or mask,
dispose of used tissues and masks, and perform hand hygiene after
contact with respiratory secretions.
Health care facilities should:
• Place acute febrile respiratory symptomatic patients at least 1 metre (3
feet) away from others in common waiting areas, if possible.
• Post visual alerts at the entrance to health-care facilities instructing
persons with respiratory symptoms to practise respiratory hygiene/cough
etiquette.
• Consider making hand hygiene resources, tissues and masks available in
common areas and areas used for the evaluation of patients with
respiratory illnesses.
 Waste disposal
• Ensure safe waste management.
• Treat waste contaminated with blood, body fluids, secretions,
and excretions as clinical waste, in accordance with local
regulations (incinerators and covered wholes).
• Human tissues and laboratory waste that is directly associated
with specimen processing should also be treated as clinical
waste.
• Discard single-use items properly.
Environmental cleaning
• Use adequate procedures for the routine cleaning and
disinfection of environmental and other frequently
touched surfaces.
 Linens management
Linens Handle, transport, and process used linen in a manner
which:
• Prevents skin and mucous membrane exposures and
contamination of clothing.
• Avoids transfer of pathogens to other patients and or the
environment.
 Patient care equipment

• Handle equipment soiled with blood, body fluids, secretions,

and excretions in a manner that prevents skin and mucous
membrane exposures, contamination of clothing, and transfer
of pathogens to other patients or the environment.
• Clean, disinfect, and reprocess reusable equipment
appropriately before use with another patient.
 CDC (1987) Universal precautions
Universal precautions measures include the following:
• Gloves
• Protection of Mucous membranes (eyes and mouth)
• Protective clothing (gown,…)
• Proper handling of contaminated instruments during the use, cleaning and
on disposal (Needles, blades, scalpels, intravenous devices, and other sharp
instruments)
 CDC Standard precautions
• Handling and disposal of linen
• Proper handling of clinical wastes
• Cleaning of spillages of blood and body fluids
• The simple standard precautions measures include:
• Handwashing (discussed above)
• Asepsis,
• Decontamination.
 Asepsis
• Decontamination of the skin or mucous membranes at the
site of a procedure.
• It is of vital importance, as is the subsequent care of such
sites.
• Aseptic technique is a method of preventing microorganisms
from reaching vulnerable sites.
• Effective antiseptics for aseptic procedures include alcohol,
iodophor, chlorhxidine and triclosan.
 Principles of medical and surgical asepsis
• When preparing a site for a procedure, the site should be fully
covered with the antiseptic, in order to thoroughly disinfect the
area and substantially reduce the normal flora on the skin.
• The antiseptic should be applied vigorously and left to dry,
particularly alcoholic solutions.
• Drying takes approximately 30 seconds.
• For surgical incision: Avoid the shaving of sites before
disinfection and incision, as shaving has been shown
to increase the risk of infection.
• However, if shaving must take place, it should happen
as close to the procedure time as possible.
 Cavity wound dressings

• The trolley or cart used should be thoroughly disinfected

between patients to prevent cross contamination.
• Any other surfaces used during the procedure must also be
disinfected.
• Supplies used for wound dressings must be sterile for each
patient, and wounds should be dressed as quickly as possible
in order that they have minimal exposure time.
 Decontamination
• Decontamination is a method of Care and
maintenance of hospital equipment.
• Decontamination includes:
1. Cleaning
2. Disinfection
3. Sterilization
 Cleaning
• The removal of all visible dust, soil, other foreign
material and removal of sufficient numbers of
microorganisms to reduce risks for those who handle
the object or an area.
• It should be performed on all items before
disinfection and sterilization.
 Disinfection
• Is a process that eliminates many, or all, microorganisms on
inanimate objects.
• Disinfectants may damage living tissue and are not
intended for use as antiseptics.
• Some disinfectants may be inactivated by soilage found on
objects and therefore soilage must be cleaned off first.
• Disinfection is of three types: chemical, moist heat, and
pasteurization.
 Sterilization

• It is the complete elimination or destruction of all types

of microbial life.
• Sterilization is accomplished by a variety of methods,
including: steam under pressure or moist heat
(autoclaving); gas (ethylene oxide); dry heat (hot air
oven), and low temperature steam and formaldehyde.
Personal Protective Equipment (PPE)

• Keeping health workers and consumers safe

Sequence for donning PPE
Remove items before hand hygiene
Remove rings, watches, etc. that
will interfere with effective hand
hygiene, and roll up your sleeves

Note: Nail polish, artificial and false

nails must not be worn in clinical
environments.
Artificial or false nails continue to
demonstrate increased opportunity
for transmitting pathogenic
microorganisms.
 Sequence for Removing PPE
• The sequence for removing PPE aims to limit opportunities for self-contamination
and further environmental contamination. When using reusable eye protection
perform hand hygiene after cleaning.
PPE Donning
Added wording that will ensure the training
of staff on the personal protective
equipment purchased. Ensuring the safety
of staff by having sufficient supplies and by
being properly trained with those supplies.
PPE Doffing
3.3.Nosocomial infection
• Nosocomial infections also referred to as healthcare-
associated infections (HAI), are infection(s) acquired during
the process of receiving health care that was not present
during the time of admission.
• Infections acquired in the hospital or Infection in a
hospitalized patient
• Acquired in hospital:
Has an infection, not a simple colonization
Was not infected at the time of admission
Had sufficient time to develop infection (72 hrs after admittance)
3. Nosocomial infection cont’d
• Although acquired in the hospital may appear after discharge
from the hospital.
• They may occur in different areas of healthcare delivery, such
as in hospitals, long-term care facilities, and ambulatory
settings, and may also appear after discharge.
3. Nosocomial infection cont’d
• These infections are monitored closely by agencies such as
the National Healthcare Safety Network (NHSN) of the
Center for Disease Control and Prevention (CDC).
• For the last few decades, hospitals have taken hospital-
acquired infections seriously.
• Several hospitals have established infection tracking and
surveillance systems in place, along with robust prevention
strategies to reduce the rate of hospital-acquired infections.
Types of Healthcare-Associated Infection (HAI)

• The Centers for Disease Control and Prevention broadly

categorizes the types of HAI as follows:
1.Central line-associated bloodstream infections (CLABSI)
2.Catheter-associated urinary tract infections (CAUTI)
3.Surgical site infections (SSI)
4.Ventilator-associated pneumonia (VAP)
5.Hospital-acquired pneumonia( HAP)
6.Clostridium difficile infections(CDI)
Etiology of HAI
The risk for hospital-acquired infections is dependent on:
• Poor infection control practices at the facility
• Prevalence of various pathogens within the community.
• The patient's immune status including immunosuppression,
and older age.
• Length of stay in the hospital
• Multiple underlying comorbidities.
• Frequent visits to healthcare facilities.
• Mechanical ventilatory support, recent invasive procedures,
indwelling devices, and stay in an intensive care unit (ICU)
Etiology Cont’d

• These pathogens can be acquired from other patients,

hospital staff, or the hospital facility. The risk is higher among
patients in ICU.
• Clostridium difficile is the organism that causes Clostridium
difficile colitis (CDI).
• Common organisms for CLABSI are candida spp (adult ICU),
Enterobacteriaceae (adult wards, pediatric ICU and wards,
and oncology wards), and staph aureus.
Etiology Cont’d

• Common pathogens that are known to cause CAUTI are

Enterococcus, staphylococcus aureus, Pseudomonas,
Proteus, Klebsiella, and Candida.
• Fungal pathogens are usually associated with opportunistic
infections in immunocompromised patients and those with
indwelling devices, such as central lines or urinary catheters.
• Healthcare-acquired hepatitis B and C and human deficiency
virus (HIV) have been implicated in unsafe needle practices.
Etiology Cont’d
• According to the National Healthcare Safety Network
(NHSN), the common causative organisms for SSI include
staph aureus, coagulase-negative staphylococcus,
Enterococcus, E. coli, Pseudomonas aeruginosa,
Enterobacter, Klebsiella pneumoniae.
• The most common pathogens for HAP and VAP are staph
aureus and Pseudomonas aeruginosa, while E. coli and
Klebsiella pneumoniae can be seen in higher proportions
among pediatric populations.
 Where do the microbes come from?

• Patient's own flora

• Cross-infection from medical personnel
• Cross-infection from patient to patient
• Hospital environment- inanimate objects
• Air and Dust
• IV catheters & fluids
• Washbowls
• Bedpans
• Endoscopes
• Ventilators & respiratory equipment
• Water, disinfectants etc
 Sources of pathogens in NI

• Reactivation of latent infection: TB, herpes viruses

• Less common
• Endogenous: normal commensals of the skin, respiratory, GI, GU tract
• common
• Exogenous:
• Inanimate environment: from hospital construction or from
contaminated water
• Animate environment: hospital staff, visitors, other patients
• Cross transmission- common
Sites of nosocomial infections
15%

8%
40%

17%

20%

Urinary tract Pneumonia Surgical site

Bloodstream (IV) Others
 Summary/Conclusion
• We continually share our environment with many different
microorganisms.
• Nurses remain above 95% of their working time with
patients with different infectious agents.
• The principles of infection control and prevention are
essential in the everyday care of patients within healthcare
settings.
• Nosocomial infections within healthcare settings can
be prevented, thereby protecting both patients and
staff.
• Every possible step must be taken to minimize
infection.
• Basic infection control measures are the best defence
against very resilient organisms.
 References
• WHO (2001), Infections and infectious diseases: A
manual for nurses and midwives in the WHO European
Region.
• WHO (2006), Infection control standard precautions in
health care, CH-1211 Geneva-27, Switzerland, available
on www.who.int/csr.
Questions or Comments