By

Prof. OSSAMA RASSLAN

Secretary General,

Egyptian Society of Infection Control

• I.C. program

• Patient care

• Employee health

• Environmental hygiene

• Surveillance of infection

Prevention & Control Activities(Outlines)

Prevention & Control Activities

• Ward specific measures

• Disease/ Organism specific measures

• Antibiotic policy

• Reportable diseases

• Isolation policies

Prevention & Control Activities (contd.)

Prevention & Control Activities

• I.C. program • Ward sp. measures

• Patient care • Ds./Org. sp. measures

• Employee health • AB policy

• Environm. Hygiene • Reportable diseases

• Surveillance of inf. • Isolation policies

Prevention & Control Activities

Prevention & Control Activities

• Organizational structure

- ICC - ICT

- ICD (ICO)

- ICN - ICLN

Infection Control Program

For each item:

Membership

Qualifications

Duties

Meeting periodicity

Prevention & Control Activities

• Handwashing

- Routine

- Surgical (H.W. facilities - antiseptics)

Patient Care

• Standard precautions

1. Protective barriers

2. Resuscitation facilities

3. Decontamination (later)

Protective barriers

- Gowns

- Gloves

- Masks

- Eye protection

- Shoe covers

Prevention & Control Activities

• Invasive Procedures

• Wound dressing

• Oral alimentation

• Other activities

Patient Care (cont.d)

Invasive procedures

- Indwelling urinary

catheters

- IV catheters

- IV injections

- Endoscopy

Prevention & Control Activities

• Old/ New Employee medical exam.[Initial (at time of employment) & Periodical]

• Exposure to blood, body fluids or tissue (exposure control plan)

• Staff accident or ward related infections

• Work restrictions

• Education

Employee health (Occupational health)

Prevention & Control Activities

• DecontaminationCleaning - Disinfection - Sterilization

• Hospital waste management.- Color coding- Segregation at source- Collection- Transportation- Storage- Disposal- Recycling regular waste

Environmental hygiene (Hosp. Env. Control)

• Regular waste• Biohazardous waste

- Identification

- Handling

- Disposal

Prevention & Control Activities

• Microbiologic sampling- Not routine- Outbreak investigation- Research purposes

• Housekeeping policy

• Laundry policy

• Construction policy(Construction, design & remodeling measures)

Environmental hygiene

Prevention & Control Activities

• Sterile water(for invasive procedures)

• Appropriate air supply(room ventilation)

• Proper storage of sterile supply

Environmental hygiene

Prevention & Control Activities

A. Elements- Data collection- Data collation (consolidated or tabulated)- Data analysis- Reporting

Surveillance of infection

• Criteria for Nosocomial infections

• Surveillance analysis & reporting

Prevention & Control Activities

• Surveillance analysis & reporting (cont.d)

B. Uses (improvement of outcomes & processes)

- Provide baseline data on infection risk - Problem identification- Problem investigation- Evaluation of control measures- Evaluation of practices- Education of HCW- Research - Risk management

Surveillance of infection

Prevention & Control Activities

C. Approaches- Comprehensive, Total - Priority-directed, Site-specific- Problem-oriented

(outbreak response surveillance)

D. Worksheets

Surveillance of infection

• Surveillance analysis & reporting (cont.d)

Prevention & Control Activities

- Site, design & construction of unit - Function & activity of unit- Type of patient - Expected infections& diseases- Treatment modality (AB, Chemoth.)- Type of intervention- Type of case

(long-term, short-term, day care)

Ward specific measures (Dept or unit)

Measures differ according to:

Prevention & Control Activities

Whe

re - O.R. - ICU- Ped. & Neon. ICU - Pediatrics- Medical wards - Outpatient clinics- Surgical wards- Ante/Postnatal care unit ……..etc

Ward specific measures

- Laboratory• Construction• Safety•Techniques & investigations( e.g. pipetting, cell counting, blood sampling)

Prevention & Control Activities

• Blood borne pathogen (Prevention precautions - Control)

e.g. HBV, HCV, HIV

• T.B.• Pneumonia• MRSA• VRE• Multidrug resistant organisms• Scabies ….etc

Disease &/or Organism specific measures

Prevention & Control Activities

• Clinical use - Therapeutic (Empirical - Targeted)- Prophylactic

• Hospital AB committee- membership- meetings- duties

• Education (better to say: Communication with clinicians)

Antibiotic policy

Prevention & Control Activities

• Investigation & mgt of majoroutbreaks (or clusters) How?- Diarrhea- MRSA- VRE

• Notification of communicable disease How?

Reportable Diseases

Prevention & Control Activities

• Enteric isolation

• Blood & body fluid isolation

• Respiratory isolation

• Strict isolation

• Contact isolation

• Protective isolation

Isolation policies

Prevention & Control Activities