HICC

• An Infection Control Committee provides a forum for multidisciplinary input and cooperation, and information sharing

• This committee should include wide representation from relevant programmes: e.g. management, physicians, other health care workers, clinical microbiology, pharmacy, central supply, maintenance, housekeeping, training services

• The committee must have a reporting relationship directly to either administration or the medical staff to promote programme visibility and effectiveness. In an emergency (such as an outbreak), this committee must be able to meet promptly.

FUNCTIONS OF HICC

• To review and approve a yearly programme of activity for surveillance and infection prevention.

• To review epidemiological surveillance data and identify areas for intervention.

• To assess and promote improved practice at all levels of the health facility

• To ensure appropriate staff training in infection control and safety

• To review and provide input into investigation of epidemics

• To communicate and cooperate with other committees of the hospital with common interests such as Pharmacy and Therapeutics or Antimicrobial use committee, and Blood Transfusion Committee etc.

COMPOSITION OF HICC

INFECTION CONTROL COMMITTEE MEMBERS • Infection control committee chairman

Microbiologist/Physician

• Infection control co-ordinator Physician/Paediatrician

• Infection control surveillant- Nurse

OTHER MEMBERS OF ICC• Administrator-Director of

Professional Services• Head of Medicine • Head of Surgery • Director of nursing• Consultant intensivist• Accident and Emergency

manager• Sr. nursing manager• Head nurse-ICU• Head nurse-O.T.• Head of pharmacy.• House-Keeping Manager• C.S.S.D Manager

COMPOSITION OF HICC

Co-opted Members• Head of engineering department• Head of laundry department• Head Of Food Supply Department• Representative of purchase department• Staff development officer

InviteesThese are additional members from the institution who are invited for a particular meeting only when there would be a discussion pertaining to their field of expertise or any issue that is to be discussed and a policy is to be derived.

ROLES OF INDIVIDUAL COMMITTEE MEMBERS

Infection Control Chairperson

Is an expert in the field of infection control and is always available to advice on all the aspects of infection-control.

Liaises between the infection control committee members and the hospital administration.

Receives all the surveillance reports and information pertaining to hospital-acquired infection, and initiates necessary action based on the reports.

Initiates research activities and surveillance programmes in the institution.

Keep oneself abreast with the recent developments in the field. Educates and provides feedback to the clinicians using surveillance

and antibiogram data. Conducts monthly meetings of the infection control committee

Infection Control Co-ordinator (Doctor) Takes hospital visits periodically to ensure all the infection

control practices are being practiced. Co-ordinates with the chairperson in planning infection

control programmes and measures. Keeps a track of any developing outbreaks Participates and guides in research activities. Management of proper isolation techniques Ensures provision of handwashing or alcohol based hand-

cleansing solutions. Develops standards for management of proper insertion of

and maintenance of all medical devices.

Infection Control Surveillant –Nurse

Works as a clinical supervisor by ensuring all the established policies and protocols are practiced e.g. hand washing procedures, use of hand rub, isolation policies, care of vascular access and urinary catheters, universal precautions, terminal cleaning / disinfection and follow up of needle-stick injuries

Works as an investigator along with the infection control committee to track down outbreaks, evaluates equipments to detect risks leading to infection hazards.

Works as an educator by participating in formal and in informal teaching programmes for nurses and other healthcare workers. Attends appropriate courses and workshops

Works as a researcher in co-ordination with the other members of the committee

Infection Control Surveillant –Nurse

Ensures adequate isolation precautions based on the reports of microbiology especially about nosocomial strains eg MRSA, ESBL etc.

Performs Surgical site infection surveillance for clean and selected clean contaminated cases.

Spot surveillance once a month to asses the peripheral lines, urinary catheters, CVC, waste disposal.

In open cases of TB, informs the nurse on the floor for immediate discharge or transfer the patient to isolation room (negative pressure).

Role of hospital managementThe administration and/or medical management of the hospital must provide leadership

by supporting the hospital infection programme. They are responsible for:• Establishing a multidisciplinary Infection Control Committee identifying appropriate

resources for a programme• To monitor infections and apply the most appropriate methods for preventing infection• Ensuring education and training of all staff through support of programmes on the

prevention of infection in disinfection and sterilization techniques• Delegating technical aspects of hospital hygiene• to appropriate staff, such as:

— nursing— housekeeping— maintenance— clinical microbiology laboratory

• Periodically reviewing the status of nosocomial infections and effectiveness of interventions to contain them

• Reviewing, approving, and implementing policies approved by the Infection Control Committee ensuring the infection control team has authority

• To facilitate appropriate programme function participating in outbreak investigation

Role of the physicianPhysicians have unique responsibilities for the prevention and control of hospital infections: By providing direct patient care using practices which minimize infection By following appropriate practice of hygiene (e.g. hand washing, isolation) Serving on the Infection Control Committee Supporting the infection control team. Protecting their own patients from other infected patients and from hospital staff who may

be infected Complying with the practices approved by the Infection Control Committee Obtaining appropriate microbiological specimens when an infection is present or

suspected Notifying cases of hospital-acquired infection to the team, as well as the admission of

infected patients Complying with the recommendations of the Antimicrobial committee. Advising patients, visitors and staff on techniques to prevent the transmission of infection Instituting appropriate treatment for any infections they themselves have, and taking

steps to prevent such infections being transmitted to other individuals, especially patients.

Role of the Microbiologist Handling patient and staff specimens to maximize the likelihood of a

microbiological diagnosis

Developing guidelines for appropriate collection, transport, and handling of specimens

Ensuring laboratory practices meet appropriate standards

Ensuring safe laboratory practice to prevent infections in staff

Performing antimicrobial susceptibility testing following internationally recognized methods, and providing summary reports of prevalence of resistance

Monitoring sterilization, disinfection and the environment where necessary

Timely communication of results to the Infection Control Committee or the hygiene officer

Epidemiological typing of hospital microorganisms where necessary.

Infection control professionals (infection control team)

• The infection control team or individual is responsible for the day-to-day functions of infection control, as well as preparing the yearly work plan for review by the infection control committee and administration

• These individuals have a scientific and technical support role: e.g. surveillance and research, developing and assessing policies and practical supervision, evaluation of material and products, control of sterilization and disinfection, implementation of training programmes

• They should also support and participate in research and assessment programmes at the national and international levels.