Hospital acquired infection
-
Upload
sri-adhikari -
Category
Health & Medicine
-
view
1.801 -
download
6
description
Transcript of Hospital acquired infection
![Page 1: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/1.jpg)
HOSPIAL ACQUIRED INFECTION (DEPARTMENT OF COMMUNITY MEDICINE)
Moderated by- Dr. Dhiraj SrivastavaPresented by- Srihari Adhikari
Roll No.- 73Batch- 2010
U.P. RURAL INSTITUTE OF MEDICAL SCIENCES AND
RESEARCH
![Page 2: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/2.jpg)
![Page 3: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/3.jpg)
Definition• Hospital acquired infection / nosocomial
infection are infection acquired during hospital care which are not present or incubating at admission.
• Infection occurring more than 48 hours after admission are usually considered nosocomial.
![Page 4: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/4.jpg)
• Word Nosocomial comes from the greek word nosokomeion meaning hospital (nosos= disease, komeo= to take care of)
![Page 5: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/5.jpg)
Definition by CDC
• Infection that patients acquire during the course of receiving treatment for other conditions or that health workers acquire while performing their duties within healthcare setting
![Page 6: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/6.jpg)
![Page 7: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/7.jpg)
Surgical site infection
• Any purulent discharge or abscess or spreading cellulitis at the surgical site during the month after the operation.
![Page 8: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/8.jpg)
Urinary infection
• Positive urine culture (1 or 2 species) with at least 1o thousand bacteria/ml without clinical symptoms.
![Page 9: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/9.jpg)
Respiratory infection
Respiratory symptoms with at least 2 of the following signs appearing during hospitalization
• Cough• Purulent sputum• New infiltrate on chest
radiograph consistent with infection.
![Page 10: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/10.jpg)
septicaemia
• Fever or rigors and at least one positive blood culture
![Page 11: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/11.jpg)
Vascular catheter infection
• Inflammation, lymphangitis or purulent discharge at the insertion site of the catheter
![Page 12: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/12.jpg)
Special situation that is usually HAI
![Page 13: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/13.jpg)
Infection in neonates that
result from passage
through birth canal
![Page 14: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/14.jpg)
Special situation that are not usually HAIs
![Page 15: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/15.jpg)
Complication or extension of infection(s)
already present on admission unless a change in pathogen
or symptoms strongly suggest
the acquisition of new infection
![Page 16: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/16.jpg)
Infection in an infant that is
known or proven to have been
acquire transplacentally & become evident
before 48 hour of birth
![Page 17: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/17.jpg)
![Page 18: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/18.jpg)
![Page 19: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/19.jpg)
![Page 20: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/20.jpg)
![Page 21: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/21.jpg)
![Page 22: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/22.jpg)
Researches in India
![Page 23: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/23.jpg)
Prospective study in burn unit of a tertiary case referral centre in north india
• Hospital wide study is Performed by Taneja N., Emmanuel R.,Chari P S, Sharma M. in 2004
• 71 patient developed 59 hospital acquired infection.
• Infection density- 36.2 infection per 1000 patient day
• Commonest- invasive wound infection
![Page 24: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/24.jpg)
U.T.I. study in JNMC Aligarh
• Performed by M. Akram, M.Shahid, A U Khan in 2007.
• 100 sample infected out of 920 tested urine sample.
• Infection of E. Coli- 61%Klebsiella – 22%
![Page 25: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/25.jpg)
Hospital acquired infection can be considered from 3 angles
1) Source2) Route of spread 3) recipients
![Page 26: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/26.jpg)
1) SOURCE
• Patient
• Staff
• environment
![Page 27: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/27.jpg)
2) Routes of spread
a) Direct contact b) Droplet infectionc) Air borne particled) Release of hospital dust into the aire) Through various hospital procedure
![Page 28: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/28.jpg)
a) Direct contact
![Page 29: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/29.jpg)
b) Droplet infection
![Page 30: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/30.jpg)
c) Air borne particle
![Page 31: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/31.jpg)
d) Release of hospital dust into
the air
![Page 32: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/32.jpg)
e) Through various hospital procedure like
• catheterization• Intravenous
procedure • dressing • infected cat gut • sputum cups• bed pans• urinals etc.
![Page 33: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/33.jpg)
3) RECIPIENTS
a) Patient especially severely ill & under corticosteroid therapy
b) Cross infection is greater in• Intensive care unit• Urological ward• Geriatric ward• Special baby care unit
![Page 34: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/34.jpg)
PREVENTIVE MEASURES
![Page 35: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/35.jpg)
1) Isolation of infectious patient
![Page 36: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/36.jpg)
2) Hospital staff
• Keep away from work until completely cured
![Page 37: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/37.jpg)
3) Hand washing
![Page 38: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/38.jpg)
WHO guideline for hand hygiene in health care
• Washing hand with soap & water
• Preferably use an alcohol based hand rub for routine hand antisepsis
• When alcohol based hand rub is already used do not used antimicrobial soap concomitantly.
![Page 39: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/39.jpg)
Perform hand hygiene
• Before & after having direct contact with patients• Before handling an invasive device for patient care
regardless of whether or not gloves are used• After contact with body fluid or excretion , mucus
membrane, non intact skin, or wound dressing.• If moving from a contaminated body site to a clean
body site during patient care.• After contact with inanimate objects (including
medical equipment) in the immediate vicinity of the patient.
![Page 40: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/40.jpg)
![Page 41: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/41.jpg)
![Page 42: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/42.jpg)
4) disinfection• Sterilization of instrument• Disinfection of article used by patient• Patients urine, faeces, sputum should be
properly disinfected
![Page 43: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/43.jpg)
5) Dust control
• Suppression of dust by wet dusting & vacuum cleaning
![Page 44: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/44.jpg)
6) Proper disposal of hospital waste
![Page 45: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/45.jpg)
7) Control of droplet infection
• Face mask• Proper bed
lighting• ventilation
![Page 46: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/46.jpg)
8) Nursing technique
• Barrier nursing
• Task nursing
![Page 47: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/47.jpg)
9) Administrative measures
• There should be hospital control of infection committee
![Page 48: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/48.jpg)
Hospital infection control committee
• Medical superintendent- chairperson• Representative from major clinical
departments.• Representative for nursing services.• CSSD in charge.• OT in charge.• Microbiologist.
![Page 49: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/49.jpg)
Standard to be maintained in hospital
![Page 50: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/50.jpg)
An attempt should be made to achieve and maintain an average
count of 10-15 bacteria/cubic foot of air in hospital
less than 5 bacteria/ cubic foot- minimal risk of infection
more than 35 bacteria/ cubic foot of air- heightened risk
![Page 51: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/51.jpg)
Guideline to evaluate the floor cleaning procedure
Based on rodac plate count
• 0-25 bacteria/cubic foot- good floor cleaning procedure
• 26-50 bacteria/cubic foot- satisfactory• More than 50 bacteria/cubic foot- not
satisfactory
![Page 52: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/52.jpg)
Role of central sterile supply department (CSSD)
• CSSD is an accepted feature of hospital planning.
![Page 53: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/53.jpg)
Function of CSSD
• Supply of sterile instrument & material for dressing & procedure carried out in wards & department.
• Sterilization of instrument & linen for use in operation theatre
![Page 54: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/54.jpg)
CSSD also look after
• Disinfection & sterilization of medical equipment such as ventilators, baby incubators, oxygen tents etc.
• Selection & distribution of single use (disposable) sterile supplies such as catheters, suction tubing & syringe.
![Page 55: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/55.jpg)
CSSD of our hospital
![Page 56: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/56.jpg)
• Manual steam sterilizer
![Page 57: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/57.jpg)
• Semi-automatic steam sterilizer
![Page 58: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/58.jpg)
Automatic steam sterilizer
![Page 59: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/59.jpg)
ETO (ethylene trioxide) sterilizer
![Page 60: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/60.jpg)
Washer disinfector
![Page 61: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/61.jpg)
Ultrasonic cleaner
![Page 62: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/62.jpg)
Gloves unit in CSSD
![Page 63: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/63.jpg)
Glove washer
![Page 64: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/64.jpg)
Glove dryer
![Page 65: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/65.jpg)
Glove testing machine
![Page 66: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/66.jpg)
Glove powdering machine
![Page 67: Hospital acquired infection](https://reader035.fdocuments.us/reader035/viewer/2022081505/5560b0f3d8b42a033c8b45b8/html5/thumbnails/67.jpg)
References• Park’s textbook of Preventive & social medicine• Harrisons principle of internal medicine• Textbook of microbiology: Ananthnarayana• Bennett & Brachmans hospital acquired infection:
William R. Jarvis• Hospital administration: Francis & De Souza• www.burnsjournal.com date 09-07-2012• www.ann-clinmicrob.com date 09-07-2012• www.jornalofhospitalinfection.com date 09-07-
2012• CSSD of UP RIMS&R Saifai, Etawah
THANK YOU