Infection control -_students.ppt;filename*= utf-8''infection control - students
Infection control
-
Upload
jasleenbrar03 -
Category
Healthcare
-
view
11 -
download
2
Transcript of Infection control
Infection COntrol
Presented by-Jasleen Kaur Brar
2
Infection• Infection is the entry & multiplication of an infectious agent in the tissues of the host • Bacteria, virues, fungus etc…
3
Infection• One of the leading causes of
preventable death in hospital
• CDC estimates approx. 2 million preventable infections in hospital
• Importance of keeping hospitals clean and infection free is greater now than ever.
4
Types of infections :-
• Primary & Secondary • Local & Systemic • Acute & Chronic • Nosocomial
5
Who is at Risk of Infection??
Health care personals
Clients
Community
6
Chain of Infection
In order for infection to spread, several steps (chain of infection) must occur. An infection will develop only if this chain remains intact.
Chain of Infection
Reservoir
Portal of Exit
Mode of transmission
Portal of Entry
Susceptible Host
Infectious agent
8
BREAKING THE CHAIN OF INFECTION
prevent the transmission of
infection
Include entire spectrum of microbes Bacteria Viruses
Fungi Protozoa
INFECTIOUS AGENT
BREAKING THE CHAIN-1 OF INFECTION
RAPID AND ACCURATE IDENTIFICATION OF ORGANISMS
Routinely send Blood cultures, urine culture , skin swabs, throat swabs, tracheal aspirate cultures.
Send Endotracheal Tube tip, Urinary catheter tip and central line tip for culture after removal.
BREAKING THE CHAIN 1 Cont…..
Control or elimination of infectious agents including:
• Proper cleaning by water and mechanical action with or without detergents.
• Disinfection• Sterilization of contaminated objects.
Sterilization and disinfection are physical processes, involving the use of heat, radiation, chemical processes, etc., which use various solutions or gases.
BREAKING THE CHAIN 1 Cont…..
DISINFECTANTS HIGH LEVEL DISINFECTANTS • Activated Glutaraldehyde (cidex2%)• Sodium hypochlorite 1%.• Carbolic Solution 5%• Bleaching Powder 1%
LOW LEVEL DISINFECTANTS • Methylated spirit 70%• Betadine solution 10%• Savlon 1%
DISINFECTANTS
BREAKING THE CHAIN 1 Cont…..
Regular Cleaning and Disinfection of• Bed Trolleys • I.V stands • Table & Chairs • Resuscitation equipments • Suction Apparatus • Ventilator tubings • Leads
•Infusion Pumps•Floor•Windows•Walls•Ceiling•Wash Basins•Drums for Biomedical Waste
BREAKING THE CHAIN 1 Cont…..
For Sterilized Items:
Store at dry & clean place.Put date of sterilization.Use within 72 hrs of sterilization.Check date before use. Put indicator tape.Follow manufacturer’s advice for particular piece of equipment & their preferable method of sterilization.
BREAKING THE CHAIN 2 Cont…..
BREAKING THE CHAIN-2 OF INFECTION
RESERVOIRS
It includes: Humans
Animals
The inanimate environment
(water, food, soil and soiled medical equipment)
EMPLOYEE HEALTH
Immunization of health personnel’s e.g. Hepatitis B vaccination.
Regular check up for early detection of any communicable disease
Restriction from work of patient contact when infected with communicable disease.
BREAKING THE CHAIN 2 Cont…..
• Cleaning with hospital approved cleaner disinfectant e.g. phenol.
• Thorough cleaning of bed and bedside equipments before admitting new admission.
• Separate mops should be used for cleaning of the unit. (twice a day)
• Damp dusting should be done.
• Avoid Brooming.
• Drains should be patent.
ENVIRONMENTAL CLEANING
BREAKING THE CHAIN 2 Cont…..
• Keep the bed sheets dry and clean.
• Change sheets every day.
• Do not shake blankets and linen in ICU area.
• Do not throw them on floor.
• Soiled linen counting should be done in separate place.
HANDLING OF LINEN BREAKING THE CHAIN 2 Cont…..
• Traffic should be restricted except for doctors, nurses & supportive staff.
• Allow only one attendant.(3-4hrs).
• Keep the doors and windows closed.
• Instruct the attendants about hand washing, disposal of waste , hygienic preparation of baby’s feed etc.
TRAFFIC CONTROL BREAKING THE CHAIN 2 Cont…..
• No personal clothing, flowers and eatables should be allowed.
• Mobile phones should not be allowed inside the area.
• Machines(X-Rays ,echo machines ,ultrasound machines) from outside should be cleaned with spirit before their use.
BREAKING THE CHAIN 2 Cont…..
• Measures to be taken to avoid their entry into the unit i.e. by proper cleaning, sealing & draining.
• Patient diet should be kept in covered containers.
• Keep fly flappers on each bedside of patient.
• Fly trapper should be in working order.
• Pesticides sprays should be used weekly.
PEST CONTROL
BREAKING THE CHAIN 2 Cont…..
• Use of safe drinking water-Purified• Use of Distilled water for Humidifiers
WATER
BREAKING THE CHAIN 2 Cont…..
BREAKING THE CHAIN 3 OF INFECION
• PORTAL OF EXIT
BREAKING THE CHAIN 3 Contd..
• Practise aseptic precautions.• Avoid talking directly into the client’s face to
prevent droplet infections.• Wearing of masks is important once the nurse
herself has infection or deals with clients suffering from infections.
• Careful handling of wastes like urine, faeces, emesis and blood is important.
• Disposable gloves should be worn to prevent direct contact with wastes or infected materials.
BREAKING THE CHAIN 4 Cont…..
•MODE OF TRANSMISSION
PHYSICAL BARRIERS
Cap Mask Gown Gloves
BREAKING THE CHAIN 4 Cont…..
Transmission based precautions:
• Airborne precautions• Well ventilated, private room with door closed, should
be there for patient with respiratory bacterial or viral infection.
• Place client in a private room that has negative air pressure 6-12 air changes per hour.
• Wear masks when entering the room of a client who is known or suspected of having primary tuberculosis.
• Susceptible people should not enter the room of a client who has measles or chickenpox. If they must enter they should wear a respirator.
• Limit movement of client outside the room to essential purposes.
Droplet Precautions:• To be followed in case of Meningitis,
Diphtheria, pertusis, and influenza etc., mumps• Place client in private room.• If a private room is not available, place client
with another client who is infected with same organism.
• Wear a mask if working within 3 feet of the client.
• Limit movement of client outside the room to essential purposes. Place surgical mask during transport.
Contact PrecautionsTo be followed in case of cellulitis, acute diarrhea, bronchiolitis
etc.
• Place client in private room.• Wear gloves, Remove gloves before leaving client
room.• Clean hands immediately after removing gloves. Use
antimicrobial agent.• Wear gown when entering room if there is a
possibility of contact with infected surfaces or items or if the client is incontinent or has diarrhoea, colostomy or wound drainage not covered by a dressing.
• Remove gown in the client’s room.
• Proper Hand washing.• Separate utensils for each patient.• Store in air tight containers .• Separate refrigerator for food.
FOOD HANDLING
BREAKING THE CHAIN 4 Cont…..
1. Primary contamination from improper sterilizing/packaging procedure.
2. Secondary contamination when fluid additives from contaminated multi dose containers are used.
3. Breaks in aseptic tech. most likely at connection in system.
4. Blood withdrawal through 3-way stop cock leaves residual blood in system providing medium for bacterial growth.
5. Flushing a blocked or malfunctioning I.V. Line may lead to contamination.
6. Prolonged use of site may result in phlebitis, septicemia
SEPSIS ASSOCIATED WITH I.V FLUID ADMINISTRATION
1
22
3
4
45
6
BREAKING THE CHAIN 4 Cont…..
DRUGS AND I.V.FLUID THERAPY• Aseptic Technique while catheter insertion.• Use of disposable syringes.• Meticulous cleaning of I.V puncture with spirit.
(3swab method)• Secure I.V. lines, well cover them with sterile pad.• Change I.V. site q48hrly or on indication.• Change of Administration sets-72 hrs Lipid based solutions-24 hrs Blood products-discard after use
• Keep them labeled with date and drug name.
BREAKING THE CHAIN 4 Cont…..
PORTAL OF ENTRY
BREAKING THE CHAIN 5 Cont…..
•Maintain integrity of skin and mucous membranes.•Proper positioning of tubings, etc. may prevent injuries and skin breakdown.•Turning and positioning of debilitated clients•Ensure personal hygiene of clients regularly.•Dispose of contaminated syringes and needles properly to prevent accidental injuries to hospital personnel as well as clients.•Proper handling of catheters, drainage sets etc. is essential.•Care should be taken while collecting and handling specimens.•Regular wound care is to be instituted properly to prevent infection.
BREAKING THE CHAIN 5 Cont…..
SUSCEPTIBLE HOST
Host’s Susceptibility
Low Immunity Diseases : DM, Nephritis,
Malignancy(Leukemia), Severe Burns
Immunosuppressive drugs
Indiscriminate use of antibiotics and steroids
BREAKING THE CHAIN 6 Cont…..
BREAKING THE CHAIN 6 Cont…..
Protection of susceptible Host
Protecting normal defence mechanisms by:• The appropriate use of prophylactic antibiotics• Maintaining an adequate intake. • Care of invasive devices that breach the natural
defences. ( e.g. urinary catheter, intravenous lines)
• Encouraging deep breathing and coughing exercises.
• Encouraging proper immunization of children and adult clients.
BREAKING THE CHAIN 6 Cont…..
Maintaining healing processes:• Promotion of intake of a well balanced diet
containing essential proteins, vitamins, fats and carbohydrates.
• Institution of measures to improve appetite of the patient.
• Promotion of the client’s comfort and sleep.• Helping the client to identify method to relieve
stress
BREAKING THE CHAIN 6 Cont…..
39
CDC devised Guidelines to reduce the
transmission of Infection
(1996)
40
STANDARD PRECAUTIONS IN MEDICAL AND SURGICAL ASEPSIS:
Hand washingGowning GlovingMask/capDisposing contaminated
equipments
5 MOMENTS FOR HAND HYGIENE
Types of Handwashing
• There are three kinds of handwashing used in the clinical setting, each of which is appropriate in different situations:
1.Handwashing with plain soap and running water
2. Handwashing with antiseptic soap and running water
3.Alcohol handrub
44
Gloving:Barrier against
potentially infectious micro-organisms found in blood, other body fluids & waste
Double gloving provides added protection.
45
Mask :
Mask should be changed after 20-30 minutes/ if it becomes moist
Mask should not be reused
46
Disposing of contaminated equipments:
Decontamination to make items safer to handle
Cleaning to remove those materials interfering with sterilization
Sterilization to minimize risk of infection
Store items properly for further use
47
SURGICAL
ASEPSIS
48
Aseptic technique
Practices that help reduce the risk of
post procedure infections in clients
by decreasing the likelihood that
microorganisms will enter the body
during clinical procedures
49
COMPONENTS :• Surgical scrub • Using barriers• Client preparation• Maintaining a sterile
field • Using safe operative
technique• Maintaining a safer
environment in the surgical/procedure area
50
Surgical scrub
Help prevent this rapid growth
of microorganisms
Will reduce the risk of infections
• Warm water makes antiseptics
and soap work more effectively
• Scrubbing for at least 3-5
minutes.
51
Surgical attire
acts as a barrier that protects clients from exposure to microorganisms that could cause infections include:
• Surgical Gloves• Caps• Masks • Gowns • Footwear
52
Client prep for clinical procedures
• Clean with soap & water• Apply antiseptic &
gently scrub in circular motion
• Before giving injection, wipe with antiseptic solution
53
Creating and maintaining a sterile field
A sterile field is an area created by placing sterile towels or surgical drapes around the procedure site and on the stand that will hold sterile instruments and other items needed during the procedure.
54
To maintain the sterile field:
• Place sterile items within the sterile field.
• Do not contaminate sterile items when
opening, dispensing, or transferring them.
• Consider items located below the level of
the draped client to be unsterile.
• Do not allow sterile personnel to reach
across unsterile areas or to touch
unsterile items.
• Recognize that a sterile barrier that has
been wet, cut, or torn is considered
contaminated.
55
Using safe operative technique
• Making small incisions
• Avoiding trauma to
tissue and surrounding
structures
• Controlling bleeding
56
Maintaining a safer environment in the
surgical/procedure area• Limit the number of people who enter
surgical areas.• wear clean clothes, a mask, a cap, and
sturdy footwear. • Enclose the areas to minimize dust and
eliminate insects. • Air-condition the room, if possible. • Before a new client is brought into the
room, clean and disinfect all surfaces
57
Control of Hospital Associated infections
The hospital-Associated infection Control Committee should be responsible for:
• monitoring of HAI • implementation of control measures
58
ISOLATION SYSTEM
Isolation or barrier nursing is technique which is intended to confine the micro- organisms within a given and recognized area.
59
Universal precautions by Occupational Safety & Health Administration
• Disease Specific isolation method: certain practices are followed for each infectious disease.
• Client specific isolation: grouped into following categories
60
A. STRICT ISOLATION:
Prevents transmission of highly contagious infections by air & contact like rabies
Gowns, plastic aprons, masks, and gloves should be worn.
Crockery & cutlery should be disposable. All other clinical equipment should be
sterilized. Hospital staff and visitors should be made
aware of the risks when attending such patients.
61
B. CONTACT ISOLATION
• Prevents transmission of infections spread by close/ direct contact
• Private room • Hand washing • Wearing gown & Gloves while caring
etc
62
C. Respiratory isolation
• Prevents transmission of highly transmissible infections spread by close contacts in case of respiratory diseases or infection spread by droplet infection e.g. Swine flu, influenza, T.B. etc.
• Wear gowns, gloves & masks before touching in case of drooling.
• Restrict numbers of visitors• Patients advised to cover nose and mouth
during coughing, talking, sneezing etc.• Keep reasonable distance from the
patients
63
D. Enteric isolation
• Prevents infection transmission by direct or indirect contact with faeces.
• Gloves and gown worn when handling soiled articles.
• Thorough hand washing by patients and nurses with antiseptic soaps.
• Scrub nail beds.• Disinfection of soiled linen.• Ensure daily cleaning and disinfection
of articles
64
E. Wound and skin isolation
• Prevents infection transmitted by direct or indirect contact with purulent material or drainage from an infected body site.
• Use gown and gloves.• Strict isolation for patients with
infected burns, rabies, tetanus, scabies
• Frequent and thorough hand washing.
65
ROLE OF THE NURSE In controlling Infections
• Washing hands • Adhering to aseptic
techniques• Segregate contaminated
articles• Isolation of infected material• Periodical screening &
immunization• Surveillance of nosocomial
infections
66
BIO MEDICAL WASTE MANAGEMENT POLICY
• Biomedical waste (management and handling) rules, 1998 are promoted by the ministry of environment and forest’s, govt. of India, under environment protection act, 1986.
• These rules apply to all persons who generate, collect, receive, store, transport, treat dispose or handle biomedical waste in any form.
67
1.Infectious waste : Waste suspected to contain pathogens e.g. laboratory cultures; waste from isolation wards; swabs, or equipments that have been in contact with infected patients; excreta.
2.Pathological waste: Human tissues or fluids e.g. body parts; blood and other body fluids; fetuses
68
3.Sharps: Sharp waste e.g. needles; infusion sets; scalpels; knives; blades; broken glass
4. Pharmaceutical waste: Waste containing pharmaceuticals e.g. pharmaceuticals that are expired or no longer needed; items contaminated by or containing pharmaceuticals ( bottles, boxes)
69
5. Genotoxic waste Waste containing substances with genotoxic properties e.g. waste containing cytostatic drugs (often used in cancer therapy);
6. Chemical waste: Waste containing chemical substances e.g. laboratory reagents; film developer; disinfectants that are expired or no longer needed; solvents
70
7. Wastes with high content of heavy metals: Batteries; broken thermometers; blood-pressure gauges; etc.
8. Pressurized containers:Gas cylinders; gas cartridges; aerosol canes
71
9. Radioactive waste: Waste containing radioactive substances e.g. unused liquids from radiotherapy or laboratory research; contaminated glassware, packages, or absorbent paper; urine and excreta from patients treated or tested with radionucleides
72
COLOR CODING & TREATMENT OF BIOMEDICAL
WASTE
73
WASTE CATEGORY :• INFECTIOUS WASTE• PATHOLOGICAL WASTE• MICROBIOLOGY & BIOTECHNICAL WASTE• SOILED WASTE
TREATMENT • INCINERATION• DEEP BURIAL
74
WASTE CATEGORY :• MICROBIOLOGY & BIOTECHNICAL WASTE• SOILED WASTE• SOLID WASTE
TREATMENT • AUTOCLAVING • MICROWAVING• CHEMICAL TREATMENT
75
WASTE CATEGORY :• SHARP WASTE• SOLID WASTE
TREATMENT • AUTOCLAVING • MICROWAVING• CHEMICAL TREATMENT & DESTRUCTION• SHREDDING
76
WASTE CATEGORY :• DISCARDED MEDICINE & CYTOTOXIC WASTE• INCINERATION ASH• CHEMICAL WASTE
TREATMENT • DISPOSAL IN SECURED LANDFILL
77
Thank you!