This document discusses infection control protocols in the ICU. It covers definitions of infection control and common hospital-acquired infections. Standard safety measures like hand hygiene, use of personal protective equipment, disinfection, and proper waste disposal are described. Various safety bundles to prevent infections like CAUTIs, CLABSIs, and SSIs are outlined. The document also addresses biomedical waste management regulations and proper handling, storage, transportation, and disposal of hospital waste.

1. INFECTION CONTROL PROTOCOL IN
ICU
PRESENTED BY:
MR. ABHAY RAJPOOT

2. INTRODUCTION
• “The very first requirement in a hospital that it
should do the sick no harm" - Florence Nightingale
• Health care associated infections(HCAI)- economic
loss, prolonged hospital stay & adverse patient
outcomes.
• In most health care facilities the average
incidence of HCAI is around 5-10 %

3. INFECTION CONTROL - DEFINITION
Measures practiced by health care personnel to
prevent spread, transmission & acquisition of
infection between clients, from health care
providers to clients & from clients to HCP.
Standard precaution
Based on
Additional
precaution

6. COMMON ORGANISMS
BACTERIA
 Staphylococcus aureus
 Enterococcus
 Pseudomonas aeruginosa
 Klebsiella
 E- coli
VIRUS
 HIV
 HBV
 HCV
 CMV

7. FUNGAL
 Candida albicans
 Aspergillus
PARASITES
 Giardia lambia

8. • Low resistance of patient to infections.
• Invasive procedures/interventions.
• Inappropriate anti-microbial usage.
• Drug resistance of endemic microbes.
• Contaminated environment.
RISK DUE TO

10. STANDARD SAFETY
MEASURES

11. STANDARD PRECAUTION
• Set of infection control practices used to prevent
transmission of diseases that can be acquired by
contact with blood, body fluids, non- intact skin &
mucus membrane
• STANDARD PRECAUTION STEPS
– Hand washing
– PPE
– Decontamination
– Waste disposal

12. HAND HYGIENE
Hand washing is the single most effective measure
in infection control.
80% of the diseases are spread through hands.

16. POINTS TO BE REMEMBERED
• Covering cuts & wounds
• Gloves is not a substitute for hand washing
• When a bar soap is used, it should be kept dry
in soap case
• When liquid soaps are used, avoid topping off
of the solution , dispenser should be kept clean

18. PERSONAL PROTECTIVE EQUIPMENT
• Gloves
• Gown
• Mask
• Protective eye wear
• Face shield
• Apron

19. SEQUENCE FOR DONNING PPE
GOGGLES OR
FACE SHIELD
GLOVES
GOWN
MASK

20. SEQUENCE FOR REMOVING PPE

21. SAFE HANDLING OF SHARPS
 Never pass sharps from one person to
another.
 Always dispose your own sharps.
 DO NOT RECAP needles.
 Dispose sharps in puncture proof container.

22. DISINFECTION
Reduce the number of microorganisms on
an object or surface but not the complete
destruction of all microorganisms or spores.

23. TYPE OF DISINFECTANTS
• High level disinfectants
2% glutaraldehyde (cidex)
stabilised hydrogen peroxide
1% sodium hypochlorite
• Intermediate level disinfectants
0.1% sodium hypochlorite
Iodophores & phenolic solutions
• Low level disinfectants
Quateranary ammonium compounds

24. STERILIZATION
Procedures, which would remove all
microorganisms, including spores, from an object.
Sterilization Methods
• Dry heat sterilization
• Moist heat sterilization
• Chemical sterilization
• Radiation sterilization

27. Safety bundles
• A “bundle” is a group of evidence based care
components for a given disease that, when
executed together, may result in better
outcomes than if implemented individually.

28. CAUTIs Bundle
• Avoid unnecessay urinary catheters
• Insert using aseptic technique
• Maintain catheter using recommended
guidelines (daily care)
• Review catheter necessity daily & remove
promptly.

29. CLABSIs
• Hand hygiene
• Maximal barrier precautions
• Chlorhexidine skin antisepsis
• Optimal catheter site selection
• Daily review of line necessity with prompt removal
of unnecessary lines
• Line secure with clean & intact dressing

30. SSI Bundle
• Appropriate use of antibiotics
• Appropriate hair removal
• Post operative glucose control
• Peri & postoperative normothermia

31. VAP Bundle
• DVT prophylaxis
• GI prophylaxis
• Head of bed elevated to 30-45º
• Daily sedation vacation
• Daily spontaneous breathing trail

32. BIO MEDICAL WASTE
MANAGEMENT

33. DEFINITION
Waste generated during the diagnosis, testing,
treatment, research or production of biological
products for humans or animals (WHO)
Waste management is the collection, transport,
processing or disposal, managing & monitoring of
waste material.

34. PURPOSES OF WASTE DISPOSAL
To reduce hazardous nature of waste.
 To reduce volume of waste.
 To prevent misuse or abuse of waste.
 To ensure occupational safety & health.
 To consider aesthetics.

35. LEGISLATION
• Ministry of environment & forests (MOEF) issued
guidelines to the hospitals to ensure proper &
safe disposal of bio medical waste.
– Bio medical waste management & handling
rule came in to effect in 1998

36. Human
anatomical waste
Chemo drugs
Soiled waste
Expired or
Discarded
Medicines,
soiled linen
C)ontaminated
Plastic Waste
(Recyclable
Waste
sharps
including
Metals
Glassware:
Broken or
discarded
&
contaminated
glass including
medicine vials
& ampoules
37
General
waste
3 BINS, 01 CONTAINER, O1 BOX

37. CATEGORY TYPE OF TREATMENT & DISPOSAL
WASTE
YELLOW
(a)Human
anatomical
waste
(b)Animal
anatomical
waste
(c) Solied waste
Incineration or plasma pyrolysis or
deep burial
(d) Expired or
discarded
medicine
Incineration at tem. >12000C Or
Encapsulation or Plasma Pyrolysis
(e) Chemical liquid
waste
(f) Linen
Pre treatment before mixing with
waste water.
Non- chlorinated chemical
disinfection
BMW RULE 2016

38. CATEGORY TYPE OF
WASTE
TREATMENT &
DISPOSAL
RED
Contaminated
plastic waste
(Recyclable)
Autoclaving or micro-
waving followed by
shredding, sterilization &
then sent to registered
recyclers for energy
recovery or for road
making
BMW RULE 2016

39. CATEGORY TYPE OF
WASTE
TREATMENT & DISPOSAL
White
(Translucent
Puncture proof,
containers)
Waste sharps
including
Metals
Autoclaving & shredding &
sent for final disposal to iron
foundries.
consent to operate from the
State Pollution Control Boards
or concrete waste sharp pit.
BMW RULE 2016

40. TYPE OFWASTE TREATMENT &
DISPOSAL
CATEGORY
Cardboard boxes
with blue
coloured marking
Glassware:Broken
or discarded &
contaminated glass
Metallic Body
Implants
Disinfection then
Sent for
recycling.
BMW RULE 2016

41. WASTE MANAGEMENT
3R’s

42. WASTE SEGREGATION
Done at the source of waste generation
Responsibility of generator of waste.
segregation as per categories applicable.

43. WASTE STORAGE
Storage facility should have sufficient
capacity.
 Location - within hospital premises.
Untreated biomedical waste not to be kept
beyond 48 hrs (Permission required for
>48 hrs).

44. WASTE TRANSPORTATION
Points to be remembered:
Before taking the bags it should be tied &
labeled.
Waste handlers should not touch any other
articles.
A covered cart with biohazard symbol to
carry the waste to the central area of
collection.

45. AIIMS-OUT SOURCING BY BIOTIC

46. TRAINING ON BIOMEDICAL WASTE
MANAGEMENT
Overall aim of training:
• To develop awareness of health, safety
& environmental issues relating to
health care waste.
• Roles & responsibilities of health care
personnel in overall management
program should be highlighted.

47. STAFF SAFETY CONSIDERATIONS
• Separate trolleys for transporting waste within
• the hospital.
• All workers involved in the work are aware of the hazardous
nature of the work.
• Provided with all protective equipment.
• Immunized against tetanus & hepatitis B.

48. ROLE OF INFECTION CONTROL NURSES
• Visits all wards & high risk units.
• Checking nursing supervisor’s register &
records for cases suggestive of infection.
• Collection of sample from different areas of
the hospitals & sending them to the lab.

49. ROLE OF INFECTION CONTROL
NURSES(CONTD..)
• Daily visit to microbiology lab to ascertain
results of sample collected.
• Monitoring & supervision of infection among
hospital staffs.
• Training of nursing & paramedical personnel
on correct hygiene practices & aseptic
technique.

50. SUMMARY
• Infection control
• Chain of infection
• Standard safety measures
• Safety bundles
• Staff safety
• Role of infection control nurses

51. CONCLUSION
•This is the time to understand that infection
control, standard precaution, hospital waste
management are of great concern.
•The human element is more important than
technology.
•Well trained, motivated staff can really work
wonders.
•Strict adherence to simple infection control
procedures go long way in controlling infection.

52. BIO HAZARD

53. RADIOACTIVE WASTE

54. CYTOTOXIC WASTE