The document discusses the prevention of hospital-acquired infections through various means. It begins by outlining the prevalence of such infections, ranging from 3-21% globally. It then discusses the major risk factors and modes of transmission, including contact, common vehicles, airborne, and vectors. Key prevention strategies are also highlighted, such as proper hand hygiene, use of protective equipment, safe handling and disposal of sharps, and waste management. Adopting universal precautions and enforcing infection control practices can significantly reduce infection rates and healthcare costs from hospital-acquired infections.
3. WHOLESTIC LIFECYCLE APPROACH TO
WOMEN HEALTH
1. CSSM
3. CARE OF
WOMEN
FOR
RTI/STI(AIDS)
RCH
2. FAMILY
PLANING
4. ADOLESCENT
HEALTH
Dr. P.P.SINGH
4. Definition
• Infection acquired by the patients from hospital facilities
i.e.
- during hospitalisation
- due to any therapeutic / diagnostic
procedures
Dr. P.P.SINGH
5. Sources of Hospital Infections
• Cross Infection
• Self or auto infections
• Environmental
Dr. P.P.SINGH
6. Prevalence of Hospital Acquired Infection
• In early seventies Barrett Connor
Estimated 3-13%
• Estimate in USA
Around 1.5 million cases of 5-20% and operative
infections 4.7 to 21.8% with an average of 9.7%
• WHO
Estimated after study in 47 countries 3-21% with
mean of 8.4%
• India
Authenticated data not available.
Dr. P.P.SINGH
References of few hospitals indicate around 10%
7. Aetiology
• Like any other disease Process Hospital Infection has
also got epidemiological triad i.e. the agent, host and
environment
• Entire spectrum of microbes i.e. bacteria, viruses,
ricketsis, fungi and protozae etc. responsible for hospital
infection
• 20-25% of all Hospital Infections due to Gram +ve
Organisms
• Proteous, e-coli, salmonella, klebsiella, pseudomonas are
on the rise
cont.
Dr. P.P.SINGH
8. Risk Factors
• Patient factors:
•
•
•
•
•
•
Extreme age
Malnutrition
Immune deficiency
Injuries
Diseases like Diabetes, Nephritis, Severe burns
Endogenous infection
cont.
Dr. P.P.SINGH
9. • Microbial factors:
•High conc. Of agent
•High level of virulence
•Emergence of resistant strains
•Presence of new organism
• Environmental factors:
•Level of contamination
•Medical interventions
Dr. P.P.SINGH
11. Modes of transmission
• Contact spread
– Contaminated inanimate objects
• catheters
• Cystoscopes
• Bed pans etc.
– Person to person & Droplet infection
• Infective Hepatitis
• Streptococcal Pharyngitis
Cont.
Dr. P.P.SINGH
12. • Common Vehicle Spread
– Transmission through food
• Salmonella
– through blood and blood products & Injections and
intravenous fluids
•
•
•
•
Hepatitis B & C
HIV / AIDS
Gram -ve Septicemia
Salmonellosis
Cont.
Dr. P.P.SINGH
16. High Risk Procedures for HAI
•
•
•
•
•
•
•
Injections
Surgical Procedures
Dressing of wounds
Management of deliveries
Investigative procedures
Laboratory investigations
Dialysis
Dr. P.P.SINGH
17. High Risk Areas for HAI
•
•
•
•
•
•
•
•
Haemodialysis Unit
Intensive Care Unit
Nursery Unit
Pharmacy
Dietetics services
Laundry
Operation Theatre
O.P.D.
Dr. P.P.SINGH
18. Management of HAI
• HAI Control Committee (meeting once a month)
– Chairman
Medical Superintendence
– Member Secretary - Infection Control Officer
(Microbiologist)
– Members
Head of all clinical units
Chief of blood bank
Microbiologist
Medical record officer
Chief of nursing services
Infection control sister
– Invited Members - Chiefs of all supportive services
Dr. P.P.SINGH
Cont.
-
19. •
•
•
•
•
•
•
•
Surveillance of HAI
Sterilisation and high level disinfection
Proper discarding and disposal of hospital waste
Universal blood and body fluid precautions by health
care workers
Dietetics services
Laundry
Antibiotic policy
In-service training
Dr. P.P.SINGH
20. Universal Precautions
•
•
•
•
•
•
•
•
Wash hands before and after patient contact
Wear gloves for contact with blood & body fluids
Wear masks to protect against aerosols & splashes
Wear gowns to protect against splashes
Handle and dispose sharps safely
Disinfect and sterilise critical items
safe disposal of waste
Hepatitis B vaccination
Dr. P.P.SINGH
21. Safe Handling & Disposal of Sharps
• Always dispose of your own sharps
• Never pass sharps directly from one person to other
• The risk of injury in high risk areas should be minimised
by ensuring best possible visibility for operator
• Protect fingers from injuries by using forceps while
suturing
• Locate sharps disposable container close to the point of
use
Dr. P.P.SINGH
22. Infection Control Indicator Checklist
• Handle sharps safely to minimise injury
–
–
–
–
Appropriate puncture proof sharps container
Container less than three quarter full
Sharps not protruding from container
No recapping or one hand recapping of needle & syringe
• Instrument decontaminated fully
– Steriliser available and in good working order
– Equipment thoroughly cleaned after use
– Clean instruments stored in cupboards
Dr. P.P.SINGH
23. • Hands washed appropriately to prevent cross infection
– Soap and clean water available
– Clean towels available
– Staff wash & dry hands after contact with body fluid, removal
of gloves and contact with patients
• Protective barrier worn to prevent blood exposure
Depending on the clinical area and risk of exposure use
•
•
•
•
•
Disposable gloves
Heavy duty gloves
Masks
Aprons
Protective eye wears
Dr. P.P.SINGH
24. • Waste disposal safety
– Evidence of deep burial or incineration regularly
– No contaminated waste visible
Dr. P.P.SINGH
25. Cost related to HAI
• The outbreak infections are expansive. The cost
increased can be summarised as
–
–
–
–
–
–
Prolonged patient stay
Increase consumption of disinfectants
Increase use of protective clothing
Increase in overhead expanses
Cost associated with patient screening
Need for expansive antibiotic therapy
Dr. P.P.SINGH
26. HIV / AIDS
PROBLEM IN DELHI. 35000 HIV +Ve.
780AIDS Cases.
PROBABLE SOURCE
•HETRO SEXUAL
75%
•INJECTABLES
7.3%
•RECIPIENT OF BLOOD
•OTHER
7.5%
11%
Dr. P.P.SINGH
29. Common cold
5 – 15 years
Anti bodies
Death
6-8 wks
Dr. P.P.SINGH
30. RISKS.
Needle stick/prick injury--- 0.25 to 0.3% for HIV,
9 to 30% for HBV, 3-10% for HCV
0.3% risk through muco -cutanious exposure
0.6% IN NON SURGICAL.
4% IN SURGICAL, HIGER IN
GYNAECOLOGIST
5 / 1000 IN OTHERS
40% WHILE SUTURING.
60% RECAPPING.
Dr. P.P.SINGH
32. MISCONCEPTIONS
MOSQUITO BITE
ANY INSECT BITE
CASUAL CONTACT WITH AIDS pt.
WITH IN HOUSE HOLD
SHARING FOOD, WATER, CLOTHS OR
TOILETS
PROFESSIONAL CONTACT.
Dr. P.P.SINGH
33. METHODS OF PREVENTION AMONGST HEALTH
PERSONNEL
1.
KNOWLEDGE, ATTITUDE,PRACTICE.
1.
2.
3.
4.
5.
6.
Barrier precautions,
Aseptic precautions
Management of parenteral &MM exposure to blood/blood products, tissue
organs.
HAND WASHING WITH SOAP 10 -15 SECONDS
WEAR GLOVES – BOTH HANDS, WASHING HAND AFTER
REMOVING GLOVES.
WEAR EYE GLASSES, FACE SHIELD ,APRON /GOWANS
DECONTAMINATION / DISINFECTING –
INSTRUMENTS,GLOVES,LINEN ALL THINGS WITH BLEACHING
POWDER -15 gms /liter.
- SURFACE – 10% BLEACH
BIO MEDICAL WASTE ( BMW).
P.E.P.
Dr. P.P.SINGH
34. • SALIVA as source.
- Mouth piece.
- Resuscitation Bags
-Ventilation devices
- Suction machines
-Mouth to Mouth Breathing
•
HOSPITAL DISINFECTANT- Chlorine – 1-1.5%
Sod. Hypochlorite 1 gm/L
Calcium hypochlorite 1.4 gm/L
Bleach at least 10 min.
Dr. P.P.SINGH
35. HANDLING SPECIMENS
USE GLOVES
SCREW CAPPED LEAK PRFOOF CONTAINERS
CARE TAKEN WHILE TRANSPORT OF SAMPLES.
SERA CAN BE KEPT - - HEAT 56 0 C FOR 30 MIN.
NO MOUTH PIPETTINGS
ANY SPILLAGE OF BLOOD & OTHER BODY FLUIEDS ON
TABLE TOP OR ANY SURFACE – CLEAN WITH SOD.
HYPOCHLORITE.
ALL OPEN WOUNDS ON HAND & ARMS SHUOLD BE COVERED
Dr. P.P.SINGH
36. ASEPTIC PRECAUTIONS
(IN RELATION TO INJECTION / OTHER SKIN PIERCING
PROCEDURES)
REDUCE UNECESSARY USE.
SINGLE USE DISPOABLES
REUASBLE SHOULD BE DIS INFECTED ,WASHED ,
& STERILISE
PUNCTURE PROOF CONTAINERS
P E P – ANY NEEDLE STICK , INJURY , CUTS OR
MUCUS MEMBRAIN EXPOSURE.
- WASH PROPERLY
- BLEEDING IS ENCOURAGED
Dr. P.P.SINGH
37. NON INVASIVE PROCEDURES
VAGINAL & RECTAL EXAMINATION.
INTRA OCCULAR PRESSURE
CONTACT LENSES TRIAL.
TRACHIAL & LARYNGIAL EX.
THROAT & NASAL EX.
X RAY & CT SAN ETC,
- THERE IS CHANCES OF BREAK OF MM.
- BODY FLUIDS / SECRETION MAY ACT AS SOURCE
OF INFECTION.
*** EFFECTIVE USE OF STERILISATION &
DISINFECTANTS
Dr. P.P.SINGH
38. Conclusion
• Prevention of Hospital Infection will cut the wasteful
expenditure. Savings could be re-deployed for
betterment of hospital
• Incidence of Hospital Acquired Infection can be reduced
to great extent by
–
–
–
–
Work culture & attitude of health care providers
Religious observation of universal precautions
Application of antiseptic technique
Proper Disposal of hospital waste
Dr. P.P.SINGH