INFECTION PREVETION AND CONTROL

HOSPITAL ASSOCIATED/ACQUIRED INFECTIONS

BY: MOLLY RIAGA

25/8/2023

WHAT IS IPC?

• Processes
• Policies
• Procedures
• Activities

Prevent the transmission of diseases within the health care facilities and community.

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OBJECTIVE OF IPC

• Provision of quality health care

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• Promote patient safety

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• Reduce occupational hazards associated with health care

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WHY THE CORNCERN ON IPC

• Crowding and population size are increasing

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• Existing microorganism develop even greater resistance

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• Routine use of anti-microbial agents that create emergence of resistant strains

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17/2/2015

WHY THE CONCERN ON IPC cont.

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• Spread from medical staff as they move from one patient to another

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• Medical procedures that bypass the body's natural protective barrier

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Where are the organisms?

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BREAKING THE CHAIN OF INFECTION

INFECTIOUS AGENT

Bacteria , Fungi, Viruses &Parasites

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RESERVOIRS

People

Equipment

Environment

Water

SUSCEPTIBLE HOST

Low immune status,

Diabetes, Surgery, Burns, Neonates, foreign bodies, length of hosp. stay,

PORTAL OF ENTRY

Mucous membrane GI / urinary / Respiratory track Broken skin

PORTAL OF EXIT

Thro. The body systems- Skin, urinary, Resp. system.

MEANS OF TRANSMISSION

Direct Contact Fomites

- Injection / Ingestion - Airborne

INVOLVES ALL

HEALTH

PROFESSIONALS

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Air flow control

Food handling

Isolation

Trash & waste disposal

Control of excretions and secretions

Hand-hygiene

Disinfection/

sterilization

Environmental sanitation

Employee health

Care

Rapid accurate identification of organism

Treatment of underlying disease

Recognition of

high risk

patients

Aseptic

Technique

Catheter

Care

Wound

Care

Hand-hygiene

Sterilization

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1. The various ways infection can be transmitted.

2. The ways the infection chain can be broken.

Remember

Standard Precautions

HOSPITAL ASSOCIATED INFECTIONS

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Definition

• Hospital Associated Infections (HAI) or nosocomial infections are those infections that were neither present nor incubating at the time the patient was admitted to the health care facility.
• The majority of HAI become evident 48 hours or more following admission. However, it may not become clinically evident until after discharge.

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�Strategies to Prevent Healthcare-Associated Infections�

• Hand hygiene.
• Maintaining a safe, clean, hygienic hospital environment.
• Screening and categorizing patients into cohorts.
• Public health surveillance.
• Antibiotic stewardship.
• Following patient safety guidelines

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ABBREVIATIONS.

HAIs-Hospital Association Infections

CAUTI-Catheter Associated Urinary Tract Infection

CLABSI-Central Line Associated Blood stream Infection

SSI-Surgical Site Infection

VAP-Ventilator Associated Pneumonia

HAP-Hospital Acquired Pneumonia

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Most common hospital acquired infections?�

These infections include:

1. catheter-associated urinary tract infections,
2. central line-associated bloodstream infections,
3. surgical site infections,
4. ventilator-associated pneumonia,
5. hospital-acquired pneumonia,
6. Clostridium difficile infections.

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Central line-associated bloodstream infections(CLABSI)

• More Common Mechanisms
• 1. Pathogen migration along external surface - more common early (< 7days)
• 2. Hub contamination with intraluminal colonization -more common >10 days
• Less Common Mechanisms
• 1. Hematogenous seeding from another source
• 2. Contaminated infusates

Basic interventions:

• – Hand hygiene
• – Full barrier precautions during CL insertion
• – Skin cleansing with chlorhexidine
• – Avoiding femoral site
• – Removing unnecessary catheters
• – Use of insertion checklist
• – Promotion of safety culture

Surgical Site Infection (SSI)�

A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place.

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Surgical site infections can sometimes be superficial infections involving the skin only. Other surgical site infections are more serious and can involve tissues under the skin, organs, or implanted materials

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• Preoperative measures:
• To prevent SSI, healthcare providers should practice good hand hygiene before and during surgery, wear sterile protective equipment, and thoroughly clean the skin at the site of surgery.
• Administer antimicrobial prophylaxis in accordance with evidence based standards and guidelines
• Identify and treat any remote infections before elective operation
• Do not remove hair at the operative site unless it will interfere with the operation; do not use razors

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• Intraoperative Measures:
• Maintain Operating Room Traffic
• Maintain surgical wound dressing
• Control blood glucose level during the immediate post-operative period
• Discontinue antibiotics within 24 hours after surgery end time
• Postoperative Measures:
• Feedback of surgeon specific infection rates
• asking for explanation of everything to know about taking care of a wound before leaving the hospital.

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Ventilator-associated pneumonia (VAP)

It is a healthcare associated infection that can complicate care of mechanically ventilated patients in the intensive care unit.

To reduce risk for VAP, the following nurse-led evidence-based practices are recommended:

• reduce exposure to mechanical ventilation,
• provide excellent oral care and subglottic suctioning,
• promote early mobility, and
• advocate for adequate nurse staffing and a healthy work environment.

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CATHETER ASSOCIATED URINARY TRACT INFECTIONS�(CAUTI)

• CAUTIs occur when germs enter and infect the urinary tract through the urinary catheter.
• This could happen upon insertion, if the drainage bag is not emptied enough, contamination of bacteria from a bowel movement, irregular cleaning, and if urine from the catheter bag flows backward into the bladder.

• Appropriate Catheter Use
• Appropriate Indications. ...
• Inappropriate Indications. ...
• Consider Alternatives to Indwelling Urinary Catheters. ...
• Engaging Patients and Families. ...
• Properly Trained Clinicians. ...
• Aseptic Insertion. ...
• Appropriate Maintenance. ...
• Reminders and Stop Orders.

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Standard precautions

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