Health care associated infection is challenge for every health care set-up, It's very important to reduce the HAI.

1. INFECTION CONTROL
PROGRAMME
Mitesh Lohar
Infection control nurse

2. WHAT IS INFECTION?
• INFECTION MEANS DEPOSITION OF
MICROORGANISMS IN TISSUES
AND THEIR GROWTH WITH
ASSOCIATED TISSUE REACTIONS

3. Healthcare associated infection
• Infections that are not present, nor
under incubation at the time of
hospital admission, and that they
appear after 48-72 hrs after hospitalization.
• In case of any MIS up to 30 days post discharge
and in case of implant surgeries, up to 1 year of
surgery can be included as HAIs.
• Infections acquired from patient’s, HCWs,
visitors and environments of the healthcare set-
up.

4. WHERE DO H.A.I. COME
FROM?
Colonization
Food & water
Hands: HCW, visitors
Hospital equipments and air.

5. Risk factors
• Long hospital stay
• Use of indwelling catheters
• Failure of health care workers to wash
hands
• Overuse of antibiotics
• Mechanical ventilation
• Intravenous catheters
• Underlying disease

6. Impact of HAI on customer
• Increase the LOS.
• Increase the cost .
• Increase mortality and morbidity.
• Decrease the customer satisfaction.
• Decrease the employee satisfaction as a
care giver.
• Decreasing the hospital income.

7. Who are at risk?
• Patients
• Healthcare Workers (Staff)
• Visitors
• Community
• Environment

8. RESERVOIRS
PORTALS
OF
EXIT
SUSCEPTIBLE
HOST
PORTALS
OF
ENTRY
INFECTIOUS
AGENTS
MODES
OF
TRANSMISSION

10. HOW TO BREAK
THE CHAIN OF INFECTION?

11. Standard Precautions
and/or
Universal Precautions

12. •Standard precautions are the precautions to be used/practiced
By ALL healthcare workers in ALL situations involving the care
of patients, or contact with the environment.
Universal precautions are a set of precautions designed to prevent
transmission of HBV, HCV, HIV and other blood-borne pathogens
while providing healthcare to all patients regardless of their diagnosis
or presumed infective status.
Definition

13. Remember…/Please note…
Standard PrecautionsStandard Precautions
have replaced
Universal Precautions.

14. The additional precautions go beyond standard
precautions and are based on the basis of the
mode of transmission of microorganisms or
infectious agents leading to infection.
Airborne precautions
Droplet precautions
Contact precautions
Remember…/Please note…

15. So before we go on to describe
Standard Precautions
let us be clear…
Remember…/Please note…

16. Remember…/Please note…
Standard precautions
are the precautions to be used/practiced
by
ALL healthcare workers
in
ALL situations
involving the care of patients, or
contact with the environment.

17. ELEMENTS
of
STANDARD PRECAUTIONS

18. Elements of Standard Precautions
• Hand Hygiene
• Use of Personal Protective Equipments (PPEs)
• Preventing Occupational Exposure
• Accommodation: Patient Placement – ISOLATION
• Patient-Care Equipment
• Environment
• LAUNDRY (Linen)
• Biomedical Waste Management
• Blood and Body Fluid Spillages

19. HAND HYGIENE
SAVE LIVES
Clean Your Hands

20.  Hand washing
Washing hands with plain or antiseptic soap and
water,
 Social
 Procedural or Antiseptic
 Surgical hand wash/scrub
 Hand rub
Rubbing hands with alcohol (without water)
 Plain alcohol
 Procedural - alcohol with antiseptic agent
 Surgical hand rub/scrub
Hand Hygiene Techniques

21. The “My 5 Moments for Hand
Hygiene” approach

23. When should you wash your
hands with soap and water?
(INDICATIONS)
Wash your hands with plain soap and water,
or with antimicrobial soap and water if:
• your hands are visibly soiled (dirty)
• hands are visibly contaminated with blood or body fluids
• On entering workplace
• After leaving workplace
• Before and after drinking, eating and food contact
• after using the restroom or toilet

24. When should you use an
alcohol-based hand rub?
If hands are not visibly soiled or contaminated with blood
or body fluids, use an alcohol-based hand rub for routinely
cleaning your hands:
before having direct contact with patients
Before entering into and leaving isolation room
Before taking care of susceptible patient
Before performing any invasive procedure
Before moving from a contaminated site to clean body
site

25. Personal Protective Equipment
Definition
“Specialized clothing or
equipment worn by an employee
for protection against infectious
materials”

26. •Gloves – protect hands
•Gowns/aprons – protect skin and/or clothing
•Masks & respirators – protect mouth/nose
•Respirators – protect respiratory tract from
airborne infectious agents
•Goggles – protect eyes
•Face shields – protect face, mouth, nose & eyes
Types of PPE Used in Healthcare Settings

27. Steps for wearing PPE

28. Steps for Removing PPE

29. Preventing Occupational
Exposure
• Cover all cuts and abrasions with waterproof dressings
• Take care to prevent sharps injuries.
– Use gloves when handling sharps.
– Do not resheath or recap needles.
– Never manipulate any sharp that involves directing the point of a
needle toward any part of the body.
– Dispose of sharps immediately into an approved container.
– Take a sharps container to the point of use.
– Refer to needle stick injury guideline.
– HCWs with skin conditions must seek the advice of an
Occupational Health Nurse.
– Use devices such as Pocket Mask as an alternative to mouth-to
-mouth resuscitation.

30. ISOLATION
Accommodation:
Patient Placement -
ISOLATION
• Place a patient who could contaminate the environment,
with blood, body fluid or faeces in a single room.
• If a single room is not available, consult with the ICN.
• If the patient is clinically unsuitable to be placed in a
single room a risk assessment must be undertaken by the
clinical team in conjunction with a member of the ICT.
• Babies and children will be isolated if they have
symptoms suggestive of an infectious disease which can
spread person to person. The ICT will advise.

31. Patient-Care Equipment
• Patient-care equipment should be
decontaminated as per the Decontamination
Policy. Wear protective clothing when handling
contaminated equipment.
• Patient-related equipment, e.g. pumps, drip
stands, etc, must be kept clean.
• Do not reuse single-use equipment.
• Do not reuse single-patient equipment on more
than one patient.

32. Environment
• Ensure that the clinical areas are clean.
• Particular attention must be paid to cleaning of
horizontal surfaces, floors, beds, bed-side
equipment and other frequently touched
surfaces.
• If areas are not clean the domestic supervisor
must be informed.

33. LAUNDRY (Linen)
• Always wear a plastic apron (and gloves where
linen is soiled) when handling used linen.
• Discard linen soiled with blood / body fluids, or
from patients in isolation, directly into a yellow
bag and then a secondary bag (clear plastic or
laundry bag) to prevent further contamination.
• Never place linen (soiled/used or clean) on the
floor.
• Do not expose clean linen to potential
contamination by storing inappropriately before it
is used.

34. Bio-Medical Waste
"Bio-medical waste" means any waste, which is
generated during the diagnosis, treatment or
immunization of human beings or animals or
in research activities pertaining thereto or in
the production or testing of biological, and
including categories mentioned in Schedule
I/GPCB.

35. NON-HAZARDOUS
(80%)
HAZARDOUS
(20%)
Infectious (15%)
• Non-sharp
• Sharp
• Disposable plastic
• Liquid
CLASSIFICATION OF BIO-MEDICAL WASTE

36. TYPES OF BIOMEDICAL WASTE
GENERAL (NON – INFECTIOUS) WASTE
 BIO MEDICAL PLASTIC WASTEBIO MEDICAL PLASTIC WASTE
 BIO MEDICAL INFECTED WASTEBIO MEDICAL INFECTED WASTE
 SHARP WASTESHARP WASTE

37. GENERAL WASTEGENERAL WASTE
- PAPERS & WRAPPERS- PAPERS & WRAPPERS
- CARTONS & CARDBOARD- CARTONS & CARDBOARD
- KITCHEN WASTE- KITCHEN WASTE
- PLASTIC BAGS- PLASTIC BAGS
COLLECTION :COLLECTION : BLACK BAGBLACK BAG
(CONSIDER FOR RECYCLING)(CONSIDER FOR RECYCLING)
DISPOSAL :DISPOSAL : - FERTILISER- FERTILISER
- RAGPICKERS- RAGPICKERS

38. BIO MEDICAL PLASTIC WASTEBIO MEDICAL PLASTIC WASTE
 EMPTY BLOOD BAG
 GLOVES, URO BAGS
 IV SETS, CATHETERS, FEEDING TUBES
 DRAINS, ICDS, SYRINGES
COLLECTION: RED BAGRED BAG
(MUTILATION BEFORE DISPOSAL)(MUTILATION BEFORE DISPOSAL)
DISPOSAL : LANDFILL

39. Bio Medical Infectious WasteBio Medical Infectious Waste
 AMPUTED HUMAN ORGANSAMPUTED HUMAN ORGANS
 PLACENTAPLACENTA
 DRESSING COTTON, BANDAGES, PADSDRESSING COTTON, BANDAGES, PADS
 ALL DRESSING MATERIALSALL DRESSING MATERIALS
 BLOOD STAINED CLOTHES, BEDSHEETSBLOOD STAINED CLOTHES, BEDSHEETS
 BIOPSY SAMPLESBIOPSY SAMPLES
 MICROBIOLOGY CULTURE & SPECIMENSMICROBIOLOGY CULTURE & SPECIMENS
COLLECTION :COLLECTION : YELLOW BAGYELLOW BAG
(NO DISINFECTION BEFORE DISPOSAL) DISPOSAL :(NO DISINFECTION BEFORE DISPOSAL) DISPOSAL :
INCINERATION AND DEEP BURIALINCINERATION AND DEEP BURIAL

40. INFECTIOUS SHARP WASTEINFECTIOUS SHARP WASTE
 NEEDLES
 BROKEN GLASS
 SLIDES & COVER GLASS
 AMPOULES
 SCALPEL
 KNIFE
COLLECTION : BLUE BAGBLUE BAG
(MUTILATION BEFORE DISPOSAL & IN PUNCTURE(MUTILATION BEFORE DISPOSAL & IN PUNCTURE
PROOF CONTAINER)PROOF CONTAINER)
DISPOSAL METHOD : LANDFILL / DEEP BURIAL

41. Blood and Body Fluid
Spillages
• Disinfect all blood and body fluid spillages
immediately wearing protective clothing (gloves,
apron and if risk of splash, goggles).
• Chlorine releasing agents will inactivate the
blood borne viruses.
• NB: Chlorine releasing granules must not be used
on URINE spillages.
• Decontaminate spillages as per the Spillages
Management section of the Decontamination
Policy.

42. Who is responsible for
implementing Standard
Precautions?

44. ANY QUESTIONS?