Infection Control in Healthcare Settings

Contrast Media in Radiography and Medical Imaging

• This lecture, RAD 244, focuses on infection prevention and control methods in radiology.
• The lecture objectives cover various concepts including asepsis, the chain of infection, hand hygiene, infection prevention and control, common healthcare-associated infections, transmission-based precautions and minimizing infection transmission in the radiology department.

Asepsis

• Asepsis is the absence of disease-producing organisms.
• It's a practice aimed at preventing infections.
• It involves the absence of bacteria, viruses, and other microorganisms.
• Types of asepsis:
  • Medical asepsis (clean technique): Practices that reduce the number, growth, transfer and spread of pathogenic microorganisms. This includes things like handwashing, bathing, cleaning, gloving, gowning and using antiseptics.
  • Surgical asepsis (sterile technique): Practices that keep an area or objects free from all microorganisms (pathogenic and non-pathogenic).

Purposes of Medical Asepsis

• To prevent cross-infections in hospital environments.
• To control infections.
• To ensure patient comfort, safety, and psychological well-being.

Definitions

• Disinfection: Eliminating pathogenic organisms from an inanimate object, excluding spores.
• Disinfectant: Chemical substances used for disinfecting inanimate objects (e.g., phenol, chlorine).
• Antiseptic solution: Substances used on skin to inhibit the growth and activity of microorganisms without necessarily destroying them.

Definitions (cont.)

• Contamination: The rendering of something unclean or unsterile
• Infection: Pathogenic microorganisms invading body tissues.
• Carriers: Individuals or animals carrying pathogens without symptoms.
• Nosocomial infections (Hospital-acquired infections): Infections acquired in healthcare settings.
  • Can be exogenous (from outside sources) or endogenous (from the client's own flora).

Definitions (cont.)

• Resident pathogens: Organisms normally present on skin that are not easily removed by handwashing.
• Transient pathogens: Microorganisms attaching to skin when people interact then easily removed by disinfection.
• Concurrent disinfection: Daily practices to limit infection spread in client care environments.

The Chain of Infection

• Susceptible host (Elderly, Infants, Immunocompromised).
• Pathogen (Bacteria, Virus, Fungi, Parasite).
• Portal of Entry (Mouth, Nose, Eyes, Cuts).
• Reservoir (People, Animals, Soil, Food, Water).
• Mode of Transmission (Direct Contact, Indirect Contact, Vectors).
• Portal of Exit (Coughing/Sneezing, Bodily Secretions, Feces).

Hand hygiene and Gloves

• Thousands of people die daily from infections acquired during healthcare.
• Hands are the main germ transmission pathway.
• Hand hygiene is the most important measure to avoid infections and transmission.
• All health care workers need to be concerned and practice correct hygiene.
• Clean hands by rubbing with alcohol-based formulations when not visibly soiled
• Wash with soap and water for visibly soiled hands/body fluids.

Hand hygiene (cont.)

• If exposure to spore-forming pathogens is likely, use soap and water.
• Hand hygiene procedures:
  • Apply product to all hand/surface areas (20–30 sec).
  • Right palm over left dorsum, interlocked fingers
  • Palm to palm, interlocked fingers
  • Backs of fingers to opposing palms, interlocked fingers
  • Rotational rubbing of left thumb clasped in right palm and vice versa
  • Repeat circular motions, backwards and forwards

Handwashing

• Handwashing procedures (40-60 sec):
  • Wet hands with water
  • Apply enough soap to all surfaces
  • Rub hands palm to palm
  • Right palm over left dorsum with interlocked fingers and vice versa
  • Palm to palm with fingers interlocked
  • Backs of fingers to opposing palms with fingers interlocked
  • Rotational rubbing of left thumb clasped in right palm and vice versa
  • Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa
  • Rinse hands with water
  • Dry thoroughly with a disposable towel

Points to Remember

• Use protective hand creams daily.
• Do not wash hands with soap and water just before or after an alcohol-based rub
• Do not use hot water to rinse hands
• Let hands air dry.
• Avoid using artificial nails.
• Keep natural nails short.

Hand Hygiene - When

• Practice hand hygiene before and after patient contact.
• Hand hygiene is needed when potential exposure risk to body fluids is present

Medical Glove Use

• Gloves do not replace hand hygiene.
• Hand hygiene is performed regularly, regardless of glove use.
• Gloves should be removed before hand hygiene.
• Gloves should be discarded after each use.

The Glove Pyramid

• Provides a decision-making guide for glove use versus no glove use in different scenarios.

Infection Prevention and Control (IPC)

• IPC is a scientific approach to prevent infection harm in patients and healthcare workers.

IPC Functions

• IPC units should deliver their work via five main functions: leadership, campaigns, technical guidance, capacity building, and measuring & learning.

Common Healthcare-Associated Infections

• Direct contact
• Airborne
• Droplet
• Enteric
• Blood borne

Standard Precautionary Measures

• Hand hygiene
• General education
• use of Personal protective equipment(PPE)
• Patient handling
• Isolation protocols
• Disposal precautions
• Needles/sharps handling
• Equipment/environment hygiene

Minimizing Infection Transmission in the Radiology Department

• Hand hygiene is the primary strategy for preventing healthcare-associated infections.
• Personal protection equipment (PPE) is needed when there is anticipated exposure to blood or body fluids.
• Respiratory hygiene and cough etiquette should be followed.
• Safe injection techniques and infection control practices are needed.
• Special procedures (e.g., lumbar) require specific care.
• Wear masks during catheter placement or injection into the spinal or epidural space.
• Report all bloodborne pathogen exposures to the appropriate health care provider.

How to Minimize Infection Transmission (cont.)

• Appropriate hand hygiene is critical; washing with soap and water is better than alcohol-based hand rubs for many pathogens.
• Prions are unusually resistant to standard decontamination methods. Incineration is the best method to eliminate them.