1 Lec - Infection control.pptx

Infection control Prof Esam Lecture objectives  Team of Infection Control, Administrative work related to infection control  The role and responsibilities of the Infection Control team  Ethical Considerations in Isolation Precautions for Visitors to Healthcare Facilities Infection • The entry...

Infection control Prof Esam Lecture objectives  Team of Infection Control, Administrative work related to infection control  The role and responsibilities of the Infection Control team  Ethical Considerations in Isolation Precautions for Visitors to Healthcare Facilities Infection • The entry and development or multiplication of an infectious agent in an organism, including the body of man or animals • Body responds in form of Immune response or disease • An infection does not always cause illness Chain of Infection The role of the Infection Prevention and Control Team • The Code of Practice on the Prevention and Control of Infections and Related Guidance (Department of Health [DH], 2010), part of the Health and Social Care Act 2008, requires healthcare organisations to have, or have access to, ‘an appropriate mix of both nursing and consultant medical expertise (with specialist training in infection The Infection Prevention and Control Team (IP&CT) • Size and structure vary depending on where they work and the size of the Trust • Nursing and medical experts responsible for providing the organisation with evidence-based best-practice advice on all aspects of infection prevention and control • Responsibility for patients, staff, the public and the environment • The WHO recommends having a dedicated and trained team in each acute healthcare facility to prevent Healthcare-associated infections (HCAIs). • Infection control in hospitals is implemented by the ICT. • ICTs originated in the UK in the 1950s and have been established in many countries. • Initially, doctors, nurses, epidemiologists and microbiologists were trained as infection control specialists and appointed in the ICT. • Later, infection control specialists were referred to by a variety of different titles, such as infection control professionals, infection control • The majority of infection control specialists are nurses, known as infection control nurses (ICNs). • Many countries apply a standard of one ICN per 250 hospital beds and one epidemiologist or medical microbiologist per 1000 hospital beds. • Hospital epidemiologists are clinicians such as physicians or paediatricians with training in infection control. • HCAIs are infections that patients acquire while they are receiving care for other illnesses at hospitals, acute care clinics, community health centres or care homes. • A high proportion of HCAIs occur in the intensive care unit, and many HCAIs are due to the use of invasive devices, in particular, central lines, urinary catheters and ventilators. • The true global burden of HCAIs remains unknown due to the lack of reliable data. However, the pooled HCAI prevalence has been reported to be 7.6% in highincome countries and 10.1% in low-income and middle-income countries. • HCAIs are problematic for both patients and healthcare professionals as they result in prolonged hospital stays, increased resistance of microorganisms to antimicrobial agents and additional financial burden for the health system and patients. • The risk of HCAIs can be reduced by adhering to infection control guidelines. • In healthcare setting, hand hygiene, the use of clean and well-functioning equipment and infection prevention and control programmes and teams are effective in preventing a large proportion of HCAIs. The roles of the ICT generally include: Developing and executing infection control programmes Developing and disseminating guidelines Coordinating continuous education and training Establishing systems for surveillance of HCAIs (including outbreak detection) • Monitoring and auditing the practices and standards of care for infection control • Facilitating access to the essential infrastructure, materials and equipments • Building effective links with related programmes and promoting the implementation of multimodal strategies • • • • The multifaceted roles of ICNs include: • Leading prevention activities such as infection surveillance • Implementing evidence-based best practices and educating staff regarding these • Conducting outbreak investigations • Monitoring infection prevention compliance activities • Reporting infection data to the public and governing agencies and observing organisational preparedness and responses to infectious diseases. ICT performs the following infection control measures: • Formulating and revising policies/guidelines. • Performing surveillance of HCAIs. • Training and educating healthcare professionals. • Monitoring and auditing practices and standard of care. • Liaising with other staff and departments. • Infection control measures for HIV, tuberculosis and malaria. • Transmission of infectious organisms within healthcare settings is an increasingly recognized threat to the safety of patients and healthcare personnel. • There has been much attention on healthcare providers as potential vectors of infection transmission and many infection-prevention strategies focus on this population. • However, visitation to healthcare facilities by individuals other than healthcare personnel is common. • Additionally, hospital visitors spend significant time with patients within the healthcare setting, often for longer periods than healthcare personnel Ethical Considerations in Isolation Precautions for Visitors to Healthcare Facilities • Visitor restriction policies can conflict with the individual freedoms of patients and caregivers and the philosophy of patient-/familycentered care. • Infection control practitioners must be cognizant of the powerful psychosocial impact denying visitation rights may have on patients and families. • Such restrictions can be justified to protect public health on the basis of the epidemiological evidence demonstrating the role visitors can play in transmission of high-consequence infections such as SARS • For instance, in the case of MERS-CoV, the public health rationale for such stringent visitor precautions includes the lack of a safe and effective vaccine and chemoprophylaxis, the high rate of morbidity and mortality among infected patients, and incompletely defined modes of transmission • Communication to patients and families explaining visitation restriction policies should be clear and sensitive. • Moreover, in some exceptional circumstances, the adverse psychosocial impact of visitor restriction and the patient’s and family’s emotional needs may necessitate flexibility in restricting visitation, particularly at the end of life. • Isolation precautions and visitor restriction in pediatric populations pose unique ethical issues as such precautions may have additional adverse consequences such as interference with bonding, breastfeeding, and negative psychosocial impact for both children and parents . • Using gowns and gloves and masks for such visitors and emphasizes the importance of standard precautions, good hand hygiene practices, and individualized considerations Isolation precautions Standard Precautions • Standard Precautions are routine IPC precautions that should apply to ALL patients, in ALL health-care settings. The precautions are: • hand hygiene • use of PPE; • respiratory hygiene • environmental controls (cleaning and disinfection); • waste management; • packing and transporting of patient-care equipment, linen and laundry, and waste from isolation areas; • prevention of needle-stick or sharps injuries. • Standard Precautions are the basic IPC precautions in health care. They are intended to minimize spread of infection associated with health care, and to avoid direct contact with patients' blood, body fluids, secretions and, non-intact skin. • The SARS outbreak illustrated the critical importance of basic IPC precautions in health-care facilities. Transmission of SARS within health-care facilities was often associated with lack of compliance with Standard Precautions. • The threat of emerging respiratory infectious diseases makes the promotion of Standard Precautions more important than ever and it should be a priority in all healthcare facilities. IPC • Infection prevention and control (IPC) is a practical, evidence-based approach preventing patients and health workers from being harmed by avoidable infections.