Infection Control PDF

Dr Haddad Salim Alhebshi INFECTION CONTROL INTRODUCTION: Aims:  Improve quality of care  Provide a safe working environment  Maintain safe environment for people, patient health care environment  Reducing morbidity and mortality  Reduce health care costs  Improve quality of health care serv...

Dr Haddad Salim Alhebshi INFECTION CONTROL INTRODUCTION: Aims:  Improve quality of care  Provide a safe working environment  Maintain safe environment for people, patient health care environment  Reducing morbidity and mortality  Reduce health care costs  Improve quality of health care services INFECTION CONTROL  Provide safe working environment ,Based on risk assessment and risk management (identify hazards, classify risk to success infection control management  Once principals are well understood its easy to apply protect health care workers INFECTION CONTROL  Infection: the entry and multiplication of infectious agent (presence of pathogens) in body  Control infection is an important part of every action the nursing performs INFECTION CONTROL  In order to explore the meaning of infection control,  A knowledge base is needed about:  The body normal defenses against infection  Asepsis  Infection control precaution  The chain of infection control INFECTION CONTROL  An infection will develop if chain remain intact  The nurse use aseptic practice to break element of chain so that infection will not develop INFECTION CONTROL  The process of infection:  Begin with transmission of infectious organism into host its outcome has a complex interaction of infectious agent an environment and susceptible human host INFECTION CONTROL  Agent : any factor in environment can leads to illness or disease  Host : the person or groups who may or may not at risk of acquire illness or disease  Pathogens: life virus invade cell interfere with cellular metabolism growth replication others invade cause hyperplasia, and necrosis cell death INFECTION CONTROL  Infectivity: pathogen ability to invade replicate the host the invasiveness by enzymes produced by organism,  These enzyme dissolve host connective tissue and protect pathogen from host defenses  Pathogenicity: ability of organism to induce disease depends on organism speed of reproduction in the host, the extent tissue damage, strength of toxin release INFECTION CONTROL  Virulence: pathogen potency in production severs disease  Toxigenicity : some bacteria secrete water soluble antigenic exotoxins that quickly disseminated in the blood causing potentially severe systemic and neurological manifestation INFECTION CONTROL  Antigenicity : ability of pathogens to stimulate immune response in the host  Carriers: persons or animals that have a specific infectious agent but not symptoms of illness can be transferred to other INFECTION CONTROL  Chain of infection : They are six component in the chain of infection  Infectious agent  Reservoir  Portal of exit  Mode of transmission  Portal of entry  Susceptible host INFECTION CONTROL Susceptible Infectious host agent Reservoir Portal of Mode of Portal of entry transmission exit  Infectious agent: 1. Viruses: influenza, mumps, measles, polio 2. Bacteria: staphylococcus, streptococcus, tetanus, typhoid 3. Protozoa: malaria, amoebic, dysentery 4. Fungi: ring worm of body or scalp 5. Parasites: Bilharzias  The infectious agent may produce the disease by:  Invasiveness: typhoid , paratyphoid  Toxicity: tetanus  Hypersensitivity: streptococci INFECTION CONTROL  Reservoir:  Place where infectious agent survive grow and multiply  Reservoirs include man, animal, soil  Man may be case or carrier  Not all human are created equal some are more susceptible than other  Personal characteristic and behavior that increase probability of infection disease developing  Such as: age, sex, ethnicity, heredity, attitude, temperature, general health nutritional status, hormonal, personal behaviors such as:  Drug use, diet , hygiene, sexual practice  Line of defenses 1- Barriers:  Physical barriers include intact skin and mucous membrane, oil, perspiration on skin, cilia in respiratory passage, gastrointestinal saliva and tears.  Chemical composition by secretion such as tear sweet, ph. of saliva, vaginal secretion urine, digestive juice 2-Inflammatory response:  Body cellular response to injury or infection  Protective vascular reaction that deliver fluid, blood products and nutrients to interstitial tissue in the area of injury 3- immune response:  Include lymphatic system, leukocyte and multitude of protein of enzymes  When antigen enter body a series of response change the body make up produce antibodies 4- Immunization programs:  To stimulate immune system to counteract the infectious agent  Active immunization referee to administration of modified infecting agent It is called vaccine  or modified toxin called toxoid  Long lived protection against disease INFECTION CONTROL  Passive immunization:  Referee to administration of antibody to non immune person to provide temporary protection against pathogenic agent or toxin  Short lived protection for few weeks INFECTION CONTROL  Immunization schedules:  All children are immunized against measles ,mumps, rubella, diphtheria, pertussis, tetanus, poliomyelitis haemophilus influenza, hepatitis B, and varicella zoster INFECTION CONTROL  Portal of exit:  Respiratory tract: through coughing, sneezing such as measles, influenza, diphtheria  Alimentary tract: through vomits in cholera and through stool as typhoid  Discharge from skin: as in malaria  Urinary tract : urine such as bilharzias  Uteri transmission: German measles, AIDS INFECTION CONTROL  Portal of Entry The point where the infectious agent enters a new host is known as the portal of entry, such as:  Non intact skin (e.g., broken skin such as bed sores or wounds coming in contact with contaminated material)  Respiratory tract by inhalation  Gastrointestinal tract (e.g., eating contaminated food)  mucous membranes (e.g., eyes, nose or mouth exposures with infectious agents) INFECTION CONTROL  Parenteral (e.g., exposure to a contaminated sharp instrument )  Tubes inserted in body cavities like urinary catheters or feeding tubes Urinary catheter Feeding tube INFECTION CONTROL  Susceptible host:  Inability to resist persons who is at risk for infection  Host provides a proper conditions for growth of microorganism  Risk factors includes:  Age very young , very old  High level of stress (school, work)  Poor nutrition  Disease (cancer, chronic lung disease  Persons with impaired immune system  Surgical, radiation INFECTION CONTROL  Preventing and controlling infection  The simplest most effective way to prevent transmission hand washing even use gloves , washing before donning gloves, after removing , then teach this procedure all personal (inexpensive)  Disinfection , sterilization or anti infective drugs and environment sanitation  Water treatment , food safety programs and control of animals, vectors, solid wastes INFECTION CONTROL  Treatment infection by prescribed drugs antimicrobial or antibiotic  Surveillance activities include early detection of infection , reporting , relevant data to designated individual for appropriate action  Protective barriers include gloves, gowns, masks, over head, over shoes, protective eye  Isolation procedure to prevent transmission of pathogen among hospitalized patient, health care visitors Sterile gloves Donning gloves INFECTION CONTROL  Instruction for each category were printed on color, coded cards and placed on doors and bed of the patient  Program for immunization  Discussed of drugs and antibiotic to improve immune response INFECTION CONTROL  Breaking the chain of infection:  Control or eliminate of infectious agent though:  Proper cleaning and disinfection by antiseptic solution For articles before used.  Hand washing  Proper cleansing , disinfection and sterilization of contaminated object  The nurse must alert to physiologic change in infectious patient such as:  Elevated WBC  Pus or exudate  Purulent discharge from wound  Production of thick sputum or cloudy urine  Elevated body temperature  Control or eliminate the reservoir through:  Bathing to remove dirty  Change dressing that becomes wet or soiled  Contaminated articles should be placed in plastic bag for proper disposal  Contaminated needles should not be recapped or broken out placed in puncture proof container and labeled  Wound drainage bottles or bags should be kept patent to prevent accumulation of a serous fluid under skin, empty all drainage system on each shift, unless other wise or ordered by physician  Drainage bag Needle dispose Wound drainage INFECTION CONTROL  Healthy personal in hospital  Environmental cleaning and sanitation  Sterilization and disinfection of equipment  Eliminate source of body fluids, drainage or solution that harbor microorganisms  Carefully discard articles that become contaminated INFECTION CONTROL  Control portal of exit through:  Covering mouth and nose when sneezing, coughing  Careful handling of exudate, urine, or feces  Wear disposable gloves  Dispose soiled articles appropriately  Hand washing  Proper waste disposal  Proper handling of blood, secretion, excretion, and mucous  Follow aseptic practices INFECTION CONTROL  Control mode of transmission through:  Frequent hand washing  Use personal items for each patient  Avoid sharing of bed or clothes  Avoid contact of soiled items with uniform  Discard any item thoroughly.  Hand washing  Proper waste disposal  Proper handling of blood, secretion, excretion and mucus  Follow aseptic practices INFECTION CONTROL  CONTROL portal of entry:  Change patient position, frequent oral hygiene  Keep bed linen clean , free from wrinkles or wet  Follow aseptic technique  Aseptic technique for cleaning wound  Proper catheters care  Proper wound care  Proper drainage system care  Healthy body systems  Hand washing  proper waste disposal, e.g. needle disposable INFECTION CONTROL  Protection of susceptibility host to infection  Recognition of the high-risk patient  Treatment of any underling disease  Increase host resistance through : vaccination for patient and health care worker INFECTION CONTROL A. Reduce susceptibility to infection:  Maintain integrity of skin and mucus membrane  Ensure that the patient receives balance diet and fluid to maintain body function,  Oral hygiene  Immunization INFECTION CONTROL B- isolation practice:  These precaution that used to control transmission of pathogen to susceptible client  Using protective barriers as mask, gloves, gown, private room  Isolation apply to not only patient but also items that patient touches or used INFECTION CONTROL  Universal precaution are measures taken in advance by all health care worker to prevent spread of infection  Universal blood fluid precaution :  Wear gloves before touching blood, body fluid, mucous membrane, and broken skin  Wash hand immediately after removing gloves  Wash other skin surface contaminated  Wear mask, protective eye if expect splashing blood or other  Discard needles , syringes other sharp object Role of nurse in infection control :  Providing staff education regarding infection control  Review infection control recommends and appropriate isolation procedures  Review patients records and laboratory reports to policies and procedures  Consult with occupational health department regarding the recommendation to prevent and control the infection among personnel  Gathering statistics regarding the epidemiology of nosocomial infection  Notifying public health departments regarding the incidence of communicable disease  Conferring with all hospital departments to investigate unusual events or clusters of infection  Educating patients and families  Identifying infection control problems with equipment's  Check microorganisms sensitivity to antibiotics in use and prevent resistance  Communicate with hospital and community health care personnel