Hospital Infection Control: Policies, Procedures & Management PDF - PDF

Here is the converted markdown format of the provided text: # Hospital Infection Control ## Introduction Hospitals are naturally places where patients gather, and some of them carry microbes. Hospital infections (hospital-acquired infections) occur epidemically and dangerously unless the necessary...

Here is the converted markdown format of the provided text: # Hospital Infection Control ## Introduction Hospitals are naturally places where patients gather, and some of them carry microbes. Hospital infections (hospital-acquired infections) occur epidemically and dangerously unless the necessary precautions are taken to control infection in hospitals. Over many years, an integrated system for infection control in hospitals has developed, aimed at limiting the transmission of any infection from the environment, workers, patients or visitors. The infection control system in hospitals consists of a set of policies and procedures that limit the transmission of infection and help control it. Everyone who deals with the hospital, including workers, patients and visitors, must abide by these policies and procedures to protect them from contracting infectious diseases while they are in these hospitals. To ensure the proper implementation of these policies and procedures, it is necessary to train hospital staff on how to implement these policies and procedures, depending on the nature of their work, as well as give sufficient instructions to patients and visitors regarding infection control measures. To implement these procedures, it is necessary to provide the capabilities, facilities and materials needed in terms of quantity and good quality in proportion to the size and nature of the work in the hospital. To ensure the effectiveness of this system, its implementation must be continuously monitored and verified to meet the standards of quality and patient safety. The infection control system is applied in hospitals through an administrative structure consisting of the following: - The Infection Control Committee to develop policies and procedures. - Infection control team to monitor the implementation of policies and procedures. - Infection control representatives in departments. - The infection control policy is a general policy that must be followed in health facilities by all personnel and at various organizational and administrative levels, from the hospital director and health service teams, employees and workers, and it must be a general and permanent behavior. - The anti-infection policy aims to protect service providers (doctors, nurses and workers) in addition to patients, their companions, visitors, as well as protecting the surrounding environment. ## Defining Infection Control Infection: is the entry of disease-causing microbes into the human body. Chain of infection emergence: For the transmission of infection within the hospital from one individual to another, three elements must be available: - Source of infection. - Method of transmission. - Host. Defining hospital infections: Hospital infections are the infections acquired from the hospital whether the subject is a patient or anyone from the health staff or whoever goes in and out of the hospital. Hospital-acquired infections are a global problem ## How Does Infection Occur in Hospitals? Infection occurs in the hospital as a result of: - The presence of many patients in one place means: - Friction between carriers of infection and patients susceptible to disease through secretions (sputum - droplets). - The proliferation of microbes. - The pollution of machines and tools. - Contaminated waste and excrement. - Failure to follow infection control procedures during examinations, diagnosis, or treatment, for example: - Surgery or cutting or piercing the skin increases exposure of internal tissues to microbes. - Catheter: It paves the way for microbes. - Antibiotics - Incorrect and excessive use of antibiotics leads to the emergence of strains of microbes resistant to these drugs. ## Organizational Structure for the Committee and Team for Infection Control A diagram to describe the organizational structure, as follows: - **The Human Element**: (Committee, team, representatives) - **The Administrative Part**: (Registration and reports) - **The Implementation And Training**: (Policies, procedures, public and private) A hierarchical chart stemming from these to describe the organizational structure of infection control in hospitals, as follows: **Board of Directors** -> **Director General of the Hospital** -> **Chief of the Medical Staff** -> **Director of Medical Support Services** -> **Financial Manager** -> **Head of Nursing** -> **Medical Departments** -> **Committees** -> **Infection Control Committee** -> **Team** -> **Coordinators** - **Infection Control Committee:** This committee is comprised of: 1. The hospital director or his representative. 2. Nursing staff supervisors in the departments. 3. Heads of major clinical departments. 4. Representative of the Accommodation, Nutrition and Maintenance Department. 5. Financial and Administrative Officer. 6. Head of the Pharmacy Department. 7. Head of the Laboratory Department. 8. Anyone the committee deems necessary to be present at any of the meetings. ## Duties and Responsibilities of the Infection Control Committee ### First: Preventive duties: Supervise the preventive measures for infection control within the hospital, including: 1. Educating workers and providing them with information by holding training seminars and providing workers with a manual of infection control and prevention specific to each department. 2. Supervising the development of a program and policy of prevention and infection control within the training decisions for new employees upon joining the service. 3. Supervising the implementation of the infection control policy within the hospital departments in correct scientific ways. ### Secondly: Practical duties: Making the necessary decisions in the event of an infection outbreak in order to provide the means to discover its causes and develop an appropriate plan to control it and avoid its occurrence in the future. ### Thirdly: Administrative Duties: 1. Hold a committee meeting regularly once every month. 2. To convene the Committee on the occurrence of an emergency (the emergence of infection). 3. Permanent contact with the infection control team by providing a monthly report including daily activities. 4. Follow-up methods of prevention of infection in the hospital departments. 5. Maintain records of committee meetings and decisions taken, signed and approved by the Chairman of the Committee. 6. Review the protocol of studies on infection control within the hospital. 7. Planning to conduct follow-up research and update of infection control methods to keep pace with modern global methods and develop them in proportion to the capabilities of the hospital and the surrounding community. ## The Infection Control Team Consists of the Following: 1. Doctor. 2. Nurse for every 250 beds. 3. Infection control coordinator. ### The Responsibilities of the Infection Control Team Are: 1. Daily follow-up of the procedures for infection control in the various laboratories and departments to demonstrate compliance with protocols to combat infection. 2. Write the daily report and present it to the hospital director and the head of the committee. 3. Holding training courses for old and new workers. ## Additional points - Providing appropriate solutions and participation in planning and decision-making. - Working as a liaison between heads of departments in the hospital with respect to the implementation of the infection control program. - Implementing performance metrics and tests and developing and updating methods to implement infection control measures. - Giving guidance to hospital staff and ensuring proper isolation procedures for isolation patients, and conducting a comprehensive daily or weekly survey of patients, staff, and the hospital environment. - Maintaining records, reports, and information on infection control at the hospital level. - Monitoring, treating, and reporting cases of primary or additional infection as a result of the patient's presence in the hospital. ## Types of Infections Inside Hospitals Infections inside hospitals are divided into three types: 1. Cross infection. 2. Acquired infection. 3. Self-infection. `CROSS INFECTION` - Transferred from one patient to another; Because of the direct contact between patients due to fungi or Saliva or secretions that come out of patients suffering from infections or boils... etc. - Infection may also be transmitted by mixing to doctors, nurses or other staff `ACQUIRED INFECTION` - Microbes move to the patient from the surrounding environment, such as dirty dust and furnishings or Instruments that are not properly sterilized or waste, etc. This type also includes taking contaminated medicines such as solutions, drops, ointments or tablets Which are traded by hands. Likewise, what may arise in the hospital from food poisoning as a result of Poor kitchen conditions or its workers or poor food preparation methods. `SELF INFECTION` - In this type, microbes pass from one organ of the patient to another organ in his body. It is natural that every patient has sufficient microbes on the surface of the skin, in the throat, and in Respiratory system, digestive system and genitourinary system... etc. These microbes multiply and harm the patient as a result of weakness of his resistance due to The disease, with the clear examples of this infection being the opening of wounds in abdominal operations or the emergence of Abscess or sore as a result of itching. ## The Most Important Means and Tools to Prevent Infection The head of the infection control department at the hospital or whomever he authorizes must ensure that the health personnel adhere to wearing appropriate personal protective equipment according to the nature of the work. Personal protection equipment are tools that work to protect workers and patients in the hospital From the danger of exposure of the skin or mucous membranes or the respiratory system to infection with microbes Infectious agents or substances that cause disease, and other widespread risks in the environment Hospital. ### Personal Protective Equipment - Gloves - Gown Aprons - Head cover - Face mask - Eyes cover - Foot cover ### The Most Important Reasons for the Spread of Infection Inside Hospitals 1. Use of antibiotics without relying on laboratory tests. 2. Failure to have an infection control system in place in hospitals, taking into account Patients most vulnerable to infection, such as newborns, the elderly, those with malnutrition, and those with Diabetes... etc. 3. Failure to follow proper sterilization procedures for modern tools and equipment used in diagnosis Diseases. 4. Failure to have a team with experience in controlling infection and dealing with it in hospitals. 5. Absence of policies and systems that organize the movement of patients, treatment, and medicine, and the disposal of wasteproducts within the hospital in accordance with the infection control system. 6. Lack of sufficient awareness among health staff about infection, how it is transmitted, its types, and methods and methods of controlling it. ### Common Hospital Infection Cases Hospital infection is widespread in some departments, such as: urinary tract departments, respiratory system diseases, General and specialized surgery as a result of handling any fluids and excretions coming out of the patient in a way Wrong and from common infectious diseases (urinary infection, lower respiratory tract infection, infection after Surgical operations, infection of injection sites or venous catheters). ### Sources of Infection and Methods of Controlling Them There are a number of sources of infection in medical facilities, and the following table summarizes these, as well as methods of disinfection and control: | Source | Control Method | | :---------------------------- | :-------------------------------------------------------------------- | | Needles - Injections - Machines - Sheets - Tools | Cleanliness - Disinfection - Sterilization - Following proper methods for disposing of sharp instruments | | Hands | Washing hands with soap and water | | Environment | Wearing protective clothing - Cleanliness - Disinfection - Sterilization | | Wounds - Secretions - Sputum - Blood, Urine | Following safe methods to dispose of contaminated dressings and secretions | ### Important general procedures to control infection: 1. Routine hand cleaning (washing hands is the most important and influential procedure in infection control, especially infection within hospitals). - **Uses**: Before starting work, after using the bathroom, before and after touching the patient, his secretions, or his tools, after touching waste, before and after eating or drinking, when finishing work, before leaving the ward or unit, before and after any therapeutic or nursing procedure, before and after taking or collecting samples. - Cleaning hands before surgical operations, therefore, importance must be given to cleaning the hands of surgeons and their assistants before any surgical procedure. 2. Wet cleaning of the environment. 3. Cleaning and disinfecting the patient's unit to receive a new patient. 4. Cleaning, disinfecting and sterilizing machines and equipment. 5. Knowing how to follow infection control methods during taking, handling, and analyzing laboratory samples. 6. Disposal of laboratory waste (all laboratory waste is considered contaminated and care must be taken to dispose of it). 7. Cleaning and disinfecting repetitive blood purification machines (the dialysis unit is considered one of more The places prone to infection, especially during repetitive blood purification, because the handling here is done With the patient’s blood, and due to weakness of the immune system of the dialysis patient, which makes him more susceptible to For infection). 8. Wearing and removing the mask and gloves to avoid the spread of infection. 9. Properly handling waste and disposing of it to limit the spread of infection. ### Nursing Procedures Necessary for Isolation Patients When nursing infectious cases, the nurse must follow the foundations and rules of sterilization and disinfection to prevent Pollution and infection transmission from and to the patient or to workers in the hospital, whether through contact Direct or indirect. Objectives: - Avoid the spread of pollution and limiting it to a limited scope. - Protecting the patient from contracting another infection. - Protecting members of the health team and the patients' families from contracting infection. ### Place of Isolation: It consists of a room for the patient connected to a corridor or another room used to store and prepare supplies The patient's needs necessary for his nursing care. It is attached to a sanitation cycle separate from the rest of the water cycles in the department. It is preferable that this room be far away About the rest of the patients' rooms and a sign on it prohibiting entry except by individuals authorized to do so. Isolation can also be done in the patient's room, one patient or a group of patients, provided that The curtains should be used if this is done in one corner of the room, and a separate toilet is dedicated to the patients, as a A team of workers is assigned to them. Keep in mind the following in the place of isolation: 1. That the room is wide, ventilated, and sunlight enters it. 2. Use of single-use tools and machines in such cases. 3. It is preferable that the isolation rooms have a pressure less than the atmospheric pressure so that pollutants do not come out of them if possible. 4. The patient's room must contain only the necessary furniture, and it must be made of materials Washable (all furniture in the isolation room is considered contaminated). 5. The contents of the tool storage room and the equipment connected to the isolation room are all considered clean And must contain all the patient's necessary supplies. 6. The hospital clothes worn by the isolation patient are considered contaminated. The clothes are sent to the laundry for washing. If it is not possible to disinfect clothes by using vapor or by wash them well, expose the items for 8 hours to 3 days. The Patient's clothes are treated the same way and then thrown away. 7. When the patient enters the isolation unit, the person in charge of nutrition is informed of the patient's name and type of food prescribed for him. Care should be taken that: - A plate dedicated to the patient's food is requested with its contents of plates and other tableware And dedicated to the patient only until the end of the isolation period, then sent for disinfection and sterilization. It is preferable that it be Of the type that is used once and burned after that. - The person responsible for bringing the daily food waits outside the patient's room and the nurse receives Food. - The nurse provides food to the patient and supervises him and observes him during the meal. - If the patient cannot feed himself, the nurse feeds him. - Caring for the isolation patient after death. ### Isolation Place Specifications 1. Contents of the patient's room in the health isolation department: The patient's room must contain only the necessary furniture, and it must be made of materials A: Washable. metal bed B: Wardrobes C: Metal cabinet D: Side lighting. E: The patient's personal belongings. F: 2 tables (one clean and the other used during disinfection or packaging of waste). G: Containers for waste and trash (dry, liquid, sharp). H: Small trash can (plastic) placed next to the bed. 2. Contents of the tool and equipment storage room connected to the isolation room: All what is contained is considered clean and must contain all the following needs for patient care: A: A large table on which cleaning boxes are placed (bags can be used if the hospital has a section For central sterilization). B: Bag for used laundry. C: A place to store clean shoe covers and another for usedshoe covers. D: Wear a service provider's mask is essential. E: Closet to store the employee's belongings. F: A large table contains supplies for giving medicine, dressings, thermometers, Blood pressure monitor, stethoscope .... etc. G: It is preferable to use single-use tools whenever possible. H: If there is a central sterilization, it is preferable to use the packets system. I: The box is full of running water, soap, clean towels. J: Disinfectants (Piptadine - Chlorine - Sidex). ### Policies 1. Hospital staff health policy: for the worker to improve their overall health. 2. Policy Implementation Universal Precautions for infection control, and to wash your hands...etc. 3. The Cleaning, Disinfection, and sanitization policy ### The Policies and Procedures for the Health Professionals In order to ensure proper application, these should always be enforced or reminded to the personnel. The different types of the disinfection are: 1. Cleaning: is to remove from hospital for removal of visual contaminants. 2. Disinfection: a system that is implemented, a number of ways to ensure a prevention. 3. Sterilization: System is introduced to eliminate all living organisms, and using it to help prevent all infections. ### The Most Commonly Spread Infections are: 1. Urinary tract infections 2. Respiratory Virus