Lec.-5.-Infection-Control.pptx

Infection Control SMD Learning Objectives  Learn how to control the spread of infection  Learn the standard control measures of CDC  Control measures in case there is an outbreak of infection Breaking the Chain of Infection 1. INFECTION CONTROL: First line of...

Infection Control SMD Learning Objectives  Learn how to control the spread of infection  Learn the standard control measures of CDC  Control measures in case there is an outbreak of infection Breaking the Chain of Infection 1. INFECTION CONTROL: First line of Defense  Hand hygiene is the first line of defense against infection and is the single most important practice in preventing the spread of infection Infection Control  HCP should wear gloves, masks, and goggles during cleansing.  DISINFECTION- is the elimination of pathogens, except spores from inanimate objects  DISINFECTANTS- are chemical solutions used to clean inanimate objects. Common disinfectants are alcohol, sodium hypochlorite, quartenary ammonium, phenolic solutions and glutaraldehyde  GERMICIDE- is a chemical that can be applied to both animate and inanimate objects to eliminate pathogens. Antiseptic preparations such as alcohol and silver sulfadiazine are germicides.  STERILIZATION- is destroying all m.o. including their spores. Equipment that occurs normally sterile tissue or blood vessels must be sterilized.  Autoclaving sterilization: which uses moist heat or steam, the most common sterilization technique used in the hospital setting.  Stages of Infections: 1.INCUBATION Stage: is the time between entry of infectious agent in the host and the onset of symptoms, during this time, the infectious agent invades the tissue and multiplies to produce an infection  The client is typically infectious to other during the latter part of this stage  For e.x. the incubation pd for varicella is 2-3 wks; the infected person is contagious from 5 days before any skin eruptions to no more than 6 days after the skin eruptions appear. 2. PRODROMAL STAGE- is the time from the onset of nonspecific symptoms until specific symptoms begin to manifest. The infectious agent continues to invade and multiply in the host. 3. ILLNESS STAGE- is the time when the client has specific signs and symptoms of an infectious process. 4. Convalescent stage- is from the beginning of the disappearance of acute symptoms until the client returns to previous state of health  NOSOCOMIAL INFECTIONS  Is an infection acquired in a hospital or other healthcare facility that was not present or incubating at the time of the client’s admission.  They also include those infections that become symptomatic after the client is discharged and infections passed among the medical personnel  Are also called as hospital acquired infections  Most common examples are UTI from e.coli infection and pneumonias Center for Disease Control Precautions (Standard) 1. HANDWASHING 2. GlOvEs 3. Face Protection 4. Gowns and other protective apparel 5. In General  Clean and reprocess reusable equipment before using it on another client  Follow agency procedure for routine cleaning and disinfection of surfaces and for handling spills of blood and body fluids  Avoidcontamination of self with soiled linen by folding the body and placing directly into the laundry receptacle  Avoid recapping needles; use scoop technique if recapping is necessary.  Discardused syringes and needles immediately into a puncture- proof container while holding the needle pointed away form self; do not bend or break needles.  Transmission based Precautions (use when indicated) A. Airborne Precaution  Place client in private room or with a client with the same infection but no other infection.  If possible, use room equipped with (-) pressure ventilation  Keep the door to the room close  Wear a special approved particulate filter mask (N95) whenever entering room of all client’s with TB  Limit visitors and caretakers to those already immune if chickenpox or measles involved  Keep client in room; place surgical mask on client if transport B. DROPLET PRECAUTION  Place client in private room or with client with the same infection but no other infection.  When in private room or cohorting is unavailable, keep 3 feet or more between the infected client and other clients.  Special ventilation is not necessary and the door may remain open  Limit transport of the client from the room and then mask the client if possible C. CONTACT PRECAUTION  Place client in private room  Wear gloves when entering the room, change gloves before leaving room and wash hands immediately with anti microbial agent or waterless antiseptic agent then ensure that hands do not touch potentially contaminated surfaces or items.  Wear a clean, nonsterile gown when entering room  If use of common equipment or items is unavoidable, adequately clean and disinfect them before use to another client  Remove gown before leaving the room  Limit to essential purposes client transport from room.  B. Control- limit the spread of infection by means of: 1. ISOLATION: separation of infected individuals from other persons during the period of communicability in order to prevent the direct and indirect transmission of the infectious agent from infected persons to other person who are susceptible or who may spread the disease to others. 2. QUARANTINE: limitation of freedom of movement of persons or animals who have been exposed to a communicable disease for a period time equal to the longest usual incubation pd of the diseases so as to prevent effective contact with those who are not exposed. 3. FUMIGATION: any process by which killing of animal form is accomplished with the use of gaseous agents 4. DISINFECTION: any physical or chemical process to destroy undesired animal forms present in the person, clothing or environment 5. ASEPSIS: the state or condition of being free from infection either medical or surgical Disease Distribution  the methods and technique of epidemiology are desired to detect the cause of a disease in relation to the characteristic of the person who has it or to a factor present in his environment  for the purpose of analyzing epidemiology data, it has been helpful to organize the data according to the variables of time, person and place Time  refers to both to the period during which the cases of the disease being studied were exposed to the source of infection and the period during which the illness occurred.  Epidemic Period : a period during which the reported number of cases of a disease exceed the expected, or usual number for that period Time  Year : For many disease the incidence (frequency of occurrence) is not uniform during each of 12 consecutive months. Instead, the frequency is greater in one season the any of the others. This seasonal variation is associated with variations in the risk of exposure of susceptible to the source of infection.  Period of Consecutive years: recording the reported cases of a disease over a period of tears-by weeks, months or year occurrence-useful in predicting the probable future incidence of the disease and in planning appropriate preventions and control programs. Persons  refer to the characteristics of the individual who were exposed and who contacted the infection or the disease in question.  Person can be described in terms of their inherent or their acquired characteristics (such as age, race, sex, immune status, and marital status); and the circumstances under which they live (social, economic and environmental condition). Place  refersto the features, factor or conditions which existed in or described the environment in which the disease occurred.  Itis the geographic area described in terms of street, address, city, municipality, province, region or country. Patterns of Occurrence and Distribution  the variables of disease as to person, time and place are reflected in distinct patterns of occurrence and distribution in a given community. Distinct patterns recognized as:  Sporadic occurrence – it is the intermittent occurrence of a few isolated and unrelated cases in a given locality. The cases are few and scattered, so that there is no apparent relationship between them and they occur on and off, intermittently, through a period of time. Patterns of Occurrence and Distribution  Endemic occurrence – is the continuous occurrence throughout a period of time, of the usual number of cases in a given locality. For example : Schistosomiasis is endemic in Leyte and Samar, Filkariasis is endemic in Sorsogon, Tuberculosis is endemic practically in all specific areas of the country.  Epidemic occurrence – is of unusually large number of cases in a relatively short period of time  Pandemic – is the simultaneous occurrence of epidemic of the same disease in several countries.  Epidemiological Process and Investigation  Establish fact of presence of epidemic a. Verify diagnosis b. Reporting c. Is there an unusual prevalence of the disease? a. Past experience of given community b. Relation to nature of disease c. Which cases are endemic? Epidemic? Epidemiological Process and Investigation  Establishtime and space relationship of the disease  Arethe cases limited to or concentrated in any particular geographical subdivision of the affected community?  Relation of cases by days of onset to onset of the first known cases Epidemiological Process and Investigation  Relations to characteristics of the group of community  Relation of cases to age groups, sex, color, occupation, school attendance, past immunization  Relation to sanitary facilities, especially water supply, sewage disposal, general sanitation of homes and relation to animal or insect vectors.  Relation to milk and food supply  Relation of cases to other cases and known carriers if any Epidemiological Process and Investigation  Correlation of all data obtained  Summarize data clearly with the aid of such tables and charts are necessary to give a clear picture of the situation.  Build up the case for the final conclusion carefully utilizing all the evidences available.  Establish the source of the epidemic and the manner of spread  Make suggestions as to the control, if disease is still present in community and as to prevention of future outbreaks. Outline on the Operational Procedure During a Disease Outbreak  Organization of Team  Coordination of personnel National Regional Provincial/ city municipal  Orientation on the methodology to be employed  Area assignment of teams  Checklist on the team’s paraphernalia  Pooling of data and resource – Record Keeping Outline on the Operational Procedure During a Disease Outbreak  Epidemiological investigation  Active case finding  Carriers and contact control  Surveillance Outline on the Operational Procedure During a Disease Outbreak  Collection of Laboratory specimens  Rectal swabbing Transportmedia, empty sterile bottles, applicator for specimen collection  Food sampling Food leftovers/ suspicious food stuffs  Others that are relevant to the disease Vomitus, feces , blood, other secretion, excretion, discharges Outline on the Operational Procedure During a Disease Outbreak  Treatment of patients and contacts  Different medicines  Parenteral fluids  Isolation of patient  Boiling and disinfection of fomites  Conduction of patient to hospital Outline on the Operational Procedure During a Disease Outbreak  Immunization campaign  Type of vaccine  Dosage, schedule, technique  Areas to be covered  Target population  Consolidation and evaluation of data  Outline on the Operational Procedure During a Disease Outbreak Environmental sanitation (during the survey) Water Boiling Chlorination of drinking jars and other containers for domestic use Treatment of improved dug wells, pumps, water system Toilets and surroundings Location of toilet Construction of temporary lathes Backfilling with soil Drainage construction Outline on the Operational Procedure During a Disease Outbreak  Garbage disposal Burning, burying  Insect and vermin control Elimination of harborage and proper storage of food Fogging Insecticidespraying Baits, rodenticide  Food sanitation Proper cooking Protection from flies, cockroaches, rats Proper handling of cooked food and utensils Outline on the Operational Procedure During a Disease Outbreak  Health education  Individual approach  Community approach and meeting  Schools PTA, church, others  Involvement of other agencies  Reporting  Telegraphic report  Written  Preliminary  Progressive and analytical  Finalreport  Evaluation  recommendation