By

Prof. OSSAMA RASSLAN

Secretary General, Egyptian Society of Infection Control

Prevention & Control Activities(Outlines)

I.C. program Patient care Employee health Environmental hygiene Surveillance of infection
Prevention & Control Activities

Prevention & Control Activities (contd.)

Ward specific measures Disease/ Organism specific measures Antibiotic policy Reportable diseases Isolation policies
Prevention & Control Activities

Prevention & Control Activities

I.C. program Patient care Employee health Environm. Hygiene Surveillance of inf. Ward sp. measures Ds./Org. sp. measures AB policy Reportable diseases Isolation policies
Prevention & Control Activities

Infection Control Program

Organizational structure - ICC - ICT - ICD (ICO) - ICN - ICLN

For each item: Membership Qualifications Duties Meeting periodicity Prevention & Control Activities

Patient Care
Handwashing - Routine - Surgical (H.W. facilities - antiseptics) Standard precautions 1. Protective barriers 2. Resuscitation facilities 3. Decontamination (later)
Protective barriers - Gowns - Gloves - Masks - Eye protection - Shoe covers

Prevention & Control Activities

Patient Care (cont.d)

Invasive Procedures Wound dressing Oral alimentation Other activities

Invasive procedures - Indwelling urinary catheters - IV catheters - IV injections - Endoscopy

Prevention & Control Activities

Employee health (Occupational health)

Old/ New Employee medical exam. [Initial (at time of employment) & Periodical] Exposure to blood, body fluids or tissue
(exposure control plan)

Staff accident or ward related infections Work restrictions Education

Prevention & Control Activities

Environmental hygiene
Decontamination

(Hosp. Env. Control)

Cleaning - Disinfection - Sterilization

Hospital waste management.

- Color coding - Segregation at source - Collection - Transportation - Storage - Disposal - Recycling regular waste
Regular waste Biohazardous waste - Identification - Handling - Disposal

Prevention & Control Activities

Environmental hygiene
Microbiologic sampling
- Not routine - Outbreak investigation - Research purposes

Housekeeping policy Laundry policy Construction policy

(Construction, design & remodeling measures)
Prevention & Control Activities

Environmental hygiene

Sterile water
(for invasive procedures)

Appropriate air supply

(room ventilation)

Proper storage of sterile supply

Prevention & Control Activities

Surveillance of infection
Criteria for Nosocomial infections Surveillance analysis & reporting A. Elements
- Data collection - Data collation (consolidated or tabulated) - Data analysis - Reporting
Prevention & Control Activities

Surveillance of infection
Surveillance analysis & reporting (cont.d) B. Uses (improvement of outcomes & processes)
- Provide baseline data on infection risk - Problem identification - Problem investigation - Evaluation of control measures - Evaluation of practices - Education of HCW - Research - Risk management
Prevention & Control Activities

Surveillance of infection
Surveillance analysis & reporting (cont.d) C. Approaches
- Comprehensive, Total - Priority-directed, Site-specific - Problem-oriented (outbreak response surveillance) D. Worksheets
Prevention & Control Activities

Ward specific measures

(Dept or unit)

Measures differ according to:

- Site, design & construction of unit - Function & activity of unit - Type of patient - Expected infections& diseases - Treatment modality (AB, Chemoth.) - Type of intervention - Type of case (long-term, short-term, day care)
Prevention & Control Activities

Ward specific measures

W h e r e
- O.R. - ICU - Ped. & Neon. ICU - Pediatrics - Medical wards - Outpatient clinics - Surgical wards - Ante/Postnatal care unit ..etc - Laboratory Construction Safety Techniques & investigations
( e.g. pipetting, cell counting, blood sampling) Prevention & Control Activities

Disease &/or Organism specific measures

Blood borne pathogen (Prevention precautions - Control) e.g. HBV, HCV, HIV T.B. Pneumonia MRSA VRE Multidrug resistant organisms Scabies .etc
Prevention & Control Activities

Antibiotic policy
Clinical use - Therapeutic (Empirical - Targeted) - Prophylactic Hospital AB committee - membership - meetings - duties Education
(better to say: Communication with clinicians) Prevention & Control Activities

Reportable Diseases

Investigation & mgt of major outbreaks (or clusters) How? - Diarrhea - MRSA - VRE Notification of communicable disease How?

Prevention & Control Activities

Isolation policies
Enteric isolation Blood & body fluid isolation Respiratory isolation Strict isolation Contact isolation Protective isolation

Prevention & Control Activities