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Healtheare-asssociated (Nosocomial) Infections Fo Mpa Yawn Ab ah Impact of Nosocomial infections 5 ~10% of hospitalised patients CDC. Suny on the Efficacy of Nosocomial Infection Control (SENIO) STUNT per 100 admission nana be deo IMATE AL Increase morbidity and mortality Increase hospital cost 1992-US $4.5 billion nation-wide cost LM contribute to 2.7% deats Inerease medical interventi Lengthen hospital stay 1846, Dr. Ignaz Semmelweis Ward 1 Ward 2 Caregivers Desi MS Midwives Mortality 8% 2% Mortality after handwashing 15% Spread of infection ‘A causative agent Sourcelinfectious reservoir A portal of exit from the reservoir Mode of transmission A susceptible host A portal of entry into the host Causative agents Go te Sptyten + Vives Rote yer a, + Panga sd) Cont Ape Reservoirs of infection + Inanimate objects seri vl - Peedononns 7p. ‘cme reise mati juin Honan beingsanimals caves ani cxviens ‘ncaatngcomvaletcent nceient a chee airs etl a ies + Food, water and milk Blood Porial of exit and entry Usually the site where the organism grows = + Respiratory (uberculosis, commen cold) + Genitourinary + Gastrointestinal tract (typhoid fever, AGE) + Skin and mucus membranes + Blood and body fuids (sputum, stool, urine wound drainage, vomitus) Mode of transmission Contact sirect + indirect Airbome Vehicle — water, blood, serum, plasma, medications, food and feces Susceptible host 1 SE cen deen ty Lp ainprbpemy Sasha he Universal Precautions Blood and body fluid precautions DC 1985 Due fo HIV/AIDS epidemic Standard Precautions + Handwashing + Gloves + Gownsaprons, + Masks/eye shields/gopgles'face shields + Appropriate handing and disposal of waste + Aseptic techniques + Include ‘enteric precautior Additional Precautions (transmission-based) Used together with standard precautions Airborne (TB, measles, chickenpox) «Su droplet auelei, suspended in air Droplet (mumps, rubella, pertussis, fluenza) =u large panicle droplets, require close contact, up to Im Contact (direct or indizeet) Success of Infection Control Faciliny wide application ‘Toxal commitment of organisation Ongoing, assessment Regular evaluation of effectiveness Strategies for successful IC - 1 + Basic uowladge of microbiology and disease + plement good work practices standard and athe precautions + Personal hygiene, handwashing, + Regular and proper cleaning of work areas, ciprorat aid instr + Adopt recommend procediares fr sterilisation ud disinfection Strategies for successful IC -2 ‘Good clinical urgical procedures + Single use equipment, where practical Appropriate antibiotic use HCW safety ~cevupational & safety policies and etices, ine. vaccination Surveillance of iafetion Infection Contol Tea and Corsmittee Oo-poing edueston & tsning Surveillance - definition The ongoing, systematic collection, analysis, ‘and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know” CDC 1988 Purpose of IC surveillance Eatablish and maintain a database on NUAE Identity clusters of ML Flements of Surveillance + Define categories of infection or adverse events + Systematic data collection + Vabulate data + Analyse and interpret data + Reporting + Implement appropriate action