methods to prevent the spread of pathogenic organisms in

healthcare settings
prepared by : Mohamed said
reviewed by : DR amal elsheikh
Objectives
 By the End of lecture we will be able to identify
 1- The modes and mechanisms of transmission of pathogenic organisms in the
healthcare setting and strategies for prevention and control
 2-mode of transmission
 3-standered precaution

Introduction
. Healthcare-associated infection (HCAI) is one of the most common complications of health
care management. It is a serious health hazard as it leads to increased patients’ morbidity and
mortality, length of hospital stay and the costs associated with hospital stay
. Effective infection prevention and control is central to providing high quality health care for
patients and a safe working environment for those that work in healthcare settings.
.it is important to minimize the risk of spread of infection to patients and staff in hospital by
implementing good infection control program
HOSPITAL INFECTION CONTROL PROGRAM
Prevention of HCAI in patients is a concern of everyone in the facility and is the responsibility of
all individuals and services providing health care. Risk prevention for patients and staff must be
supported at the level of senior administration.
*the following Hospital Infection Control Policies are needed to be framed and practiced and
monitored by the Hospital Infection Control Team (HICT) and Hospital Infection Control
Committee (HICC)
1. Guidelines for prevention & control of infections : define as a manual which
contain all hospital policy & procedure regarding infection control
2. Antimicrobial policy : the antibiotic policy is the set of strategies and activities
undertaken to organize the antimicrobial treatment in the hospital, and
achieve health outcomes for patients. The basic principles are to be direct
evidence-based medicine, local epidemiology and freedom for prescribing
physicians
3. Surveillance policy : systematic collection, analysis, interpretation, and
dissemination of data regarding a health-related. event for use in public
health action to reduce morbidity and mortality and to improve health
4. Disinfection policy : it is the aim of this policy to implement safe systems of work to
protect patients and staff from the transmission of infection from medical equipment and
 devices. The aim of disinfection is the reduction in the numbers of pathogenic organisms
to below that required to cause infection.
DEFINITIONS
Cleaning: Cleaning is the removal of dirt and organic matter. Cleaning removes up to 80%
of microorganisms and is an essential part of an infection control program. Given that
organic matter will inactivate disinfectants, all items must be cleaned before disinfection
or sterilization can be achieved. The item must be cleaned thoroughly using neutral
detergent and hot water, rinsed and dried. Alternatively, detergent wipes may be used.
Disinfection: Disinfection is the removal or destruction of adequate numbers of
potentially harmful micro-organisms to allow the item to be handled or used safely. The
most effective method of disinfection is heat disinfection. However the most common
method used is with liquid chemicals, for example alcohol.
Sterilization: Sterilization is the total destruction and removal of all micro-organisms
including spores.
5. Isolation policy : it is defined as what hospital doing in case of patient require
isolation regarding to type of organism
6. Policy for investigation of an outbreak of infection : it is defined as policy how to
investigate in case of outbreak of infection such as outbreak of viruses on renal
dialysis unit or spread of organism in icu or in case of surgical site infection

The modes and mechanisms of transmission of pathogenic organisms in

the healthcare setting and strategies for prevention and control
The "Chain of Infection" is a basic component of understanding the prevention and control of
infection that most healthcare workers recall from their early days of training. It is a critical
concept in infection control that is worth reviewing:
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M Chain of infection
How to break chain of infection

Transmission of microorganisms
Microorganisms are transmitted in the following ways and in combination:

Direct contact indirect contact

droplet air born

vector borne common vehicle

Direct contact transmission

Direct contact transmission occurs when microorganisms are transferred by direct
physical contact with an infected or colonized individual. Direct contact is one of the
most common modes of transmission.
*prevention method: by use contact precaution when dealing with patient (gloves-
gown-mask)

indirect contact transmission

Indirect contact transmission involves transfer of microorganisms via an object.
Examples include, hands not washed between residents, contaminated gloves,
objects in the resident’s bed space or environment, medical equipment, and/or
contaminated instruments. Indirect contact is also a common mode of transmission.
Prevention methods: 1- 5 moment hand washing
2-disinfection surfaces & environment periodically

Airborne transmission
Microorganisms transmitted by this route are carried by dust or other small particles floating in
the air and are < 5micron in size. These microorganisms remain suspended in the air and are
widely dispersed by air currents. Susceptible hosts, who may be some distance away from the
source resident, even in different rooms inhale these microorganisms. Control of airborne
transmission is the most difficult, as it requires control of airflow through special ventilation
systems.
Prevention methods: by use airborne precaution when enter patient room ( gown-gloves-n95
mask)
Isolate patient in separate room with negative pressure

Common vehicle transmission

 Common vehicle transmission refers to transmission through a contaminated source. Examples
include food, medication, intravenous fluid, or shared equipment that transmits infection to
multiple hosts. This transmission may result in a large-scale outbreak.
Prevention methods : hospital should apply food safety programs
Using of single use Equipment as much as possible
Follow up standard of sterilization methods
Apply infection control program in each department in the hospital according to minimize
exposure to contaminated equipment or disposal
Vector borne transmission
Vector borne transmission refers to infections caused by animals and insects. Examples of these
infections include, West Nile Virus and Dengue Fever. Appropriate facility construction and
maintenance, closed or screened windows, and proper housekeeping prevent Vector borne
transmission.
Standard precaution
Standard precaution are mean to reduce the risk of transmission of bloodbrone & other
pathogens from both recognized & unrecognized sources
They are the basic level of infection control precaution to be used as a minimum in the care of
all patients
1- Hand hygiene : is a major component of standard precaution
perform hand hygiene by means of hand rubbing or hand washing
2- personal protective equipment : should be guided by risk assessment
A-gloves : wear when touching blood, body fluid, mucous membranes
Change between procedures on the same patient & after contact with potentially infectious
material
Remove after use& before touching non contaminated items or surface
B- facial protection ( Eyes, nose & mouth)
Wear surgical mask and eye protection ( face shield , goggles) to protect mucous membrane of
the eye, nose and mouth during procedure that are likely to generate splashes or sprays of
blood, body fluids, secretions
C- Gown : wear to protect skin & prevent soiling of clothes during procedures likely to generate
splashes or sprays of blood ,body fluids, secretions
3- prevention of needle stick injuries: take care when
A- handling needles, scalpels & other sharp instrument or devices
B- cleaning used instrument
C- disposing of used needles
4-Environmental cleaning: use adequate procedures for the routine cleaning and disinfection of
environmental and other frequently touched surfaces
5-linens : handle, transport & process used linen in a manner which
A- prevent skin &mucous membrane Exposures and contamination of clothing
B- avoids transfer of pathogens to other patients and or the Environment
6- waste disposal:
Ensure safe waste management
Treat waste contaminated with blood , body fluids in according to local Regulation
Discard single use items properly
7- patient care Equipment:
Handle Equipment soiled with blood, body fluids, secretions in a manner that prevents skin &
mucous membrane Exposure , contamination of clothing, and transfer of pathogens to other
patients or the Environment
Clean, disinfect & reprocess Reusable Equipment appropriately before use with another patient