Infection Control

:Presented by
Dr. Dena Eltabey Sobeh,

February 21, 2024 1

 Out line

1-Define infection &nosocomial infection

2-Describe modes of infection transmission
3- Identify types of nosocomial infection
4-Determine factors that affect the risk of
acquiring hospital infection
5-Discuss universal precaution for infection
control
6-Identify infection control team
7-Discuss role of infection control nurse 2
February 21, 2024
 Definitions

Infection: “An illness produced by a

microorganism or other infectious agent”

Nosocomial: “An infection acquired by an

individual while receiving care or services
in the health care organization.”.

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 Nosocomial infections result from delivery
of health services in a healthcare setting,
clients are at increased risk.

Nosocomial infections lead to increased

healthcare costs, extended hospital stays
and prolonged recovery time.
• Hospital acquired infection

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 Infection Control:
Includes all of the practices used to
prevent the spread of microorganisms
that could cause disease in a person.

Infection control practices help to protect

clients and healthcare providers from
disease by reducing and/or eliminating
sources of infection.

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 Chain of Infection:

Portal of Transmission Portal

Exit of Entry

Host
Reservoir
Infectious Susceptibility
Agent

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 Chain of Infection: (cont.)

1-Infectious agent – microorganisms

(bacteria, viruses, fungi, )

• Resident – normally reside on the skin in stable

numbers
• Transient – attach loosely to the skin by contact
with another – easily removed by hand washing

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 2-Reservoir:
A Reservoir is the environment in which the
infection agent can survive and reproduce.
Human , animals, or non living reservoir,
such as contaminated food ,water and
equipment.

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 3-Portal of exit:
Portal of exit provides a means for the
microorganism to leave the source.
- Sputum
- Stool
- Blood
- Wound drainage
- Secretion from genital tract
- Animal discharge or blood- borne organisms
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 4- Modes of Transmission

Contact transmission- direct or indirect contact

with physical transfer of organisms between an
infected person and a susceptible host

Most common and important mode of

transmission
Droplet transmission- droplets of respiratory
secretions generated through coughing, talking.

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 Modes of Transmission cont
Airborne transmission- dissemination
of airborne droplet nuclei that remain
suspended in air for prolonged periods

Common vehicle transmission- usually

involves contaminated medications or
food and water equipment

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 5-Portal of Entry: (to the host)
Enter the same way they exit
skin (open wound)
GI tract
Urinary tract
Respiratory tract

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 6-Host susceptibility:
Host must be susceptible to the strength and
numbers of the microorganisms.
Immunosuppression
Diabetes
Burns
Old age

To reduce susceptibility – provide adequate

nutrition & rest, promote body defenses against
infection & provide immunization.
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 3- types of nosocomial infection

1-Urinary tract infection

Urinary tract infection (UTI) are the most
common infection acquired in hospital. UTI
39% of all nosocomial infection, and
indwelling urinary catheters have been
implicated in 80% of these.

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 2-surgical wound infection

wound infection is the second most

nosocomial infection. surgical wound
infection account for around 20% of
infection acquired by patient in hospital.

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 3-Infection associated with IV
therapy

Intravascular (IV) are now widely used in

medical care for the administration of
fluid, blood products.

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 4-respiratory tract infection

Hospital-acquired pneumonia may be

caused by inhalation of
microorganism

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 5-gastrointestinal infection

The source of microorganisms which cause

hospital acquired gastrointestinal infection
are contaminated food or infectious feces
and vomit.

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 4-Predisposing factors for
nosocomial infections

Age
Underlying disease
Existing infection
Medicines and treatments
Medical procedures
Accidental wounds

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 Patient Susceptibility

Age: infants and old age have decreased

resistance to infection.
Immune status: Patients with chronic
diseases as malignancy, leukaemia,
diabetes mellitus, renal failure or AIDS
have increased susceptibility to infection.
Immunosuppressive drugs or irradiation

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 Environmental Factors

 Healthcare settings are environment

where both infected persons and
persons at high risk of infection
congregate.
 Crowded conditions within hospital,
frequent transfers of patients between units.
 Microbial may contaminate objects,
devices and materials which subsequently
contact susceptible body sites of patients.

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 Principles of infection control 1

Removal of the source

Cure infectious patients (antibiotics)

Isolate
Sterilisation and disinfection
Careful disposal of contaminated articles

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 Principles of infection control 2

Interrupt (prevent) transmission

Good hygiene
Education
Vaccination of non-immune individuals

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 Principles of infection control 3

Increase resistance of individual

Avoid invasive procedures
Minimise use of immunosuppressive
drugs
Antibiotics only when necessary
Vaccination

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Scope of Infection Control

Aiming at preventing spread of infection:

Standard precautions: these measures must be applied
during every patient care, during exposure to any
potentially infected material or body fluids as blood and
others.
Components:
A. Hand washing.
B. Barrier precautions.
C. Sharp disposal.
D. Handling of contaminated material.

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 A.HAND WASHING
 Hand washing is the single most effective
precaution for prevention of infection
transmission between patients and staff.
 Hand washing with plain soap is
mechanical removal of soil and transient
bacteria.
 Hand antisepsis is removal & destroy of
transient flora using anti-microbial soap or
alcohol based hand rub (for 60 sec.)

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When to Wash our Hands

1. Before & after an aseptic technique or

invasive procedure.
2. Before & after contact with a patient or
caring of a wound or IV line.
3. After contact with body fluids & excreta
removal.
4. After handling of contaminated
equipment or laundry.
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 5. Before the administration of medicines
6. After using the toilet.
7. Before having meals.
8. At the beginning and end of duty.
9. Gloves cannot substitute hand washing
which must be done before putting on gloves
and after their removal.

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 B. Barrier Precautions

1. Gloves:
Disposable gloves must be worn when:

a) Direct contact is expected.

b) Examining a lacerated or non-intact skin
e.g wound dressing.
c) Examination of GIT, UIT and dental
procedures.

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d) Working directly with contaminated
instruments or equipment.

 Sterile gloves are used for invasive

procedures.

 GLOVES MUST BE of good quality, suitable

size and material. Never reused.

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2) Masks & Protective eye wear:

MUST BE USED WHEN: engaged in procedures likely

to generate droplets.

During surgical operations to protect wound from

staff breathings, …

Masks must be of good quality, properly fixed on

mouth and nasal openings.

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3) Gowns/ Aprons:

Are required when:

blood or body fluids is anticipated e.g surgical procedures.

Gowns must not permit blood or body fluids to pass

through.

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 C.Sharp precautions
Needle and sharp injuries carry the risk of blood
born infection e.g AIDS, HCV,HBV and others.
Sharp injuries must be reported and notified
NEVER TO RECAP NEEDLES
Dispose of used needles and small sharps
immediately in puncture resistant boxes (sharp
boxes).
Sharp boxes: must be easily accessible, must not
be overfilled, labeled or color coded.

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 D. Handling of Contaminated
Material
1. Cleaning of spills:
a- wear gloves.
b- wipe-up the spill with paper or towel.
c- apply disinfectant.
2. Cleaning of equipment: protective barriers
must be worn.
3. Handling & processing lab specimens:
must be in strong plastic bags.

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4. Handling and processing linen:
Soiled linen must be handled with barrier
precautions, sent to laundry in coded bags.

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 Environmental control:

1. Cleaning of hospital environment and dis-infection

according to policies.
2. Proper air ventilation.
3. Water pipes examination, check its quality.
4. Proper waste collection and disposal.
5. Cleaning and dis-infection of equipment.
6. Proper linen collection, cleaning, distribution

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 7. Food : ensure quality and safety.
8. Sterilization:
Central sterilization department serving
all hospital departments compiling with infection
control precautions.

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INFECTION CONTROL TEAM

- Hospital microbiolgists
- Hospital epidemiologist
-hospital physician| surgeon
-Registered nurses

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Infection Control Nurse (ICN)

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Infection Control Nurse (ICN)

An ICN or practitioner is a registered nurse with

an additional academic education and practical
training which enables her to act as a specialist
advisor in all aspects relating to infection
control.
The ICN is usually the only full-time practitioner
in the ICT and therefore takes the key role in
day-to-day infection control activities with the
ICD providing the leading role
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The role of Infection Control Nurse

The role and responsibilities of the ICN are

summarized as follows:
 Has an ongoing contribution to the
development and implementation of IC
policies and procedures, and monitoring tools
related to IC and infectious diseases.

 Provide specialist nursing input in the

identification, prevention, monitoring and
control of infections within the hospital
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The role of ICN (cont)

 Participate in surveillance and outbreak

investigation
 Identify, investigate and monitor infections,
hazardous practice and procedures
 Participate in training and educational
programs and in membership of relevant
committees where infection control input is
needed
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