CONTROL OF HOSPITAL INFECTION

BY,
SHREYA BHANJA CHAUDHURY
ASSISTANT PROFESSOR(ADHOC)
SHS, TNU
DEFINITION:
Hospital infections can be either hospital associated infections or hospital acquired infection.
HOSPITAL ASSOCIATED INFECTION:
Hospital associated infections are those, that are acquired during hospitalization as well as those
that are present upon admission, having been acquired prior to hospitalization.
HOSPITAL ACQUIRED INFECTION OR NOSOCOMIAL INFECTION:
It can be defined as “infection acquired by the person in the hospital, manifestation of which may
occur during hospitalization or after discharge from the hospital’. The person may be a patient,
members of the staff and/ or visitors.
The most common Hospital infections are:

UTI- URINARY TRACT INFECTION

SSI- SURGICAL SITE INFECTION
PSI- POST SURGICAL INFECTION
ICU OR CCU via PNEUMONIA
BSI- BLOOD STREAM INFECTION
SKIN DISEASES
MENINGITIS
What causes nosocomial infections?
Bacteria, fungus, and viruses can cause HAIs. Bacteria alone cause about 90 percent of these
cases. Many people have compromised immune systems during their hospital stay, so they’re
more likely to contract an infection. Some of the common bacteria that are responsible for HAIs
are: Staphylococcus, E. coli, Enterococci etc.

Bacteria, fungi, and viruses spread mainly through person-to-person contact. This includes
unclean hands, and medical instruments such as catheters, respiratory machines, and other
hospital tools. HAI cases also increase when there’s excessive and improper use of antibiotics.
This can lead to bacteria that are resistant to multiple antibiotics.
HOSPITAL INFECTION CONTROL
The hospital infection control is related to the reduction of prevalence of infection to such an
extent, that it ceases to be a public health problem and problems of hospital administration. It is
very difficult to reduce it to zero level, though ultimate desired state is to maintain the zero level
of hospital infections.
HOSPITAL INFECTION CONTROL
COMMITTEE( HICCOM)
All hospitals must have a HICCOM in order to use the expertize of members from various department of the
hospital, in implementing the policy and procedures of infection control. The organization of the HICCOM is as
follows:
CHAIRPERSON: Hospital Administrator.
MEMBER SECRETARY: The HOD of Microbiology .
CONVENOR: Infection Control Officer
MEMBERS:
- one interested member should be drawn from each clinical speciality.
- a microbiologist, responsible for the Infection Surveillance Team(IST)
- nursing superintendent.
- incharge of Operation theatre, ICU, IPD, OPD, Emergency department, CSSD, Laundry, Bio-medical waste,
Maintenance, Medical Equipment and General Management
ROLE & FUNCTIONS OF HICCOM
Hospital Infection Control Committee with the help of Surveillance staff ensures smooth
surveillance and control of hospital infection by:
-Meet periodically to take decision.
- Lay down standards of aseptic procedures in hospitals.
- To distinguish between infection acquired in the hospital and those acquired outside.
- To prepare manual for control of infection and lay down training programme of personnel.
- Take all decisions based on reports received through hospital infection control officer regarding
investigation and control measures in the event of sudden rise of hospital infection rate.
- Establishing reporting system.
- Investigation of an epidemic.
INFECTION SUEVEILLANCE TEAM:
The basic purpose of the surveillance is data collection for action. To watch over the factors
responsible for causation and spread of infection with great attention, suspicion and authority.
Objectives are:
- conduct surveillance which include defining the events to be surveyed as precisely as possible.
- collection of relevant data.
- classify the data and summarize it.
- analysis of data and drawing interpretations.
- Investigation of outbreak.
- education and training.
- employee health, staff screening.
HIGH RISK PROCEDURES IN THE HOSPITAL:
INJECTION:
- disinfection of skin.
- use sterile needles and syringes
- disposal of disposable needles and syringes.

SURGICAL PROCEDURES:
To ensure that all instruments, equipments and materials used during the surgery are sterile.
DRESSING OF WOUNDS:
Disposal of dressing materials, disposable material and reusable instruments need special
attention. All materials and instruments used and removed during the dressing should be taken
as contaminated. All materials should be disinfected before disposal.

MANAGEMENT OF CHILD BIRTH:

all instruments, equipments used for delivery must be sterile and must be decontaminated after
use. The surface including table top and floors which have been contaminated by blood or
amniotic fluid must be decontaminated.
INVESTIGATIVE PROCEDURE:
- INVASIVE PROCEDURE: open cut, lumber puncture, biopsy etc. during this procedures all precautions of surgical
procedures should be adopted.
- NON INVASIVE PROCEDURED: ENT exam, echo, USG, X-ray etc. only sterile instruments and materials should be used.

LABORATORY INVESTIGATIONS:
-Use only autoclaved disposable instruments to remove the tissue or blood contaminated materials like pus and body
fluids.
- transportation of clinical samples
- processing of clinical specimens
- discarding
- disposal
- high risk areas description. Assignment.
- department wise taking precautions against HAI. Assignment.