IPFC 4013

FUNDAMENTAL OF INFECTION CONTROL PERSONNEL

Tittle:
ROLE AND RESPONSIBILITIES ICD, ICN AND ICLN

Student’s name Student’s no

Mohd Kamil bin Mat Ludin ADIP 2/2023 (11)-0011

Siti Zulaika binti Abu Jamil Prepared by: ADIP 2/2023 (11)-0026

Noor Suhana binti Mamat@Zakaria ADIP 2/2023 (11)-0016

Siti Amirah binti Abdul Halim ADIP 2/2023 (11)-0023

 INTRODUCTION
• Infection control refers to the policy
and procedures implemented to
control and minimize the
dissemination of infections in
hospitals and other healthcare
settings to reduce infection rates.

(Habboush et al., 2023)

 ORGANIZATION OF INFECTION PREVENTION
AND CONTROL TEAM CONSIST:

3) Infection control
1) Infection control
link nurse (ICLN)
doctor (ICD) OR

2)Infection control nurse

(ICN)
(ICB)
INFECTION CONTROL TEAM RESPONSIBLE
 INTRODUCTION OF CVC

• A Central Venous
Catheter (CVC) is a
catheter that is inserted
into the vessel until the tip
reaches a more prominent
vein near the heart.

(Sohail et al., 2021)

SCENARIO
17/9/2023

• Mr Z, 38 years old, male patient, ESRF, admitted from the Emergency

Department with complaints of fever 2/7 chills and rigor, vomiting 5x/day, loose
stool. The underlying comorbid were hypertension and diabetes mellitus.

• Patient on regular haemodialysis (HD) at dialysis centre via internal jugular

catheter (IJC). History of sudden short of breathiness (SOB) during dialysis.
• Vital sign on admission:

● BP: 174/88mmHg

● Temp: 40’C

● PR: 123/min

● Respiration: 21/min

● Spo2: 96% under RA

• Started IV Ceftazidime as an empirical treatment to cover patients who clinically came

with signs and symptoms of septic, prior to blood culture from the IJC (blue and red).

• Seen by Doctor B at an emergency, an early diagnosis was made as TRO CRBSI.

18/9/2023

• By tracing old notes patient, specialist noted that had recurrent CRBSI.

• Dr de-escalation antibiotic to IV Cefazolin 1g stat and OD.

• To repeat blood culture and sensitivity on the peripheral line after more

than 48 hours of admission.

1.BLOOD C&S RESULT (21/9/2023)- Taken at ED
19/8/2023 (day 3 in ward)

• Repeated blood culture and sensitivity were done at the peripheral and IJC (blue

and red lumen).

• The blood culture was repeated after three days (3):

• To determine whether the antibiotic was working on the organism or whether

the infection's source was resolved.

• According to Deawtrakulchai et al. (2022), a standard differential time to positivity

(DTTP) is between 120 minutes or more efficient.

8/10/2023
• Patient condition was well and stable, signs and symptoms of sepsis
were resolved, specialists planned to exchange guide wire for a new
tunnel catheter. Exchange guide wire done under aseptic technique .
ROLE AND RESPONSIBILITIES OF:
 (1)COORDINATOR 3) Represent the hospital
and SIACC meeting.
1) Have appropriate
training and
experience in matters
2) Lead the hospital-level infection
relating to infection
and prevention and antibiotic
and antibiotic control.
activities.
 (2) SURVEILLANCE

4) Deeply involved in monitoring and data analysis

concerning CRBSI rates.
1)Work closely with
members of the HIACC 4)Provide guidance
and ICT represent the (1)CLINICAL and support to the
hospital and SIACC DUTIES infection control link
nurse.
meeting.

2)Supervised and 3)Clinical advised and

advised on IPC support to HCWs on
infection control issue
1. Coordinate
surveillance activities (2) SURVEILLANCE
for the hospital.

2) Collect relevant information including point

prevalence study on HCAI and hand hygiene
1)Monitor the (3) COORDINATION AND
compliance with ADMINISTRATIVE OF INFECTION
infection control
policies CONTROL

2)Prepare report within a

specified period (ICN have to
alert about HCAI cases in the
hospital)
 4) Ensure compliance
1) Hand hygiene (1) Education and with aseptic techniques
Clinical Duties and proper cleansing and
proper sterilization
according to standard
precaution.

2) Acts as a liaison
between the HCWs in 3) Supervised and
the ward and the ICT. ensure PPE
compliance.
 (2)CLINICAL SURVEILLANCE

1)Participate in national surveillance and audit

activities.
 DISCUSSION

the collection of blood culture samples from 3 sites including

peripheral vein, catheter hubs, and HD circuit, were obtained to
ascertain the differential time to positivity (DTTP) recommended by
the guidelines (Pelletier et al., 2016).

According to the research by Pelletier et al. (2016) and

Deawtrakulchai et al. (2022), peripheral vein blood culture is the
gold standard for diagnosing CRBSI with 120 minutes or more of
differential time to positivity compared to catheter blood culture.
Authors Finding
Pelletier et al. (2016 The collection of blood culture samples
from 3 sites including peripheral vein,
catheter hubs, and HD circuit, were
obtained to ascertain the differential time
to positivity (DTTP) recommended by
the guidelines
 DISCUSSION

 The infection control link nurse (ICLN) function as liason between infection
control teams in the ward on matters related to infection control (Jackson,
Lowton, & Griffiths, 2019).
 ICLN and ICN take the roles including taking the surveillance after the CVC
is placed.
 DISCUSSION

 Role of an ICD is pivotal in strategizing and leading initiatives to reduce the

occurrence of these infections.
 involvement of the Infection Control Team should be enhanced in the
supervision of blood sample procedures performed by doctors.
 IMPACT OF CRBI

PATIENT
-Prolonged stay HOSPITAL
-Costing -Treatment costs
-Mental health HEALTH CARE WORKER -Costing
- Work Load -Bed Occupied in Hospital
 RECOMMENDATION
To reduce the event of bloodstream infection :

1)Applied central venous catheter care bundles

a)hand hygiene,
b)maximal barrier precautions upon insertion,
c)chlorhexidine skin antisepsis,
d)optimal catheter site selection,
2)with subclavian vein as the preferred site for non-tunneled catheters
3)daily review of line necessity with prompt removal of unnecessary lines.
 CONCLUSION
As an Infection Control Team, we need to monitor, advise, and
ensure staff compliance in preventing nosocomial infections.
Every hospital's infection control team is essential in preventing
cross-infection from spreading (CRBSI)
References
• Deawtrakulchai, P., Cheawchanwattana, S., Sribenjalux, W., & Meesing, A. (2022). The comparative accuracy of pooled vs. individual blood culture
sampling methods for diagnosis of catheter-related bloodstream infection. BMC Infectious Diseases, 22(1). Retrieved October 6, 2023, from:
https://doi.org/10.1186/s12879-022-07605-x
• Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream
infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLOS ONE, 12(6), e0180473. Retrieved October 6, 2023,
from, https://doi.org/10.1371/journal.pone.0180473
• Habboush, Y., Yarrarapu, S. N. S., & Guzman, N. (2023). Infection Control. In StatPearls. StatPearls Publishing.
• Fujimoto, K., Iida, E., Kumano, S., Fujii, A., Adachi, H., Furuichi, K., & Yokoyama, H. (2021). Effect of sutureless securement on hemodialysis catheter-
related bloodstream infection. Scientific Reports, 11(1). Retrieved October 6, 2023, from: https://doi.org/10.1038/s41598-021-01372-6
• Pelletier, F. Q., Joarder, M., Poutanen, S. M., & Lok, C. E. (2016). Evaluating approaches for the diagnosis of Hemodialysis Catheter–Related Bloodstream
Infections. Clinical Journal of the American Society of Nephrology, 11(5), 847–854. Retrieved October 6, 2023, from:
https://doi.org/10.2215/cjn.09110815
• Shahar, S., Mustafar, R., Kamaruzaman, L., Periyasamy, P., Pau, K. B., & Ramli, R. (2021). Catheter-Related Bloodstream Infections and Catheter
Colonization among Haemodialysis Patients: Prevalence, Risk Factors, and Outcomes. International Journal of Nephrology, 2021, 1–9. Retrieved October
5, 2023, from https://doi.org/10.1155/2021/5562690
• Muaainuedeen, S. N., Badri, I. B., Noor, S. S. M., Kob, T. N. T., Yaacob, N. M., & Asma Hassan, S. (2022). EVALUATION OF A PROGRAM TO CONTROL
CATHETER-RELATED BLOODSTREAM INFECTIONS AT A TERTIARY INSTITUTION IN MALAYSIA. Retrieved October 5, 2023, from Southeast Asian Journal of
Tropical Medicine and Public Health, 53(1), 58-72
• Maskon, K., Siew Hien, N., Cheng Cheng, T., Tong May Geok, J., Li Ling, T., Abd Rahman, P. M. N., Amran, F., Othman, N., & Mohd, N. (2008). Central
Venous Catheter Care Bundle; A quality initiative for the prevention of Central Venous Catheter-Related Blood Stream Infection (CVC-BSI). Kementerian
Kesihatan Malaysia. Retrieved October 6, 2023, from https://patientsafety.moh.gov.my/uploads/cvc_manual.pdf
• World Health Organization: WHO. (2022, May 6). WHO launches first ever global report on infection prevention and control. Retrieved October 5, 2023,
from https://www.who.int/news/item/06-05-2022-who-launches-first-ever-global-report-on-infection-prevention-and-control
References
Deawtrakulchai, P., Cheawchanwattana, S., Sribenjalux, W., & Meesing, A. (2022). The comparative accuracy of pooled vs. individual blood culture sampling methods for diagnosis of catheter-related bloodstream

infection. BMC Infectious Diseases, 22(1). Retrieved October 6, 2023, from: https://doi.org/10.1186/s12879-022-07605-x

Esposito, M. R., Guillari, A., & Angelillo, I. F. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional

study in an area of southern Italy. PLOS ONE, 12(6), e0180473. Retrieved October 6, 2023, from, https://doi.org/10.1371/journal.pone.0180473

Habboush, Y., Yarrarapu, S. N. S., & Guzman, N. (2023). Infection Control. In StatPearls. StatPearls Publishing.

Fujimoto, K., Iida, E., Kumano, S., Fujii, A., Adachi, H., Furuichi, K., & Yokoyama, H. (2021). Effect of sutureless securement on hemodialysis catheter-related bloodstream infection. Scientific Reports, 11(1).

Retrieved October 6, 2023, from: https://doi.org/10.1038/s41598-021-01372-6

Pelletier, F. Q., Joarder, M., Poutanen, S. M., & Lok, C. E. (2016). Evaluating approaches for the diagnosis of Hemodialysis Catheter–Related Bloodstream Infections. Clinical Journal of the American Society of

Nephrology, 11(5), 847–854. Retrieved October 6, 2023, from: https://doi.org/10.2215/cjn.09110815

Shahar, S., Mustafar, R., Kamaruzaman, L., Periyasamy, P., Pau, K. B., & Ramli, R. (2021). Catheter-Related Bloodstream Infections and Catheter Colonization among Haemodialysis Patients: Prevalence, Risk

Factors, and Outcomes. International Journal of Nephrology, 2021, 1–9. Retrieved October 5, 2023, from https://doi.org/10.1155/2021/5562690

Muaainuedeen, S. N., Badri, I. B., Noor, S. S. M., Kob, T. N. T., Yaacob, N. M., & Asma Hassan, S. (2022). EVALUATION OF A PROGRAM TO CONTROL CATHETER-RELATED BLOODSTREAM

INFECTIONS AT A TERTIARY INSTITUTION IN MALAYSIA. Retrieved October 5, 2023, from Southeast Asian Journal of Tropical Medicine and Public Health, 53(1), 58-72

Maskon, K., Siew Hien, N., Cheng Cheng, T., Tong May Geok, J., Li Ling, T., Abd Rahman, P. M. N., Amran, F., Othman, N., & Mohd, N. (2008). Central Venous Catheter Care Bundle; A quality initiative for the

prevention of Central Venous Catheter-Related Blood Stream Infection (CVC-BSI). Kementerian Kesihatan Malaysia. Retrieved October 6, 2023, from https://patientsafety.moh.gov.my/uploads/cvc_manual.pdf

World Health Organization: WHO. (2022, May 6). WHO launches first ever global report on infection prevention and control. Retrieved October 5, 2023, from

https://www.who.int/news/item/06-05-2022-who-launches-first-ever-global-report-on-infection-prevention-and-control