Infection Control

and
Covid Safety
Dr. Adeuga Adekuoye
Senior QA Lead for Reddington Multi-Specialist Hospital V/I
and
Reddington Zaine Laboratory

IPC TRAINING
What is IPC?
 The practice of preventing or stopping the spread of infections during
healthcare delivery
– Hospitals, outpatient clinics, dialysis centers, long-term care facilities,
traditional practitioners

 IPC Goal for COVID-19: To support the maintenance of essential healthcare

services by containing and preventing COVID-19 transmission within
healthcare facilities to keep patients and healthcare workers healthy and
safe
The Chain of Infection

To prevent the spread of

infection, break any one of the
links in the chain.
Coronavirus Background
What we know about
coronavirus disease
2019 (COVID-19)
• First identified in Wuhan, China, in
December 2019
• It is an enveloped RNA virus
• The lipid coat of the virus can be
removed by alcohol hand rub, soap
and detergent and household
disinfectants
• Infection happens if virus spikes stick
to the lining of the respiratory tract
(inside the mouth, nose or in the eye)
• Infection happens in a person who is
not immune (very few people are
immune)
• The virus does not go through the skin
 Routes of Transmission
The figure below illustrates the difference between the
distance travelled between droplet and airborne after
aerosol generation through coughing or sneezing.
COVID-19 can produce many symptoms that range in severity. Most people will experience mild
symptoms, but some people may show no symptoms—while others may become dangerously ill.
COVID-19 Prevention
COVID-19: Preventative actions – vaccination
 Get vaccinated
• Be sure to check that your country is offering the vaccine and you
are eligible
• Safe and effective vaccines are a great tool for prevention, but it
is important to continue other preventative actions, such as
wearing masks, hand hygiene, cough etiquette especially as new
COVID-19 strains emerge and vaccination coverage in some
countries continue to be low.
• There are several vaccine candidates, and many have been listed
under WHO’s emergency use
Infection Prevention and Control (IPC) for COVID-19
COVID-19: IPC Priorities
 Rapid identification of suspect cases
 Immediate isolation and referral for testing
• Group patients with suspected or confirmed COVID-19 separately
• Test all suspected patients for COVID-19
 Safe clinical management
• Immediate identification of inpatients and healthcare workers with suspected
COVID-19
 Adherence to IPC practices
• Appropriate personal protective equipment (PPE) use

Strategic Priority IPC Activities for Containment and Prevention

 General IPC 1
Frequent hand washing and use of
alcohol-based hand rub (ABHR)
Precautions –
All Staff 2
Correct cough etiquette and respiratory
hygiene

Social distancing: Keep a distance of 1.5

to 2 m when in contact with other
3 people except during patient’s
examination or procedure

Clinical, Security, Do not touch your face unless your

Food Aids, 4 hands are clean
Cleaning Staff,
Nurses, and
Doctors 5 PPE is necessary at the workplace
 Take the correct required samples and
1
General IPC send to the laboratory for processing

Precautions – 2
Ensure nasopharyngeal and other
samples are processed and reported
Laboratory and timeously

Clinical Staff Implement effective management of

patients (triage, isolation, treat
3 promptly, discharge)

4 Follow IPC protocols meticulously

Use IPC equipment as indicated to avoid

5 unnecessary wastage
 Key Elements of Standard Precautions
Standard precautions (SP) are aimed at reducing the risk of transmission. The key
elements of SP precautions are:
Required Method

PLEASE NOTE
Currently staff giving direct
care are required to include
washing arms up to the
elbows.
 Bare Below the Elbows….
Hand hygiene is the most important method of preventing the spread of infection.

All staff will need to comply with "BBTE" principles when providing direct clinical
care to patients or touching the immediate patient environment

Any staff who do not work in a clinical environment, but may need to enter the
patient environment as part of their role, will need to have the ability to be Bare
Below the Elbow and comply on these occasions.
Respiratory Hygiene
These are infection prevention measures designed to limit the transmission of respiratory
pathogens spread by droplet or airborne routes.
COVID-19: Transmission-Based Precautions

 Wear PPE for contact and droplet precautions*

 Use disposable or dedicated patient care equipment
(e.g., stethoscopes, blood pressure cuffs)
– If equipment needs to be shared among patients, clean and
disinfect it between use for each patient by using ethyl
alcohol of at least 70%

*WHO Infection prevention and control during healthcare when COVID-19 is suspected or confirmed
COVID-19: Transmission-Based Precautions
 Use adequately ventilated single rooms (preferable) or dedicated
COVID-19 ward rooms with dedicated bathrooms
– Bathrooms should be cleaned and disinfected twice daily
 Avoid transporting COVID-19 patients out of room unless
medically necessary
– Place a mask on COVID-19 suspected or confirmed patients if
transport out of a room is medically necessary
– Healthcare workers should wear appropriate PPE during transport*
 Designate healthcare workers to care for patients with COVID-19
 Restrict the number of visitors allowed

*WHO Rational Use of personal protective equipment for COVID-19

COVID-19: Additional Control Measures
COVID-19: Administrative Controls
• Ensure all staff have undertaken awareness training around COVID-19
• Ensure all staff are trained with standard and transmission-based precautions:
 Hand hygiene & respiratory etiquette
 Appropriate choice and use of PPE
 Procedures for safely donning and doffing of PPE and disposal of PPE
 Decontamination of the environment and equipment
 Physical distance and wearing masks
 Where possible roster staff in consistent groups to minimize mixing

•Ensure staff have undertaken relevant training provided and are competent in performing
swabbing techniques

•Supervision should be in place to ensure correct guidance is in place

IPC TRAINING
COVID-19: Administrative Controls - 2
• Alcohol Hand Rub at each entrance and point of test
• Surfaces that can be cleaned and disinfected
• Car parking convenience to allow waiting in car for test appointment
(walk-in)
• In circumstances of mobility or distressed person, testing may be
completed in transport vehicle such persons arrive in
• Space to support physical distancing from other people
• Dedicated Testing Pod with sufficient space for 2 – 4 people (to
accommodate parent and child/carer)

IPC TRAINING
COVID-19: Administrative Controls - 3
• Hand wash sink within close proximity to testing pods
• Designated packaging area for samples to be organized for
transportation
• Dedicated waste holding area that can be secured
• Clean toilet facilities twice daily and check 4 times daily
• Designated area for any staff who becomes unwell to await transport
home if required
• Separate dining facilities with guidance on hand hygiene, mask use
and physical distancing observed

IPC TRAINING
Personal Protective
Equipment (PPE)

• PPE is specifically used to

protect clinical and non-
clinical health workers from
exposure to body fluids or
from droplet or airborne
pathogens, chemicals or
heat.
• The use of PPE is based on
risk assessment and
evidence of the route of
transmission for a given
microbe.

1 2
Human coronaviruses can
remain infectious on surfaces
for up to 9 days. The SARS-CoV-
2 virus has been detected after
up to 72 hours in experimental
conditions. Therefore, cleaning
the environment is paramount
and detailed in the NCDC
covid-19 IPC Guidelines (2020).
Environmental cleaning and
Disinfection
To summarise, each area of the
healthcare facility must be
cleaned at least twice daily,
with a proper schedule,
checklist and programme. In
high risk areas (COVID-19
triage, isolation ward and ICU
settings), the environment
must be cleaned and
disinfected at least 3-4 times
per day and checked by the
supervisor each time.
3 4
The cleaning can
be validated using visual
inspection and a record of
cleaning must be kept.
Following thorough cleaning,
surfaces are wiped (NOT
SPRAYED) with disinfectants
such as 1:1000 ppm chlorine or
70% alcohol, as
recommended.
Environmental spraying of
walls, floors, ceilings and
passages in health care
facilities with chlorine is not
recommended. There is no
evidence that transmission
from these areas occurs.
5
Body spraying of humans with
any chemical or product in any
situation including entrances to
healthcare facilities, is not
warranted. The chemicals used
may be toxic to the skin, eyes
and respiratory tract and may
aggravate the acquisition of
SARS-CoV 2.
Biomedical Waste management
Segregation, Packing, Transportation and Storage
• Untreated bio-medical waste should not be mixed with other wastes
• Bio-medical waste shall be segregated into containers or bags at point
of generation (as per BMWM Rules 2016, amendment 2018 & 2019)
• Bio-medical waste containers or bags should be prominently labelled
with biohazard symbol (and other details as per Rules)
• Untreated bio-medical waste must not be stored >48 hrs
• Ensure no spillage occurs during handling and transit of bio-medical
waste
Biomedical Waste management
Conclusions
CONCLUSIONS - What to do to keep
yourself and others safe from COVID-19
• Maintain at least a 1-metre distance between yourself and others to
reduce your risk of infection when they cough, sneeze or speak.
Maintain an even greater distance between yourself and others when
indoors..
• Make wearing a mask a normal part of being around other people.
• The appropriate use, storage and cleaning or disposal are essential
to make masks as effective as possible.
CONCLUSIONS - How to make your
environment safer
• Avoid the 3Cs: spaces that are closed, crowded or involve close
contact.
• Outbreaks have been reported in restaurants, choir practices, fitness classes,
nightclubs, offices and places of worship where people have gathered, often
in crowded indoor settings where they talk loudly, shout, breathe heavily or
sing.
• The risks of getting COVID-19 are higher in crowded and inadequately
ventilated spaces where infected people spend long periods of time together
in close proximity. These environments are where the virus appears to spread
by respiratory droplets or aerosols more efficiently, so taking precautions is
even more important.
CONCLUSIONS - Don’t forget the basics of good hygiene

• Regularly and thoroughly clean your hands with an alcohol-based

hand rub or wash them with soap and water. This eliminates germs
including viruses that may be on your hands.
• Avoid touching your eyes, nose and mouth. Hands touch many
surfaces and can pick up viruses. Once contaminated, hands can
transfer the virus to your eyes, nose or mouth. From there, the virus
can enter your body and infect you.
CONCLUSIONS – Respiratory and Surface
Hygiene
• Cover your mouth and nose with your bent elbow or tissue when
you cough or sneeze. Then dispose of the used tissue immediately
into a closed bin and wash your hands. By following good ‘respiratory
hygiene’, you protect the people around you from viruses, which
cause colds, flu and COVID-19.
• Clean and disinfect surfaces frequently especially those which are
regularly touched, such as door handles, faucets and phone screens.

IPC TRAINING
References.....
• World Health Organization. Director-General's remarks at the media briefing on 2019-nCoV on 11
February 2020. http://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-
media-briefing-on-2019-ncov-on-11-february-2020 (Accessed on February 12, 2020).
• Centers for Disease Control and Prevention. 2019 Novel coronavirus, Wuhan, China. Information
for Healthcare Professionals. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html (Ac-
cessed on February 14, 2020).
• World Health Organization. Novel Coronavirus (2019-nCoV) technical guidance. https://
www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance (Accessed on
February 14, 2020).
• Gorbalenya AE, Baker SC, Baric RS, et al. Severe acute respiratory syndrome-related coronavirus:
The species and its viruses – a statement of the Coronavirus Study Group. bioRxiv 2020. https://
www.biorxiv.org/content/10.1101/2020.02.07.937862v1 (Accessed on February 12, 2020).
• Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019
.N
Engl J Med 2020; 382:727.