Topic 9

1. Topic 9 Minimizing infection through improved infection control

2. LEARNING OBJECTIVE Demonstrate the devastating effects of inadequate infection control and know how to minimize the risks of contamination

3. KNOWLEDGE REQUIREMENTS • know the extent of the problem of infection • know the main causes and types of infection

4. PERFORMANCE REQUIREMENTS • apply universal precautions • be immunized against Hepatitis B • use personal protection methods • know what to do if exposed • encourage others to use universal precautions

5. WHAT IS THE URGENCY? • can no longer rely on antibiotics • increased rates of nosocomial infections • infected patients: • stay longer in hospital • die • treated with more toxic and less effective drugs • prone to surgical site infections

6. CAMPAIGNS TO DECREASE INFECTION RATES • WHO “Clean hands are safer hands” campaign • Centers for Disease Control and Prevention campaign to prevent antimicrobial resistance in health-care settings • Institute for Healthcare Improvement “5 million lives” campaign

7. MAIN CAUSES OF INFECTION • person-person via hands of health-care providers patients and visitors • personal equipment (e.g. stethoscopes, personal digital assistants) and clothing • environmental contamination • airborne transmission • carriers on the hospital staff • rare common-source outbreaks

8. MAIN TYPES OF INFECTIONS • urinary track infections usually associated with catheters • Surgical infections • blood stream infections associated with the use of an intravascular device • pneumonia associated with ventilators • other sites

9. MAIN TYPES OF INFECTIONS Burke J Infection control-a problem for patient safety New Eng Journal of Medicine

10. PREVENTION IN HOSPITALS • visibly clean • increased cleaning during outbreaks • use hypochlorite and detergents during outbreaks

11. Prevention through handwashing • how to clean hands • rationale for choice of clean hand practice • technique for hand hygiene • protecting hands from decontaminates • promoting adherence to hand hygiene guidelines

12. PROTECTIVE EQUIPMENT • gloves • aprons • face masks

13. SAFE DISPOSAL OF SHARPS • keep handling to a minimum • do not recap needles; bend or break after use • discard each needle into a sharps container at the point of use • do not overload a bin if it is full • do not leave a sharp bin in the reach of children

14. PERFORMANCE REQUIREMENTS • apply universal precautions • be immunized against Hepatitis B • use personal protection methods • know what to do if exposed • encourage others to use universal precautions

15. ACT TO MINIMIZE SPREAD OF INFECTION • before contact with each and every patient: • clean hands before touching a patient • clean hands before an aseptic task • after contact with each and every patient: • clean hands after any risk of exposure to body fluids • clean hands after actual patient contact • clean hands after contact with patient surroundings

16. ENCOURAGE OTHERS TO PARTICIPATE IN INFECTION CONTROL • students may routinely observe staff who: • apply inadequate technique in handwashing • fail to wash hands • routinely violate correct infection control procedures

17. SUMMARY • know the main guidelines in each of the clinical environments you are assigned • accept responsibility for minimizing opportunities for infection transmission • let staff know if supplies are inadequate or depleted • educate patients and families/visitors about clean hands and infection transmission • ensure patients on precautions have same standard of care as others • frequency of entering the room • monitoring vital signs