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Prevention & Control Activities. By Prof. OSSAMA RASSLAN. Secretary General, Egyptian Society of Infection Control. Prevention & Control Activities(Outlines). I.C. program Patient care Employee health Environmental hygiene Surveillance of infection. Prevention & Control Activities.
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Prevention & Control Activities By Prof. OSSAMA RASSLAN Secretary General, Egyptian Society of Infection Control
Prevention & Control Activities(Outlines) • I.C. program • Patient care • Employee health • Environmental hygiene • Surveillance of infection Prevention & Control Activities
Prevention & Control Activities (contd.) • Ward specific measures • Disease/ Organism specific measures • Antibiotic policy • Reportable diseases • Isolation policies Prevention & Control Activities
Prevention & Control Activities • I.C. program • Ward sp. measures • Patient care • Ds./Org. sp. measures • Employee health • AB policy • Environm. Hygiene • Reportable diseases • Surveillance of inf. • Isolation policies Prevention & Control Activities
Infection Control Program • Organizational structure • - ICC - ICT • - ICD (ICO) • - ICN - ICLN • For each item: • Membership • Qualifications • Duties • Meeting periodicity Prevention & Control Activities
Patient Care • Handwashing • - Routine • - Surgical (H.W. facilities - antiseptics) • Standard precautions • 1. Protective barriers • 2. Resuscitation facilities • 3. Decontamination (later) • Protective barriers • - Gowns • - Gloves • - Masks • - Eye protection • - Shoe covers Prevention & Control Activities
Patient Care (cont.d) • Invasive Procedures • Wound dressing • Oral alimentation • Other activities • Invasive procedures • - Indwelling urinary • catheters • - IV catheters • - IV injections • - Endoscopy Prevention & Control Activities
Employee health (Occupational health) • Old/ New Employee medical exam. • [Initial (at time of employment) & Periodical] • Exposure to blood, body fluids or tissue • (exposure control plan) • Staff accident or ward related infections • Work restrictions • Education Prevention & Control Activities
Environmental hygiene (Hosp. Env. Control) • Decontamination • Cleaning - Disinfection - Sterilization • Hospital waste management. • - Color coding • - Segregation at source • - Collection • - Transportation • - Storage • - Disposal • - Recycling regular waste • Regular waste • Biohazardous waste • - Identification • - Handling • - Disposal Prevention & Control Activities
Environmental hygiene • Microbiologic sampling • - Not routine • - Outbreak investigation • - Research purposes • Housekeeping policy • Laundry policy • Construction policy • (Construction, design & remodeling measures) Prevention & Control Activities
Environmental hygiene • Sterile water • (for invasive procedures) • Appropriate air supply • (room ventilation) • Proper storage of sterile supply Prevention & Control Activities
Surveillance of infection • Criteria for Nosocomial infections • Surveillance analysis & reporting • A. Elements • - Data collection • - Data collation (consolidated or tabulated) • - Data analysis • - Reporting Prevention & Control Activities
Surveillance of infection • Surveillance analysis & reporting(cont.d) • B. Uses (improvement of outcomes & processes) • - Provide baseline data on infection risk • - Problem identification • - Problem investigation • - Evaluation of control measures • - Evaluation of practices • - Education of HCW • - Research • - Risk management Prevention & Control Activities
Surveillance of infection • Surveillance analysis & reporting(cont.d) • C. Approaches • - Comprehensive, Total • - Priority-directed, Site-specific • - Problem-oriented • (outbreak response surveillance) • D. Worksheets Prevention & Control Activities
Ward specific measures (Dept or unit) • Measures differ according to: • - Site, design & construction of unit • - Function & activity of unit • - Type of patient • - Expected infections& diseases • - Treatment modality (AB, Chemoth.) • - Type of intervention • - Type of case • (long-term, short-term, day care) Prevention & Control Activities
Ward specific measures Where • - O.R. - ICU • - Ped. & Neon. ICU - Pediatrics • - Medical wards - Outpatient clinics • - Surgical wards • - Ante/Postnatal care unit ……..etc • - Laboratory • Construction • Safety • Techniques & investigations • ( e.g. pipetting, cell counting, blood sampling) Prevention & Control Activities
Disease &/or Organism specific measures • Blood borne pathogen • (Prevention precautions - Control) • e.g. HBV, HCV, HIV • T.B. • Pneumonia • MRSA • VRE • Multidrug resistant organisms • Scabies ….etc Prevention & Control Activities
Antibiotic policy • Clinical use • - Therapeutic (Empirical - Targeted) • - Prophylactic • Hospital AB committee • - membership • - meetings • - duties • Education • (better to say: Communication with clinicians) Prevention & Control Activities
Reportable Diseases • Investigation & mgt of major • outbreaks (or clusters)How? • - Diarrhea • - MRSA • - VRE • Notification of communicable disease • How? Prevention & Control Activities
Isolation policies • Enteric isolation • Blood & body fluid isolation • Respiratory isolation • Strict isolation • Contact isolation • Protective isolation Prevention & Control Activities