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UNIT-XI INFECTION CONTROL IN CLINICAL SETTING

UNIT-XI INFECTION CONTROL IN CLINICAL SETTING. PRESENTED BY: Mrs. JYOTHI RAO Lecturer MSN Department. LEARNING OBJECTIVES. At the end of the class students will be able to Define N osocomial infection

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UNIT-XI INFECTION CONTROL IN CLINICAL SETTING

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  1. UNIT-XIINFECTION CONTROL IN CLINICAL SETTING PRESENTED BY: Mrs. JYOTHI RAO Lecturer MSN Department

  2. LEARNING OBJECTIVES At the end of the class students will be able to Define Nosocomial infection Explain the types of Nosocomialinfection List down the sources of Nosocomial infection Describe the preventive measures of nosocomial infection

  3. HEALTH CARE ASSOCIATED INFECTION

  4. INTRODUCTION A Nosocomialinfection is defined as an infection that is not present or incubating when a patient is admitted to a hospital or a healthcare facility.Infections are considered Nosocomialif they first appear 48hrs or more after hospital admission or within 30 days after discharge. It isalso called as Hospital acquired infections.

  5. DEFINITION • Health care associated infections(HAIs),formerly called nosocomial or health care acquired infection, results from the delivery of health services in a health care facility. OR • Infection developing in patients after admission to the hospital,which was neither present nor in the incubation period at the time of hospitalization

  6. They occur as a result of invasive procedures, antibiotic administration, the presence of multidrug resistant organism and breaks in infection prevention and control activities • They may become evident during patients stay or after their discharge

  7. RISK FOR INFECTION • Older adults and are poorly nourished • People with lowered resistance to infection because of underlying condition(diabetes/malignancies) • Invasive treatment devices such as intravenous catheter or indwelling catheters. • Critical illness increases patients susceptibility to infections, especially multidrug resistant

  8. MICROORGANISM • Any pathogen on occasion can cause HAI • Bacteria: Streptococcus pyogenes Staphylococcus aureus E.coli Klebsiella Pseudomonas • Virus: HIV ,Hepatitis B&C Viral diarrhoea, chickenpox,herpes virus • Fungi: Candida albicans • Protozoa: Entamoebahistolytica

  9. SOURCES OF INFECTION Endogenous: • Patients own flora may invade patients tissue during some surgical operation or instrumental manipulation • Normal commensals of the skin, respiratory, GI, GU tract

  10. Exogenous: • From another patient/staff member/environment in the hospital • Environmental sources: Inanimate objects,air,water,food • Cross infection from other patients, hospital staff(suffering from infections)

  11. MODE OF TRANSMISSION 1.Contact: Hands or clothing • Hands of staff: Important vehicle of spread • Contact of hands & clothing of attendants Inanimate objects • Improper disinfection of instruments: Endoscope,bronchoscope

  12. 2.Airborne: Droplets • Droplets of respiratory infections transmitted by inhalation Dust • Dust from bedding,floors,wound exudates & skin Aerosol • Aerosol from nebulizer, AC

  13. 3.Oral route: • Hospital food may contain antibiotic resistant bacteria can cause infections 4. Parenteral route: • Disposable syringes & needles • Certain infections may be transmitted by blood transfusion, tissue donation, contaminated blood products

  14. TYPES OF NOSOCOMIAL INFECTION UTI: • Most common HAI • Usually associated with catheterization or instrumentation or instrumentation of urethra, bladder or kidneys • Ex: E.coli • Infection can be prevented by strict asepsis during catheterization

  15. Respiratory infections • Leading cause of mortality in patients suffering from HAI • Aspiration in unconscious patients and pulmonary ventilation or instrumentation may lead to nosocomial pneumonia • Postural drainage is useful in the prevention and management of such cases • Ex: staphylococcus aureus

  16. Wound and skin sepsis: • Follow surgical procedure where causative agents are introduced into the tissue during operation • Higher in elderly patients • Manifest within a week of surgery • Non surgical wounds due to burns, bed sore • Ex: Staphylococusaureus, E.coli

  17. Gastrointestinal infections: • Food poisoning due to salmonella • Enterotoxic manifestation due to staphylococcal contamination of cooked food • Diarrhoea due to E.coli

  18. Bacteremia & Septicemia • Bacterial invasion of blood stream in various HAIs • Mostly caused by infected intravenous cannulae

  19. Tetanus: • Inadequate attention to aseptic precautions during surgery • Use of contaminated dressings or improperly sterilized dressings • Improper disinfection of site of intramuscular injection • Inadequate care while cutting umbilical cord of new born

  20. PREVENTION • Administration of antibiotic therapy to the carrier staff or source patients to destroy the pathogenic agents • Proper sterilization and disinfection of inanimate objects.This helps to control the source of infection. • Disinfection of excreta and infected material is necessary to control the exit point of infection

  21. Transmission can be controlled by regular washing of hands, disinfection of equipment and change o working cloths. • Use of sterile dressings, surgical gloves and face masks contribute in control of nosocomial infection • Preoperative disinfection of patients skin • Proper investigations of HAI and treatment of such cases.

  22. HOSPITAL INFECTION CONTROL • Reduce patient exposure to pathogens • Reduce the number & virulence of nosocomial pathogens • Use of aseptic technique during patient care • Proper isolation of patients known or suspected of harboring infectious diseases • Whenever possible, avoid crowding wards • Use gloves when necessary

  23. Wash hands immediately after glove removal and between patients • Masks, Eye protection, Gown: Wear during activities likely to generate splashes or sprays

  24. Sharps: • Avoid recapping of needles • Avoid removing needles from syringes by hand • Place used sharps in puncture-resistant containers

  25. Ensure clean environment: • Establish policies and procedures to prevent food and water contamination • Establish a regular schedule of hospital cleaning with appropriate disinfectants in, for example, wards, operating theatre, and laundry • Dispose of medical waste safely • Needles and syringes should be incinerated • Other infected waste can be incinerated or autoclaved for landfill disposal

  26. CONCLUSION Nosocomialinfections have a significant impact on the length of hospital stay and medical care cost. Infection control for preventing nosocomial infections may play an important role in reducing medical costs, hospital stay, and mortality in hospitalized patients.

  27. EVALUATION LONG ESSAY 1. a. Define infection b. Explain the chain of infection transmission c. How do you prevent nosocomialinfction? SHORT ESSAY 1. Hospital acquired infection

  28. MCQ’S 1.Hospital acquired infection is also known as • A. Cross infection • B. Disinfection • C. Iatrogenic infection • D. Nosocomial infection

  29. 2. The most effective nursing action for controlling of infection includes • Thorough hand washing • Use of broad spectrum antibiotics • Wearing gloves and mask • Implementing isolation

  30. THANK YOU …..

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