HOSPITAL INFECTIONS
description
Transcript of HOSPITAL INFECTIONS
HOSPITAL INFECTIONS
Norazli Ghadin
What are Hospital acquired infections
An infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission.
This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility
How and When Hospital acquired infections occur.
Infections are considered Nosocomial if they first appear 48 hours or more after hospital admission or within 30 days after discharge.
Commonly occurring
Microorganisms in Hospital Infections
Common sites associated with etiological agents
Urinary tract Surgical wounds Respiratory tract Skin (especially burns) Blood (bacteraemia) Gastrointestinal tract Central nervous system
Urinary tract Infections Escherichia coli Klebsiella,
Serratia,Proteus spp Pseudomonas
aeruginosa Enterococcus spp Candida albicans
Respiratory Infections Haemophilus
influenzae Streptococcus
pneumonia Staphylococcus
aureus Enterobacteriaceae Respiratory viruses Fungi, Candida spp Aspergillus's spp
Skin sepsis and Wounds Staph aureus Streptococcus
pyogenes E.coli Proteus spp Anaerobic bacteria Enterococcus spp Coagulase negative
Staphylococcus
Gastro Intestinal InfectionsSalmonella
serotypesClostridium
difficileNorwalk like
viruses
Risk Factor
categorized into 3 areas: iatrogenic, organizational, patient-related
Iatrogenic risk Iatrogenic risk factors
include pathogens on the hands of medical personnel, invasive procedures (eg, incubation and extended ventilation, indwelling vascular lines, urine catheterization), and antibiotic use and prophylaxis.
Organizational Organizational risk
factors include contaminated air-conditioning systems, contaminated water systems, and staffing and physical layout of the facility (eg, nurse-to-patient ratio, open beds close together).
Patient associated Patient risk factors
include the severity of illness, underlying immunocompromised state, and length of stay.
Prolonged stay in the hospital is a Major contributing factor
crowding
Routes of Transmission of Infection
Air – borne route From respiratory tract via
talking, coughing, sneezing
From the skin by natural shedding of the skin scales during would dressing or bed making.
From aerosols from equipment, respiratory apparatus, air-conditioning plants.
Doctorrao’s ‘e’ learning series
Contact spread In direct contact spread
from person to person By indirect contact spread
via contaminated hands or equipment.
Clothing of staff, Urinary catheters,
contaminated with hands of the operator may introduce organisms, or patients own flora from urethra may contribute to infection.
Doctorrao’s ‘e’ learning series
Food borne spread From hospital kitchen,
or in special diets, infant feeds, kitchen, or commercial supplies
Mechanical vectors flies, cockroaches or insects, or rodents act as carriers of infection.
Doctorrao’s ‘e’ learning series
Blood borne spread The accidental
transmission of infections as HIV, HBV,and HCV by needle stick injuries is documented
Syphilis and malaria a concern in high prevalence areas
Self Infections and Cross infections
Lower bowel surgery, Self infection may occur
due to flora from nose, Staphylococcus may be introduced into wounds.
Cross infection between patients occur due to spread of Staphylococcus or coli forms
Other contributing factors Not using perfect aseptic technique. Infection from normal flora Defective hospital layout People behavior Cross infection Used of contaminated syringe Antibiotic resistance New pathogen From environment Viral agents
PREVENTION MEASURES
Hospital governor should form an infection control committee.
The committee is consist of Infection control team Infection control nurse
Infection control committee to formulate and
update policies for the whole hospital on all matter which have bearing on infection control and to manage outbreaks of Nosocomial infection
Infection Control Team Which will function
under the guidance of Infection control Doctor.
A Medically qualified Microbiologist, who will take responsibility of day to day for the policies formulated
The Functions of the infection control team
To do surveillance and infection monitoring of hygiene practices.
Educate the Medical and Paramedical staff on policies relating to prevention of infection, and safe procedures
Infection Control Nurse Is the key member of the
team Maintain the close
working relations between Microbiology Laboratory, different clinical services and supportive services like laundry, pharmacy and engineering
All are campaigners of Safe practices
It is the minimal responsibility of the members to campaign on issues related to safe practices including Hand washing
What to be educate?
campaigners of Safe practices Good practice on decontamination &
sterilization Aseptic technique procedure Cleaning & disinfection practice Promote staff awareness & training Use of prophylactic antibiotic where
applicable
preventive methods other than education
Use protective clothing in high risk environment
Isolation of source infection & highly susceptible patient (barrier nursing) Sterile room Trexler isolator
Personnel healthcare Immunization Preventive steps education
OTHERS
Hospital building and Design Routine maintenance of
the Hospital building is important, ensuring that surfaces wherever possible are smooth, impervious and easy to clean.
All constructions around the existsting Hospitals generate fungal spores and bacterial spores with have impact on specialized units serving immunocompromised patients
Monitoring of the Environment ? monitoring of the Air
conditioning plants, and machinery used for disinfection and sterilization is essential
�
Surveillance and Role of Microbiology Laboratories
The detection and identification of hospital infection incidents or outbreaks rely on the laboratory data that alert the infection control team to unusual cluster of infection, called as ‘alert organism’ system.
Surveillance Identification of MRSA &
ESBL and timely information to clinicians will help the ongoing events in the Hospital warrant to track the events on source of outbreaks and action to control the similar situations in future
Efficacy of Infection control The Following measures will certainly control the
infections Sterilization Hand washing Closed drainage systems for urinary catheters. Intravenous catheter care Peri operative antibiotic prophylaxis for
contaminated wounds, and care of equipment used in respiratory therapy.
飈