UNDP GEF Project on Global Healthcare Waste
INSTRUCTOR GUIDE
MODULE 25: HOSPITAL HYGIENE , INFECTION CONTROL AND HEALTHCARE WASTE MANAGEMENT
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UNDP GEF Project on Global Healthcare Waste
MODULE 25: HOSPITAL HYGIENE, INFECTION CONTROL AND HEALTHCARE WASTE
MANAGEMENT
Estimated Time
Module Overview
Learning Objectives
Target Audience
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Lecture: 1 hour
Explain the importance of hospital hygiene
Describe nosocomial infections, their sources, and routes of transmission
Present standard and transmission-based precautions for infection control
Describe cleaning, disinfection, sterilization, and hand hygiene
Present measures to improve infection control
Describe components of an infection control program
Understand the problem of nosocomial infections and how to prevent them
Understand basic concepts of cleaning, disinfection, and sterilization
Describe hand hygiene procedures
Understand the link between infection control and healthcare waste management
Administrative personnel
HCWM coordinators
Facility managers
Infection control and prevention officers and members of the Infection Control or
Nosocomial Infection Control Committee
Healthcare professionals
Healthcare waste workers and housekeeping/cleaning staff (Note: Presentation
slides should be adjusted to fit the needs of waste workers and cleaners.)
Facility support staff including central sterile supply staff and engineering staff
involved in maintenance of sterilization equipment
Other positions within facility
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UNDP GEF Project on Global Healthcare Waste
Instructor Preparation
Materials Needed
Student Preparation
Review Questions
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Make notes pages of PowerPoint slides to hand out to class
Look over any other materials included in the References
Make copies of any additional documents/readings that may be handed out to class,
such as those included in the References
Prepare any additional notes to be discussed during the presentation
Prepare any additional discussion points or review questions
You may add any further information on patient safety.
Projector
Student handouts: slides, exercise, homework
Flip chart and marker pens and/or board and chalk
Read Chapter 12 in the Blue Book
What are the potential routes of disease transmission and how can they be
eliminated?
What are the main components of the infection control program of your facility?
Discuss any available surveillance data related to nosocomial infections in your
facility?
What are your specific responsibilities regarding hospital hygiene and infection
control?
What areas of patient safety would you like to focus on in your facility? What are the
barriers to patient safety?
How can proper health care waste management minimize disease transmission?
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UNDP GEF Project on Global Healthcare Waste
PRESENTATION
Slide
Number/Title
Slide 1: Title Slide
Slide 2: Module
Overview
Slide 3: Learning
Objectives
Slide 4: Guiding
Principles
Slide 5: Why Hospital
Hygiene?
Slide 6: Nosocomial
Infections
Slide 7: Common
Sites of
Nosocomial
Infections
Slide 8: Examples of
Sources of
Nosocomial
Infections
Slide 9: Examples of
Nosocomial Agents
From Environmental
Sources
Slide 10: Examples of
Nosocomial Agents
By Type of Infection
Teacher’s Notes
Introduce the outline and major points of the presentation
Describe what participants will learn at the end of this module.
Healthcare waste management is an integral part of hospital hygiene and infection control
Pathogens can be found on many surfaces.
Nosocomial infections are also known as hospital-acquired infections, hospital-associated infections and
hospital infections. They are infections that are not present in the patient at the time of admission to a
healthcare facility, but develop during the course of the patient’s stay.
You may ask for examples from the students.
There may be other infections that occur in your region or at specific facilities that are not listed here
and in the following slides, and which you may wish to include in the presentation.
You may ask students for examples of cases in their facility.
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UNDP GEF Project on Global Healthcare Waste
Slide 11: Antibiotic
Resistant
Microorganisms
Slide 12: Routes of
Transmission of
Nosocomial
Infections
Slide 13: Routes of
Transmission of
Nosocomial
Infections
Slide 14: Spread of
Nosocomial
Infections
Antibiotic resistant microorganisms are becoming an increasing problem in healthcare
Routes of transmission include:
-contact
-blood borne
-vector
-droplet
-airborne
Many of the listed diseases can spread by more than one route. The figure shows only a few of the
many diseases that may be transmitted within a health-care facility.
Source: Diagram from Blue Book
Slide 15: Guiding
Principles
Slide 16: Chain of
infection
Knowing the chain of infection helps identify effective points to prevent disease transmission.
http://www.hjulmandweb.dk/HCRWCD/Gauteng%20HCW%20Project/13%20External%20Docs%20%28WHO,%20etc.%29/himpacts.pdf
http://faculty.ccc.edu/tr-infectioncontrol/chain.htm
Use the above links to :
Describe the transmission of infections via the chain of infection.
Describe the significance of the chain of infection to implement control measures and protect workers
(that is, to break the chain of infection).
Can participants think of any examples of interventions?
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UNDP GEF Project on Global Healthcare Waste
Slide 17: Standard
Precautions
Slide 18:
Transmission-Based
Precautions
Slide 19: Some
Standards of Hospital
Hygiene
Slide 20: Cleaning
Slide 21: Sterilization
and Disinfection
Slide 22: Methods for
Sterilization and
Disinfection
Slide 23: Main
Chemical
Disinfectants
Slide 24: Main
Chemical
Disinfectants
Slide 25: Main
Chemical
Disinfectants
Slide 26: Hand
Hygiene
Cleaning is the most basic measure for maintaining hygiene in a healthcare facility.
Major chemical disinfecting agents, their spectrum, uses, advantages, and disadvantages are displayed
in the chart covering the following three slides.
Review proper hand hygiene techniques
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UNDP GEF Project on Global Healthcare Waste
Slide 27: Hand
Hygiene Diagram
As the hands of healthcare workers are the most frequent vehicle of hospital infections, hand hygiene,
including both hand washing and hand disinfection, is the primary preventive measure.
Thorough hand washing with adequate quantities of water and soap removes more than 90% of the
transient bacteria/flora, including all or most contaminants.
Killing all transient flora with all contaminants within a short time (a few seconds) necessitates
hygienic hand disinfection: only alcohol or alcoholic preparations act sufficiently fast. Hands should be
disinfected with alcohol when an infected tissue or body fluid is touched without gloves.
Slide 28: Hand
Hygiene
Slide 29: Hand
Hygiene Technique
with Soap and Water
Recommended
Duration: 40-60
seconds
Slide 30: Hand
Hygiene Technique
with Alcohol-Based
Formulation
Recommended
Duration: 20-30
seconds
Slide 31-32:
Measures for
Improving Infection
Control
Slide 33: Measures
for Improving
Infection Control
Go over wasteful practices that should be eliminated in order to improve infection control.
No-cost measures: using good infection control practices
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UNDP GEF Project on Global Healthcare Waste
Slide 34-35:
Measures for
Improving Infection
Control
Slide 36: Infection
Control Program
Slide 37: Infection
Control Program
Slide 38: Review
questions and
discussion
References (in order
as they appear in
slides)
Low-cost measures: cost-effective practices
Generate a discussion based off these questions.
Blue Book, Chapter 12
Nursing Times.net: “Standard Principles: Hospital Environmental Hygiene and Hand Hygiene.”
http://www.nursingtimes.net/nursing-practice/clinical-zones/infection-control/standardprincipleshospital-environmental-hygiene-and-hand-hygiene/291499.article
Institut de veille sanitaire Enquête nationale de prévalence des infections nosocomiales, France, juin
2006, Vol. 1, Tableau 31, p. 24.
WHO: Review of Health Impacts from Microbiological Hazards in Health-Care Wastes.
http://www.who.int/water_sanitation_health/medicalwaste/en/microbhazards0306.pdf
Infection Control for Nursing Students: Chain of Infection.
http://faculty.ccc.edu/tr-infectioncontrol/chain.htm
WHO: Standard Precautions in Healthcare. Infection Control, October 2007.
http://www.who.int/csr/resources/publications/EPR_AM2_E7.pdf
WHO Guidelines on Hand Hygiene in Health Care, 2009.
http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf
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