Management of infection
prevention and control
Antoinette Barton-Gooden 2013
Objectives
• Discuss the aims of infection control
• Identify the levels of responsibility for infection
prevention and control
• Discuss the advantages of infection control
• Explain the regulatory framework at the national
and organizational levels.
• Identify components of infection prevention &
control.
• Discuss organizational control measures to
protect both patients and healthcare workers.
Introduction
• Is infection control necessary?
• http://rjrnewsonline.com/local/prisoners-atkingston-central-police-lockup-diagnosedwith-tubercolosis
Aim of infection control
• To reduce infection/health care associated
infections (HCAIs)/nosocomial infection (Hospital
acquired).
• These infections increase patients’ suffering and
can prolong the length of hospital stay.
• Many of these infected patients suffer permanent
disability and a significant number die.
• Increasing numbers of infections are being
caused by microbes resistant to conventional
treatments. (WHO Patient Safety Curriculum
Guide: Multi-professional Edition, p.210)
HCAIs
• WHO defines a health care-associated (also called
hospital acquired) infection as an infection acquired in
hospital by a patient who was admitted for a reason
other than that infection and/or 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 that are acquired in the
hospital, but appear only after discharge, as well as
occupational infections among health-care facility staff.
(WHO Patient Safety Curriculum Guide: Multiprofessional Edition, p.210)
It is not all about you!
• Infection control is everyone’s
business.
Regulatory process
• Jamaica: Ministry of Health developed policies about infection
control (2000) and immunization policy to guide health care
facilities and organizations.
– Organizations eg. Hospital, health centres, schools, workplaces.
• Professional associations: training for their stakeholders eg. Nurses,
Doctors, Occupational Safety and Health Administration (OSHA).
• Quality assurance framework within various institutions.
• Centre for Disease Control (USA) have guided the development of
policies.
Scenario
• The infection control practitioner educated the
patient and staff about the transmission route
Clostridium difficile when a case was reported on
the ward.
• While caring for the client, the nurses were
observed to be wearing mask, hair cap, gown,
gloves and hurriedly performed each task
without talking.
• What devices are necessary to ensure infection
control?
Infection prevention & control
committee
• Multidisciplinary membership: Microbiologist,
dietary, housekeeping, laundry, medical,
nursing, pharmacy, Central Sterilization and
Supplies Department, Public health nurses
(PHNs)and inspectors
Infection control functions
•
•
•
•
•
Universal precautions
Development of isolation procedures
Education of all staff
Monitoring and surveillance
Reporting as an element of quality assurance to
the CEO, SMO, Medical Officer of Health and
Nursing Directors.
• Continuous quality improvement by liaising with
all departments to identify problems and
solutions to enhance patient care.
Components of infection prevention &
control
• Isolation: Creation of a barrier, mechanical or
spatial to prevent the transmission of
infectious diseases to or from a patient.
– Adequate personnel assigned to area
– Appropriate equipment and supplies
– Schedule daily routine cleaning and maintenance
– Education of HCW, patients and family regarding
the illness and precautionary measures to be
observed.
Components of infection prevention &
control
• Standard precaution
– Hand washing before, after patient contact ,
immediately after any contact with body fluid,
after covering a sneeze, picking the nares, using
the toilet, after removing gloves, touching
contaminated objects, before preparing
food//handling food, when hands are dirty etc.
– Wear PPE when there is a risk of splashing eg.
Masks, goggles, aprons, closed shoes, gloves, caps
Components of infection prevention &
control
• Transmission based precautions
– Droplet
– Fecal
– blood
Components of infection prevention &
control
• Disinfection & Sterilization: Sterilization is a
procedure which achieves complete
destruction of all microorganisms including
bacteria spores.
• Disinfection: A procedure which removes or
kills most, but not all viable microorganisms.
• Antiseptic: A non toxic ‘disinfectant’ used on
the skin or living tissues. Usually used at a
lower dilution; should not be used to disinfect
instruments or the environment.
Components of infection prevention &
control
• Soiled instruments and surfaces soiled with body fluid
should be disinfected for at least 5 minutes with a fresh
1:10 dilution of a 5% bleach solution or 1:6 dilution of 3%
bleach solution that yields a 0.5% solution or other
effective disinfectant.
• Heavy soiled instruments should be disinfected for 5
minutes with a 1:5 dilution of 5% bleach solution or a 1:3%
bleach solution that yields a 1% solution.
Components of infection prevention &
control
• Housekeeping
– Frequent wiping of floor with bleach
– Blood spillage wiped immediately with bleach
Components of infection prevention &
control
• Health care waste management
– All soiled linen and clothing must be placed in a
clear plastic bag and labelled appropriately before
being sent to the laundry.
– All body waste must be flushed in toilet
– All other infectious waste must be placed in red or
yellow bags.
– Bags should be tied securely and removed for
incineration.
– Puncture resistant container for sharps
Components of infection prevention &
control
• Risk management: Infection control team
– Surveillance
– Outbreak investigations
– Communicable disease reporting
– Education
– Antibiotic utilization and audit
– Committee and consultant involvement
– Regulatory compliance (Hoffmann, 2009)
Components of infection prevention &
control
• Please read classification of wastes and waste
management segregation and packaging
(Ministry of Health (2000): Health Facilities
Infection Control Policies and Procedures
Manual).
Bibliography
• Hoffmann, K.(2009). Developing an infection control
program. http://www.infectioncontroltoday.com/
• Ministry of Health (2000): Health Facilities Infection Control
Policies and Procedures Manual).
• University Hospital of the West Indies (2007): Infection
Control Policy and Procedures Manual.
• WHO (2011) Patient Safety Curriculum Guide: Multiprofessional Edition.
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