UNIVERSITY CLINIC, U.E.

W
Presentation on
INFECTION PREVENTION AND CONTROL

Mrs Happy Kpodo

Physician Assistant

OBJECTIVES
At the end of this session, the participants will be able
to:

Verbalize definitions related to infection control

List modes of transmission of infections and portals of
entry of bacteria
Explain universal precautions
Explain the workers role in preventing spread of infections
Demonstrate proper hand washing techniques, application
and removal of gloves
Describe appropriate techniques for cleaning up spills
12/2/15

DEFINITIONS

Infection control the set of methods used to control and

prevent the spread of disease

Infections - are caused by pathogens (germs)

Communicable disease disease spread from one person

to another

Infectious disease disease caused by a pathogen (germ

or bacteria)
12/2/15

DEFINITIONS

Contaminated means dirty, soiled, unclean

Disinfection cleaning so that germs (pathogens) are

destroyed

Mode of transmission the way germs are passed

from one person to another

Mucous membranes membranes that line body

cavities that open to the outside of the body
12/2/15

MODES OF TRANSMISSION

Body fluids tears, saliva, sputum (mucus coughed

up), urine, feces, semen, vaginal secretions, pus or
other wound drainage, blood

Touching the infected person or their secretions

Touching something contaminated by the infected

person.

12/2/15

PORTALS OF ENTRY

Any body opening of an uninfected

person which allows pathogens to enter

Nose, mouth, eyes, rectum, genitals

and other mucous membranes

Cuts, abrasions or breaks in the skin

12/2/15

WHO IS AT RISK??

Anyone whose resistance to disease decreases

Reasons for lowered resistance: age, existing
illnesses, fatigue and stress
The elderly have weaker immune systems and
a lower resistance to pathogens
Elderly are hospitalized more often, increasing
the chance for hospital-acquired infections
Recovery longer in the elderly
12/2/15

What is infection prevention and

control?
8

Infection prevention and control measures aim to ensure the

protection of those who might be vulnerable to acquiring an
infection both in the general community and while receiving
care due to health problems, in a range of settings.

The basic principle of infection prevention and control is

hygiene.

What is Infection Control?

Worker to
Worker
Visitor
Patient

Patient to
Worker
Visitor
Patient

Visitor to
Worker
Visitor
Patient

HOSPITAL/ HEALTH CARE ACQUIRED INFECTIONS

(Nosocomial Infections)
10

Infections which were neither present nor

incubating at the time of admission

Includes infections which only become apparent

after discharge from hospital but which were
acquired during hospitalisation

Also includes occupational infections among staf

Factors increasing risk of infections

11

Clients entering the Hospital are at a high risk of acquiring

infections because;
Decreased resistance, either as a result of the clients
underlying illness or as a result of specific course of
therapy.
Other factors increasing the risk of infection include

increased exposure to types and numbers of disease causing

microbes,
invasive procedures to be performed.
Overcrowding
Staf shortages
Poor structures to support IPC practices

Impacts of Health Care-Associated

Infections (HAI)
HAI can:
Increase patients suffering.
Lead to permanent disability.
Lead to death.
Prolong hospital stay.
Increase need for a higher level of care.
Increase the costs to patients and hospitals.

PRINCIPLES OF INFECTION CONTROL

13

AIM- is to break the links in the chain/cycle of

infection thus reducing the likelihood of spread.

This process employs control measures known as

Standard Infection Control Precautions .

Additional/ Expanded/ Transmission-based (contact,

droplet and airborne precautions)

Determinants of Prevention

Successful prevention depends upon:

a knowledge of causation,
dynamics of transmission,
identification of risk factors and risk groups,
availability of prophylactic or early detection and treatment
measures,
an organization for applying these measures to appropriate
persons or groups, and
continuous evaluation of and development of procedures
applied

Standard Precautions
15

Because it is not always possible to tell who is infected,

these practices should be the approach for the care of
all patients all the time

Formerly known as universal

precautions

STANDARD PRECAUTIONS
16

Treat every patient/person as a potential biohazard.

Adopt standard infection control practices to protect

patients, self and colleagues from infection.

Use practical, common sense

Standard Precautions

Wear gloves if you may come in contact with blood, body

fluids, secretions and excretions, broken or open skin,
human tissue of mucous membranes

Bag all disposable contaminated supplies

Clean all surfaces that may be contaminated with

infectious waste, such as beds, wheelchairs and shower
chairs
12/2/15

STANDARD PRECAUTIONS
Healthcare workers must treat all
blood & body fluids as infectious.

If it is wet and not yours...use a barrier!

18

STANDARD PRECAUTIONS
19

Hand Hygiene

Aseptic technique

Personal protective

Isolation

Staf health

Linen handling and

disposal

Waste disposal

equipment [PPE]

Preventing/managing sharps
injuries

Spillages of body fluids

Environmental cleaning

Risk management/assessment

Hand Hygiene
20

Types of hand hygiene

3 major types of hand washing

Social/routine
Hygienic
Surgical

hand washing

hand washing
hand wash/scrub

Use of alcohol hand rub

Hand Hygiene
21

Hand washing: For more than 100years, studies

have shown that Hand washing is the single most
effective method to prevent the transmission
of infection.

Hand washing neither requires huge financial

investment nor complex technology

Your 5 moments for HAND HYGIENE

For Effective Hand

Hygiene
23

Fingernails are recommended to be kept short, clean, and

free from nail polish.

Artificial nails should not be worn when performing

invasive procedures or when in contact with patients.

Remove all wrist and hand jewellery. Wearing of jewelry

such as rings and wrist watches allows hoarding of bacteria.

Cover cuts and abrasions with waterproof dressings.

Steps in Hand washing

Areas hands that are frequently

missed during hand washing

Hand Hygiene
26

Drying is an essential part of the hand

hygiene process.

Tissue paper recommended

SINGLE use hand towels

Alcohol Hand Gel

Used as a compliment to handwashing not a replacement

Good for rapid disinfection of skin

Can only be used on physically clean hands

Suitable for use on ward rounds between patients.

Should only be used up to 5 times then wash hands with soap and water

Apply 3-5 mls of Alcohol hand-rub on your palm and

rub vigorously all over the hands for efectiveness.
Efective when alcohol content is at least 60-70%.

How to clean your hands

Personal Protective Equipment (PPE)

Diferent types and combinations of PPEs provide

an individual physical barrier which prevents
contamination

PPE -appropriate only if it does not permit blood or

other potential infectious materials to pass through to
the health workers clothes, uniforms, under garments,
skin, eyes, mouth or other mucous membranes.

Personal Protective Equipment

PPE when contamination or splashing with blood or body

fluids is anticipated
Disposable gloves
Plastic aprons
Face masks
Safety glasses, goggles, visors
Head protection
Foot protection
Fluid repellent gowns

31

Personal Protective Equipment:

Standard Precautions
Gloves:
If contact with blood
or body fluids may
occur

Face mask / eye

protection:
If contact with blood or body
fluids may occur

Gown:
If contact with blood
or body fluids may
occur

Risk Assessment

No risk of contact/splashing with blood/body

fluids - PPE not required

Low or moderate risk of contact/splashing wear gloves and plastic apron

High risk of contact/splashing - wear gloves,

plastic apron, gown, eye/face protection

Sequence for Donning PPE

1.

Gown

2.

Mask or Respirator

www.cdc.gov/ncidod/dhqp/ppe.html

Sequence for Donning PPE

3.

Goggles/Face Shield

4.

Gloves

www.cdc.gov/ncidod/dhqp/ppe.html

Sequence for Removal of

PPE
1.

Gloves

Sequence for Removal of PPE

2.

Goggles/Face Shield

Sequence for Removal of PPE

3.

Gown

Sequence for Removal of PPE

4.

Mask or Respirator

Wrong use of PPE?

Dont forget to WEAR it!

DECONTAMINATION
(Preparing 0.5% bleach solution)
Using liquid bleach
% Chlorine in bleach
---------------------------

- 1 = Parts of water for each part of bleach.

% Chlorine desired

Example: To make a 0.5% chlorine solution from 3.5% bleach

3.5
--------

- 1 = 7 - 1 = 6 parts water for each part of bleach

0.5
Thus to make 0.5% chlorine solution add 1 part bleach to 6 parts water.

DECONTAMINATION
(Preparing 0.5% bleach solution)

Strength of
concentrate (%)

Preparation of 0.5% solution

Using bleach
releasing tablets

Follow the manufactures instructions, since

percentage active chlorine in these products
vary.

3.5

1 part bleach to 6 parts of water

1 part of bleach to 9 parts of water.

1 part to 15 parts of water.

10

1 part of bleach to 19 parts of water.

DISINFECTION WITH
CHLORINE
Solution

Uses

0.05%

Laundry
Plates and eating
utensils
Stethoscopes
(can also use
spirit)

Cleaning And Disinfection Of Surfaces

Safe cleaning of surfaces

Put on clean gloves

Use 0.5% solution and an adsorbent material
Wipe up by cleaning from the outside
(cleanest) to the inside (dirtiest)

SPILLS
Put on clean gloves

Deal with any spills (vomit, blood, excreta or urine) immediately.

Put on clean gloves

Pour Chlorine 0.5% solution in an adsorbent material and cover the spill. Then pour the
chlorine over the adsorbent material. Take care to avoid splash.

Wipe up immediately by cleaning from the outside (cleanest) to the inside (dirtiest)

(Rinse) , Clean with water and soap

Never pick up glass, even with gloved hands

Never pick up glass, even with gloved hands

Dispose of gloves and cleaning equipment and supplies
12/2/15

Linen Handling And

Disposal

Bed making and linen changing techniques

Gloves and apron - handling contaminated

linen

Appropriate laundry bags

Avoid contamination of clean linen

Hazards of on-site ward-based laundering

Aseptic Technique

Sepsis - harmful infection by bacteria

Asepsis - prevention of sepsis

Minimise risk of introducing pathogenic micro-organisms into susceptible

sites

Prevent transfer of potential pathogens from contaminated site to other

sites, patients or staf

Aseptic technique for procedures;

IV lines,
blood transfusions
cathetarization

Sources of Infection during blood

transfusions

Intrinsic contamination
of infusion fluid
Port
for
additiv
es

Connection with
administration set
Insertion site
Injection
ports
Administration set
connection with IV
catheter

Isolation
Protective
Vulnerable patients,
with poor immune
systems.
Patients who may be
receiving chemotherapy
Stop these patients
catching an infection

Source
Patients identified
as carrying bugs
that could cause
other patients to
become ill if it
was passed onto
them.

51

Safe Injection Practices: Why

Safe injection
practices are intended
to prevent
transmission of
infectious diseases
between individuals
AND to prevent
injuries such as

52

Safe Injection Practices Include:

Aseptic technique
Using a single syringe and fluid
infusion sets ONLY once (changing
the needle is not sufficient)
Using single-dose vials when
possible
If multi-dose vials must be used,
then use & store them according to
manufacturer's recommendation

Safe Injection Practices: Fingerstick Devices

Single-use devices

Disposable
Prevent reuse through an auto-disabling feature
Appropriate for settings where assisted monitoring
of blood glucose is performed

Reusable devices

Single-Use Fingerstick
Device
Source: CDC

Often resemble a pen (penlet)

Use not recommended due to problems that have
been observed, including:

Failure to change disposable pieces

Failure to clean and disinfect properly
Links to multiple outbreaks of hepatitis B
Risk for occupational needlestick

Only appropriate for people who do not require

assistance with blood glucose monitoring (BGM)

Reusable Fingerstick
Device
Source: CDC

Blood Glucose Monitoring Best Practices

54

Fingerstick devices should never be

used for more than one person
Select single-use devices that
permanently retract upon puncture

Dedicate blood glucose meters to a

single patient, one person, if possible
If shared, the device should be cleaned
and disinfected after every use, per
manufacturers instructions

Insulin pens and other medication

cartridges and syringes are for singleuse only and should never be used for
more than one person

Preventing/managing sharps injuries

correct disposal in appropriate

container

Avoid bending the needle

avoid breaking the needle

discard syringes as single unit

avoid over-filling sharps container

Wear gloves

Disposal of Sharps

Staff Health

Risk of acquiring and transmitting infection

Acquiring infection

immunisation

cover lesions with waterproof dressings

restrict non-immune/pregnant staf

Transmitting infection

advice when sufering infection

Report accidents/untoward incidents

Needle stick injuries

Waste Disposal
Waste should be sorted and disposed of on appropriate
container
1. Clinical waste

HIGH risk;

potentially/actually contaminated waste including body fluids and human tissue

YELLOW plastic sack, tied prior to incineration

2. Household waste - LOW risk

paper towels, packaging, dead flowers, other waste which is not dangerously contaminated
black plastic sack, tied prior to incineration

3. Hazardous /chemical waste- Brown/Red bins and bin

liners

Pharmaceutical waste.

Waste disposal

Waste disposal

61

In Review

Infections can be transmitted in the hospital setting via

contact, droplet, or airborne spread

Hand hygiene is the single most effective method

and reduces the risk of transmission of pathogenic
organisms

Adherence to Isolation Precautions prevents transmission

of disease to you and to other persons

Appropriate use of PPE and safe handling of sharp

devices can reduce your risk of exposure to blood borne
pathogens

Q&A
63

Thank You!
I don't see the glass as halfempty or half-full.
I see it as a glass somebody else
has already put
their lousy germs on.