INFECTION CONTROL

IN HOSPITAL

m.vijiyalakshmi
INTRODUCTION

 Hospital infection is also called Nosocomial

infection. It is the single largest factor that
adversely affects both the patient and the hospital.
 The English word Nosocomial is derived from the
Greek NOSOKOMEION meaning "hospital".
NOSOCOM
IAL • >48 hours of
INFECTIO hospitalization
N
COMMUN
ITY • <48 hours of
ACQUIRE admission
D
DEFINITION OF INFECTION:

 Injurious contamination of body or parts of the

body by bacteria, viruses, fungi and protozoa or by
the toxin that they may produce Infection may be
local or generalized and spread throughout the
body.
BASICS OF INFECTION CONTROL

 Prevention of nosocomial infection is the

responsibility of all individuals and services
provided by healthcare setting.
 To practice good asepsis, one should always know
what is dirty, what is clean, what is sterile and keep
them separate.
 Hospital policies & procedures are applied to
prevent spread of infection in hospital
 PRINCIPLES

Client safety in the

health care Infection control
environment practices
Nurses are responsible for Nurses and clients must
protecting clients & be educated
themselves
CHAIN OF INFECTION
MODES OF TRANSMISSION

 Contact transmission
 Airborn transmission
 Vechile transmission
 Vector born transmission
Contact transmission
Airborn transmission
Vechile transmission
Vector born transmission
SURGICAL ASEPSIS

 Bacillocide
 Korsolex
 Cidex
 Savlon
 Sterilium
 Betadine
 Formalin
Asepsis solution component dilution Areas used

bacillocide Formaldehyde 2% in 200 ml of Surfaces and spraying

Glutaraldehyde concentrate in 10 liters rooms
Alkylurea of water
benzalkonium

korsolex Formaldehyde 2%=20ml in 1 liters of Closed door

glutaraldehyde water Window, fan

cidex flutaraldehyde 2% solution Machine in critical

area
salvon Cetrimide 1:100- equipment -
Chlorhexidine 1:30- treating dirty
gluconate wound, catheters or
Isopropyle alcohol thermometer

sterlium Propanolol - Disinfection of hands

Ethyl hexadechyle
dimethyl amomnium
ethyl surfate

betadine 7.5% solution of - Skin preparation and

povidine wound care
formalin 40% of formaldehyde - fumigation
PREVENTION

 Fumigation:-
Doors, windows, walls and floors are scrubbed
thoroughly with soap and water. The Oxygen and
central suction lines are shut off. The fans and air
conditioners are put off.
In centers where excellent housekeeping and aseptic
routines are maintained, fumigation does not
provide any additional benefit.
Isolation:- is intended to confine the micro-organism
within a given and recognized area
 Respiratory isolation

 Enteric isolation

 Wound and skin isolation

 Blood isolation
BARRIER PROTECTION:
 Materials that protect the health care worker from

infection.
 Gloves

 Mask

 Apron

 Eyewear

 Footwear
HAND WASHING:
 Social hand washing

 Hygienic hand disinfection

 Surgical hand disinfection

HOSPITAL WASTE MANAGEMENT
HOSPITAL INFECTION CONTROL
PROGRAMME
 The main aim of the hospital infection programme is to
lower the risk of an infection during the period of
hospitalization.
THREE ASPECTS
 Development of an effective surveillance system to

know the risk of nosocomial infection.

 Development of policies and procedures to reduce risk

of nosocomial infections.
 Maintenance of continuing education programme from

hospital personnel
RESPONSIBILITY OF HOSPITAL ADMINISTRATOR/ HEAD OF HEALTH CARE
FACILITY

 Provide the funds and resources for infection

control programme
 Ensure a safe and clean environment
 Ensure the availability of safe food and drinking
water
 Ensure the availability of sterile supplies and
material, and
 Establish an infection control committee and team
INFECTION CONTROL
ORGANIZATIONS IN AHOSPITAL

Infection Control Team (ICT)

Each hospital will be having their own infection control
team and commnittee.
 Chairperson- the head of the infection control team.

-The designation of chairperson

-registered doctor may be microbiologist.
 Coordinator- member of infection control team.

-registered doctor
-HOD of surgery, medicine or other dept.
 Surviellent- may be the Nursing superintendent of that

hospital
Functions of infection control team
 Detects, investigates nosocomial infections. Investigation

of environmental problems related to hospital infection.

 Detects community acquired infections in the hospital and

refers to the appropriate

 Authority for follow-up.

 Prompts initiation by physicians of hospitals infection

report.
 Assist in development and review of infection control

procedures, to be forwarded to the central committee

annually.
 Monitoring the hospital policy compliance on isolation

procedures.
Infection Control Committee (ICC)
 The infection control committee includes all the in

charge staffs of all the department of hospital like

medical, nursing, paramedical, class four workers
etc. The infection control officer is the member
secretary. The committee meets regularly and not
less than three times a year.
FUNCTIONS OF ICC
The committee will:
 Conduct periodic review of statistics on nosocomial

infections.
 Carry out evaluation of routine surveillance activities

including reports on bacteriological swab counts of critical

areas surveyed.
 Supervise epidemiological investigations.

 Review current policies.

 Convey infection control information to hospital staff

Infection Control Officer (ICO)
The Infection Control Officer is usually a medical microbiologist
or any other physician with an interest in hospital associated
infections.
Functions
 Secretary of infection Control Committee and responsible for

recording minutes and arranging meetings;

 Consultant member of ICC and leader of ICT

 Identification and reporting of pathogens and their antibiotic

sensitivity.
 Regular analysis and dissemination of antibiotic resistance

data, emerging pathogens and unusual laboratory findings.

 Initiating surveillance of hospital infections and detection of

outbreaks.
 Investigation of outbreaks, and Training and education in

infection control procedures and practice.

Infection Control Doctor (ICD)
 The ICD must be a registered medical practitioner.

 Hospital consultants in other disciplines (e.g.

infectious diseases) may be appointed. Irrespective

of their professional background, the ICD should
have knowledge and experience in asepsis, hospital
epidemiology, infectious disease, microbiology,
sterilization and disinfection, and surveillance. It is
recommended that one ICD is required for every
1,000 beds.
Role and responsibilities of the ICD
 Serves as a specialist advisor and takes a leading role in

the effective functioning of the ICT.

 Should be an active member of the hospital Infection

Control Committee (ICC) and may act as its Chairman.

 Assists the hospital ICC in drawing up annual plans,

policies and long-termprogrammes for the prevention of

hospital infection.
 Advises the chief executive/hospital administrator

directly on all aspects of infection control in the hospital

and on the implementation of agreed policies.
 Participates in the preparation of tender documents for the

support services and advises on infection control aspects.

Infection Control Nurse (ICN)
 sufficiently senior and experienced full- time nurse,

with special training in hospital infection control

activities. In very large hospitals, there should be at
least one infection control nurse for every 250
beds.
TASKS OF INFECTION CONTROL
NURSE
Activities will include the following.
 Daily visit to all wards and patient holding units.

 Checking ward sister's report register for tell-tale

records suggestive of infection.

 Collection and tabulation of daily data of incidence

of hospital infection.
- the identification and location of the patient
- the type of infection
- the cultures taken and the results
- antibiotics administered
 Ensuring that the samples are collected and
despatched to the laboratory in time.
 Laboratory records are an important surveillance
tool and data source.
 Initiating the hospital infection control form while
documenting for nosocomial infections, the
registration form used should be different from the
routine investigation forms, so that minimum time
is wasted in getting the culture and sensitivity
reports.
 Compilation of ward wise, descipline wise or
procedure wise statistics.
Infection Control Manual (ICM)
 It is recommended that each hospital develops its

own infection control manual based upon existing

documents but modified, for local circumstances
and risks
EFFECTIVE CONTROL MEASURES

 People  Prevention of Injuries.

 Aseptic Techniques  Outpatient Department
 Segregation of  Dietary service
contaminated  Handling the laboratory
Instruments specimens
 Isolation policy  Handling the blood spills
 Masking and Gowning  Housekeeping routines
and Glowing
 Disinfection Practices
 Sterilization Practices
Post exposure protocol for needle stick injury
 Don't panic.

 Don't squeeze the injured site

 Wash with soap and water immediately.

 Report to the casualty and provide proper history of

exposure for immunization.

Post exposure protocol regimen for HIV
 (Basic regimen) Zidovudine [There is risk for79% of

infection] (Expanded regimen) It goes for 28 days +

basic regimen
Post exposure prophylaxis regimen for Hepatitis
infection
 If vaccinated no problem.

 If not vaccinated previously take Immunoglobulin's

immediately then take hepatitis vaccine regimen for 6

months.
Handling the laboratory specimens
 The specimens should be collected in screw capped plastic

disposable container without soiling laboratory forms.

 Never pipette blood or other body fluid with your mouth.

Handling the blood spills

 The spill should be covered with cotton, news paper or other

absorbent material.
 Pour 1% of Hydro chlorate solution or bleach solution over the spill

 Wipe the spill soaked area after 20 minutes.

 Discard the soiled materials in a polythene lined waste bag(red bag)

 The soiled floor should be cleaned with the detergents.

Housekeeping routines
 Dry dusting and sweeping should be avoided; it is

preferable to vacuum cleaner to suck the dust from the

floor, walls and equipments.
 Wet mopping of floors with soap and water containing

3% phenol should be carried out at least thrice daily

 The waxing of surfaces and use of oil in water for

mopping may limit Dissemination of microorganisms.

 The walls should be wiped or sprayed with 2%

bacillocide once a week

POLICY GUIDELINES RELATED TO
INFECTION CONTROL

Recommended Standards
 Physical Setup

 Administrative arrangement
Physical Setup

Space
 Each infant care space in the Neonatal Intensive Care

Unit shall preferably contain a minimum of 11.2

square meters (120 square feet), excluding sinks and
aisles
 There shall be an aisle adjacent to each infant care

space with a minimum width of 0.9 meters (3 feet).

 Traffic to other services shall not pass through the unit

 
Ventilation
 A minimum of 6 air changes per hour is required for

the NICU, with a minimum of 2 changes being outside

air.
 The ventilation pattern shall inhibit particulate matter

from moving freely in the space and intake and

exhaust vents shall be situated as to minimize drafts on
or near the infant beds.
 Ventilation air delivered to the NICU shall be filtered

with at least 90 % efficiency.

Scrub Areas
 In the NICU, there should be at least 1 hands-free

hand washing sink for 4 beds.

 In single bedroom, a hands-free hand washing sink

shall be provided within each infant care room.

 Sinks for hand washing should not be built into

counters used for other purposes

Air-borne isolation Room(s)
 Isolation rooms adequately designed to care for

airborne infection should be available in any

hospital with an NICU.
 Isolation rooms should have a minimum of 13.94

sq metre (150 square feet) of clear space, excluding

the entry work area. Single and multi-bedded
configurations are appropriate based on use.
II. Administrative arrangement

Surveillance for Nosocomial infection

 With appropriate resources allocated from the

hospital, the infection control committee of each

hospital should work with perinatal care personnel
to establish workable definitions of nosocomial
infection for surveillance purposes, with particular
reference to the definitions/ guidelines set out by
this Working Group.
 The definition selected should be applied
consistently to allow uniform reporting and
analysis of nosocomial infections
 With appropriate resources from the Hospital,
NICU personnel should cooperate with hospital
infection control personnel in conducting and
reviewing the results of surveillance programs for
nosocomial infections in a confidential manner.
 Prevention and Control of Infections
 Staff Health
 Hand washing
 Sibling Visits
 Dress Code
 General Housekeeping
 Cleaning & Disinfecting Patient Care
 Neonatal Linen - clean and soiled
 Soiled Linen
 Laundering
 Catheter-related sepsis
Role of infection control nurse
 Conduct daily ward rounds to inspect the documentation
on infection control measures.
 Educate the nursing staff on the infection control
practices set forth by the hospital.
 Provide feedback on instances of any communicable
diseases reported by head nurses.
 Assess and evaluate the isolation protocol done by the
unit staff.
 Detection of incidence of hospital acquired infection
and identification of the cause of infection.
 Ensure that all hospital employees are vaccinated
against infectious diseases, as per hospital policy.
 Participate in regular infection control committee
meetings to evaluate the situation at any given
time.
SUMMARY:

 Till now we have seen about infection control, its

principles, chain of infection, infection
transmission, surgical asepsis, prevention of
infection, hospital infection control programs, role
of infection control nurse.
CONCLUSION:

 Infection control refers to the policy and

procedures implemented to control and minimize
the dissemination of infections in hospitals and
other healthcare settings with the main purpose of
reducing infection rates.
To analyze the performance and influencing factors of
Infection Prevention Control Nurses (IPCN).

Method
This research used a descriptive cross-sectional design. A total of 32 IPCN
working in several hospitals in Indonesia were recruited. All nurses are
members of the Nurses Association of Infection Prevention Control. The
participants completed an online questionnaire, which was created by
using Google Form and the link was distributed through a WhatsApp
Group.
Results
 The performance criteria score of IPCN was 50% poor and 50% well.

Moreover, the reward is the most factors related to IPCN performance.

Odds Ratio (OR) of the reward variable was 27.5, which means that a
good reward had 28 a good chance to improve the performance compared
to IPCN which received fewer rewards after controlling of other variables.
BIBLIOGRAPHY

BOOK REFERENCE:
 Jogindra Vati,”Nursing Management Administration”,Jaypee

Brother Medical Publishers (P),2013, New Delhi, Pg.No:94-

105
 Deepak,”a comprehensive Textbookon nursing

Management”,EMMESS publications, 2nd edition, Pg

no:552-565.
NET REFERENCE:
 https://www.emccochin.com/facilities-service /role-infection-

control-nurse.
