Chapter: 16

Infection prevention and control (IPC)

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Outline

 Chapter Overview
 Operational Standards for Infection Prevention and Control (IPC)
 System design for standard hospital-based IPC Activity
 Quality management activities across IPC Program
 Chapter Summary

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 Objectives

By the end of this session, the participants will be able to

 Describe the operational standards of Infection prevention and control
in hospital
 Design a system to implement standard Infection prevention and
control Activity
 Explore quality management practices across Infection prevention and
control

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Activity 16. 1 Think Pair Share
Instruction: Think individually about the activity question below
for 2 minutes and find a partner near you to discuss and share
your thoughts for 3 minutes, then share the discussed points with
the large group orally.
Activity: What are two common ways healthcare-associated
infections (HAIs) can spread in a hospital setting?

Time Allocated: 07 Minute (5 minute for Discussion 2 minute for

presentation)

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Introduction

Healthcare-acquired infections - infections that are acquired in any

healthcare setting during healthcare Services delivery.

The potential for the transmission of infections in the healthcare

setting is high.

Both Patients and HCPs are at risk of acquiring and transmitting

infections

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Introduction …..(2)

Ensuring hospital cleanliness and safety with the introduction of

infection prevention and control (IPC) an important determinant of
quality of care and patient satisfaction.

Federal Ministry of Health (FMOH) has developed national IPC

Policy, strategy and Implementations Guides.

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Operational standards of IPC

1.The hospital has a functional Infection Prevention and Control (IPC) Program

2.The hospital has adapted evidence based IPC guidelines, SOPs and
monitoring tools

3.The hospital has IPC training and education program for its HCWs

4.The hospital has active surveillance for its prioritized HAIs

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 Operational standards of IPC…

5. The hospital implements multimodal strategy to improve

its prioritized IPC interventions

6. The hospital conducts regular monitoring and audit as

well as provide feedback to ensure compliance of
standardized IPC practice

7. The facility has appropriately built facility, materials and

equipment for IPC

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 Operational standards of IPC…

8. Safe injection practices are implemented to minimize

risk to clients, staff and surrounding community

9. The hospital practices safe healthcare waste

management

11. The hospital ensures the cleanliness of healthcare

environment

12. The hospital avails adequate and functional laundry

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Operational standards of IPC…

13. The hospital has proper medical devices

decontamination and reprocessing mechanism

14. The hospital has a monitoring system to ensure

safety of food and water served in the premises

15. The hospital ensures all preventive and post

exposure interventions and procedures are in place in
case of occurrence of occupational risks and hazards
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Activity 16. 2 Individual reflection
Instruction: Think about the activity question below and
reflect on your ideas.
Activity: Reflect on your idea on how to check the presence
of a functional IPC program in the hospital and share your
thoughts in the general discussion.

Time Allocated: 5 Minutes (3 minutes for Discussion, 2

minutes for presentation)

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Implementation
guidance

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1. The hospital has a functional IPC Program

 The activities of the facility-level IPC program should be guided by national

strategies

 The Hospital IPC program at the hospital level should be led by

 Well-trained, dedicated full-time IPC professionals

 Hospitals should have a minimum ratio of one full-time or equivalent IPC

nurse or doctor per 250 beds

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The hospital has functional IPC Program…

 The hospital IPC program should have clearly defined

objectives and operational plans.
 Hospitals should have dedicated budgets to implement

their operations plans.

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 2. The hospital has adapted evidence based IPC
guidelines, SOPs and monitoring tools

 Hospitals should develop/ adapt guidelines and implement for the purpose of
reducing HAI and AMR.

 Guidelines should be evidence-based and reference international or national

standards

 Engagement of stakeholders in the development and production of guidelines

 HCWs should be trained on IPC guideline recommendations

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 2. Evidence-based IPC guidelines, SOPs and
monitoring tools…

 Adherence with these guidelines should be monitored by the IPC focal person
in conjunction with hospital management.

 At a minimum, the hospitals should develop/ adapt 11 standard operating

procedures (SOPs) which mentioned in the EHSIG Guidelines

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 3. IPC Education and Training

 The hospital should have IPC education and training for all healthcare workers

 It should be a part of an overall health facility education strategy

 It should include;

 New employee orientation

 Continuous educational opportunities for existing staff

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Implementation guidance

 The training and education should cover the following

category of human resources.
 IPC focal person and members of the IPC team; all
IPC personnel shall update their competencies
 All healthcare workers should be trained on the
facility-level adapted guidelines/ SOPs
 Other personnel that support health service delivery:

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4. Healthcare associated Infections
(HAIs) Surveillance
 Hospital-level HAI surveillance should;

 conducted based on national HAIs Surveillance

Guide
 Guide IPC interventions and detect outbreaks,
 Providing timely feedback to healthcare workers and
stakeholders.

 Regular reports on healthcare-associated infections

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should be made available to treating clinicians
5. Multimodal Strategies Implementation

 Multimodal strategy consists of Five elements

implemented in an integrated way

Elements of multimodal strategy are;

i. System change
ii. Education and training
iii. Monitoring and audit
iv. Reminders in the workplace or communications;
v. Culture change

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 6. Monitoring, Audit and Feedback

 The hospital should conduct regular monitoring/ audit and timely

feedback of
 IPC standards/IPC best practices
 Compliance with regulations

 Feedback should be provided to all audited persons ,relevant staff

and hospital management and senior administration

 IPC program should also be periodically evaluated

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7. Built Environment, Materials &
Equipment

 Patient care activities should be undertaken in a clean and

hygienic environment

 The following are the minimum requirements for the built

environment, materials, and equipment for proper IPC
practices:

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7. Built Environment, Materials & Equipment…
 Water should always be available from a source on the premises to perform
basic IPC measures

 A minimum of two functional, sanitation facilities should be available for

outpatients and one per 20 beds for inpatient wards;

 Functional hand hygiene facilities should be available at points of care and

toilets

 Sufficient and appropriately labeled bins to health care waste segregation

should be available and used;
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 7. Built Environment, Materials & Equipment…

 Waste should be treated and disposed of safely

 Designed to allow adequate ventilation (natural or mechanical
 Spacing of at least one meter between the edges of beds; and no more than
one patient per bed

 Sufficient and appropriate IPC supplies and equipment;

 Dedicated space/area for performing the decontamination and reprocessing of

medical devices

 Adequate single isolation rooms

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Activity 16.3 Small Group Activity
Instruction:
 Be in group of 3-4 people
 Discuss the topics below in your group and report the work in
the plenary (share group response to the larger groups using
flipchart)
Activity: Discuss the components of
Group I: Standard precautions
Group II: Transmission based precautions
Time Allocated : 10 min for reading, discussion and presentation

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 8. Hand Hygiene

 Some of the basic principles when we implement hand hygiene:

 Guidelines on hand hygiene have to be properly disseminated,

promoted, followed and Every staff member have to be involved
 Best practices on hand hygiene have to be benchmarked

 The culture of providing positive feedback and rewarding role models

 There has to be a culture of Basic orientation/training

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 8. Hand Hygiene…

Hospitals shall ensure The basic infrastructures (minimum requirement):

1.Functional hand washing sinks

2.Functional water container (if there is no running tap water)

3.Water tanker for reserve water during water supply interruptions

4.Functional drainage system

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9. Safe Injection Practices
 Hospitals should ensure basic principles of injection;

 Eliminating unnecessary injections,

 One syringe for one injection,
 Avoided recapping
 Educating patients and the community
 Hospitals should ensure the availability of supplies to make injections safe

 The healthcare provider administering the injection should follow the

procedure and guidance of the injection protocol

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10. Healthcare Waste Management

 Health care waste should be disposed of in a manner that poses minimal

hazard

 Health facilities should ensure that HCWs are safely managed along the
waste stream.

 Waste Management Procedures and principles has a multi-step process

that Involves
 Waste Minimization Segregation
 Handling, Collection, Storage, Transportation,
 Treatment and Disposal
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 11. Environmental Cleaning
 Hospital may use its staff or by contracting out the service to clean the
environment

 The housekeeping department should develop operating procedures or work

plan

 The hospital should have a regular supply of all necessary cleaning materials

 Different areas of the hospital should be cleaned based on;

 The procedure and protocols of the hospital regulations adopted

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12. Laundry service

 Hospitals may provide the laundry service through its own staff or, or may
contract out services to an outside vendor

 Each hospital laundry should develop an operating procedure or work plan for

laundry services.

 The laundry should ensure that there is always an available supply of

detergent and bleach.

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 13. Medical devices decontamination and Processing
Instruments and Reusable Items

 Decisions should be made based on Spaulding categories

 Spaulding classified instruments and patient care devices into three

 Critical
 Semi-critical and
 Non-critical

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NB. Soaking instruments in 0.5% chlorine solution or any other disinfectant before
cleaning is not recommended

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14. Food and Water Safety

 Food safety should be ensured through the provision of adequate, clean

facilities for food preparation and storage.
 The kitchen should have adequate space

 Kitchen staff maintain personal hygiene and health

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Food and Water Safety…

 A committee consisting of representatives from;

 The kitchen,
 Environmental hygiene
 And procurement unit

 Should be created to oversee the delivery of food items for the kitchen.

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 15. Occupational safety

 Hospitals are expected to minimize occupational hazards and ensure

occupational safety practices

 Sharp prick which exposes to blood born infection

 Avail post-exposure prophylaxis (PEP) 24 hrs. a day and seven days a week

 The other service is Preventive interventions for HBV & HCV

 Facilitating vaccination of hospital staff members for HBV

 Ensuring all staff members properly utilize necessary PPE when
needed
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Summary
 The infection and prevention and control has about 15
operational standards that all hospitals shall adhered to

 The surveillance part of infection prevention standard has

big role in identifying hospitals priories problem

 Evidence based infection control has been a key in fighting

hospital acquired infections and AMR

 Hospitals should implement multimodal strategies to

improve prioritized IPC intervention
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THANK YOU!

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