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Your Heart…Our Passion
RUSMAWATI KHOSIM
(INFECTION CONTROL NURSE)
INSTITUT JANTUNG NEGARA
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National Heart Institute
(IPSG 5)
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National Heart Institute
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National Heart Institute
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National Heart Institute
INFECTION CONTROL UNIT
All clinical area
(ward, ICU, CCU, Renal unit)
Out patient and emergency department
Engineering and Facilities
department
Pharmacy LaboratoryNon Invasive
Cardiac Lab and ICL
OT CSSD Kitchen
Mortuary
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National Heart Institute
HEALTH CARE ASSOCIATED INFECTION
Healthcare Associated Infection
Blood stream
Infection
Pneumonia
Urinary Tract
Infection
Surgical Site Infection
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National Heart Institute
INFECTION CONTROL
AND
CSSD
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National Heart Institute
CENTRAL STERILE SUPPLY DEPARTMENT
Instrument Processing
Prolong hospital
Stay
Increased Hospital
cost
Cause death
X
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National Heart Institute
CHAIN OF INFECTION
Infectious Agent
Reservoir
Mode
of
escape
Mode of transmission
Portal
of
entry
Susceptible host
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National Heart Institute
CHAIN OF INFECTION
Infectious agent
Prion Parasite Bacteria Virus Fungi
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National Heart Institute
CHAIN OF INFECTION
Reservoir
Places where the micro organism able to multiply
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National Heart Institute
CHAIN OF INFECTION
Mode of escape/Portal of entry
microorganism leave the reservoir, commonly by
respiratory, genitourinary, skin or mucous
membrane
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National Heart Institute
CHAIN OF INFECTION
Mode of transmission
Contact/hands Airborne Vector
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National Heart Institute
CHAIN OF INFECTION
Portal of entry
Digestion Wound Suction Lines
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National Heart Institute
CHAIN OF INFECTION
Immune suppress patient
Invasive procedure
Non intact skin
Susceptible host
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National Heart Institute
BREAKING THE CHAIN
Leadership
Accountability Evidence based guidelines and
regulation incorporated into
policies and procedures
Continuous Training
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National Heart Institute
Decontamination
OR
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National Heart Institute
Decontamination
Infectious Agent
Reservoir
Mode
of
escape
Mode of transmission
Portal
of
entry
Susceptible host X
X
X
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National Heart Institute
Packaging
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National Heart Institute
Packaging
Inspection
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National Heart Institute
Packaging
Packing
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National Heart Institute
Packaging
FIFO
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National Heart Institute
Infectious Agent
Reservoir
Mode
of
escape
Mode of transmission
Portal
of
entry
Susceptible host X
X
Packaging
X
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National Heart Institute
Sterilizer: Daily Maintenance
Autoclave:
Every morning
Before first
load/test
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National Heart Institute
Sterilization: Monitoring
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National Heart Institute
Infectious Agent
Reservoir
Mode
of
escape
Mode of transmission
Portal
of
entry
Susceptible host X
X
Sterilization
X
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National Heart Institute
CDC reported…..
CDC
Surgical site infections are the
most common adverse event for surgical patients
Disinfection and sterilization- surgical
and medical instruments do not transmit infectious
pathogens to patients
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National Heart Institute
ACCREDITATION
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National Heart Institute
Training Staffing
Standardization
Safety Environment
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National Heart Institute
ACCREDITATION
TrainingOrientation, training and competency of the HCW who
process medical equipment, devices and supplies
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National Heart Institute
ACCREDITATION
StaffingLevels of staffing and supervision of HCW who process
medical equipment, devices and supplies
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National Heart Institute
ACCREDITATION
StandardizationStandardization of the process regardless of whether
it is centralized or decentralized
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National Heart Institute
ACCREDITATION
Safety•Continuous nursing education of the CSSD staff :
•Hand hygiene•Personal Protective Equipment
•Spillage, waste, linen and needle stick
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National Heart Institute
ACCREDITATION
EnvironmentRecording of the temperature and humidity in sterile store t
o ensure the sets are kept at the recommended levelAir sampling report after changing of hepa filter in
sterile store
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National Heart Institute
Our Role
• To ensure the nurses are following the procedure of receiving and returning the dirty sets to CSSD
• Cleaning of used equipment are not allowed to be done in the ward (centralized cleaning in CSSD)
Decontamination
• To ensure the CSSD sets are arranged according to FIFO
• Education on the importance of hand hygiene before handling the sterile sets.
Sterile Store
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National Heart Institute
• Regular audit in the wards on the storage of CSSD sets
• To ensure the sterile CSSD set are kept properly in the ward in a dedicated cupboard
Ward
• Air sampling in CSSD sterile store every time the hepa filter is changed.
• Regular audit on the environmental cleanliness of the CSSD working area by CSSD Infection Control Link Nurse
Environment
Our Role
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National Heart Institute
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National Heart Institute
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National Heart Institute
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National Heart Institute
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National Heart Institute
JCI ACCREDITATIONS
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National Heart Institute
JCI ACCREDITATIONS
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National Heart Institute
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National Heart Institute
….THANK YOU