Topic 9

Minimizing infection through improved infection control

Learning objective

Demonstrate the devastating effects of inadequate infection control and know how to minimize the risks of contamination

Knowledge requirements

o know the extent of the problem of infection

o know the main causes and types of infection

Performance requirements

o apply universal precautionso be immunized against Hepatitis Bo use personal protection methodso know what to do if exposedo encourage others to use universal

precautions

What is the urgency?o can no longer rely on antibioticso increased rates of nosocomial infectionso infected patients:

o stay longer in hospitalo dieo treated with more toxic and less effective

drugso prone to surgical site infections

Campaigns to decrease infection rates

o WHO “Clean hands are safer hands” campaign

o Centers for Disease Control and Prevention campaign to prevent antimicrobial resistance in health-care settings

o Institute for Healthcare Improvement “5 million lives” campaign

Main causes of infection

o person-person via hands of health-care providers patients and visitors

o personal equipment (e.g. stethoscopes, personal digital assistants) and clothing

o environmental contaminationo airborne transmissiono carriers on the hospital staffo rare common-source outbreaks

Main types of infections

o urinary track infections usually associated with catheters

o Surgical infectionso blood stream infections associated with the

use of an intravascular deviceo pneumonia associated with ventilators o other sites

Burke J Infection control-a problem for patient safety New Eng Journal of Medicine

Main types of infections

Prevention in hospitals

o visibly clean o increased cleaning during outbreakso use hypochlorite and detergents during

outbreaks

Prevention through handwashing

o how to clean handso rationale for choice of clean hand practiceo technique for hand hygieneo protecting hands from decontaminateso promoting adherence to hand hygiene

guidelines

o gloveso apronso face masks

Protective equipment

o keep handling to a minimum o do not recap needles; bend or break after

useo discard each needle into a sharps

container at the point of useo do not overload a bin if it is fullo do not leave a sharp bin in the reach of

children

Safe disposal of sharps

Performance requirements

o apply universal precautionso be immunized against Hepatitis Bo use personal protection methodso know what to do if exposedo encourage others to use universal

precautions

Act to minimize spread of infection

o before contact with each and every patient:o clean hands before touching a patient o clean hands before an aseptic task

o after contact with each and every patient: o clean hands after any risk of exposure to

body fluidso clean hands after actual patient contacto clean hands after contact with patient

surroundings

o students may routinely observe staff who:

o apply inadequate technique in handwashing o fail to wash handso routinely violate correct infection control

procedures

Encourage others to participate in infection control

Summaryo know the main guidelines in each of the clinical

environments you are assignedo accept responsibility for minimizing opportunities for

infection transmission o let staff know if supplies are inadequate or depletedo educate patients and families/visitors about clean

hands and infection transmissiono ensure patients on precautions have same standard

of care as otherso frequency of entering the roomo monitoring vital signs