Course Code: NUR 240 Lecture ( 3)

1.The Risk of Infection is always Present in every Hospital. 2.Identify frequency of nosocomial infection. 3.List factors influence of infection control. 4.Discuss transmission. 5.Explain basics of infection control. 6.Identify goals for infection control and hospital. epidemiology. 7.Discuss infection control committee. 8.Explain infection control program. OUTLINES

 Patient may acquire infection before admission to the hospital = Community acquired infection.  Patient may get infected inside the hospital = Nosocomial infection.  It includes infections:-  Not present nor incubating at admission.  Infections that appear more than 48 hours after admission.  Those acquired in the hospital but appear after discharge  Also occupational infections among staff. The Risk of Infection is always Present in every Hospital 3

Nosocomial infections occur worldwide. The incidence is about 5-8% of hospitalized patients, 1/3 of which is preventable. The highest frequencies are in East Mediterranean and South-East Asia. A high frequency of N.I. is evidence of poor quality health service delivered. 4

 The microbial agent.  Patient susceptibility.  Environmental factors. 5

Where do nosocomial infection come from? Endogenous infection: When normal patient flora change to pathogenic bacteria because of change of normal habitat, damage of skin and inappropriate antibiotic use. About 50% of N.I. Are caused by this way. Exogenous cross infection: Mainly through hands of healthcare workers, visitors, patients. 6

 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. 7

There are three principal goals for hospital infection control and prevention programs: 1.Protect the patients. 2.Protect the health care workers, visitors, and others in the healthcare environment. 3.Accomplish the previous two goals in a cost effective and cost efficient manner, whenever possible. 8

1.Review and approve surveillance and prevention program. 2.Identify areas for intervention. 3.To assess and promote improved practice at all levels of health facility. 4.To ensure appropriate staff training. 5.Safety management. 6 Development of policies for the prevention and control of infection. 7. To develop its own infection control manual. 8. Monitor and evaluate the performance of program. 9

 It is a multidisciplinary committee responsible for monitoring program policies implementation and recommend corrective actions.  It includes representatives from different concerned hospital departments & management. They meet bimonthly.  It establishes standards for patient care, it reviews and assesses IC reports and identifies areas of intervention. 10

In the majority of countries ICP, typically operates on two levels: an executive body – the infection control team (ICT) – and an advisory body to the hospital management – the infection control committee (ICC) – which adopts the ‘legislative’ role of policy making.

The important components are : 1)Basic measures i.e. standard and additional precautions. 2)Education and training of healthcare workers. 3)Protection of healthcare workers e.g. immunization. 4)Identification of hazards and minimizing risks. 5)Routine practices such as aseptic techniques, handling and use of blood and blood products, waste management, use of single use devices. 1)Surveillance. 2)Incident monitoring. 3)Research.

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Aiming at preventing spread of infection: Standard precautions: these measures must be applied during every patient care, during exposure to any potentially infected material or body fluids as blood and others. Components: A. Hand washing. B. Barrier precautions. C. Sharp disposal. D. Handling of contaminated material. 14

Model good hand washing / hand hygiene practices Encourage others to do the same. Maintain hand hygiene supplies for your area. Maintain soap and paper products for your area. 15

+Hand washing is the single most effective precaution for prevention of infection transmission between patients and staff. +Hand washing with plain soap is mechanical removal of soil and transient bacteria (for sec.) +Hand antisepsis is removal & destroy of transient flora using anti-microbial soap or alcohol based hand rub (for 60 sec.) 16

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Dr. Dalia M. Mohsen18

Dr. Dalia M. Mohsen19