1. INFECTION PREVENTION

2. INFECTION PREVENTION
It is the collective effort made by health care providers and clients to prevent or minimize the risks of transmitting infections to clients or to other health care providers

3. THE DISEASE TRANSMISSION CYCLE
Susceptible Hosts
Clients
Service Providers
Community
members
Reservoirs
People
Water and solutions
Instruments
Soil and air
Infectious Agents:
Bacteria
Viruses
Fungi
Parasites
Places of Entry
Broken skin
Puncture wound
Surgical site
Mucous
membranes
Places of Exit
Respiratory,
genitourinary,
GIT
Mucous Membranes
Placenta
Modes of
Transmission
Contact
Vehicle
Airborne
Vector

4. EXAMPLE: TRANSMISSION OF HEPATITIS B
Susceptible Hosts
Uninfected
service provider
Reservoir
Chronic hepatitis B
virus
Carrier
Infectious Agents:
Hepatitis B Virus
Places of Entry
Cut on a service
provider’s hand
Places of Exit
Bloodstream
Modes of
Transmission
Vehicle
(surgical instrument)

5. ADVANTAGES OF INFECTION PREVENTION:
Prevents post procedure infections when providing clinical contraceptive methods (eg, IUCDs, implants)
Results in high-quality, safe services
Prevents infections in staff
Protects the community
Prevents the spread of antibiotic-resistant microorganisms
Lowers the cost of health care

6. UNIVERSAL PRECAUTIONS
A simple set of effective practices designed to
protect health workers and patients from
infection with a range of pathogens
Help break the disease-transmission cycle at the
mode of transmission step
These practices are used when caring for all
patients regardless of diagnosis.

7. UNIVERSAL PRECAUTIONS
Wash hands.
Decontaminate equipment and devices.
Use and dispose of needles and sharps safely (avoid recapping, especially two-handed).
Wear protective items.
Promptly clean up blood and body fluid spills.
Use safe disposal systems for waste collection and disposal.

8. HAND WASHING 1 Wash hands After arriving at work
Before and after examining each client
After touching anything that might be contaminated
Before putting on gloves for clinical procedures
After removing gloves
After using the toilet or latrine
Before leaving work

9. HAND WASHING 2 After hand washing Air dry hands
Dry with personal hand towel
Use electric drying machine
Avoid using a communal towel

10. USE OF GLOVES 1 Types of Gloves Surgical gloves
Single-use examination gloves
Utility or heavy-duty household gloves

11. USE OF GLOVES 2
Use separate pair of gloves for each patient
Wear correct size of gloves
Remove rings
Keep nails short

12. USE AND DISPOSAL OF NEEDLES AND OTHER SHARPS 1
Causes of Injuries with Sharps
Recapping hypodermic needles
Manipulating sharps before disposal
Accidentally sticking another staff member
Leaving sharps in areas where they are unexpected
Surgical procedures with limited visibility or in confined spaces
Handling or disposing of waste
Unexpected client motion during injections

13. USE AND DISPOSAL OF NEEDLES AND OTHER SHARPS 2
To Prevent Injuries Due to Sharps
Handle all sharps minimally after use
Use extreme care whenever sharps are handled
Dispose of sharps in puncture-resistant containers
Pass sharps using the “hands-free technique”
Do NOT recap needles

14. Instrument Processing
Decontaminate
Sterilise Chemical High pressure steam Dry heat
High-Level Disinfect
Boil
Steam
Chemical
Clean
Dry/Cool and Store

15. DECONTAMINATION It is the first step in processing items
Makes items safer to handle and easier to clean
Soak items in a 0.5% chlorine solution for 10 minutes immediately after use. Do not soak longer
Replace solution daily or when it becomes heavily contaminated

16. CLEANING Removes blood, body fluids, tissue, and dirt
Reduces the number of microorganisms (including endospores)
Sterilization and HLD may not be effective without proper cleaning

17. STEPS OF CLEANING
Wear utility gloves, goggles, a mask, and protective eyewear
Scrub vigorously with a brush, detergent and water
Guard against injury from sharp objects
Hold items under the water, and be sure to get in the grooves, teeth, and joints
Rinse thoroughly to remove all detergent
Air-dry on a clean towel

18. STERILIZATION Eliminate all microorganisms, including endospores
Recommended when items will come in contact with the bloodstream or tissue under the skin

19. DRY HEAT STERILIZATION
Temperatures 170 °C for 1 hour or 60 °C for 2 hours
It is not necessary to open or disassemble items
Start timing when the oven reaches the desired temperature

20. STEAM STERILIZATION (AUTOCLAVE)
Temperature: 121 °C Pressure: 106 kPa
Time: 20 minutes if unwrapped
30 minutes if wrapped
Wrapped packs can be stored up to 1 week
Unwrapped items should be stored in a sterile or HLD container with a tight fitting lid

21. CHEMICAL STERILIZATION
Gluteraldehyde 2-4% (e.g. cidex): soak for 10hrs minimum
Formaldehyde 8%: soak for 24hrs minimum
After sterilization
Rinse with boiled water and air dry
Store in HLD container with a tight fitting lid

22. HIGH LEVEL DISINFECTION (HLD)
Eliminates all microorganisms, but does not kill all endospores
Use for items that will come in contact with broken skin or intact mucous membranes
Types:
Boiling
Use of chemicals

23. TIPS FOR HLD BY BOILING
Boil for 20 minutes in a cooking pot with a lid
Open or disassemble items
Do not add anything else to the pot after boiling begins
Articles must be completely immersed in water
Start timing when the water begins to boil
Store all items dry and use within one week

24. CHEMICALS FOR USE IN HLD
Chlorine
Cheapest effective disinfectant
Effective against many microorganisms
Can be corrosive and irritating
Prepare a new solution daily
Soak instruments for 20 minutes and rinse in clean water before use

25. CHEMICALS FOR USE IN HLD
Gluteraldehyde
Effective against many microorganisms
Not corrosive when used as directed
Irritating to people
Soak instruments for 20 minutes
Rinse in clan water before use
Use prepared solution for up to two weeks

26. HOUSEKEEPING General cleaning and maintenance of cleanliness
Reduces the number of microorganisms and thus, the risk of infections
Provides an appealing environment

27. GENERAL GUIDELINES FOR HOUSEKEEPING
Schedules should be posted and followed
Wear utility gloves and shoes when cleaning client-care areas
Minimize scattering of dust and dirt
Scrub when cleaning
Wash from top to bottom
Change cleaning solutions when they are dirty

28. ROOM ARRANGEMENT Put everything in the right place
Make all equipment and supplies needed accessible
Arrange the room so that you can move around easily and safely

29. WASTE DISPOSAL Types of Waste
General waste – non hazardous, poses no risk of injury or infection
Medical waste – material generated in a diagnosis, treatment, and/or immunization, including:
Hazardous chemical waste – chemicals that are potentially toxic or poisonous

30. IMPORTANCE OF PROPER WASTE DISPOSAL
Minimizes spread of infection to health workers, patients and the local community
Reduced risk of accidental injury to those who handle the waste
Reduced likelihood of contamination of soil, ground water, etc.
Reduces attraction of insects and rodents
Reduced bad smell.

31. GUIDELINES FOR DISPOSAL OF MEDICAL WASTE
use washable, leak-proof containers
keep containers in convenient places
empty containers daily or when three-quarters full
never put hands into containers
Always dispose of medical waste correctly
Wear utility gloves and shoes
Wash the gloves and your hands afterward

32. COLOUR CODING FOR WASTE SEGREGATION
Category
Example
Colour of bin
Non-infectious
Papers, food cartons,
Black
Infectious
Gloves, dressings, body fluids
Yellow
Highly infectious
Anatomical waste
Red

33. Medical Waste Segregation

34. DISPOSAL PROCEDURES FOR SHARPS
Dispose of all sharps in puncture-resistant containers
Close containers when three-quarters full
Burn or bury the container
Wash the gloves and hands afterward