INFECTION CONTROL
INFECTION CONTROL
INTRODUCTION:
Infection
involves interaction between the animal body (host) and the injecting
microorganism. Practice or techniques that prevent transmission of infection
protect clients and health care workers from disease. Clients in all health
care setting are at risks for acquiring infections because of lower resistance
to infectious microorganisms, increase exposure to numbers and types of disease
and causing microorganisms and invasive procedures.
NATURE
OF INFECTION:
An
infection is the entry and multiplication of an infectious agent in the tissue
of a host.
-
If the infectious agent
(pathogen) fails to cause injury to cells or tissues, the pathogen is
colonizing the cells or tissues without causing harm.
-
If the pathogens multiply and
cause clinical signs and symptoms, the infection is symptomatic.
-
If the infectious disease can
be transmitted directly from one person to another, it is a communicable or
contagious disease.
DEFINITION:
- According to
Bailliere’s Nurses Dictionary
Infection is the invasion
and multiplication of microorganisms in body tissues, specially that causing
local cellular injury due to competitive metabolism, toxins, intracellular
replication or antigen-antibody response.
- Brunner And
Suddarth’s; 9th Edition; Page no. 1870
Infection is a condition
in which the host interacts physiologically and immunologically with a
microorganism.
- Potter & Perry; 5th
Edition; Page no. 149
An infection is the
invasion of a susceptible host by pathogens or microorganisms resulting in disease.
EPIDEMIOLOGY
OF INFECTION:
The occurance and
manifestation of any disease whether communicable or non-communicable are
determine by the interactions between the agent, the host and the environment,
which together constitute the epidemiological triad.
Agent:
The first link in the
chain of infection transmission is agent, which is defined as a substance,
living or non living. A disease may have a single agent, a number of
independent alternative agents or a complex of two or more factors whose
combine presence is essential for the development of disease.
Agent
may be classified broadly into following groups:
- Biological agent: fungi, bacteria, protozoa, viruses, etc.
- Nutrient agent: protein, fat, carbohydrates, vitamins, minerals
and water. Any excess or deficiency of the nutritive elements may result
in nutritional disorders like PEM, anemia, goiter, obesity, etc.
- Physical agent: exposure to excessive heat, cold, pressure,
radiation, electricity may result in illness.
- Chemical agents:
a)
Endogenous: some of the
chemicals may be produced in the body as a result of disarrangement of function
e.g. serum bilirubin (jaundice), urea (uremia), calcium carbonate (kidney
stones), etc.
b)
Exogenous: agent arising
outside of human host e.g. fumes, dust, gases, etc.
- Mechanical agents: exposure to chronic friction and other
mechanical forces may result in crushing, tearing, dislocation, and even
death.
- Social agent: poverty, smoking, drug and alcohol abuse,
unhealthy lifestyles, social isolation and maternal deprivation.
Host:
The host is the man
itself. In some situation host factors play a major role in determining the
outcome of an individual’s exposure to infection. The host factors may be
classified as:
- Demographic characteristics: age, sex, race.
- Biological characteristics: genetic factor, blood group,
enzymes, immunological factors etc.
- Socio-economic characteristics: economic status, social class,
religion, education, occupation, marital status, housing, etc.
- Lifestyle: living habits, food habits, physical activity,
personal hygiene, use of alcohol, tobacco, drugs, etc.
Environment:
The environment of man is
of two types – internal and external.
Internal environment – is comprised by the
various tissues, organs and organ systems within the human body.
External environment – is defined as “all
that, which is external to the individual human host.”
Generally
we study the environment under three headings –
- Physical
- Biological and
- Social.
Physical environment:
applied to non-living things and physical factors e.g. air, water, soil,
housing, climate, geography, heat, light, noise, radiation, etc.
Biological environment: universe of living things which surrounds man, including man
himself.
e.g. viruses, microbial agents, insects,
animals and plants.
Psychological environment: e.g. cultural values, customs, habits, beliefs, attitudes, morals,
religion, education, lifestyles, community life, health services.
CHAIN
OF INFECTION:
The presence of a pathogen does not mean
that an infection will begin. Development of an infection occurs in a cycle
that depends on the presence of all the following elements:
- Infectious agent:
The development of an
infectious disease depends on the number of organisms present; their virulence,
or ability to produce disease; their ability to enter or survive in the host;
and the susceptibility of the host.
- Reservoir:
Places where
microorganisms can survive, multiply, and await transfer to a susceptible host
are called reservoirs. Common reservoirs are humans and animals (host),
insects, food, water, and organic matter or inanimate surfaces (fomites).
- Portal of exit:
After microorganisms find
a site to grow and multiply, they must find a portal of exit if they are to
enter another host and cause disease. Microorganisms can exit through a variety
of sites such as skin and mucous membranes, respiratory tract, gastrointestinal
tract, reproductive tract, and blood.
- Mode of transmission:
There are many modes for
transmission of microorganisms from the reservoir to the host. Although the
major mode of transmission of microorganisms is the hands of the health care
worker, almost any object within the environment can become a means of
transmitting pathogens.
- Portal of entry:
Organisms can enter the
body through the same route they use for exiting. Common portals of entry
include non intact skin, mucus membranes, genitourinary tract, gastrointestinal
tract and respiratory tract.
- Susceptible host:
Susceptibility to an
infectious agent depends on the individual’s degree of resistance to pathogens.
An infection does not develop until an individual becomes susceptible to the
strength and numbers of microorganism capable of producing infection.
STAGES
OF INFECTION:
- Incubation period: It is the
time interval between entrance of pathogen into the body and appearance of
first symptoms. (e.g. chicken pox – 2-3 weeks; common cold – 1-2 days;
influenza – 1-3days; mumps – 15-18 days).
- Prodromal stage: Interval from
onset of nonspecific signs and symptoms (malaise, low-grade fever,
fatigue) to more specific symptoms.
- Illness stage: Interval when
client manifests signs and symptoms specific to type of infection.
- Convalescence: Interval when
acute symptoms of infection disappear. Length of recovery depends on
severity of infection and client’s general state of health; recovery may
take several days to months.
INFECTION
CONTROL PRAGRAM:
Purpose: To identify and reduce risks of infections in patients, staff, and
volunteers.
Affected
areas: Clinical staff and supervisors, volunteers
and supply staff.
General
information:
Three
things must be present at the same time for an infection to be considered an
organization- acquired or community-acquired infection:
a)
An infectious agent.
b)
A susceptible host.
c)
A chain of transmission.
Policy:
1.
The agency’s infection control
program is designed to lower risks and improve the rates of employee and
patient organization-acquired infections.
2.
The infection control program
includes the following processes:
i.
Surveillance:
-
The agency collects data about
infections to detect any changes in infection trends. Targeted surveillance,
which focuses on specific patient populations and / or specific procedures, is
tracked on an annual basis.
ii.
Identification:
-
Surveillance data are used to
identify problems or undesirable trends. Undesirable trends will lead to
further investigation to determine whether the infection is
organization-acquired.
iii.
Prevention:
-
The agency implements policies
and procedure to prevent the occurrence or spread of infection. Prevention
strategies are incorporated into the patient and staff education plan.
iv.
Reporting:
-
Patient and staff infections
are reported internally and externally, as required by law.
3.
The basic components of the
agency’s infection control program include the following:
i.
Surveillance based on
systematic data collection to identify home-care-acquired infections in
patients.
ii.
A system for detection of
institutional outbreaks of infectious diseases in multiple patient dwellings
(for hospices having an inpatient facility).
iii.
An isolation/ precaution system
to reduce risk of transmission of infectious agents.
iv.
Infection control policies and
procedures.
v.
Orientation and in-service
education for staff / volunteers in infection control.
vi.
An employee health program.
vii.
A system for antibiotic review.
viii.
Disease reporting to public
health authorities.
ix.
A patient health / education
plan.
4.
The design, data collection,
and assessment of the infection control program is completed by the quality
improvement (QI) staff as a component of the QI program. Infection control
policies and procedures are reviewed and updated as needed, but are formally
reviewed by the QI staff and the Director of Clinical Services on an annual
basis.
5.
Education of home care staff in
infection control and isolation precaution is required at orientation and
annually. At a minimum, this education should include:
-
Hand washing
-
Personal hygiene
-
Employee health infection
control issues
-
Transmission of infection
-
Care of patients with
communicable diseases.
-
Standard precautions and blood
borne pathogens
-
Disposal of infectious waste
and sharps.
-
Appropriate cleaning issues.
-
Principles of asepsis.
-
Personal protective equipment.
CONTROL
OF HOSPITAL INFECTION:
Ø Hospital infection can be ‘hospital associated or hospital
acquired’.
Ø Hospital associated infections are those, that are acquired during hospitalization
as well as those that are present upon admission, having been acquired prior to
hospitalization.
Ø Hospital acquired or nosocomial infection can be defined as
“infection acquired by the licenses in the hospital, manifestation of which may
occur during hospitalization or after discharge from hospital staff and
visitors.
CONTROL
MEASURES:
- General measures:
a)
Personal hygiene and
environmental sanitation kept at high level in the hospital of any kind, is
mandatory requirement towards control of hospital infection.
b)
Efficient house keeping
including clean supply of bed linen and patient’s dress, proper bed
arrangement; frequent mopping and periodic washing of hospital wards and
department floors.
c)
Provision of ancillary
facilities like:
i.
CSSD – Facilities for standard
sterilization of all hospital supplies e.g. syringe, needles, surgical
instruments, O.T. linen, sets of trays for diagnostic and therapeutic purpose,
rubber goods and other requirements.
ii.
Mechanical laundry – in
referral institutional hospitals and larger hospitals will endure clean and
adequate linen sully to patients and reduce infections.
iii.
Food-ordering, procurement,
preparation and distribution must be arranged through organized kitchen
service. Minimum of handling
must be ensured. Adequate water supply and washing facilities of food items and
utensils to be made available.
iv.
Prompt and coordinated system
of waste disposal e.g. dry waste materials and sewage must be established
through incinerators, underground drainage.
v.
Each ward must be provided with
isolation facilities in separate rooms for infectious patients over and the
isolation wards.
vi.
In small hospitals procedure
manuals for workers to be provided for strict compliance.
- Special control
measures:
i.
Operation theater, Pediatric
wards, Maternity and Nurseries are particularly sensitive areas in hospitals
and need special attention. Some of the important considerations are:
-
Located away from general
traffic.
-
Protective, clean, aseptic or
sterile and disposal zones must be scrupulously adopted.
-
Floor and walls in good repair
state.
-
Air conditioning through fresh
filtered air.
-
24 hours water supply.
-
Washing, disinfection at
periodic interval.
-
Adherence of strict aseptic measures
for procedures in OT and frequent check.
-
Periodic bacteriological test
of OT swabs.
-
Avoidance of over-work in OT
and provision of interval.
ii.
Pediatric ward:
-
4-6 bedded ward facilities with
provision of isolation.
-
Similar age-group patients in
one room.
-
Strict aseptic procedure to be
ensured.
-
Nursing staff must ensure
strict personal hygiene and hand washing.
-
Minimum attendants.
-
Prompt removal of any attendant
with infection.
iii.
Nurseries:
-
Scrupulous cleanliness and
asepsis.
-
4-6 bedded cubicles.
-
Visitors are not to be
permitted.
-
Gowning and use of mask to be
encouraged.
-
Due care for preparation of
feeds and sterilization of bottles and other accessories.
iv.
Maternity Ward:
-
Delivery room planning on the
line of OT.
-
Strict aseptic measures to be
followed.
-
Facility for isolation should
be provided in 4-6 bedded wards.
-
Regular floor washing and
cleaning.
Other control measures
will include infection oriented training to hospital staff to assess the
importance of standards of asepsis, personal hygiene and cleanliness.
Patients, relatives and
visitors should be educated by the hospital staff about matters of infection,
isolation, hand washing and other related areas.
HOSPITAL
INFECTION CONTROL COMMITTEE:
To
control hospital infection, it is essential that the hospital according to its
available resources and requirement establishes a Hospital infection control
committee and invest it with authority to persue:
-
Investigation of all hospital
infections.
-
Establish surveillance
programme.
-
Provide guidance and leadership
in the prevention and control of hospital infection.
- Composition:
Should compose of all
major specialties as members like
-
Surgeon
-
Physician
-
Anesthetist
-
Pediatrician
-
Bacteriologist
-
Gynecologists
-
Nursing matron
-
House keeping staff
-
Engineering service representative
-
Dietician
-
Microbiologist
In a district hospital
set up, the organization should be composed of:
-
Available professional
specialist,
-
Matron of the hospital or any
other specialist officer as infection control officer,
-
Superintendent of hospital as
chairman.
In a still smaller
hospital situation, the whole responsibility can be given to one Medical
Officer only.
- Role and function:
i.
Establishing and reporting
system.
ii.
Nursing unit report – daily /
weekly.
iii.
Individual patient report.
iv.
Review of bacteriological
service record of the hospital.
v.
Autopsy report.
vi.
Meet periodically to take
decision.
vii.
Lay down standards of aseptic
procedures in hospitals.
viii.
To distinguish between infections
acquired in the hospital and those acquired outside.
ix.
To prepare manual for control
of infection and lay down training of programme of personnel.
x.
Take all decision based on
report received through hospital infection control officer regarding
investigation and control measures in the event of sudden rise of hospital infection
rate.
- Investigation of
epidemic hospital infection:
The hospital surveillance
programme should be geared to determine the endemic level of infection and be
responsive to any epidemic situation like.
-
Sudden cluster-like increase at
any period of time and in a particular hospital area.
-
Unusual sporadic cases.
-
Investigating actions.
-
Confirm diagnosis including
bacteriological culture.
-
Total number of cases
established.
-
Investigations for carrier,
common source, break-in technique, vehicle of infection and any other abnormal
situation.
-
Obtaining cultures from carrier
and from vital areas CSD, OTS, Nurseries, etc.
ISOLATION
PRECAUTIONS:
Isolation
refers to measures designed to prevent the spread of infections or potentially
infectious microorganisms to health personnel, clients, and visitors. A variety
of infection control measures are used to decrease the risk of transmission of
microorganisms in hospitals.
CDC
Isolation Precautions (1983 and 1987):
In
1983 the Centres for Disease Control and Prevention (CDC) established isolation
guidelines that allowed health facilities to choose between two systems:
category – specific or disease – specific isolation.
Category
– specific isolation precautions are based on seven categories: strict
isolation, contact isolation, respiratory isolation, tuberculosis isolation,
enteric precautions, drainage / secretion precautions, and blood / body fluid
precautions.
Disease
– specific isolation precautions provide precautions for specific diseases.
For example, pulmonary tuberculosis precautions
specify putting the client in a private room with special ventilation or having
the client share a room with other clients who are infected with the same organism
and the use of masks for nurses entering the room and gowning only to prevent
gross soilage of clothes.
Universal
precautions (CDC 1987):
1)
Wear masks and protective
eyewear or face shields in situations where droplets of blood or other body
fluids may spray onto the mucus membranes of the eyes, nose, or mouth.
2)
Wear gloves when in contact
with blood or other body fluids containing blood and when handling supplies and
equipment or surfaces soiled with blood or other body fluids. Change gloves
after client contact.
3)
Wear gown in situations where
it is likely that droplets of blood or body fluids will be sprayed.
4)
Immediately and thoroughly wash
hands or other skin surfaces that come into contact with blood or other body
fluids.
5)
To prevent needle stick
injuries, deposit used needles in a puncture-resistant container that has a
secure lid and has been placed near the area where the needles were used. Do
not recap, break, or bend needles after use.
6)
Use mouth pieces, resuscitation
bags, or other ventilation equipment when providing resuscitation. This reduces
the need for mouth-to-mouth contact.
7)
Do not provide direct client
care when you have open or exudative skin lesions.
Body
Substance Isolation (BSI) System (1991):
Body
Substance Isolation (BSI) employs generic infection control precautions for all
clients except those with the few diseases transmitted through the air.
The
main elements of BSI are:
1)
Wash hands thoroughly before
and after client care and when gloves are removed.
2)
Wear clean gloves before
contact with any body fluids, mucus membranes, non intact skin, and any moist
areas.
3)
Wear gowns, plastic aprons,
masks, protective eyewear, hair covers, and shoe covers are required to keep
moist body substances off clothing, skin, hair, and mucus membranes.
4)
Discard all needles and sharp
instruments in a puncture-proof container at the place of use.
5)
Bag soiled linen securely
before it is transported to the laundry area.
6)
Place disposable trash in
plastic bags and dispose off it according to agency protocol.
7)
Handling and reprocessing
practices are the same for all equipment used on all clients.
8)
Place all specimens in plastic
bags, seal the bags, and arrange for transport to the laboratory.
CDC
(HICPAC) Isolation precautions (1997):
The
Hospital Infection Control Practices Advisory Committee (HICPAC) of the CDC
presented new guidelines for isolation precautions in hospital. These latest
guidelines designate two tiers of precautions:
Tier 1: Standard precautions
Tier 2: Transmission – Based Precautions.
Standard
Precautions:
Ø Design for all clients in hospital.
Ø These precautions apply to blood, all body fluids, excretions and
secretions except sweat, non intact skin and mucus membranes.
Ø Designed to reduce risk of transmission of microorganisms from
recognized and unrecognized sources.
- Wash hands after contact with blood, body fluids, secretions,
excretions and contaminated objects whether or not gloves are worn.
-
Wash hands immediately after
removing gloves.
-
Use an antimicrobial agent or
an antiseptic agent for the control of specific outbreaks of infection.
- Wear clean gloves when touching blood, body fluids, secretions,
excretions and contaminated items.
- Wear a mask, eye protection, or a face shield if splashes or
sprays of blood, body fluids, secretions, or excretions can be expected.
- Wear a clean, nonsterile gown if client case is likely to
result in splashes or sprays of blood, body fluids, secretions or
excretions.
- Handle client care equipment that is soiled with blood, body
fluids, secretions or excretions carefully to prevent the transfer of
microorganisms to others and to the environment.
- Handle transport and process linen that is soiled with blood,
body fluids, secretions, or excretions in a manner to prevent
contamination of clothing and the transfer of microorganisms to others and
to the environment.
- Prevent injuries from used equipment, i.e. scalpels or needles,
and place in puncture-resistant containers.
Transmission-Based
Precautions:
Airborne
precautions:
- Place client in a private room that has negative air pressure;
6 to 12 air changes per hour and discharge of air to the outside or a
filtration system for the room air.
- If a private room is not available, place client with another
client who is infected with the same microorganisms.
- Wear a respiratory device when entering the room of a client
who is known or suspected of having primary tuberculosis.
- Susceptible people should not enter the room of a client who
has rubella (measles) or varicella (chicken pox). If they must enter they
should wear a respirator.
- Limit movement of client outside the room to essential
purposes. Place a surgical mask on the client if possible.
Droplet
Precautions:
- Place client in a private room.
- If a private room is not available, place client with another
client who is infected with the same microorganisms.
- Wear a mask if working within 3 feet of the client.
- Transport client outside the room only when necessary and place
a surgical mask on the client if possible.
Contact
precautions:
- Place client in a private room.
- If a private room is not available, place client with another
client who is infected with the same microorganism.
- Wear gloves as described in standard precautions.
- Wear gown when entering a room if there is a possibility of
contact with infected surfaces or items, or if the client is incontinent,
has diarrhea, a colostomy or wound drainage.
-
Remove gown in the client’s
room.
-
Make sure clothing does not
contact possible contaminated surfaces.
- Limit movement of client outside the room.
- Dedicate the use of non critical client care equipment to a
single client or to clients with the same infecting microorganisms.
Role
of the nurse while caring a patient with air borne diseases like tuberculosis:
ü Encourage about early detection and treatment of tuberculosis.
ü Start and complete treatment (DOTS) without delay.
ü Instruct coughing / sneezing patients to turn their heads, cover the
mouth with a cloth or rag, wash hands regularly and wash/ burn the cloth used.
ü Identify the procedures that may put a health care provider at risk
for TB
·
Suctioning
·
Nebulization
·
Intercostal drainage insertion
and dressing
·
Bronchoscopy
·
Sputum collection in poorly
ventilated areas
·
Surgery
·
Handling mycobacterium cultures
·
Cleaning suction cups
·
Post-mortem care
ü Use mask appropriately.
ü Ensure good ventilation
·
Open windows.
·
Ensure proper airflow direction
in wards with TB patients.
·
Supervise proper patient placement
and spatial separation – ideally 3 feet, of persons with respiratory infections
in OPD and between beds in infectious wards to reduce risk of transmission of
droplet infection.
ü Educate patient and families to
·
Report signs and symptoms of TB
and seek treatment.
·
Take the complete course of
treatment as prescribed.
·
Observe cough hygiene.
·
Ensure good ventilation around
them.
Standard
work precautions against Blood borne pathogens:
Blood borne pathogens are microorganisms
such as viruses or bacteria that are carried in blood and cause disease in
people.
Hepatitis
B – Stable virus, can survive outside the body
after the body fluid dries.
Hepatitis
C – Stable virus, can survive outside the body
after the body fluid dries.
HIV – Fragile virus, usually dies outside the body after the body fluid
dries.
Precautions:
ü Disinfect surfaces contaminated with body fluid or blood.
ü Follow the hospital policy for waste management.
ü Get vaccinated against Hepatitis B.
ü Reducing risk of sharp injuries:
|
Dos
|
Don’ts
|
|
¨ Use needle cutter or destroyer immediately after use.
¨ Separate sharps from other waste.
¨ Use rigid, puncture proof disposal bins.
¨ Empty sharp containers when they are ¾ full.
|
¨ Do not recap needles before disposal.
¨ Do not collect the used needles.
¨ Burn immediately – to reduce chances of getting the needle stick
injury.
¨ Handle, empty, or transfer used sharps between containers.
|
Hand
hygiene:
Hand hygiene includes an instant alcohol
hand antiseptic before and after providing client care, hand washing with soap
and water when hands are visibly soiled, and performing surgical scrub. Hand
washing is a vigorous, brief rubbing together of all surfaces of the hands
lathered in soap, followed by rinsing under a stream of water (CDC, 2002). The
decision of when and what type of hand hygiene should occur depends on the
following:
-
the intensity of contact with
clients or contaminated objects,
-
the degree or amount of
contamination that could occur with that contact,
-
the susceptibility of the
client or the health care worker to infection and
-
the procedure or activity to be
performed
The use of alcohol-based waterless
antiseptics is recommended by the CDC (2002) to improve hand hygiene practices,
protect health care worker’s hands, and reduce transmission of pathogens to
clients and personnel in health care settings.
The CDC recommends the following:
1.
Wash hands with plain soap or
with antimicrobial soap and water when hands are visibly dirty.
2.
If hands are not visibly
soiled, use an alcohol based waterless antiseptic agent for routinely decontaminating
hands in all other clinical situations:
a)
After contact with a client’s
intact skin (as in taking a pulse or blood pressure, or lifting a client)
b)
After contact with body fluids
or excretions, mucous membranes, non intact skin, or wound dressings as long as
hands are not visibly soiled.
c)
When moving from a contaminated
body site to a clean body site during client care; after contact with inanimate
objects in the immediate vicinity of the client.
d)
Before caring for clients with
severe neutropenia or other forms of severe immune suppression.
e)
Before inserting indwelling urinary
catheters or other invasive devices.
f)
After removing gloves.
Personal
protective equipment (PPE):
PPE is designed to protect employees from
workplace injuries or serious illnesses resulting from contact with chemical,
radiological, physical or mechanical or other workplace hazards.
|
PPE
|
When to wear
|
Points to keep in mind
|
|
Gloves
|
Wear sterile
gloves when handling sterile procedures.
Wear utility
gloves when cleaning or managing waste.
|
Wearing clean or
sterile gloves:
¨
Wash hands.
¨
Slip each hand into glove,
pulling snugly over the fingers to ensure a good fit.
¨
Pull glove over the wrist as
far as it will go to maximize coverage.
Utility gloves:
¨
Do not use them to touch
patients, patient care items, or anything near patient.
¨
Use the same utility gloves
for the same task.
¨
Use separate gloves for dirty
and clean task.
¨
Wash with detergent and
bleech at the end of the shift.
|
|
Eye wear
|
Protect eye when
anticipating splash of infectious body fluids.
|
¨
The eye wear surrounds the
rim of the whole eyes without any gap.
¨
Disinfect if there is a
splash of potentially infectious fluid on it.
¨
Wash thoroughly before reuse.
¨
If eye wear is not available
make use of the face shield / visor.
|
|
Gowns and aprons
|
Protect skin when
risk of splashing or spraying of blood or body fluid contact is expected
using impervious/ plastic gowns.
Prevent soiling
of clothing during procedures that may involve contact with blood or body
fluids.
|
¨
Gowns need to be thick enough
so that blood will not soak through easily.
¨
Cotton gowns are
inappropriate as the cloth absorbs dirt very easily and needs to be
disinfected and cleaned daily.
¨
Aprons need to be water
resistant preferably made of plastic.
¨
Wash hands after removal of gowns.
¨
Disinfect the cotton cloth
gowns.
¨
Soak in bleeching solution
(1%) for 20 minutes, than wash and sun dry. OT and labour room gowns would
need to sterilized, disposable gowns need not be sterilized.
|
|
Masks (cloth and
paper)
|
Protect nose and
mouth from potential splashes of infectious fluid.
Use when
handling patients with respiratory infections and while doing any invasive
procedures.
|
¨
Cover both the nose and the
mouth during procedures and patient-care activities.
¨
While wearing a mask, make
sure it is fitting properly over the nose, mouth, face, lower and below the
jaw line in a tight enough fit (face seal) to prevent air leakage.
¨
Change for each procedure.
¨
Replace if wet or
contaminated.
¨
Not worn under the chin or
dangling around the neck after use.
¨
When removing hold mask by
the strings/ ties as the centre of the mask is most contaminated.
¨
Dispose immediately after
use.
¨
Wash hands after disposing
the mask.
|
|
Caps
|
Used to keep the
hair and scalp covered so that flakes of skin and hair are not shed into the
wound during surgery.
|
¨
Should be large enough to
cover all hair.
|
|
Footwear
|
Worn during
procedures and patient care activities when large particle droplet spatter or
sprays of blood or body fluid is anticipated.
|
¨
Slippers are not sufficient
protection.
¨
If foot wear does not
completely cover the foot then put a plastic cover over it and secure it with
a rubber band.
¨
Footwear should be fluid
proof.
¨
They should be washable and
easily disinfected.
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ROLE
OF NURSE IN INFECTION CONTROL:
Infection control nurse must possess the
following qualities:
I – Intelligent
N - Neatness
F – Faithfulness
E – Energetic
C – Courageous
T – Truthful,
tactful
I – Immediate
action
O – Organized
N – Non-threatening
C – Conscious
O – Orient
N – Nursing
T – Touch
R – Reactive
O –
Observant
L – Listening
ü Provide staff education on infection prevention and control.
ü Design policies following natural guidelines to control infection
and evaluate the effectiveness of policies.
ü Investigate cases of infection.
ü Maintain total statistic related to number and types of infection.
ü Offer continuing education for health care personnel to prevent
infection.
ü Report diseases and infection to local, states and federal
authorities.
ü Identify infection control problems with equipments.
ü All employee of the hospital including biomedical waste handlers
must be vaccinated against tetanus and Hepatitis B.
ü Extreme care must be taken while handling needles and other sharp
objects.
CONCLUSION:
Good
health depends in part on a safe environment. Practices or techniques that
control or prevent transmission of infection help to protect clients and health
care workers from disease. By practicing infection prevention and control
techniques, the nurse can avoid spreading microorganisms to clients.
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