HOSPITAL INFECTION CONTROL

INFECTION CONTROL

In order to introduce effective infection control measures, the basic epidemiology of an infection (route of transmission, host risk factors, etc.) must be considered. the incidence and nature of a HAI (as with any infection)depend on the:

• organism;
• host (patients and staff);
• environment

The organism
the organisms responsible for common nosocomial infection  may be acquired endogenously or exogenously.

Endogenous infection
An infectious agent that is already present in the host causes endogenous infection. the infectious agent is usually part of the normal host flora.Antibiotics and exposure to the hospital environment can change the normal flora of the host and may select for resistant organisms. Risk of infection may be reduced by protecting any potential sites of entry, e.g.
intravascular lines.

Exogenous infection
When the infectious agent originates from outside of the host. the pathogen is usually acquired from the environment by various routes, including: airborne, direct contact, or percutaneous routes. Within the hospital setting, environmental infection is usually due to a contaminated item of equipment and can be minimized by implementing the correct decontamination, sterilization, and infection control procedures. Cross-infection (or transmission) refers to infection acquired in hospital from another person, either patients or staff. Risks can be reduced by focusing on measures to interrupt transmission, e.g. handwashing.

Organisms commonly involved in HAIs

Infection	Organism(s) involved
UtIs	Gram-negative bacteria, e.g. E. coli, Proteus spp., Klebsiella spp., Serratia spp. Gram-positive bacteria less common, e.g. Enterococcus spp. fungi are a rare cause, e.g. C. albicans
Respiratory infections (non-ventilated patients)	Bacteria, e.g. H. influenzae, S. pneumoniae, P. aeruginosa, Enterobacteriaceae Viruses: respiratory viruses fungi, e.g. Aspergillus spp.
Wounds and skin sepsis	Bacteria, e.g. S. aureus, S. pyogenes, anaerobes Uncommon cause—(surgical wounds) Gram-negative organisms. e.g. E. coli
BSI	Gram-positive bacteria, e.g. S. aureus, including MRSA, Enterococcus spp., CoNS Gram-negative bacteria, e.g. E. coli, Proteus spp., Klebsiella spp., Serratia spp., P. aeruginosa fungi, e.g. Candida spp.
GI infections	Bacteria, e.g. C. difficile
Viruses, e.g. norovirus

The host
Patient risk factors that result in increased likelihood of acquiring an infection in hospital include:
• severity of the underlying acute illness and patient co-morbidities.
Severely ill patients are more vulnerable to acquiring an infection and
more likely to have a worse outcome;
• use of medical devices—these breach host defences and provide
possible portals of entry for organisms;
• extremes of age—the elderly and very young are at higher risk;
• immunosuppression.

Staff risk factors include:
• immunosuppression, e.g. HIV; pregnancy;
• staff who perform exposure-prone procedures are more likely to be
exposed to blood-borne viral infections;
• skin conditions (e.g. eczema) increase prolonged carriage of organisms
such as MRSA.

The environment
the hospital environment includes all of the physical surroundings of the
hospital patients and staff, i.e. the building, fittings, fixtures, furnishings,
equipment, and supplies. the following are important environmental issues
in the control of infection:
• environmental cleaning (see Box 6.5);
• environmental disinfection;
• decontamination of equipment;
• building and refurbishment, including air-handling systems;
• clinical waste management;
• pest control;
• food services/food hygiene;
• isolation facilities/ability to cohort patients.

 

Routes of transmission
the isolation precautions required depend on the likely route of transmission of the organism. the main routes are:
• airborne—this is when the infection usually occurs by the respiratory
route, with the agent being carried in aerosols (<5 micrometres in diameter);
• droplet—large droplets carry the infectious agent (>5 micrometres in diameter);
• direct contact—infection occurs through direct contact between the source of infection and the recipient, i.e. person-to-person spread;
• indirect contact—infection occurs through ‘indirect contact’, i.e. via
equipment contaminated with body fluids such as urine, faeces, and
wound exudates. this route also includes contact via an environmental
source, e.g. an outbreak of gastroenteritis transmitted by food;
• inoculation—infection occurs through direct inoculation, e.g. needlestick
injury. Other routes include via blood products (hepatitis A, Yersinia
enterocolitica, Serratia), total parenteral nutrition (tPN), and other fluids
(Enterobacter, B. cepacia, Bacillus cereus). Multidose vials should be avoided.

 

Hospital cleaning

‘Dirty hospitals’ are frequently reported by the media, with attention drawn to the lack of investment and poor support for hospital cleaning. Providing a clean and safe environment for health care is a key priority for the NHS and is a core standard in Standards for better health. Other publications, such as Towards cleaner hospitals and lower rates of infection,
have further emphasized this and recognize the role of cleaning in minimizing HAIs by the physical removal of dirt, fomites, dust, and human body fluids. In 2007, the National Patient Safety Agency produced guidelines for cleaning (The national specifications for cleanliness in the NHS: a framework for setting and measuring performance outcomes). the results of PeAt (Patient environment Action team) assessments are calculated against these specifications.

 

Handwashing

the importance of handwashing has been recognized since the nineteenth century when Semmelweiss encouraged medical students in Vienna to wash their hands in chlorinated lime solution on the delivery unit. the maternal mortality rate from puerperal fever in patients attended to by medical students was far lower than those attended to by midwives who did not wash their hands. today HCW hand hygiene is a topic of global importance. The WHO produced the first global patient safety challenge relating to hand hygiene ‘Clean Care is Safer Care’. the goal of Clean Care is Safer Care is to ensure that infection control is acknowledged universally as a solid and essential basis towards patient safety.

Patient isolation
the use of universal infection control precautions should minimize the need
for isolation of most patients. In practice, isolation depends on a risk assessment for each patient, and the side rooms/facilities available in each trust. Always act on the patient’s clinical presentation, and do not wait for laboratory results to be available, as it may be too late. Involve your ICt early, and consult the DH guidance for further advice.effective isolation relies on all staff following the necessary procedures,to make sure that none of the transmission barriers are breached. the simplest solution is to use single rooms, but, in an outbreak, multi-bedded bays,
or even whole wards, may be used.

 

1. CORONA VIRUS
2. MONKEY POX
3. VAGINAL DRYNESS
4. FIBROID
5. INFERTILITY
6. OVULATION CYCLE
7. OVARIAN CANCER
8. VAGINAL BACTERIA
9. MALE INFERTILITY
10. BEST DAYS OF CONCIEVING
11. MUCUS AFTER OVULATION
12. FOODS FOR ERECTILE FUNCTIONS
13. PREGNANCY ANEMIA
14. DO AND DONT DURING PREGNANCY
15. ERECTILE DYSFUNCTION
16. U.T.I IN PREGNANCY
17. STROKE RISK
18. EAT THIS NOT THAT
19. HOOKWORMS INFECTION
20. OMEGA 3 BENEFITS
21. FASTING
22. WEIGHT LOSS TIPS
23. vitiligo
24. ABORTION
25. DENGUE VIRUS
26. EBORA VIRUS
27. FEVER
28. URINARY TRACT INFECTION
29. HOSPITAL INFECTIONS
30. WEST NILE VIRUS
31. YELLOW FEVER
32. EYE DISEASE
33. ZIKA VIRUS
34. STRESS
35. IRON DEFFICIENCE
36. INSOMNIA (SLEEPING PROBLEMS)
37. HEART PROBLEMS
38. COMPONENTS OF BLOOD
39. BLOOD DISORDER
40. LABORATORY TEST OF BLOOD DISORDER
41. BONE MARROW EXAMINATION
42. BLOOD ANEMIA
43. ANIMAL BITES
44. EYE BURN
45. CHOCKING
46. HEAT STROKE
47. SMOKE EFFECTS
48. SNAKE BITE
49. MALARIA VACCINE
50. BEST WAY TO SLEEP A CHILD
51. CHILD FEVER REDUCING
52. ELEPHANTIASIS
53. WOMEN BEARDS
54. DATES
55. PAPAYA FRUITS