Patient Care (cont.d)
• Invasive Procedures • Wound dressing
• Oral alimentation
• Other activities
Invasive procedures - Indwelling urinary catheters - IV catheters - IV injections - Endoscopy
Prevention & Control Activities
Employee health (Occupational health)
• Old/ New Employee medical exam. [Initial (at time of employment) & Periodical] • Exposure to blood, body fluids or tissue
(exposure control plan)
• Staff accident or ward related infections
• Work restrictions
• Education
Prevention & Control Activities
Environmental hygiene
• Microbiologic sampling
- Not routine - Outbreak investigation - Research purposes
• Housekeeping policy
• Laundry policy
• Construction policy
(Construction, design & remodeling measures)
Prevention & Control Activities
Environmental hygiene
• Sterile water
(for invasive procedures)
• Appropriate air supply
(room ventilation)
• Proper storage of sterile supply
Prevention & Control Activities
Surveillance of infection
• Criteria for Nosocomial infections • Surveillance analysis & reporting
A. Elements
- Data collection - Data collation (consolidated or tabulated) - Data analysis - Reporting
Prevention & Control Activities
Surveillance of infection
• Surveillance analysis & reporting (cont.d) B. Uses (improvement of outcomes & processes)
- Provide baseline data on infection risk - Problem identification - Problem investigation - Evaluation of control measures - Evaluation of practices - Education of HCW - Research - Risk management
Prevention & Control Activities
Surveillance of infection
• Surveillance analysis & reporting (cont.d) C. Approaches
- Comprehensive, Total - Priority-directed, Site-specific - Problem-oriented (outbreak response surveillance) D. Worksheets
Prevention & Control Activities
Ward specific measures
(Dept or unit)
Measures differ according to:
- Site, design & construction of unit - Function & activity of unit - Type of patient - Expected infections& diseases - Treatment modality (AB, Chemoth.) - Type of intervention - Type of case (long-term, short-term, day care)
Prevention & Control Activities
Ward specific measures
- O.R. - ICU - Ped. & Neon. ICU - Pediatrics - Medical wards - Outpatient clinics - Surgical wards - Ante/Postnatal care unit ……..etc - Laboratory • Construction • Safety •Techniques & investigations
( e.g. pipetting, cell counting, blood sampling) Prevention & Control Activities
Disease &/or Organism specific measures
• Blood borne pathogen (Prevention precautions - Control) e.g. HBV, HCV, HIV • T.B. • Pneumonia • MRSA • VRE • Multidrug resistant organisms • Scabies ….etc
Prevention & Control Activities
Antibiotic policy
• Clinical use - Therapeutic (Empirical - Targeted) - Prophylactic • Hospital AB committee - membership - meetings - duties • Education
(better to say: Communication with clinicians) Prevention & Control Activities
Reportable Diseases
• Investigation & mgt of major outbreaks (or clusters) How? - Diarrhea - MRSA - VRE • Notification of communicable disease How?