Infection Control
Date: 03/11/2024
Dr. Sulaiman Mahmoud Bani Abdel-Rahman
Bachelor degree in Medicine and Surgery - Mutah university
MSC Medical Microbiology – University of Manchester
PhD Medical Virology - University of Manchester
1
Introduction
• Definition:
• Is the discipline concerned with preventing nosocomial or healthcare-
associated infection
• Aims of infection control: to control the spread of infections within
the healthcare setting, including from
• patient-to-patient
• patients to staff
• staff to patients, or among-staff
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Most commonly used methods
• The most commonly used methods include:
• Standard precautions: which are a universal set of precautions that should be
taken with ALL patients
• Transmission-based precautions : which are designed to break the chain of
infection for specific infectious diseases.
4
Standard precautions
• All people potentially harbor infectious microorganisms. As such, it
must be assumed that all blood and body fluids/substances are
potentially infectious.
• Standard precautions are the work practices required to achieve a
basic level of infection prevention and control.
• The use of standard precautions aims to minimize, and where
possible, eliminate the risk of transmission of infection, particularly
those caused by blood borne viruses.
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Standard precautions
Standard precautions consist of the following practices:
• Hand hygiene before and after all patient contact
• The use of personal protective equipment, which may include gloves,
impermeable gowns, plastic aprons, masks, face shields and eye protection
• The safe use and disposal of sharps
• The use of aseptic "non-touch" technique for all invasive procedures, including
appropriate use of skin disinfectants
• Reprocessing of reusable instruments and equipment
• Routine environmental cleaning
• Waste management
• Respiratory hygiene and cough etiquette
• Appropriate handling of linen.
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Standard Precautions
Personal protective equipments (PPEs)
Apron cap/hair cover
shoe covers
Sharp containers
Yes NO
Prevention of needle stick/sharp injuries
Do not recap
Do not recap
Do not recap
AIDS
H ep at i t i s
Recapping using one handed technique
Step 1
If you must recap, use the "one-hand" technique:
Step 1
• Place the cap on a flat surface, then remove your
hand from the cap.
Step 2
Step 2
• With one hand, hold the syringe and the needle to
pick up the cap.
Step 3 Step 3
• When the cap covers the needle completely, use the
other hand to secure the cap on the needle hub. Be
careful to handle the cap at the bottom only (near
the hub).
What should I do if I injured myself with a used needle?
A. If skin is penetrated encourage the wound to
bleed, ideally by holding it under running water
B. Do not squeeze the affected area.
C. Wash the affected area with soap and water.
Alcohol-based hand rub can be used to clean the area
if soap and water are not available.
D. Report the incident immediately to your
supervisor.
E. Ask about follow-up care, including post-exposure
prophylaxis
F. Complete an accident report form, including the
date and time of the exposure, how it happened, and
name of the source individual (if known).
Types of Hand Hygiene
1. Hand washing:
• 40 -60 seconds for visibily soiled
hands.
• after using alcohol gel several times
• When handling patients colonized/
infected with spore forming bacteria.
2. Alcohol rubs/gels:
• Alcohol-based rub.
• 20-30 seconds.
• For hands that are not visibly soiled.
3. Surgical hand scrub:
• Brush and nail file.
• 5 minutes (first wash of the day); 2-3
minutes (in between oprations)
When you should wash your hands?
WHO My 5 moments of hand hygiene:
Gloves
When to wear gloves?
• When anticipated that contact with blood or other
potentially infectious materials, mucous membranes, non
intact skin.
Rules:
• Do not wash gloves for the purpose of reuse since this is
associated with transmission of pathogens
• Change gloves during patient care if the hands will move
from a contaminated body-site to a clean body-site
• Do not wear the same pair of gloves for the care of more
than one patient
• Remove gloves after contact with a patient and/or the
surrounding environment (including medical equipment)
using proper technique to prevent hand contamination
Proper technique to remove gloves
• Grasp outside edge near wrist. •Slide ungloved finger under the wrist of the remaining glove.
• Peel away from hand, turning glove inside-out. •Peel off from inside, creating a bag for both gloves.
• Hold in opposite gloved hand. •Discard.
Gowns
Why to wear a gown?
– To protect skin and prevent soiling or
contamination of clothing during
procedures and patient-care activities when
contact with blood, body fluids, secretions,
or excretions is anticipated
• Remove gown and perform hand hygiene before
leaving the patient’s environment
• Do not reuse gowns, even for repeated contacts
with the same patient
Removing Gown
• Unfasten ties
• Peel gown away from neck and shoulder
• Turn contaminated outside toward the
inside
• Fold
• Discard
Removing Mask
• Untie the bottom, then top tie
• Remove from face
• Discard
Mouth, Nose, Eye Protection
When to wear PPE to protect the mucous membranes of the eyes, nose
and mouth?
• during procedures and patient-care activities that are likely to generate
splashes or sprays of blood, body fluids, secretions and excretions
aerosol-generating procedures).
Transmission-Based Precautions
• Transmission-based precautions
are used in addition to standard
precautions when use of standard
precautions alone does not fully
prevent communicable disease
transmission
• Types of transmission-based
precautions:
a. Contact precautions.
b. Droplet precautions.
c. Airborne precautions.
Contact Precautions
“Contact organisms sticks like Vaseline Mode of transmission
to surfaces until cleaned”
Indication:
They are intended to prevent transmission of infectious agents which are spread by
direct or indirect contact with the patient or the patient’s environment
Contact Precautions
Examples include
Enteric infections with
C. difficile
prolonged environmental
survival such as
Highly contagious skin infections scabies, impetigo, pediculosis,
disseminated varicella zoster
(shingles)
Resistant bacterial infections (MRSA, VRE)
Diapered or incontinent patients enterohemorrhagic E. coli, shigella,
with hepatitis A, or rotavirus
1.
Contact Precautions
Patient placement
• Place patients in a single-patient room when available
• When single-patient rooms are in short supply
• Prioritize patients.
• Cohort patients.
• If it becomes necessary to place a patient who requires Contact Precautions in a room
with a patient who is not infected or colonized with the same infectious agent.
• Avoid immunocompromised patient.
• Ensure physical separation.
• Change protective clothes and perform hand hygiene between contact with patients in the
same room.
3. Patient transport
• limit transport and movement.
• In transportation, ensure that infected or colonized areas of the patient’s body are contained and
covered.
• Remove and dispose of contaminated PPE and perform hand hygiene prior to transporting patient.
• wear clean PPE to handle the patient at the transport destination.
Droplet Precautions
Definition
Droplets can be generated from the source person
during coughing, sneezing, talking and during the
performance of certain procedures such as suctioning or
bronchoscopy
Patient placement
The same as contact precautions
Droplet Precautions
Patient transport:
• limit transport and movement.
• Instruct patient to wear a mask and follow Respiratory
Hygiene/Cough Etiquette.
• No mask is required for persons transporting patients.
Examples of Infectious agents:
• Bordetella pertussis.
• Influenza virus.
• Adenovirus, rhinovirus.
• N. meningitides.
• Group A streptococcus
Droplet Precautions
B. Droplet Precautions…cont
Use of personal protective equipment
Airborne Precautions
Take Home Message
Airborne Precautions: prevent transmission of infectious agents that remain
infectious over long distances when suspended in the air
Airborne Precautions
1. Patient placement
• Place patients in an AIIR )Airborne Infection
Isolation Room)
• An AIIR is:
• A single-patient room
• Equipped with special air handling and ventilation
capacity
• Monitored negative pressure.
• Air exhausted directly to the outside or recirculated through
HEPA filtration before return.
Airborne Precautions
AIIR )Airborne Infection Isolation Room)
Pressure inside
in less than outside
Airborne Precautions
C. Airborne Precautions…cont
Infectious droplet nuclei
Small infectious droplet
Large infectious droplet
1-3 feet 3-5 feet 5-160 feet
Airborne transmitted diseases
ﻤﻼ حظات ﺯﻤﻥ العزل الماﺩﺓ المعدﻴﺔ ﻨﻭﻉ المرﺽ
االشخاص ﺍلمعر ﻀﻭﻥ للعدوى الذين ﺤﺘﻰ ﻅﻬﻭﺭ ﻗﺸﺭﺓ لجميع ﺍﻹﺼﺎﺒﺎﺕ، الجديري
ﺇﻓﺭﺍﺯﺍﺕ الجهاﺯ التنفسي ﺃﻭ
ﻻ ﻴﻤﻠﻜﻭﻥ المناعه ﻴﺠﺏ ﺃﻻ ﻴﺩﺨﻠﻭﺍ وللمرﻀﻰ الذين ﺘﻌﺭﻀﻭﺍ لخطر العدوى
ﻤﻜﺎﻥ ﺍﻹﺼﺎﺒه Chickenpox
الغرفه ﻤﻥ 10الى 21ﻴﻭﻡ ﺒﻌﺩ التعرض
األشخاص ﺍلمعر ﻀﻭﻥ للعدوى الذين التهاب هيربس (ﺩﺍﺀ المنطقه المنتشر)
ﻻ ﻴﻤﻠﻜﻭﻥ المناعه ﻴﺠﺏ ﺃﻻ ﻴﺩﺨﻠﻭﺍ ﻓﺘﺭﺓ البقاء بالمستشفى ﺇﻓﺭﺍﺯﺍﺕ ﻤﻜﺎﻥ ﺍﻹﺼﺎﺒﺔ
Disseminated Herpes Zoster
الغرفه
ﻓﻘﻁ ﺍﻷﺸﺨﺎﺹ ﺍﻷﻜﺜﺭ ﻗﺎﺒﻠﻴﺔ للعدوى لمدة 5ايام بعد ظهور الطفح ،ﻭﻓﻲ حالة الحصيه
ﻴﻘﻭﻤﻭﻥ ﺒﺎﺭﺘﺩﺍﺀ القناع ،ﺃﻭ ﻴﺒﻘﻭﻥ ﻀﻌﻑ ﺠﻬﺎﺯ المناعه للمريض ﻓﻴﻜﻭﻥ ﺯﻤﻥ ﺇﻓﺭﺍﺯﺍﺕ الجهاز التنفسي Measles (rubeola), all presentation
ﺨﺎﺭﺝ الغرفه العزل ﻓﺘﺭﺓ البقاء بالمستشفى
الجدري
ﻓﺘﺭﺓ البقاء بالمستشفى ﺇﻓﺭﺍﺯﺍﺕ ﻤﻜﺎﻥ ﺍﻹﺼﺎﺒﺔ
Smallpox
كحد ادنى 14يوم بعد بداية العالج السل الرئوي Pulmonary Tuberculosis
الكيماوي ،ﻜﻤﺎ ﻴﺠﺏ ﻭﺠﻭﺩ ﺍﺴﺘﺠﺎﺒﺔ
السل لبلعومي pharyngeal Tuberculosis
ﺇﻜﻠﻴﻨﻴﻜﻴﺔ ﻤﻊ ﻋﺩﻡ ﻭﺠﻭﺩ الجراثيم ﺩﺍﺨل
تنفسي – ميكروب السل
ﻋﻴﻨﺎﺕ البلغم ،ﻭﻓﻲ حالة ﻤﺎ ﺇﺫﺍ ﻜﺎﻨﺕ
العينات ﺴﻠﺒﻴﺔ ﻤﻊ ﺘﺤﺴﻥ حالة المريض
ﻓﻴﻤﻜﻥ ﺃﻥ ﺘﺼﺒﺢ ﻓﺘﺭﺓ ﺍﻻﺤﺘﻴﺎﻁﺎﺕ 5ايام
ﻓﺘﺭﺓ البقاء بالمستشفى تنفسي Corona virus
PARR: powered
air purifying
respirators (PAPR)
Summery
Spill management of mercury
1. Never vacuum mercury (Vacuuming can vaporize the
mercury and increase the chances of human exposure).
2. Keep children, pets and others away from the area of the
spill.
3. Ventilate the room where the spill occurred.
4. Using the scoop, collect the mercury globules together so
that they merge into larger globules.
5. Using the syringe, pick up as much of the mercury as you
can, and place it in the waste bottle.
6. Use a flashlight to detect any remaining beads of mercury.
حفظ هللا أهاليمك ،تكل العيون تعب َ ...أحت ِملُين؟ اي ابين ُ
الساهرة اليت ذبلت من أجل نت حتملين اي أَيب، مثلام ك َ
راحتمك وجناحمك وسأمحل هذا احلنني
اىل
َأ َّويل واىل أ َّو ِ هل
وسأقطع هذا الطريق اىل
أخري ...واىل أ ِخ ِر هه!
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