UNIT-XI INFECTION CONTROL IN CLINICAL SETTING

2. UNIT-XIINFECTION CONTROL IN CLINICAL SETTING PRESENTED BY: Mrs. JYOTHI RAO Lecturer MSN Department

3. STANDARD SAFETY MEASURES

4. LEARNING OBJECTIVES At the end of the class students will be able to Define standard safety measures Enlist the purposesof standard safety measures List down the safety measures used in hospital Discuss the safety measures used in hospital

5. INTRODUCTION • Standard precautions are meant to reduce the risk of transmission of blood borne and other pathogens from both recognized and unrecognized sources. They are the basic level of infection control precautions which are to be used, as a minimum, in the care of all patients.

6. STANDARD SAFETY MEASURES Definition  : • Standard safety measure is defined as the measure which help to control infection and disease in hospital or protect the heath care worker from disease and infection in hospital it is called standard safety measures.

7. PURPOSES • It help to control the communicable disease in hospital  • It prevent the harmful infection in hospital or other health care centre   • Its prevents the transmission of infection or disease  • To prevent the undesirable microorganism  • To prevent the cross infection in hospitals

8. SAFETY MEASURE USED  IN HOSPITAL • Sterilization  • Bio medical waste management  • Infection control program  • Disinfection method  • Universal precaution

9. STERILIZATION • Sterilization refers to the destruction or total elimination of all types of pathogenic & non pathogenic microorganism & spores.

10. STERILIZATION METHODS : a) Physical Methods • Moist heat sterilization • Dry heat Sterilization • Sterilization by Radiation b) Chemicals Methods • Disinfection by chemical solution • Disinfection by Chemicals vapours

11. PHYSICAL METHODS 1.Moist heat sterilization: • Moist heat sterilization Heat is most commonly used for sterilization • Moist heat is most effective, it helps to destroys the micro-organism from the surface of equipments. • Moist heat is applied by two different methods: Boiling Autoclaving

12. BOILING • Boiling is done at 100° C or 212 °F temperature for 30 mins to 1 Hour in a boiler or Boiling water sterilizer. • The articles to be boiled are first cleaned thoroughly with soap & water & washed under running water. • The sterilizer is filled with clean plain water so that the articles that are to be boiled are fully submerged.

13. The sterilizer cover is to be kept closed always & specially when the articles are boiling. • The rubber items & glass articles such as catheters ,syringes are to be wrapped in gauze before they are placed in a sterilizer. • This prevents injury to the rubber goods & also prevents crack or break of the glassware • Sharp instruments such as knife ,scissors ,needles etc are never to be boiled because heat destroys the sharpness & make the instruments blunt. • The sterilizer should be thoroughly cleaned daily

14. AUTOCLAVING • Autoclaving is a method in which a steam under pressure is used for sterilization. This is also a moist heat sterilization method. • A single exposure of the steam with a temperature of 121° C or 249° F for 20 to 30 mins is enough to render the articles for sterilization • While sterilizing the articles they are wrapped in a porous cloth wrapped & are placed in the inner chamber of the autoclave. • Steam penetrate the wrapper & circulates round the articles.

15. 2.Dry heat sterilization • Dry heat sterilization is also known as hot air sterilization . • The articles which cannot be sterilized by other method are sterilized by this method. • Dry heat or hot is used for sterilizing minerals oils ,powders or ointments • But dry heat is less effective than moist heat.   • Hot air is a method of choice to sterilize glass syringes , needles ,fine metal cannula ,

16. 3.STERILIZATION BY RADIATION • It is a physical process of sterilization where sterilization is done by exposure to radiation by : • Sunlight or ultraviolet rays • Gamma rays.

17. SUNLIGHT OR ULTRA VIOLET STERILIZATION: • Mechanical cleansing of items & then exposure to direct sunlight or UV rays is used for items with large surface that cannot be sterilized by another method. • Unwashable articles such as : mattresses ,pillows ,blankets etc are sterilized by exposure to sunlight or UV rays for 6 or more hours

18. GAMMA RAYS STERILIZATION • These rays have greater penetration power • These rays are used for sterilization of heat sensitive disposable items such as syringes ,sutures ,drugs ,intravenous drip etc.

19. CHEMICAL METHOD OF STERILIZATION DISINFECTION • Reduction of the number of pathogenic organism by application of chemical agent. • Chemical method of sterilization is used to disinfect certain articles that are damaged by heat. This process is also known as cold sterilization. a) Disinfection by chemical solution: • In this method ,the articles to be sterilized are submerged into the disinfectant solution. • Sharp instruments be sterilized by chemical process.

20. Commonly used solution are :: • Cidex- is used for sterilizing sharp instruments ,rubber wares ,endocsopes • Savlon : concentrated is used for glass ware sterilization. • Lysol : concentrated is used for sterilization of sharp instruments.

21. b)Fumigation by chemical vapors • Fumigation is a chemical method of sterilization in which chemicals vapors are used for the destruction of microorganism suspended in the air. Equipments needs to be destroyed : • Fumigation helps in the disinfection of : Patient’s ward Unit Cubicle, ICU, Infected operation theatre etc. Chemicals used in fumigation : • Chemicals used in fumigation • a) Sulphur • b)Formalin • These bactericidal vapors kill the airborne infection.

22. FUMIGATION • 1. Seal close all the outlets like doors/windows. • 2. Put off the fans, A/C, any electrical/electronic device. • 3. Formaldehyde gas is generated by adding 150grams of KMno4(Potassiumpermanganate) to 300ml of formalin (40%) for every 1000cubic feet of space

23. INFECTION CONTROL PROGRAMME • Hospital infection control programme is depend on the policy of the hospital how to control hospital acquired infection and what do for control the communicable disease in hospital . • Infection control program  play important role to control the infection in hospital .

24. SCOPE OF INFECTION CONTROL Aiming at preventing spread of infection: Standard precautions: these measures must be applied during every patient care, during exposure to any potentially infected material or body fluids as blood and others. Components: A. Hand washing. B. Barrier precautions. C. Sharp disposal. D. Handling of contaminated material.

25. UNIVERSAL PRECAUTIONS • Universal Precautions is the term applied to treating all blood , tissues and some body fluids as potentially infectious . • The appropriate level of Precautions necessary is determined according to the extent of possible exposure to blood & body fluid.

26. Universal precautions includes • Care of the skin • Hand washing • Protective barriers • Procedure for safe handling of sharps • Procedure for safe disposal of sharps • Management of blood and body fluid spillages • Waste disposal

27. CARE OF THE SKIN • Bacteria and viruses cannot penetrate intact skin. • It is therefore vital to keep the skin in good condition and prevent cracking , chapping and drying of the skin. • Regularly check skin for cuts and cover with a waterproof dressing to allow adequate hand washing. • Following removal of gloves wash hands • Ensure thorough drying of skin following hand wash.

28. HAND WASHING Hand washing is considered the simplest and most important action to prevent infection transmission Indications: BEFORE: • Starting Work • Examining a Patient • Administering an Injection • Handling Disinfected Instruments • Putting on Gloves

29. AFTER: • Examining a Patient • Handling Instruments or Potentially • Contaminated Items or Body • Secretions/Excretions • Removing gloves • Sneezing or Coughing

30. USING PROTECTIVE BARRIERS • The wearing of protective equipment provides the healthcare worker with a barrier between themselves and potential blood and body fluid. Common barriers are. • Mask  • Cap • Gloves  • Apron  • Shoes • Eye protector

31. USES OF PROTECTIVE BARRIERS Gloves • Prevent microorganisms on the service provider’s hands from coming in contact with the client’s blood or other body fluids, mucous membranes, and non-intact skin, as well as instruments, other items.

32. Mask • Prevent droplets from the service provider’s nose and mouth which contain microorganisms that are expelled during talking, coughing and breathing from contact with the client. • Prevent from being exposed to splashes of blood and other body fluids; also protects from droplets containing microorganisms. • Mask should cover nose, mouth, and cheeks and extend below the chin.

33. Cap • Prevent microorganisms in service provider’s hair or on skin shed from the service provider’s head from falling on the sterile field • Eye protectors : Prevent the mucous membranes of the service provider’s eyes from being exposed to splashes of blood or other body fluid.

34. Jacket, gown & plastic apron • Prevent microorganisms on the service provider’s arms, & clothing from coming in contact with the client • Prevents the service provider’s skin from being exposed to splashes of blood or other body fluids • A waterproof apron should be worn under the jacket or gown during all procedures in which large amounts of blood & other body fluids are likely (e.g., cesarean delivery)

35. Shoes • Clean footwear minimises the number of microorganisms brought from other areas of the facility or the outside into the surgical/procedure area.

36. Procedure for safe handling of sharps • Needles must never be re-sheathed or recapped • Staff must obtain assistance when taking blood or giving injections to uncooperative or confused patients • Never carry sharps by the hand , if transporting always place in an appropriate container • Needles must never be broken or bent prior to disposal • Needles must never be passed from hand to hand • When performing phlebotomy , cannulation or giving injections , all staff must wear appropriate disposable gloves

37. Procedure for safe disposal of sharps • Do not dispose of sharps with other clinical waste . • Sharps bins to be kept in location that prevent of happening injury to patients , visitors and staff • Ensuring that sharps bins are situated at a suitable height i.e. not placed on the floor or above shoulder height. • Always dispose of needles as a complete unit into a sharps container never disassemble prior to disposal • Sharps containers should be ¾ full prior to sealing and disposal

38. Management of spillage Spillage • Blood • Body fluid containing blood  Management: • Wear protective clothing . • Soak up excess fluid using disposable paper towels. Cover area with towels soaked in 1% hypocholrite and NaDCC(Sodium dichloroisocyanurate) • Leave for at least 2 minutes. • Clean area with hot water and detergent • Dry area using disposable paper towels

39. Urine and vomitus Management: • Disinfectant: 1% hypocholrite and NaDCC(Sodium dichloroisocyanurate) • The excess urine/vomit must be mopped up with paper towels first. • This is because if urine or vomit comes into direct contact with the chlorine product toxic fumes will be released. • The room should be well ventilated (i.e. window open) before this procedure is carried out.

40. Spillage of body fluids not containing blood / For blood on carpets or soft furnishings Management: • Disinfectant: 1% hypocholrite and NaDCC(Sodium dichloroisocyanurate) • Wear protective clothing PPE. Soak up fluid with paper towels. • Wash area with hot water and detergent • Rinse with hot water. • Dispose of paper towels and protective clothing in clinical waste

41. CONCLUSION • Standard precautions are the minimum infection prevention practices that apply to all patient care, irrespective of suspected or confirmed infection status of the patient, in any health care setting. These practices aim to both protect health care workers (HCWs) and prevent them from transmitting the infections to their patients.

42. EVALUATION SHORT ESSAY • Prevention of cross infection in hospital • Universal precautions • Standard safety precautions for infection control

43. EVALUATION MCQ’S 1.Standard precautions doesn’t include • Washing hands before and after patient contact • Appropriate handling of contaminated clinical waste • Use of aseptic technique • Use of gloves and gown at all times 2. The method of destruction of all microorganisms including vegetative and spores is by • Boiling • Cleaning • Disinfecting • Sterilization

44. EVALUATION MCQ’S 3.Which of the infection control process completely eliminates all the micro organisms including spores and pathogens • Sterilization • Disinfection • Medical asepsis • Surgical asepsis 4. The mattress can be disinfected by placing it in the sunlight both surfaces for a period of: • Sterilization • Disinfection • Medical asepsis • Surgical asepsis

45. EVALUATION MCQ’S 5.All the flowing are essential standard precautions used in the care of all patients irrespective of whether they are diagnosed infectious or not ,except one • Hand hygiene • Improper sharps and waste disposal • Personal protective equipment • Aseptic techniques. 6. Standard precautions include which of the following measures? • Wearing gloves when changing a dressing • Disposing of needles in a puncture-resistant container • Wearing eye protection during tracheal suctioning • All of the above

46. THANK YOU …..