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Infection Control In Hospital Setting

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Causitive Organisms Of Nosocomial Infections

Pathogens that are responsible for nosocomial infection are bacteria, fungi, and viruses. Bacterias are most commonly cause nosocomial infection. Let us discuss briefly causative organisms.

Bacteria: Bacterias enter into the host when there is a break in immune function. Gram-positive bacterias responsible for nosocomial infections are coagulase-negative Staphylococci, Staphylococcus aureus, Streptococcus species, and Enterococcus species. Among all Clostridioides difficile causes more infections. In the USA, it causes around 15% of total hospital-acquired infections.

Gram-negative bacterias which are responsible for nosocomial infections are the Enterobacteriaceae family, including Klebsiella pneumonia and Klebsiella oxytoca, Escherichia coli, Proteus mirabilis, and Enterobacter species Pseudomonas aeruginosa, Acinetobacter baumanii, and Burkholderia cepacian. Acinetobacter baumanii.

The well-known bacterias which cause Hospital-acquired infections are methicillin-resistant Staphylococcus aureus , Vancomycin-intermediate Staphylococcus aureus and Vancomycin-resistant Staphylococcus aureus , Enterobacteriaceae with extended-spectrum cephalosporin resistance consistent with extended-spectrum beta-lactamase production, vancomycin-resistant Enterococcus , Enterobacteriaceae and Acinetobacter species, and multi-drug resistant Pseudomonas aeruginosa.

Susceptibility To Healthcare Associated Infection

All people admitted to hospital are at some risk of contracting an HAI. If you are very sick or have had surgery, you have an increased risk. Some people are more vulnerable than others, including:

  • premature babies
  • frail people
  • people with certain medical conditions, such as diabetes
  • people with low immunity such as people with diseases that compromise their immune system or people who are being treated with chemotherapy or steroids.

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Preventive Practices And Infections

Patients hospitalized in an intensive care unit frequently need a specialized, surgically implanted intravenous catheter, or central line, for the delivery of fluids, nutrition, and medications. Central line-associated bloodstream infections are recognized as a grave risk to hospitalized patients, so several health care organizations have promoted a group of five evidence-based interventions, known as a central line bundle, to reduce the incidence of these infections. Drs. Stone and Larson, along with their colleagues, conducted a survey of 984 ICUs in 632 hospitals across the United States and found that following even one of the five evidence-based interventions could reduce these infections. Unsurprisingly, the greatest reduction in infections in intensive care units was seen when all five interventions were followed.

These findings identify practices that could lead to fewer central-line bloodstream infections and better patient outcomes.

Respiratory Hygiene And Etiquette

Infection Control In Dental Health Care Settings
  • Everyone needs to watch for and report respiratory illness.
  • Vaccinations are an important tool for preventing respiratory illnesses such as influenza and pneumococcal pneumonia.
  • Staff should stay home if they are sick.
  • Staff should go home if they develop respiratory symptoms while working.
  • A virus can cause a cold for a staff member but may develop into a serious illness for an older adult.
  • Visitors, families, and staff can be a source of respiratory illness outbreaks.
  • Cover coughs, and wear a mask if recovering from an illness.
  • Educate residents and visitors to cover their mouths and noses with a tissue when coughing or sneezing.
  • Residents should stay in their rooms if they develop a new cough with fever or other symptoms of a respiratory infection.

Basic Background

Respiratory illnesses, including pneumonia, are a major cause of outbreaks in LTC facilities. While a virus can cause a cold for a staff member, it can develop into a serious illness for an older adult. Respiratory illnesses often result in hospital staysâand sometimes even death.

Practice Tips

  • Pay attention to coughing and sneezing residents, family members, visitors, and staff.
  • Always cover your mouth and nose with your sleeve or a tissue when coughing or sneezing and then perform hand hygiene.
  • Make sure infected residents wear a mask whenever they leave their rooms.

Communication Tips

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Iv Engaging Everyone In Infection Prevention And Control

Key Messages

  • Good infection prevention practices, including hand hygiene, respiratory hygiene, safe injection practices, and appropriate antibiotic use, contribute to a safe facility for residents and a safe workplace for staff.
  • Everybody who works in the facility needs to work together to practice infection prevention to prevent harm and increase resident safety.
  • Residents and family members play a role in increasing resident safety by practicing infection prevention themselves, and in supporting the health care team in prevention practices.

Basic Background

Everyone in an LTC facility has a role to play in infection prevention and controlâ including health care workers, residents, and their families. A team of staff must work together to improve resident safety outcomes and improve resident, family, and staff satisfaction.

Good teamwork and good communication are crucial to preventing infection and building a culture of safety. Staff members should feel comfortable reporting safety concerns without fear of discipline. Harm to residents from infections can increase if staff members are reluctant to report lapses in infection prevention practices. Good teams and a culture of safety can reduce the chance of clinical errors, reduce staff turnover, and reduce concerns by residents and their families.

Practice Tips

Communication Tips

Basic Background

  • Nausea
  • Allergic reactions
  • Antibiotic-related infection

Practice Tips

Communication Tips

Survey Readiness

Key Messages

State Laws To Improve Infection Control And Prevention

To improve patient safety, a variety of federal and state laws require hospitals to report HAIs, however it is not clear whether these laws have improved outcomes and processes. To better understand the effects of these laws, Dr. Stone and colleagues surveyed hospital IPC departments in hospitals across the U.S. Their analysis found that IPC departments in states with HAI reporting laws had a perception of greater resources and influence on hospital decision-making than those without such laws. However, departments in states with HAI laws also perceived that there was less time for routine IPC activities, and that they had less visibility than departments in states without such laws.

These findings shed light on the potential benefits and possible unintended consequences of state HAI laws.

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Monitoring Of Infection Control

What should be monitored? Monitoring includes various aspects of infection control practices . Simultaneous monitoring of all the aspects might not be possible therefore prioritization must be done by the infection control team depending upon the need and situation. Monitoring of process compliance is most important to reduce incidence of HAI, preventing multidrug resistance to antimicrobials and protecting HCWs from getting infection. Methodology of monitoring should be adopted as per the institutional policy. Environmental monitoring along with microbiological surveillance has been claimed to reduce infection rate. Adherence to hand hygiene is being considered as one of the most important preventive action. Observed adherence to hand hygiene protocol ranges from 5% to 89% among the HCWs.

Preventing Infections In Multiple Healthcare Settings

The Invisible Challenge II Spread of bacteria in hospital settings

Health care-associated infections are numerous, costly, and largely preventable events that can cause significant illnessand even deathparticularly in vulnerable elderly patients. Nurses are responsible for most direct patient care in health care settings, so they are closely involved with infection control and prevention. Research led by nurse scientists on infection control has helped provide a foundation of evidence and guided best practices in multiple clinical settings.

With support from NINR, Drs. Elaine Larson, Jingjing Shang, and Patricia Stone of the Columbia University School of Nursing have led significant investigations regarding HAI prevention in hospitals, home healthcare, and nursing homes. Some highlights of their work in infection prevention and control are described below.

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Factors Influence Infection Control And Prevention

Various factors influence a patients susceptibility to infection. It is very important to know about each factor that influences infection because it helps to provide better treatment and care to the patient.

Age: Throughout life risk of acquiring infection changes. E.g. infants generally have immature immune systems to fight the infection whereas adults have strong immunity. Most adults are affected by viral infections. Vaccines make immunity strong at all ages. The defence system of the body declines with the ageing process.

Nutritional status: Nutritional status of the person also influences the infection. Less intake of protein reduces the ability of wound healing. Patients who have undergone any surgery require protein. A person who is involved in laborious work is required to take an adequate amount of carbohydrates in the food.

Stress: in her research study, stress: Firdaus S Dhabhar, found that short term stress activates the immune system and improves immunity. Long term stress suppresses or dysregulates innate and adaptive immune responses. It may be a risk factor for severe diseases like cancer.

Disease process: People with some immunological disorders have compromised immune systems and are more susceptible to infection. Diseases like Leukemia, AIDS, aplastic anaemia and lymphoma weakens the defence system of the person. People with some chronic diseases like diabetes mellitus are more susceptible to infection.

Elements Of A Personnel Health Service For Infection Control

  • Placement evaluations
  • Protocols for surveillance and management of job-related illnesses andexposures to infectious diseases
  • Counseling services for personnel regarding infection risks related toemployment or special conditions
  • Guidelines for work restriction because of infectious disease
  • Maintenance of health records
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    Hand Hygiene & Infection Prevention

    Healthcare-associated infections, which can occur in the blood, surgical sites, lungs or urine, are a major but preventable threat to patient safety. Protecting our patients, visitors and staff is a top priority for UCLA, and our goal is to have zero healthcare-associated infections. To ensure we do our best to prevent infections in patients, staff and visitors, we take several precautions. We invite you to partner with us and participate in these prevention efforts.

    Act To Stop Infection Spreading Now

    Infection Control in Health Care Settings

    Infections are dangerous and deadly. Even minor infections can become major problems for patients with healing problems, such as diabetes. Start following these steps today, and help your team stop the spread of infection before it begins.

    About Mackenzie

    Mackenzie is a lover of world travel, photography, design, style and Chinese cooking. She is passionate about working towards a purpose, recently graduated from Indiana University with a degree in Media and Marketing, and is currently residing in Manhattan.

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    How To Improve Procedures

    More than half of infections are considered preventable, through proper protocols4. The strict adoption of standard infection control procedures is a major factor, but there are other elements to improving IPC.

    Adopting medical devices which actively limit infection spread is one way that hospitals could see an improvement in infection control.

    TRITEMP is a medical grade non-contact thermometer that requires zero contact, therefore reducing the likelihood of cross-infection. For Infection Prevention and Control Teams the removal of unnecessary points of contact provides a significant reduction in probability of infection spread.

    Due to the sheer volume of use of thermometers in hospitals, non-contact thermometers result in contact transmission being reduced significantly and positively impact infection prevention and control.Changing from traditional methods of temperature measurement is essential to tackling infection spread, never more so than during the pandemic.

    An average sized 900-bed hospital on average will take approximately 3 million temperature readings, thats 3 million unnecessary contact points with the patient when using contact thermometers.

    Environmental Cleaning And Disinfection

    • Personal care wipe packages

    When cleaning, consider the contact time for the product. Contact time is the length of time a disinfectant needs to remain wet on a surface to be effective.

    Practice Tips

    • Wear gloves if the cleaning product requires them.
    • Change gloves between rooms and when moving from a contaminated surface area to a clean one.
    • Use the right product for the right surface.
    • Make sure the product you are using stays wet on the surface for the time needed to kill germs.
    • Do not flush wipes down the toilet.
    • Do not mix chemicals as some combinations can release toxic gas.
    • Keep chemicals locked up away from residents when not in use.

    Communication Tips

    • Ask the facility for training on how to use cleaning chemicals properly, and choose a surface-appropriate product.
    • Suggest that the facility purchase wipes that are premoistened with cleaner/disinfectant as these are easier to use.
    • Ask your supervisor how to alert residents and family members to use alcohol-based hand wipes to help keep their own rooms clean.

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    Proper Antibiotics Use And Management

    Proper antibiotic use may be achieved by following:

    • A standard treatment guidelines or hospital natibiotic use policy should be formulated.
    • Educate clinicians about the policy for ensuring its implementation.
    • Before starting any antibiotic therapy send specimen for bacteriological examination, and select antibiotics based on spectrum of disease, sensitivity, patient tolerance and cost.
    • Based on the test result use narrow spectrum antibiotics as much as possible.
    • Monitor surveillance of antimicrobial use.
    • Carry out periodic prescription audit in the institution.
    • Use antibiotic prophylaxis when there is more benefit than risk.

    Preventing And Controlling Healthcare

    #COVID19 Pandemic | Infection Prevention and Control in Health Care Settings

    Evidence-based systems are used to mitigate the risk of infection. These systems account for individual risk factors for infection, as well as the risks associated with the clinical intervention and the clinical setting in which care is provided. A precautionary approach is warranted when evidence is emerging or rapidly evolving.

    Patients, consumers and members of the workforce with suspected or confirmed infection are identified promptly, and appropriate action is taken. This includes persons with risk factors for transmitting or acquiring infection or colonisation with an organism of local, national or global significance.

    The health service organisation is clean and hygienic and has well-maintained and configured engineering systems for the delivery of effective models of care.

  • Pathology Accreditation Standards
  • Infection control is a health and safety issue. All people working in the health service organisation are responsible for providing a safe environment for consumers and the workforce. Infection prevention and control programs should be in place, in conjunction with use of the hierarchy of controls, to reduce transmission of infections so far as is reasonably practicable.

    Hand hygiene is an essential infection prevention and control strategy. The current National Hand Hygiene Initiative promotes a multimodal approach to improving hand hygiene. That includes:

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    Before Admission To Hospital

    If you are going to hospital, there are things you can do before admission and in hospital that will help reduce the chance of you getting an infection. Steps to follow before you go to hospital include:

    • stop smoking smoking can interfere with healing processes. It also damages your airways, which can increase your chances of getting a chest infection
    • maintain a healthy weight people who are overweight are more prone to infection
    • inform your doctor of all existing or recent illness a cold or the flu can lead to a chest infection, so let your doctor or the hospital staff know if you are not well
    • manage diabetes if you are a diabetic, make sure that your blood sugar levels are under control.

    During Your Hospital Stay

    Some things that can help reduce the chance of infection while you are in hospital include:

    • Make sure that you clean your hands often with soap and running water, or use an alcohol-based hand rub, especially after using the toilet and before eating.
    • Dont be afraid to ask nursing and medical staff if they have cleaned their hands before they touch you.
    • If you have an IV cannula, let your nurse know if the site around the needle is red, swollen, painful or leaking.
    • Tell your nurse if any dressings are not clean, dry and attached around your wound.
    • Let your nurse know if tubes or catheters feel displaced.
    • Let your nurse or doctor know if you have diarrhoea.
    • Cover your mouth and nose when you cough or sneeze.
    • Complete any course of antibiotics that you start.
    • Ask relatives or friends who have colds or are unwell not to visit.

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    Safe Management And Care Of Environment

    The environment for patients and healthcare staff must be safe for practice. Even if an area may look clean many dangerous micro-organisms can live on surfaces. There are many hotspots for these pathogens to live such as door handles, rails, tables, etc.

    Therefore, the cleaning of these high-risk touchpoints is essential. When cleaning it is essential the appropriate cleaning products and disinfectants are used. Healthcare professionals should be aware of the schedules and responsibilities for cleaning and disinfecting the area and every facility should have strict cleaning protocols.

    Risk Factors For Acquiring An Hai

    Infection Control in Health Care Settings

    There are other risk factors that may increase your risk of acquiring an HAI. These include:

    • increased length of stay a long hospital stay can increase your risk of HAI, for example, if you are admitted to hospital for complex or multiple illnesses
    • surgical procedures the length and type of surgery can increase the risk
    • hand hygiene techniques inadequate hand hygiene practices by hospital staff and patients may increase your risk
    • invasive procedures some procedures that bypass the bodys normal protective layer, the skin, can introduce infection into the body for example, insertion of urinary catheters, IV cannulas, respiratory equipment and drain tubes
    • non-intact skin wounds, incisions , burns and ulcers are more prone to infection than intact skin.

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    Precautions For Preventing Monkeypox Transmission

    Standard Precautions should be applied for all patient care, including for patients with suspected monkeypox. If a patient seeking care is suspected to have monkeypox, infection prevention and control personnel should be notified immediately.

    Activities that could resuspend dried material from lesions, e.g., use of portable fans, dry dusting, sweeping, or vacuuming should be avoided.

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