infection control committee
DESCRIPTION
Infection control committeeTRANSCRIPT
DR.T.V.RAO MD 1
Dr.T.V.Rao MD
INFECTION CONTROL COMMITTEE
NEED CONSTITUTION AND RESPONSIBILITIES
DR.T.V.RAO MD 2
Patient may acquire infection before admission to the hospital = Community acquired infection.
Patient may get infected inside the hospital = Nosocomial infection.
It includes infections not present nor incubating at admission, infections that appear more than 48 hours after
admission, those acquired in the hospital but appear after
discharge also occupational infections among staff.
THE RISK OF INFECTION IS ALWAYS PRESENT IN EVERY HOSPITAL
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INFECTION
• Definition: Injurious contamination of body or parts of the body by bacteria, viruses, fungi, protozoa and rickettsia or by the toxin that they may produce.
Infection may be local or generalized and spread throughout the body.
Once the infectious agent enters the host it begins to proliferate and reacts with the defense mechanisms of the body producing infection symptoms and signs: pain, swelling, redness, functional disorders, rise in temperature and pulse rate and leukocytosis.
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FREQUENCY OF NOSOCOMIAL INFECTION
Nosocomial infections occur worldwide.
The incidence is about 5-8% of hospitalized patients, 1/3 of which is preventable.
The highest frequencies are in East Mediterranean and South-East Asia.
A high frequency of N.I. is evidence of poor quality health service delivered.
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FACTORS INFLUENCING N.I.
The microbial agent
Patient susceptibility
Environmental factors
TRANSMISSION• Where do nosocomial infection come from?
Endogenous infection: When normal patient flora change to pathogenic bacteria because of change of normal habitat, damage of skin and inappropriate antibiotic use. About 50% of N.I. Are caused by this way.
Exogenous cross-infection: Mainly through hands of healthcare workers, visitors, patients.
CRITERIA OF NOSOCOMIAL INFECTIONS
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INFECTION CONTROL PROGRAM
The important components are :1) Basic measures i.e. standard and additional
precautions
2) Education and training of healthcare workers
3) Protection of healthcare workers e.g. immunization
4) Identification of hazards and minimizing risks
5) Routine practices such as aseptic techniques, handling and use of blood and blood products, waste management, use of single use devices
6) Surveillance
7) Incident monitoring
8) Research
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BASICS OF INFECTION CONTROL
Prevention of nosocomial infection is the responsibility of all individuals and services provided by healthcare setting.
To practice good asepsis, one should always know: what is dirty, what is clean, what is sterile and keep them separate.
Hospital policies & procedures are applied to prevent spread of infection in hospital.
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GOALS FOR INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY
There are three principal goals for hospital infection control and prevention programs:
1. Protect the patients2. Protect the health care workers, visitors,
and others in the healthcare environment.3. Accomplish the previous two goals in a
cost effective and cost efficient manner, whenever possible.
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INFECTION CONTROL COMMITTEE
1. Review and approve surveillance and prevention program
2. Identify areas for intervention
3. To assess and promote improved practice at all levels of health facility.
4. To ensure appropriate staff training
5. Safety management
• 6 Development of policies for the prevention and control of infection
• 7. To develop its own infection control manual
• 8. Monitor and evaluate the performance of program
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FUNCTION AND ORGANIZATION OF THE
INFECTION CONTROL PROGRAM The provision of an effective infection control
program (ICP) is a key to the quality and a reflection of the overall standard of care provided by the health care institution.
The growth in ICP has been paralleled by the establishment and growth of a number of professional and governmental organizations which focus on NI prevention and control such as (APIC, SHEA, CDC, HICPAC).
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INFECTION CONTROL PROGRAM(ICP)
In the majority of countries ICP, typically operates on two levels: an executive body – the infection control team (ICT) – and an advisory body to the hospital management – the infection control committee (ICC) – which adopts the ‘legislative’ role of policy making.
In fec tio n C on r to l T e am In fec tion co n tro l co m m ittee In fec tio n co n tro l m a nu a l
H osp ita l P ro gram
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INFECTION CONTROL TEAM
• The optimal structure varies with hospitals types, needs and resources.
• Hospital can appoint epidemiologist or infectious disease specialist, microbiologist to work as infection control physician.
• Infection control nurse who is interested and has experience in infection control issues.
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INFECTION CONTROL COMMITTEE
E It is a multidisciplinary committee responsible for monitoring program policies implementation and recommend corrective actions.
E It includes representatives from different concerned hospital departments & management. They meet bimonthly.
E It establishes standards for patient care, it reviews and assesses IC reports and identifies areas of intervention.
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INFECTION CONTROL COMMITTEE (CONT): The membership of the hospital ICC should reflect the spectrum of
clinical services and administrative arrangements of the health care facility. As a minimum, the committee should include:
1. Chief executive, or hospital administrator or his/her nominated representative.
2. ICD or hospital microbiologist (chairperson).3. Infection Control Nurse (ICN).4. Infectious Diseases Physician (if available)5. Director of nursing or his representative.6. Occupational Health Physician (if available).7. Representative from the major clinical specialties.8. Additionally representatives of any other department (pharmacy,
central supply, maintenance, housekeeping…etc) may be invited as necessary
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TEAM MEMBERS TO BE AUTHOURSIED
Team should have authority to manage an effective control program.
Team should have a direct reporting with senior administration.
Infection control team members or are responsible for day-to-day functions of IC and preparing the yearly work plan.
They should be expert and creative in their job.
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THE ICC HAS THE FOLLOWING TASKS:
• To review and approve the annual plan for infection control
• To review and approve the infection control policies.
• To support the IC team and direct resources to address problems as identified
• To ensure availability of appropriate supplies• To review epidemiological surveillance data and
identify area for intervention.
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THE ICC HAS THE FOLLOWING TASKS (CONT):
• To assess and promote improved practice at all levels of the health care facility
• To ensure appropriate training in infection control and safety.
• To review risks associated with new technology and new devices prior to their approval for use.
• To review and provide input into an outbreak investigation
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INFECTION CONTROL COMMITTEE (ICC):
The hospital ICC is charged with the responsibility for the planning, evaluation of evidenced-based practice and implementation, prioritization and resource allocation of all matters relating to infection control.
The ICC must have a reporting relationship directly to either administration or the medical staff to promote ICP visibility and effectiveness. The ICC should meet regularly (monthly) according to local need
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THE ROLE OF INFECTION CONTROL TEAM :
• To develop an annual infection control plan with clearly defined objective.
• To develop written policies and procedures including regular evaluation and update.
• To supervise and monitor daily practices of patient care designed to prevent infection.
• To ensure availability of appropriate supplies• To organize an epidemiological surveillance program
(particularly in high risk areas for early detection of outbreak).
• To educate all grades of staff in infection control policy, practice and procedures
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THE ROLE OF ICN Identify, investigate and monitor infections,
hazardous practice and procedures
Participate in the preparation of documents relating to service specifications and quality standards.
Participate in training and educational programs and in membership of relevant committees where infection control input is needed
• Active surveillance (Prevalence and incidence studies)
• Targeted surveillance (site, unit, priority-oriented)
• Appropriately trained investigators
• Standardized methodology
• Risk- adjusted rates for comparisons
KEY POINTS IN SURVEILLANCE
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• Automated laboratory, pharmacy and HIS data integration Detection of pathogenic microorganisms Sending of alerts in real time Increased productivity. Calculation of Infection Incidence Rates Generation of statistical data in real time
HOSPITAL EPI DEMIOLOGIC CONTROL
INFECTION CONTROL MANUAL
Every Hospital should have a nosocomial infection prevention manual compiling recommended instructions and practices for patient care.
This manual should be developed and updated in a timely manner by the infection control team.
It is to be reviewed and accepted by infection control committee.
Surveillance Preventive Activ ities S taff Training
Program Com ponents
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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.
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• Model good hand washing/hand hygiene practices
• ˙ Encourage others to do the same
• ˙ Maintain hand hygiene supplies for your area
• ˙ Maintain soap and paper products for your area
MAKE YOUR HOSPITAL A MODEL FOR HAND WASHING
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Hand washing is the single most effective precaution for prevention of infection transmission between patients and staff.
Hand washing with plain soap is mechanical removal of soil and transient bacteria (for 10- 15 sec.)
Hand antisepsis is removal & destroy of transient flora using anti-microbial soap or alcohol based hand rub (for 60 sec.)
HAND WASHING
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INFECTION CONTROL IS RESPONSIBILITY OF ???
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DO NOT FORGET IT IS EVERYONE'S RESPONSIBILITY
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HAVE A VISION FOR CREATING BETTER HOSPITALS
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Programme created by Dr.T.V.Rao MD for basic Infection control Programme in
Developing world Email