Transcript NOSOCOMIAL INFECTIONS

‫ای لقای توجواب هرسئوال‬
‫مشکل ازتوحل شودبی قیل وقال‬
‫فرازی ازدعای عرفه‬
‫• اللهم اجعلنی اخشاک کانی اراک‬
‫• واسعدنی بتقواک‬
‫• والتشقنی بمعصیتک‬
‫• اللهم اجعلنی غنای فی نفسی‬
‫• والیقین فی قلبی‬
‫• واالخالص فی عملی‪.‬والنورفی بصری‬
‫والبصیرت فی دینی‬
Antimicrobial resistance research center
Mazandaran university of medical sciences, Sari, Iran
NOSOCOMIAL
INFECTIONS
CONTROL
DR.BABAMAHMOODI
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HOSPITAL TERMINOLOGY
INFECTION
DISINFECTION
STERILIZATION
CLEANING
DECONTAMINATION
GERMICIDE
ANTISEPTICS
CRITICAL,SEMICRITICAL,NON-CRITICAL ITEMS
CHEMICAL DISINFECTANTS(H,M,L) LEVEL
• ISOLATION
ISOLATION
PURPOSE
prevent the transmission of
microorganisms from infected or
colonized patients to other
1-patients.
2-hospital visitors.
3- health care workers.
Isolating patients
1-Expensive.
2-Time-consuming.
3-often uncomfortable
for patients.
4-may impede care
ISOLATION
Should be
implemented only
when necessary
Failure to isolate
1-Morbidity.
2-Mortality.
3-expensive.
Expensive
1-Costs
of an investigation
of an outbreak
2- Excess
length of stay.
3-The indirect costs of
lost productivity.
practice of isolating patients
1-separate infectious
disease hospitals.
2-to separate wards for
these patients.
3- ultimately to providing
precautions in the general
hospital environment.
ISOLATING ROOMS
1-single-patient
rooms.
2- double-patient
rooms
.
Guidelines for isolation(2007 CDC(
1-standard precautions, which
apply to all patients .
2-transmission-based
precautions.
TRANSMISSION -BASED
precautions. to patients which
apply with documented or
suspected infection or
colonization with certain
microorganisms.
Standard Precautions
All patients may
potentially be colonized or
infected with organisms that
can transmitted wherever be
health care is provided.
STANDARD PRECAUTIONS
gloves should be worn to touch
any of the following:
blood, all body fluids, secretions,
and excretions. except
sweat,
regardless of whether they are
visibly bloody, non intact skin,
and mucous membranes.
STANDARD PRECAUTIONS
Hands should be washed
immediately after
-gloves are removed,
-before and after patient contact.
with items in the patient’s and after
contact environment that may be
contaminated.
Two new elements of standard precautions
1-In Lumbar puncture
wear masks to prevent contamination
of the spinal needle or the procedure
site with the oral flora of
the operator, which may occur when
the
operator is talking.
Two new elements of standard precautions
2-respiratory hygiene, which includes instructing
patients to cover their nose and mouth with a tissue
when coughing or sneezing .
placing a surgical mask on the coughing
patient in common areas.
and spatially separating patients
with respiratory infections from
other patients when feasible.
- using hand hygiene after contact with
respiratory secretions.
.
STANDARD PRECAUTIONS
1-gloves
2-HAND WASHING.
 3-mask with eye protection
4-gown
5-Needles and syringes.
HAND HYGIENE
•Hand hygiene is the
single most important
factor in preventing
nosocomial infections.
HAND HYGIENE
It prevents transmission
of pathogens by contact
and the fecal-oral route
HAND HYGIENE
The principles of hand
washing are based
on the work of
Semmelweis.
HAND HYGIENE
hand washing remains the
single most important
means to prevent
transmission of nosocomial
pathogens.
HAND HYGIENE
It has been estimated that an
increase in hand washing
compliance by 1.5- to 2.0-fold
would result in a 25% to 50%
decrease in the incidence of
HAIs.
microorganisms on hands
1-transient flora
2-resident flora
Transient flora
1-Are important causes of HAIs.
2-These organisms are acquired
primarily by contact.
3- Loosely attachedto the skin
4-Easily washed off.
RESIDENT FLORA
1-organisms of low virulence
(e.g., coagulase-negative staphylococci,
Micrococcus, Corynebacterium)
2-that are rarely transmitted to patients except
when introduced by invasive procedures
3- Not easily removed through hand washing.
Purpose of hand washing
Remove the transient
flora recently acquired
by contact with patients
or environmental surfaces.
HANDS OF HCWS
HAIs have been attributed to
bacterial contamination of
artificial fingernails
therefore, they should not be
worn by health care workers.
Alcohol-based hand rubs
the recommended
agents for hand hygiene
in the health care setting.
washing with soap
1-visibly soiled, washing with soap
(antimicrobial or non antimicrobial)
and water .
2-Clostridium difficile diarrhea.
CDC suggests that soap and water
be used because of the poor sporicidal activity of
alcohols .
ALCOHOL -BASED
HAND RUBS
WHEN
1-before and after
contact with patients.
2-immediately after
removing gloves.
Wall-mounted dispensers
alcohol-based, waterless hand rubs
should be installed in all hospital and
outpatient rooms.
In areas in which this is not feasible,
individual health care workers
should carry small containers of
waterless agents.
1-to
GLOVES
prevent contamination
of the hands with microorganisms.
2-to prevent exposure of the health care
Worker to blood-borne pathogens.
3- to reduce the risk of transmission
of microorganisms from the hands of the
health care worker to the patient
GLOVES
1-gloves do not replace the need for hand hygiene
2-gloves should be changed during the care
of a patient when moving from a contaminated or
body site (e.g., wound perineal care)
to a clean body site
.
3-Gloves have small perforations that may
allow to contaminate the hands.
-not
as a substitute for hand hygiene.
Transmission-Based precautions
patients based on a suspected
or confirmed clinical syndrome.
a specific diagnosis, or
colonization or infection with
epidemiologically important
organisms.
IMPORTANT
It is important to note that
transmission-based
precautions are
always
implemented in
conjunction with
standard precautions.
TRANSMISSION-BASED PRECAUTIONS
Three types•
1-Airborne•
2-Droplet borne•
3-Contact borne•
ISOLATION CATEGORY
A few diseases varicella,
SARS, MERS-COV
require more than one
isolation category.
TB-TRANSMISSION
• COUGH
• LAUGH
• SPEAKS
• SNEEZES
• SPITS
• SIGNS
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