Infection Control

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Infection Control

• Institutional
• Individual
• Community

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Topics

• Infection control basics
• What is it
• Transmission Risks
• Institutional Infection Control (IC)
• Community IC
• Individual IC

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Transmission
To Catch website www.tocatch.info/en/Tuberculos
is.htm
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Transmission
Just by breathing
NLM website http//www.nlm.nih.gov/medlineplus/en
cy/images/ency/fullsize/19099.jpg
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Transmission
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What is infection control?
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Infection Control is

• Measures to prevent transmission of infectious
  germ from a source to others
• Its a primary prevention method to keep those
  who are uninfected free from infection

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Good IC Practices should

• Be done in the context of providing access to
  care. IC without access to care will lead to
  stigma
• Always respect human rights and dignity of
  patients
• Be seen as a shared responsibility, not primarily
  something that needs to be imposed upon
  patients/community

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Infection Control Measures

• Looking at three levels
• Institutional
• Community
• Individual
• All methods that follow can be done where we live
  and work
• Low-resource settings
• Areas of HIV prevalence

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Institutional IC

• Health care settings should have a plan
• How to do
• Have a plan that entails
• Patient flow
• Health care worker and patient education
• Mechanical tools to reduce infection
• Make coordination and responsibilities clear
• Crisis management for when plans dont flow

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Institutional IC

• Earlier case detection and treatment
• How to do
• Dont rely on poor diagnostics
• We can use symptom screen algorithms
• Proper training for staff (looking for smear (-)
  TB, making TB priority for PLH)
• Must include strengthening of TB program to
  reduce defaulting

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Institutional IC

• Administrative cohorting or isolation with rapid
  evaluation for TB and MDR TB
• How to do
• Develop a patient flow strategy for limited space
• Requires HCW to be on alert for TB patients not
  responding to 1st line treatment
• Requires 2nd-line drugs
• Requires adequate space for TB suspects to be
  evaluated

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TB Triage PIH (Haiti)
Community based TB treatment
Hospitalized patients
General ward Sm -, HIV /-
6 isolation rms SM and HIV
TB Pavilion
Sm, HIV-
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• TB Pavilion
• Fenestrated walls
• Louvered windows
• UV lamp
• High ceilings
• Overcrowded

• TB Pavilion
• Fenestrated walls
• Louvered windows
• UV lamp
• High ceilings
• Overcrowded

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Institutional IC

• Regularly screen health care workers
• Have IC tools available
• How to do
• Provide regular screening for TB for ALL health
  care workers (including lay counselors)
• Provide staff support for TB services
• Equip staff with fans, masks, and uv whenever
  possible

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Institutional IC

• Germicidal uv radiation

http//pic3.ohpy.com/up/elbbs/2007/11/26/93009/851
902899/mid_44503kowalski12_00000020268.jpg
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Community IC

• Patient/community education
• How to do education for TB
• Training for health care workers to use IC tools
  (masks, fans, windows, etc)
• Skin testing for TB and prevention
• Signs and symptoms
• Treatment literacy

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Community IC
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Community IC

• Anti-stigma Education
• How to do
• The NO FEAR tactic
• Quarantine and scary stories can inhibit patients
  desire to seek care
• This can increase TB in the community!
• Main MessageTB can be cured!

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Community IC continued..

• Look for infection control in your clinics
• Are the windows open? Can the waiting room be
  outside?
• Ask for infection control measures to be
  implemented

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Individual IC

• Personal respiratory protection
• Know the signs and symptoms of TB
• Look for TB in our communities
• Educate, educate, educate

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WHO Recommended 10 Steps for Infection Control

• Include Patients Community in Advocacy for IC
• Develop an IC Plan
• Ensure Safe Sputum Collection
• Promote Cough Etiquette Hygiene
• People with symptoms suspected to be TB should be
  triaged to be fast tracked/ separated

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10 Steps for IC (Contd)

• Assure Rapid Diagnosis Treatment
• Improve Room Air Ventilation
• Protect Health Care Workers
• Build Capacity of Health Institutions for IC
• Monitoring IC practices