Infection Control

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Infection Control
Hospital Epidemiology and Infection Control

• Capital Health Infection Control Department
• ted.pincock_at_cdha.nshealth.ca

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Lecture Objectives

• Scope of Infection Control Practice
• Health Care Associated Infections
• Infection Control Guidelines
• Infection Control in Clinical Practice

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Expected Outcomes

• Identify 5 Health Care Associated Infections
• Quantify annual impact of HCAI in Canada
• Identify primary measure to reduce HCAI
• Discuss 4 modes of infection transmission
• Discuss role of Infection Control Dept
• Discuss the significance of infection control in
  clinical practice

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Healthcare Infection Facts

• An infection in hospital
• increases length of stay by 4 - 7 days
• increases pain and suffering which, in turn,
• increases the need for additional drugs,
  treatments or surgeries
• All, of which, increase the cost of Healthcare

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Healthcare Infection Facts

• Health Care Associated Infections (HCAI) kill
  8,000 12,000 Canadians every year
  It is estimated that between 1/3 1/2 of
  all HCAIs are preventable
• Hand hygiene is the primary measure to reduce
  HCAIs and the spread of AROs
• HCW compliance with hand hygiene considered to be
  less than 40

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The Role of the Infection Control Department

• Hospital Infection Control Department is
  responsible for instituting and maintaining an
  evidence based Infection Control Program which
  assists healthcare providers improve patient
  outcomes by
• establishing surveillance measures to identify
  Health Care Acquired infections
• providing prevention, containment control
  measures that reduce the probability of
  occurrence of infection.

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Infection Control Practitioner

• Patient Surveillance
• Monitor Patient Outcomes Record HCAI data
• Educator Promoter of safe clinical practice
• Not an ENFORCER
• Outbreak Investigation Management
• Contain control transmissible infection
• Research Analysis of HCAI data
• Provide feedback for evidence based change
• Board Certified (CBIC - North American Body)

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Five Notable Healthcare Associated Infections or
(HCAI)

• Blood Stream Infection (BSI)
• Pneumonia (HCAP or VAP)
• HCAP Health Care Associated Pneumonia Duhh!!
• Surgical Site Infection (SSI)
• C. difficile Associated Diarrhea (CDAD)
• Urinary Tract Infection (UTI)

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Infection Control GuidelinesFocus - Patient Care

• Hand Washing
• Gloves
• Gowns
• Masks Eye protection
• Accommodation
• Patient Care Equipment
• Environmental Controls

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Routine Practices and Additional Precautions for
Preventing the Transmission of Infection in
Health Carehttp//www.phac-aspc.gc.ca/publicat/cc
dr-rmtc/99vol25/25s4/index.html

• Additional Precautions
• based upon modes of microbial transmission
• also known as Transmission-based precautions

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4 Modes of Transmission
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Additional Precautions

• Contact Precautions
• Direct Contact
• Skin to skin Infected individual gt susceptible
  host
• Indirect Contact
• Passive transfer of microbes to a susceptible
  host
• Droplet Contact
• Contact transmission but requires different
  precautions

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Remember The 4 moments of Hand Hygiene
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Additional Precautions

• Droplet vs. Airborne Precautions
• Droplet Precautions
• Microbes in droplets (gt 5 micron diameter) fall
  out of air
• Droplet Zone defined as 1 metre from source
• Airborne Precautions
• Microbes in droplet nuclei (lt 5 micron) stay
  suspended
• Droplet nuclei or dust particles with skin
  squames or debris

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The Risk We Run

• Following Routine Practice Additional
  Precautions further lowers the risk of
  transmission and infection
• Poor or inappropriate practice increases the risk
  of transmission and subsequent infection for
• your patients / clients
• you and your colleagues, family friends
• In addition, patients (already at greater
  infection risk) have a right to safe, ethical
  care. This not only requires but demands safe
  practice.

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Why are patients at greater risk?

• Patients are
• Unwell to begin with
• Normal flora altered
• Exposed to risk by Healthcare System Healthcare
  Providers

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The Added Burden Antibiotic Resistant Organisms

• Microbial evolution Increased resistance
• MRSA
• Methicillin-Resistant Staphylococcus aureus
• VRE
• Vancomycin-Resistant Enterococcus

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Forestalling Evolution through Evolution of Our
Practice

• Practice modifying your technique to comply
  with recommended guidelines
• Remember each patient space is a microcosm of
  transmissible organisms
• Hand Hygiene is a visible indicator of your
  safety as a healthcare provider