Hospital infection control programme and nurse

[Varghese John]

An infection control program puts together various practices which when used appropriately restrict the spread of infection.

A breach in infection control practices facilitates transmission of infection from patients to health care workers, other patients and attendants. It is therefore important for all health care workers, patients, their family members, friends and close contacts to adhere to the infection control guidelines strictly. It is also imperative for health care administrators to ensure implementation of the infection control program in health care facilities. Infection control practices "Standard precautions" require that health care workers assume that the blood and body substances of all patients are potential sources of infection, regardless of the diagnosis, or presumed infectious status. Additional precautions are needed for diseases transmitted by air, droplets and contact. These are termed "additional (transmission-based) precautions". The terms "standard precautions" and "additional (transmission-based) precautions" have replaced previous terms such as universal blood and body fluid precautions, universal precautions and barrier nursing. While particular care needs to be taken in the management of patients/clients known to have active infections it must be remembered that infection will not always be detected and complete safety can lie only in following the appropriate level of precautions. Purpose The guidelines have been prepared specifically to assist infection control practitioners in the management and prevention of hospital-associated infections and to ensure that health care administrators understand the significance of infection control program. Objectives The general objective of these guidelines is to provide administrators and health care workers with the tools to enable them to implement the infection control programme effectively in order to protect themselves and others from the transmission of infections. The specific objectives of these guidelines are to provide directions and information in relation to: * Facilities, equipment, and procedures necessary to implement standard and additional (transmission-based) precautions for control of infections * Cleaning, disinfecting and reprocessing of reusable equipment * Waste management * Protection of health care workers from transmissible infections * Infection control practices in special settings INFECTION CONTROL PROGRAMME What is infection Control programme? [h=3]1 Introduction[/h] [h=3]Nosocomial infection (hospital acquired infection) is an infection acquired by a patient during hospital stay or one developing in hospital staff. Infections are acquired in the hospital from patients, from hospital environment or brought in to the hospital from community by other people, are potential hazards to all persons in the hospital. Nosocomial infections may be bacterial, viral or fungal and are aggravated by reduced resistance of patients and commonly transmitted when healthcare workers (HCWs) do not practice correct hygiene regularly. Effective measures must be developed and identified to control such infections. This is done with the help of a well-designed infection control programme.[/h] [h=4]2 Scope of Infection Control Programme[/h] [h=3]- Prevents threat of infection from one person to other from all areas of hospital regardless of its origin.[/h] [h=3]- Reduce hospital acquired infection for e.g Device related infections like catheter associated blood stream infection & procedure related infections like surgical site infections [/h] [h=3]- Protect employee health by vaccinations, post exposure prophylaxis and limiting exposure to hazardous chemicals.[/h] [h=3]- Follow policies and procedures throughout the hospital with continuous surveillance, control measures and preventive measures, taken on a daily basis.[/h] 3 Need of infection control programme . Such a programme must: Ø set relevant objectives develop and continually update guidelines for recommended health care surveillance, prevention, and practice; Ø develop a system to monitor selected infections and assess the effectiveness of interventions; Ø harmonize initial and continuing training program for health care professionals; Ø facilitate access to materials and products essential for hygiene and safety; and encourage health care establishments to monitor health-care associated (nosocomial) infections and to provide feedback to the professionals concerned. . Ø to review risks associated with new technologies, and monitor the risk of acquiring an infection from new devices and products, before their approval for use; Ø to review and provide input into investigation of outbreaks and epidemics; Ø to communicate and cooperate with other committees of the health care facility with common interests such as Pharmacy and Therapeutics or Antimicrobial Use Committee, Biosafety or Health and Safety Committees, and Blood Transfusion Committee. Each health care facility needs to develop an infection control programme to ensure the well being of both patients and staff. Risk prevention for patients and staff is a concern of everyone in the facility, and must be supported by the senior administration. An annual work plan to assess and promote good health care, appropriate isolation, sterilization, and other practices, staff training, and epidemiological surveillance should be developed. Health care facilities must provide sufficient resources to support this programme. 4 Criteria for updating Infection Control Manual Infection control manual will be reviewed and updated every 3 years. Any updates and revisions in policy or procedures will be done as and when necessary. An yearly plan (goal) for the HIC program will be conceived and implemented (yearly update of Infection Control Program) ORGANIZATION OF AN INFECTION CONTROL PROGRAMME As with all other functions of a health care facility, the ultimate responsibility for prevention and control of infection rests with the health administrator. The hospital administrator/head of hospital should: establish an infection control committee which will in turn appoint an infection control team; and provide adequate resources for effective functioning of the infection control programme. Infection control committee An infection control committee provides a forum for multidisciplinary input and cooperation, and information sharing. This committee should include wide representation from relevant departments: e.g. management, physicians, other health care workers, clinical microbiology, pharmacy, sterilizing service, maintenance, housekeeping and training services. The committee must have a reporting relationship directly to either administration or the medical staff to promote programme visibility and effectiveness. In an emergency (such as an outbreak), this committee must be able to meet promptly. It has the following tasks: to review and approve a yearly programme of activity for surveillance and prevention; to review epidemiological surveillance data and identify areas for intervention; to assess and promote improved practice at all levels of the health facility; to ensure appropriate staff training in infection control and safety management, provision of safety materials such as personal protective equipment and products; and training of health workers. The infection control program will be effective so long as it is comprehensive and includes surveillance and prevention activities, as well as staff training. The infection control committee is responsible for the development of policies for the prevention and control of infection and to oversee the implementation of the infection control programme.