INFECTION CONTROL COMMITTEE
THE RISK OF INFECTION IS ALWAYS PRESENT IN EVERY HOSPITAL
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
Occupational infections among staff.
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
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.
FACTORS INFLUENCING N.I.
The microbial agent
Patient susceptibility
Environmental factors
TRANSMISSION
Where do nosocomial infection come from?
Endogenous infection: When normal patient flora changes 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.
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Exogenous cross-infection: Mainly through hands of healthcare workers, visitors,
patients.
INFECTION CONTROL PROGRAM
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
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
GOALS FOR INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY
There are three principal goals for hospital infection control and prevention programs:
1. Protect the patients
2. 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.
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
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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.
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)
INFECTION CONTROL PROGRAM (ICP): In the majority of countries ICP, typically
operates on two levels:
An executive body – the infection control team (ICT) –
An advisory body to the hospital management – the infection control committee (ICC) –
which adopts the ‘legislative’ role of policy making.
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.
INFECTION CONTROL COMMITTEE
It is a multidisciplinary committee responsible for monitoring program policies
implementation and recommend corrective actions.
It includes representatives from different concerned hospital departments &
management. They meet bimonthly.
It establishes standards for patient care, it reviews and assesses IC reports and
identifies areas of intervention.
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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.
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.
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
• 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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HOSPITAL 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
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
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.
