Basics of
Infection Prevention
and control (1)
(Standard precautions)
By
Dr. Manar Emara
Lecturer of Medical Microbiology and Immunology
Objectives
by the end of this lecture, you will be able to
identify:
1. Appropriate precautions in healthcare setting .
2. Standard precautions.
Healthcare associated infections
Health care-associated infections (HCAIs) are infections
that occur while receiving health care, developed in a
hospital or other health care facility that first appear 48
hours or more after hospital admission.
Our goal in infection control
Breaking
the chain
of
infection
Modes of transmission
A microorganism may be spread by a single or multiple routes.
• Contact (direct or indirect)
• Droplet
• Airborne
• Vector-borne (usually arthropods)
• Common environmental sources or vehicles - includes food-borne
and waterborne, medications e.g., contaminated IV fluids
Contact transmission
Direct Indirect
Droplet contact
Types of precautions
Standard Precautions
All patients
Transmission based Pt with certain
precautions. communicable
diseases
Expanded precautions. Pt with newly
emergent
pathogens
Levels of infection prevention and control
(CDC Guidelines)
Standard Precautions
All
patients
Transmission based
Who infected
precautions (confirmed)
(isolation precautions ) or may be infected
(suspected)
CDC categories
• Standard
• Contact
Transmission
• Airborne based
precautions
• Droplet
Standard precautions
A. Standard precautions
They are the minimum infection prevention practices that
apply to all patients care, regardless of suspected or confirmed
infection status of the patient, in any setting where health care
is delivered.
Apply to
(1) blood.
(2) all body fluids, secretions, and excretions except sweat, regardless
of whether or not they contain blood.
TREAT ALL
(3) non intact skin.
PATIENTS AS
(4) mucous membranes.
INFECTIOUS
Standard precautions
1. Hand Hygiene.
2. Personal Protective Equipment.
3. Respiratory Hygiene / Cough
Etiquette.
4. Safe waste disposal/Sharps Safety.
5. Safe Injection Practices.
6. Sterilization and Disinfection of
Patient-Care Items and Devices
7. Environmental Infection Prevention
and Control
1) Hand Hygiene (form the section )
Hand hygiene is the most important measure to
prevent the spread of infections among patients.
Answer these questions:
1) What are the types of bacteria
recovered from the hand?
2) Compare between different types of
hand hygiene procedures
3) Enumerate compounds used for hand
antisepsis
4) When do you perform hand hygiene?
Type Routine Hand washing Antiseptic Hand Hygiene Surgical Hand
Hygiene
Procedure ✓ Washing hands with Rubbing hands with an alcoholic ✓ Washing hands and
plain soap and water hand preparation (hand rub). forearms with
(40-60 sec) or washing hands with water antimicrobial soap for
and antiseptic soap e.g., 5-6 minutes (surgical
iodophore (betadine) or scrub).
chlorhexidine ✓ Rubbing hands and
(40-60 sec) forearms with
alcoholic preparation
after washing with
plain soap (surgical
rub).
Purpose (remove soil & transient (remove transient & reduce (remove transient &
flora) resident flora) reduce resident flora
Indications before & after non-invasive Before invasive procedures Before all surgical
procedures) procedures .
5 moments for HH
2) PPE (form the section )
Gowns
Indications
Disposable
• When large blood spill is anticipated.
• Care for patient with contact inf.
Reusable
• Sterile for surgical procedures.
• Clean lab coat for daily examination of
patients.
Gloves
Indications
Clean 1. Blood e.g. use of anesthetic syringe.
2. Secretions e.g. handling soiled equipment.
3. Excretions e.g. handling specimens.
4. Mucous membranes e.g. performing oral care/ oral examination.
5. Non-intact skin e.g. removal of necrotic skin from wound.
Sterile 1. Surgery.
2. Invasive procedure e.g. bone implant.
3. Wound dressing.
Heavy 1. Handling & cleaning of contaminated items.
duty 2. Waste collection.
3. Environmental cleaning .
Masks
Indications
Surgical • OR.
• Care for patient with droplet inf.
• Care for immuno -compromised patient.
• Lumbar puncture.
• Central sterilization service department (CSSD).
Respirator • Care for patient with airborne infection.
Eye protection
Types Goggles
Face shield
Indications
1. When splash generating procedures is anticipated.
2. In surgical procedures.
3) Respiratory Hygiene / Cough etiquette
4) Safe waste disposal /Sharps Safety
• Of the total amount of waste generated by health-
care activities, about 85% is general, non-hazardous
waste comparable to domestic waste.
• The remaining 15% is considered hazardous material
that may be infectious, chemical or radioactive.
Cultures of Blood, its
Cytotoxic
microorganisms products
Radioactiv Pathological
e materials wastes
Animal waste
Safe waste disposal
Collection, Treatment and Selecting
Segregation and packing
transportation and and adopting the final
of waste at point of care
storage of waste disposal options.
Safe waste disposal
Collection, Treatment and Selecting
Segregation and packing
transportation and and adopting the final
of waste at point of care
storage of waste disposal options.
Waste containers
This is done at the site of use in color coded according to
Come in many shapes and sizes.
the national color guidelines In all cases, they should be
durable and leak-proof, and
(except for sharps containers)
lined with a secure plastic
bag.
• Specifically labelled
• Should have well-fitting lids,
either removable by hand or a
foot pedal.
Sharp box /safety
Non-hazards Infected Human Infectious box
waste plastic anatomical waste, waste e.g. Puncture resistant,
needless Used gloves
microbiological, narrow neck,
syringes contaminated tightly closed
pathological, dressing container
cytotoxic and , blood bags,
urine bags,, etc.
discarded
medicines
Designate waste as infectious or non infectious at
the point of generation.
➢Infectious waste (red containers )
➢Non infectious (black containers)
➢Sharps ( sharp containers)
Safe waste disposal
Collection, Treatment and Selecting
Segregation and packing
transportation and and adopting the final
of waste at point of care
storage of waste disposal options.
Waste trolleys covered, only used for waste
Workers should wear heavy duty transport, clearly labelled, cleaned daily, and
gloves, mask and special plastic gown. never over filled able to contain leaks or spills.
Safe waste disposal
Segregation and packing Treatment and Selecting
of waste at point of care Collection, transportation
and adopting the final
and storage of waste
disposal options.
Treatment:
• Incineration
• Chemical Disinfection
• Autoclaving
• Microwave irradiation
Final Disposal
• Landfill
• Discharge into Sewer etc.,
Infectious waste requires treatment of the waste before landfill disposal
by incineration or decontamination with or without .
5)Safe Injection Practices
• Prepare injections using aseptic technique in a clean area.
• Disinfect the rubber septum on a medication vial before piercing as
well as the skin with 70% alcohol.
• Use single-dose vials and a disposable syringe for parenteral
• medications when possible
• Multidose vials:
➢Dedicate multidose vials to a single patient whenever possible
➢Are entered with a new needle and new syringe, even when
obtaining additional doses for the same patient.
➢Date when first opened, discard according to the manufacture or
when
spoiled.
6) Sterilization and Disinfection of
Patient-Care Items and Devices
Cleaning: getting rid of foreign material from an object
Decontamination is removal, inactivation or
destruction of pathogens on the surface of an item
Disinfection: reduction of the number of pathogenic
organisms (not always including spores)
Sterilization: destruction of all microorganisms
including spores and viruses
7) Environmental Infection Prevention
and Control
• Routine, at regular bases according to guidelines.
• Use water with soap/detergents/disinfectants according to
degree of contamination and level of asepsis.
• Cleaning solution and equipment should be changed between
rooms and cleaned and dried daily.
• Dry sweeping and profuse watering are forbidden.
• Start cleaning from cleanest to dirtiest / highest to lowest/ non-
infected to infected.
