05 PCS HIC: Hospital Infection Control

HIC 6 Infection control programme - Training of staff.

posted Jan 20, 2011, 4:21 AM by Dr.Murali BK   [ updated Jan 24, 2011, 1:11 AM ]

 

HIC 5 Bio Medical Waste Management

posted Jan 20, 2011, 4:19 AM by Dr.Murali BK   [ updated Jan 20, 2011, 4:25 AM ]

1.   Aim:

       This policy will provide guidance to the staff for medical waste management, segregation and treatment and disposal ,based upon current best practice.

 

                                                                     

2.   Rationale:

To protect the environment.

To prevent the infections.

 

 

3.   Responsibilities of various personnel in the department

1 Doctors

2 Nurses

3 Patient assistants

4 Housekeeping staff

5 Pantry boys

6 Technicians

 

4.   Colour coding for Categories of waste

·         Yellow - Human Anatomical Waste human tissues, organs, body parts

bleeding parts, fluid, blood.

Microbiology & Biotechnology waste (wastes from laboratory cultures, stocks or specimens of micro-organisms live or attenuated vaccines,

 

·         Red-Solid Waste (Items contaminated with blood and body fluids including cotton, dressings, soiled plaster casts, line beddings, other material contaminated with blood)

 

·         Black- Discarded Medicines and Cytotoxic drugs ,wastes comprising of outdated, contaminated and discarded medicines. Chemical Waste , chemicals used in disinfect ion, as insecticides, etc

 

·         White-General waste, stationary, paper,non infectious plastic,etc.

 

·         Puncture Proof Container(PPC)- Waste Sharps (needles, syringes, scalpels blades, glass etc. that may cause puncture and cuts. This includes both used & unused sharps)

 

·         Green-Kitchen waste and food.

 

5.   Staff responsibility

       All the staff follow the colour coding systems for different wastes, ensure before discarding anything that you are using the right bin.

       The syringes should be cut and the needle should be burned before discarding.

       Training of a new staff will be responsibility of the incharge sister.

       The biomedical waste management chart should always be displayed on the wall of every nursing station.

       There should be a display on the bin also.

       The infection control nurse will supervise all the staff for following biomedical waste management policy.

       Guiding the  patient and the relatives will be duty of the ward staff.

 

 

 

 

 

 

 

 

 

Table1.                       Schedule I of the Bio- Medical Waste Rules

 

 

Option                       Treatment & Disposal                Waste Category

Cat. No. 1                  Incineration /deep burial               Human Anatomical Waste (human tissues,

                                                                                         organs, body parts)

Cat. No. 2                  Incineration /deep burial               Animal Waste Animal tissues, organs, Body

                                                                                         parts carcasses, bleeding parts, fluid, blood and

                                                                                         experimental animals used in research, waste

                                                                                         generated by veterinary hospitals/ colleges,

                                                                                         discharge from hospitals, animal houses)

Cat. No. 3                 Local autoclaving/ micro               Microbiology & Biotechnology waste (wastes

                                  waving/ incineration                      from laboratory cultures, stocks or specimens of

                                                                                         micro-organisms live or attenuated vaccines,

                                                                                         human and animal cell culture used in research

                                                                                         and infectious agents from research and industrial

                                                                                         laboratories, wastes from production of

                                                                                         biological, toxins, dishes and devices used for

                                                                                         transfer of cultures)

Cat. No. 4               Disinfections (chemical                     Waste Sharps (needles, syringes, scalpels blades,

                             treatment/autoclaving/micro              glass etc. that may cause puncture and cuts. This

                              waving and mutilation shredding      includes both used & unused sharps)

 

Cat. No. 5            Incineration / destruction                    Discarded Medicines and Cytotoxic drugs

                            & drugs disposal in                            (wastes comprising of outdated, contaminated

                            secured landfills                                   and discarded medicines)

                                

Cat. No. 6            Incineration,                                        Solid Waste (Items contaminated with blood and

                             autoclaving/micro waving                  body fluids including cotton, dressings, soiled

                                                                                         plaster casts, line beddings, other material

                                                                                         contaminated with blood)

Cat. No. 7           Disinfections by chemical                    Solid Waste (waste generated from disposable

                           treatment autoclaving/micro                  items other than the waste sharps such as tubing,

                           waving& mutilation shredding.            Catheters, intravenous sets etc.)

                          

                          

Cat. No. 8            Disinfections by                                 Liquid Waste (waste generated from laboratory

                            chemical treatment and                      & washing, cleaning , house-keeping and

                            discharge into drain                            disinfecting activities)

 

Cat. No. 9           Disposal in municipal                         Incineration Ash (ash from incineration of any

                            Landfill                                               bio-medical waste)

 

Cat. No. 10         Chemical treatment &                        Chemical Waste (chemicals used in production

                            discharge into drain for                      of biological, chemicals, used in disinfect ion, as

                            liquid & secured landfill                     insecticides, etc)

                           for solids

 

 

Treatment Options as per  Schedule 1

 

Yellow               Plastic bag                         1,2,3,6                     Incineration/deep burial

Red                    Disinfected Container      3,6,7                        Autoclaving/Micro waving/

                          / Plastic bag                                                      Chemical Treatment

Blue/ White      translucent Plastic bag/        4,7                         Autoclaving/Micro waving/

                           puncture proof container                                 chemical treatment and

                                                                                                    destruction/shredding

                        

Black                Plastic bag                        5,9,10                     (Solid) Disposal in secured landfill

 

 

 

6.   Segregation

7.   Transportation

8.    Disposal

HIC 4 Sterilisation activities

posted Jan 20, 2011, 4:18 AM by Dr.Murali BK   [ updated Feb 13, 2011, 11:22 PM by naomi coutinho ]


HIC 3 Hospital Associated Infection (HAI)

posted Jan 20, 2011, 4:16 AM by Dr.Murali BK   [ updated Feb 1, 2011, 3:48 AM by monica d ]

General guide - Hospital Acquired infection


Definition
Hospital-acquired infection is usually one that first appears three days after a patient is admitted to a hospital or other health-care facility. Infections acquired in a hospital are also called Nosocomial infections.

Description

Hospital-acquired infections can be caused bacteria, viruses’ fungi, or parasites.
These microorganisms may already be present in the patient's body or may come from the environment, contaminated hospital equipment, health-care workers, or other patients.
An infection may start in any part of the body. If a surgical wound in the abdomen becomes infected, the area of the wound gets infected
A generalized infection is one that enters the blood stream and causes general systemic symptoms such as fever, chills, low blood pressure.
Hospital-acquired infections may develop from surgical procedures, catheters placed in the urinary tract or blood vessels, or from material from the nose or mouth that is inhaled into the lungs.

The most common types of hospital-acquired infections are Urinary tract infections, pnemonea and surgical wound infections.

Causes
·         Persons with compromised immune systems  are more likely to get an infection.
·         Prolonged hospital stay
·         Use of indwelling catheters
·         Failure of hospital staff to wash their hands
·         Overuse of antibiotics




Symptoms
·         Fever is often the first sign of infection.
·         Other symptoms and signs of infection are rapid breathing, mental confusion, low blood pressure, reduced urine output, and a high white blood cell count.

Patients with a UTI may have pain when urinating and blood in the urine.
·         Symptoms of pneumonia may include difficulty breathing and coughing.
·         A localized infection causes swelling, redness, and tenderness at the site of infection.


Diagnosis
Diagnosis of a hospital-acquired infection is based on:
·         symptoms and signs of infection
·         examination of wounds and catheter entry sites-
·         Wounds and the skin where catheters have been placed are examined for redness, swelling, or the presence of pus or abscess
·         The physician reviews the patient's record of procedures performed in the hospital to determine if any posed a risk for infection and review of procedures that might have led to infection.
·         laboratory test results-
1.  CBC can reveal if the WBC is high.
2.  White blood cells or blood may be present in the urine when there is a UTI.
3.  Cultures of blood, urine, sputum, other body fluids, Catheter tip, or tissue are done to look for infectious microorganisms.
·         X Ray chest is done to look for infiltrates of white blood cells and other inflammatory substances in the lung tissue.
·         Samples of sputum can be studied with a microscope or cultured to look for bacteria or fungi.


Treatment

Once the source of the infection is identified, the patient is treated with antibiotics or other medication that kills the responsible microorganism.


Prognosis
Hospital-acquired infections are serious illnesses that cause death in about 1% of cases. Rapid diagnosis and identification of the responsible microorganism is necessary, so treatment can be started as soon as possible.

Prevention
·         All the staff should adhere the infection control policies developed by the infection control team in the hospital to prevent nosocomial infections
·         High risk procedures such as urinary catheterizing should be performed only when necessary and catheters should be left in for as little time as possible.
·         Medical instruments and equipment must be properly sterilized to ensure they are not contaminated.
       The nurses should follow the Policy nursing barrier/Isolation
·         Frequent hand washing by staff and visitors is necessary to avoid passing infectious microorganisms to hospitalized patients.
·         Antibiotics should be used according to the antibiotic policy. Overuse of antibiotics is also responsible for the development of bacteria that are resistant to antibiotics.




HIC2 Infection control manual

posted Jan 20, 2011, 3:56 AM by Dr.Murali BK   [ updated Mar 12, 2011, 1:20 AM by naomi coutinho ]


HIC 2
     INFECTION CONTROL MANUAL 



    1.    PURPOSE
    
    1.1  To maintain standards in infection control measures and minimize hospital infection in patients and staff.
    1.2  To define policy and procedure regarding hospital acquired infections in the hospital

    2.    SCOPE
           Hospital wide 

    3.    DEFINITION
           Infection control refers to policies and procedures used to implement the best practices to minimize the risk of     spreading infections diseases ,in the hospital. These diseases are usually caused by bacteria or viruses and can be spread by human to human contact, human contact with an infected surface, airborne transmission through tiny droplets of infectious agents suspended in the air, and, finally, by such common vehicles as food or water. 

    4.     RATIONALE

    4.1.To reduce the occurrence of infectious diseases.

    4.2.Prevention and Control of Nosocomial Infections.

    4.3.To prevent post surgical infection

    4.4.To safeguard staff from infections.


    5.    HIGH RISK AREAS
    5.1  Operation Theater
    5.2  Intensive care unit
    5.3  Recovery room

 
    6.    HOSPITAL INFECTION CONTROL COMMITTEE
           
           Dr.B.K.Murali
           Dr.Girish Gautam
           Dr.Reena Rao
           Dr.Jaya Jeswani
           Mrs.Monica Ganvir
           Sr.Prerna
           Sr.Naomi

  
    7.    OBJECTIVES OF THE COMMITTEE
           
    7.1  To minimize the risk of infection to patients, staff and visitors
    7.2  To identify the roles and responsibilities of kep personnel involved in the prevention and control of infection
    7.3  To maintain surveillance over hospital acquired infections
    7.4  To develop a system for identifying, reporting, analyzing, investigating and controlling hospital acquired infections.
    7.5  To develop and implement preventive and corrective programmes in specific situationswhere infection hazards exist
    7.6  To review and update hospital infection control policies and procedures from time to time
    7.7  To provide employee health education regarding mattersrelated to hospital acquired infections.

    
    8.     FUNCTIONS OF INFECTION CONTROL COMMITTEE

    8.1  Maintenance of sound habits in personal hygiene and individual responsibility in infection control by training the s    
           staff throughout the organization. 

    8.2  Monitoring and investigating infectious diseases, potentially harmful infectious exposures, and outbreaks of   
           infections among personnel. 

    8.3  Providing care to personnel for work-related illnesses or exposures.

    8.4  Identifying infection risks areas related to employment and instituting appropriate preventive measures.

    8.5  Surveillance activities for tracking and analyzing appropriate infection rates.

    8.6  Providing feedback regarding these rates on regular basis to top management, medical and nursing staff. 


    9 .   FUNCTIONS OF INFECTION CONTROL NURSE

    9.1. Regular visit to the all clinical areas to make sure that the patients with particular infection receives an appropriate treatment in regard to the isolation precaution, and the type of treatment.
    
    9.2. To make sure that, the staffs are educated and updated with the protocols in relation to the infection control.

    9.3. To advise and supervise the work of staff for the best infection control practices like Bio-Medical waste management,   
           Hand washing, Isolation throughout the hospital.

    9.4. To arrange special teaching session to the staff and even for specific group of patients pertaining to the infection  
           control and prevention.
    
   9.5.  To collect data of patients with infections that require isolation precaution and use of specific antibiotics.eg; MRSA  
           etc;
   
   9.6. To conduct clinical audit as a member of Infection control committee member ,to make sure that, the infection control  
          and prevention.

   9.7. To updates his/ her knowledge by participating in the clinical governance meeting.

   9.8. To share her or his concerns to the Director or the microbiologist in order to get an idea and for a possible solution.

          In the hospital situation, any outbreak of infection is normally informed by the Head of the microbiology or virology  
    department. The information will then be cascaded to the local unit/ward through the infection control nurses and infection 
    control link nurses.


   10.   PERSONNEL RESPONSIBLE

          Doctors

          Nurses

          Patient assistants

          Housekeeping staff

          Pantry boys

          Lab Technicians

          OT Technicians


    11.  INFECTION CONTROL MEASURES

         Proper Hand wash technique (Refer policy and procedure for hand wash NUR/SOP/VER1)

         Isolation /Nursing barrier techniques (Refer policy and procedure for Isolation /Nursing barrier NUR/SOP/VER1

         Appropriate pre and post exposure prophylaxis (Refer policy and procedure for pre and post exposure prophylaxis    
         HR/SOP/VER1)

        Sterilization Technique (Refer policy and procedure for Sterilization OT/SOP/VER1)

        Proper Bio- Medical waste management (Refer policy and procedure for Bio- Medical waste management   
        HK/SOP/VER1)

        Proper Equipment cleaning (Refer policy and procedure for Equipment cleaning HK/SOP/VER1)

        Laundry and linen Management (Outsourced)

        Kitchen sanitation and food handling (Outsourced)

        Engineering control Programme (Refer policy and procedure for Engineering control Programme ENG/SOP/VER1)

        Sensitization programme for staff.

        In service training programme for staff.

        Surveillance programme (Refer policy and procedure for Surveillance Programme NUR/SOP/VER1)







HIC1 Hospital infection control programme

posted Jan 20, 2011, 3:53 AM by Dr.Murali BK   [ updated Jan 31, 2011, 10:48 AM by naomi coutinho ]

HOSPITAL INFECTION CONTROL COMMITEE

   

·        Dr. B.K. Murali

·        Dr.Girish Gautam

·        Dr.Reena Rao

·        Dr.Jaya Jeswani

·        Ms.Monica Ganvir

·        Mrs.Prerna

       Ms.Naomi.


                         HOSPITAL INFECTION CONTROL PROGRAMME

* Monthly staff training sessions on infection control

*  Frequent assesment of staffs knowledge regarding spread of infection and control

* Regular meetings between ward-in- charges and infection control nurse

* Up-to-date register/records maintainence regarding sterilization activities, linen

   and housekeeping logs etc

* Detection of HAI(Hospital acquired infections)

* Accurate data collection and statistics on incidence of HAI

* Reporting and documentation of needle stick injuries among staff and the appropriate protocol

   to be followed

* Motivational activities such as competitions on various topics related to infection control.

* Involvement of staff in overall maintainence of optimum standards of infection control





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