Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Hospital Infection Control Guidelines: Principles and Practice
Sanjeev Singh, Shakti Kumar Gupta, Sunil Kant
CHAPTER 1:
Organizational Structure for Infection Control Program
INTRODUCTION
INCIDENCE
IMPLEMENTATION STRATEGY
STEP 1
STEP 2
STEP 3
STEP 4
ORGANIZATIONAL STRUCTURE
Health Facility Level
Hospital Infection Control Committees
Recommended Terms of Reference
INFECTION CONTROL TEAM
Infection Control Team Personnel
Team Leader
Members
Terms of Reference
Nursing Representatives or “Link Nurses”
CONCLUSION
CHAPTER 2:
Functional Aspects of Infection Control Program
INTRODUCTION
SURVEILLANCE OF HEALTHCARE ASSOCIATED INFECTIONS
SUMMARY
CHAPTER 3:
Importance of Infection Control in Healthcare Facilities
IMPORTANCE OF INFECTION CONTROL PROGRAMS
INFECTIONS IN HEALTHCARE FACILITIES
MODES OF INFECTIOUS DISEASE TRANSMISSION
Natural Barriers to Infection
Transition from Colonization to Infection
Risk Groups for Acquiring Healthcare Associated Infections
Conventional, Conditional and Opportunistic Pathogens
Classification of Pathogens (Table 3.1)
Minimal Infective Dose of a Microorganism
Modes of Transmission
Chain of Infection or Disease-transmission Cycle
Components of the Disease-transmission Cycle
Infectious Agent
Reservoir
Place of Exit
Mode of Transmission
Place of Entry
Susceptible Host
PRINCIPLES OF PREVENTION OF NOSOCOMIAL INFECTION
Isolation Precautions for Infected Patients
Protective Clothing
Standard Precautions
IMPORTANCE OF INFECTION CONTROL PRACTICES
SUMMARY
CHAPTER 4:
Hand Hygiene
INTRODUCTION
Why Hand Hygiene Practices have not Worked?
MICROBIAL FLORA OF THE SKIN
HAND WASH METHODS
ROUTINE HAND WASH
Indications
Steps for Routine Hand Wash
ROUTINE HAND WASHING TIPS
Jewellery
Condition of Nails and Hands
Water
PROVISION FOR HAND WASHING FACILITIES
ANTISEPTIC HAND WASH OR ALCOHOL BASED HANDRUB
Indications for Hand Antisepsis
Products
Duration
Other Aspects Related to Hand Hygiene
SURGICAL HAND SCRUB AND ANTISEPSIS
Indications for Surgical Hand Scrub
Products
Duration and methods
IMPLEMENTATION OF HAND HYGIENE STRATEGY AT HEALTHCARE INSTITUTIONS
SUMMARY
CHAPTER 5:
Aseptic Techniques
INTRODUCTION
PRINCIPLES OF ASEPSIS
INTRAVENOUS THERAPY
Definition
Intravenous Infusion Sites of Possible Contamination (Fig. 5.1)
Sources and Routes of Transmission (Fig. 5.2)
Sources of Infection may be
Procedure for Inserting Peripheral IV Cannulae
Possible Sources of Infection
Factors Related to Equipment and to Fluids
Factors Related to Insertion and to Duration
Protective Clothing for Inserting IV Cannula
Maintenance of IV Lines
Procedure for Inserting Central Venous Catheters (CVC)
Protective Clothing during Insertion of CVC
Management of the Febrile Patient Receiving IV Therapy
INJECTION SAFETY AND PROPER USE OF MULTIDOSE VIALS
Instructions for Administrating a Safe Injection
Aseptic Injection Practices
Do not Touch the Injection Site with Fingers
Tips for Injection Safety
Observe the Patient when Administering an IV Infusion
PROPER USE OF MULTI-DOSE VIALS
URINARY CATHERIZATION
Procedure for Insertion of a Urinary Catheter
Emptying the Drainage Bag
Collecting Urine Samples
Bladder Irrigation
Prophylaxis and Treatment with Antibiotics
WOUND INSPECTION AND WOUND CARE
Surgical Wounds
Traumatic Wounds
Procedure for Wound Care
SUMMARY
CHAPTER 6:
Isolation Precautions
INFECTION CONTROL PRECAUTIONS
Objectives
Standard Precautions
Hand Hygiene
Personal Protective Equipment
PRINCIPLES FOR USE OF PERSONAL PROTECTIVE EQUIPMENT
Gloves
Masks
Protective Eyewear/Goggles/Visors/Face Shield
Gowns and Plastic Aprons
Caps and Boots/Shoe Covers
ADDITIONAL PRECAUTIONS
General Requirements of Transmission-based Precautions
AIRBORNE PRECAUTIONS
PRECAUTIONS TO AVOID DROPLET INFECTION
CONTACT PRECAUTIONS
Single Rooms
Anterooms
Cohorting
Transportation of Patients
Special Air Handling for Airborne Precautions
Negative Pressure Room
PROTECTIVE PRECAUTIONS (POSITIVE PRESSURE ROOM)
DONNING AND REMOVAL OF PPE
Donning PPE
Gown
Mask or Respirator
Goggles/Face Shield
Gloves
Safe Work Practices
Removing PPE
Gloves
Goggles/Face Shield
Gown
Mask or Respirator
Hand Hygiene
SUMMARY
CHAPTER 7:
Disinfection and Sterilization
INTRODUCTION
BACKGROUND
DEFINITIONS
Disinfection
Disinfectant
Decontamination
Sterilization
SPAULDING’S CLASSIFICATION
USE OF DISINFECTION AGENTS ACCORDING TO SPAULDING’S CLASSIFICATION
High-level Disinfection: Agents for Critical Equipment
Intermediate-level Disinfection: Agents used for Semicritical Equip ment
Low-level Disinfection: Agents used for Noncritical Equipment
CHEMICAL DISINFECTANTS
DISINFECTION OF PATIENT CARE INSTRUMENTS
DISINFECTION OF SPECIAL SEMICRITICAL INSTRUMENTS
Rigid Instruments with Optics
SURFACE DISINFECTION
Standard Guidelines
MANAGEMENT OF SPILLS
DISINFECTION IN HEMODIALYSIS UNITS
PRINCIPLES OF STERILIZATION
Principles
Basic Requirements for Sterilization Systems
Effectiveness
Penetration
Safety
Quality Assurance
Material Compatibility
Approval
TYPES OF STERILIZATION
Physical Processes of Sterilization
High Temperature Technologies
Steam Sterilization
Equipment
Dry Heat Sterilization
Low Temperature Technologies
Ethylene Oxide Sterilization
Hydrogen Peroxide (Plasma)
Liquid Peracetic Acid
Chlorine Dioxide
Ozone
STERILIZATION PROCESS MONITORS
Need for Process Monitoring
Mechanical Indicators
Temperature Measurement
Pressure Measurement
Chemical Indicators
Biological Indicators
Types of Biological Indicators
Test Organisms Used
Frequency of Testing
MONITORING AND EVALUATION
SUMMARY
CHAPTER 8:
Infection Control: Planning and Designing
BACKGROUND
General Considerations
PLANNING AND DESIGN CONSIDERATIONS FOR SPECIFIC AREAS
Wards
Operation Theater
Isolation Rooms
Category
All classes of isolation rooms require the following
Unique features for Class N and P isolation rooms are
Intensive Care Units
Structural Requirements
Ventilation Requirements
Internal Air Quality: Maintenance of HVAC
Water Quality
Central Sterile Supply Department
Structural Requirement
Ventilation Requirements
Unique Features for Storage of Sterile Goods
SUMMARY
CHAPTER 9:
Antimicrobial Resistance and Stewardship
BACKGROUND
SCOPE
MECHANISMS OF ACTION BY ANTIMICROBIAL DRUGS
MECHANISMS OF ANTIMICROBIAL RESISTANCE BY MICROORGANISMS
ANTIBIOTIC RESISTANCE
METHODOLOGY OF ANTIMICROBIAL STEWARDSHIP
Supplements to Core Antibiotic Stewardship Program (IDSA 2007 Guidelines)
MANPOWER, INFRASTRUCTURE AND RESOURCES
Antimicrobial Stewardship Program: Implementation Process and Toolkit
Antibiogram
Antimicrobial Cycling or Rotation
MECHANISM OF IMPLEMENTATION
The Do's and Don'ts of antibiotic resistance are enumerated in Table 9.6.
SUMMARY
CHAPTER 10:
Clinical Laboratory Standards Relating to Infection Control
INTRODUCTION
ROLE OF MICROBIOLOGY LABORATORY IN INFECTION CONTROL
QUALITY CONTROL IN CLINICAL LABORATORIES
Organizational management and structure
Quality standards
Documentation
Training
Assessment
STANDARDIZED METHODS
Quality Control of Microbial Growth Media
Quality Assurance in Antibiotic Susceptibility Testing
External Quality Assessment Scheme
SUMMARY
CHAPTER 11:
Healthcare Workers Safety: Risk Reduction and Management Plan
INTRODUCTION
TYPES OF OCCUPATIONAL INJURY
Needle-stick Injuries with Blood and Body Fluid Exposures
Identifying NSI and BBF
SHARPS INJURY PREVENTION PROGRAM: ROLE OF MANAGEMENT
SHARPS INJURY PREVENTION PROGRAM: SAFETY ENGINEERED DEVICES AND TRAINING
TAKING CARE OF THE EXPOSED HCWs
Immediate Measures to be Followed Upon Exposure to HIV Infected Blood
Subsequents Steps to be Followed
Post-exposure Prophylaxis
Determination of the Exposure Code
Determination of PEP Recommendation
Basic Regimen
Expanded Regimen (4 Weeks Therapy)
Testing and Counseling
PEP for Hepatitis B and Hepatitis C
Treatment of Exposure Site
Evaluation of Exposure
Post-exposure Management of Hepatitis C
TAKE HOME MESSAGE—HCWs SAFETY FROM SHARPS
SOME OTHER OCCUPATIONAL INJURIES TO HEALTHCARE WORKERS
Antineoplastic Agents
Latex Allergies
Safe Patient Handling
Tuberculosis
Study on Needle-stick Injuries using EPINet
SUMMARY
CHAPTER 12:
Surveillance of Healthcare Associated Infections
INTRODUCTION
HAIs Fact Sheet (WHO)
PURPOSE OF SURVEILLANCE
DEFINITIONS
SURVEILLANCE PROGRAM
Methodology
Manpower/Resources
Implementation of Surveillance Program
Process Surveillance for HAIs
Outcome Surveillance for HAIs
Tool Kit (Collection of Data)
Working Tools
Managing Data
Analysis of Data
Feedback of Data
Comparison of Data
Monitoring and Evaluation of Surveillance Systems
SUMMARY
ANNEXURE-1
ANNEXURE-2
ANNEXURE-3
ANNEXURE-4
ANNEXURE-5
ANNEXURE-6
Catheter Associated Urinary Tract Infections (CAUTIs)
Formula for Catheter Associated Urinary Tract Infections (CAUTIs)
Central line Associated Bloodstream Infections (CLABSI)
Formula for CLABSI
Ventilator Associated Pneumonia (VAP)
Formula for VAP
Surgical Site Infection (SSI)
Formula for SSI rate
Process Surveillance
Hand hygiene
Formula for calculation of compliance rate
CHAPTER 13:
Management of Disease Outbreak
INTRODUCTION
DEFINITIONS
Outbreak Detection
Epidemiological Methods
Role of the Hospital Infection Control Team
STEPS TO BE TAKEN TO INVESTIGATE AN OUTBREAK
Infection control staff should ensure the following
Step 1
Step 2
Step 3
Step 4
Immediate Control Measures
Specific Control Measures
Evaluation of Efficacy of Control Measures
Factors to be Considered for Convening a Hospital Outbreak Control Team (HOCT) Meeting
DO’S AND DON’TS
The important Do's and Don'ts of Disease Outbreak are
SUMMARY
ANNEXURE-I
Outbreak Control Team-membership (Community/Hospital or Healthcare Facility)
ANNEXURE-II
Terms of Reference of HOCT
ANNEXURE-III
Functions of Hospital Epidemiologist or Designee, Acting as the Main Coordinator
ANNEXURE-IV
Checklist of Tasks for Hospital Outbreak Control Teams (HOCTs)
Preliminary Phase
Descriptive Phase
Analytical Phase
Control Measure
Evaluation
ANNEXURE-V
Report Form for Infectious Disease Outbreak
CHAPTER 14:
Infection Prevention and Control Training Curriculum
INTRODUCTION
Course Description
Participants
Recommended Duration
Hands on Demonstrations During Workshops
Course Objectives
MODULE 1, PART 1: BASIC MICROBIOLOGY
Module Description
Module 1, Part 1: Objectives
MODULE 1, PART 2: BASIC EPIDEMIOLOGY
Module Description
Hands on Demonstration
Module 1, Part 2: Objectives
MODULE 2: INFECTION CONTROL PRACTICES, PART 1
Module Description
Hands on Demonstration
Module Objectives
MODULE 3: INFECTION CONTROL PRACTICES, PART 2
Module Description
Hands on Demonstration
Module Objectives
MODULE 4: MANUAL OF INFECTION PREVENTION AND CONTROL POLICIES AND GUIDELINES
Module Description
Required Reading
Hands on Demonstration
Module Objectives
MODULE 5: MANAGEMENT OF INFECTION PREVENTION AND CONTROL POLICIES AND GUIDELINES
Module Description
Required Reading
Hands on Demonstration
Module Objectives
SUMMARY
CHAPTER 15:
Economics of Healthcare Associated Infections
BURDEN
ECONOMIC IMPLICATIONS
Methods to Determine Cost
An Indian Example
Universal Impact
HAIs vs HIC
SUMMARY
Glossary
Annexure: List of Existing Guidelines for Infection Control
Bibliography
INDEX
TOC
Index
×
Chapter Notes
Save
Clear