BASIC HOSPITAL

INFECTION
CONTROL

Ramil V. Garcia RN, MAN

Romana B. Cortes RN, MAN
NURSING DIVISION
TRAINING AND EDUCATION
GENERAL OBJECTIVE:
At the end of the lecture,
the participants will be able to
know and understand
Healthcare Associated
Infection, its prevention and
control.
NURSING DIVISION
TRAINING AND EDUCATION
SPECIFIC
OBJECTIVES:
 To know the definition of
Healthcare Associated
Infection
 To understand the basic
infection control practices.

NURSING DIVISION
TRAINING AND EDUCATION
BASIC CONCEPTS IN HOSPITAL
INFECTION CONTROL

 “Nosocomial infection”
 “Hospital acquired infection”
 “Healthcare associated
infection”
 Infection acquired in the hospital
48 hours after admission

NURSING DIVISION
TRAINING AND EDUCATION
NURSING DIVISION
TRAINING AND EDUCATION
 CAUSATIVE AGENT
 Causative agents in infection are
pathogens.

 Pathogens are micro-organisms that are

capable of causing diseases or
infections.

NURSING DIVISION
TRAINING AND EDUCATION
 EXAMPLES OF CAUSATIVE AGENT

NURSING DIVISION
TRAINING AND EDUCATION
EXAMPLES OF CAUSATIVE AGENT

NURSING DIVISION
TRAINING AND EDUCATION
 EXAMPLES OF CAUSATIVE AGENT

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TRAINING AND EDUCATION
 RESERVOIR
Definition:
A reservoir is any person, animal,
arthropod, plant, soil, or substance
(or combination of these) in which an
infectious agent normally lives ,
multiplies, and depends primarily for
survival. It is where it reproduces
itself in such manner that it can be
transmitted to a susceptible host.

NURSING DIVISION
TRAINING AND EDUCATION
 ANIMATE RESERVOIRS
INCLUDE PEOPLE,
INSECTS, BIRDS, AND
OTHER ANIMALS.

INANIMATE RESERVOIRS
include soil, water, food,
feces, intravenous fluid and
equipment.

NURSING DIVISION
TRAINING AND EDUCATION
 PORTAL OF EXIT
Definition:
A portal of exit is the site from where
micro-organisms leave the host to enter
another host and cause
disease/infection.
Example:
a micro-organism may leave the
reservoir through the nose or mouth
when someone sneezes or coughs, or in
feces.

NURSING DIVISION
TRAINING AND EDUCATION
COMMON PORTAL OF EXIT

 Respiratory
 Genitourinary tract (GUT)
 Gastrointestinal tract (GIT)
 The Skin and Mucous
Membrane
 The Placenta

NURSING DIVISION
TRAINING AND EDUCATION
 MODE OF TRANSMISSION

Definition:
The movement or the
transmission of pathogens from a
reservoir to a susceptible host.
Once a pathogen has exited the
reservoir, it needs a mode of
transmission to the host through a
portal of entry.

NURSING DIVISION
TRAINING AND EDUCATION
 FORMS OF TRANSMISSION
1.Horizontal Transmission
A. Contact Transmission
a.1 direct contact- person to person
a.2 Indirect contact- inanimate
objects or personal things
a.3 Droplet contact- contact with
discharges from coughing,
sneezing or
talking with an infected person
NURSING DIVISION
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 FORMS OF TRANSMISSION

B. Airborne Transmission
b.1 Droplet nuclei- within 3 feet
particles from the source
b.2 Dust particles in the air
C. Vector borne
> transmitted with the aid of
contaminated or infected
arthropods such as flies,
mosquitoes and ticks
NURSING DIVISION
TRAINING AND EDUCATION
 FORMS OF TRANSMISSION
D. Vehicle Route
> transmitted through inanimate
objects like food, water, and
contaminated infusion products
and equipment
d.1 food-salmonellosis
d.2 water-shigellosis
d.3 drugs- e.g. bacteremia from infusion
of a contaminated product
d.4 blood- e.g. Hepa B
NURSING DIVISION
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 FORMS OF TRANSMISSION

2. Vertical Transmission

> refers to the mother to child

transmission through the placental
barrier or breastfeeding
EXAMPLES : MODE OF
TRANSMISSION

NURSING DIVISION
TRAINING AND EDUCATION
EXAMPLES : MODE OF
TRANSMISSION

NURSING DIVISION
TRAINING AND EDUCATION
EXAMPLES : MODE OF TRANSMISSION

NURSING DIVISION
TRAINING AND EDUCATION
 PORTAL OF ENTRY

A portal of entry is the site

through which micro-organisms
enter the susceptible host and
cause disease/infection

NURSING DIVISION
TRAINING AND EDUCATION
 EXAMPLES : PORTAL OF ENTRY
 Upper respiratory tract-
inhalation (eg. influenza)
 Gastrointestinal tract-
ingestion (eg. gastroenteritis)
 Blood-needlestick injury (eg.
hepatitis B)
 Urogenital tract- sexual contact
(eg. chlamydia)
 Skin and mucous membranes-
open wound or punctures (eg.
stepping on a nail) ulcers
NURSING DIVISION
TRAINING AND EDUCATION
 SUSCEPTIBLE HOST

The host (also called the susceptible

host) is the human body: someone
who is at the risk of infection.

NURSING DIVISION
TRAINING AND EDUCATION
SUSCEPTIBLE HOST

Compromised Host
 One whose resistance to infection is impaired by
broken skin, mucous membranes and suppressed
immune system
Skin and Mucous Membrane
 physical barrier i.e. burns, surgical wounds, trauma,
IV site invasive procedures
Suppressed Immune System
i.e. drugs, radiation, steroids, DM, AIDS

NURSING DIVISION
TRAINING AND EDUCATION
NURSING DIVISION
TRAINING AND EDUCATION
 ADMINISTRATION OF INFECTION
CONTROL IN THE HOSPITAL

The Infection Control Committee

The responsibility of the ICC is to
design and implement an infection control
program. The goal is to identify and
reduce the risk of patients and healthcare
workers acquiring and transmitting
infection.

NURSING DIVISION
TRAINING AND EDUCATION
 DR.PJGMRMC
INFECTION CONTROL COMMITTEE
Chairman – Dr. LAILANIE M. GUSTILO
Asst. Chairman –Dr. LESLY ANNE C. DELA
CRUZ
 Administrative Division
(Engineering&Maintenance,General Services
 Medical Division
 Nursing Division
 Infection Control Nurse
NURSING DIVISION
TRAINING AND EDUCATION
 ADMINISTRATION OF
INFECTION CONTROL IN THE
HOSPITAL

Surveillance
Surveillance involves the
routine collection of data on
infection, analysis of the data and
feedback to the hospital staff.

NURSING DIVISION
TRAINING AND EDUCATION
 HOSPITAL INFECTION CONTROL
AND PREVENTION PRACTICES

NURSING DIVISION
TRAINING AND EDUCATION
STANDARD PRECAUTION

 WASH HANDS
• Before touching the Patient
• Before any aseptic Procedure
• After Touching Body Fluids and Splashes
• After Touching patients Surroundings
• After touching the patient
 WEAR GLOVES
• When touching blood, body fluids, secretions,
excretions
NURSING DIVISION and contaminated item
TRAINING AND EDUCATION
•
 MASK /EYE PROTECTION
 To protect mucous membranes of the eyes, nose
and mouth when procedures and activities are
likely to generate splashes or sprays of blood
and body fluids.
 WEAR GOWN
 To protect skin and clothing during procedures
and activities likely to generate splashes or
sprays of blood and body fluids
 Remove soiled gown immediately and wash
hands

NURSING DIVISION
TRAINING AND EDUCATION
Take care:

 To prevent injuries when using needles,

scalpels and other sharp instruments.
 When handling sharp instruments after
procedures
 When cleaning used instruments
 When disposing of used needles

NURSING DIVISION
TRAINING AND EDUCATION

AIRBORNE PRECAUTIONS
PATIENT PLACEMENT
 Private Room
 Negative Pressure Room
 Door Closed
 WEAR MASK
 Tuberculosis - N95 RESPIRATOR
 Chickenpox (VARICELLA) Measles
(RUBEOLA)
 Immune Persons. NO MASK REQUIRED
 Susceptible Persons, NOT TO ENTER
ROOM
NURSING DIVISION
TRAINING AND EDUCATION
 PATIENT TRANSPORT
 Limit transport of patient to
essential purposes only
 Use surgical mask on patient during
transport
 Notify area receiving patient

NURSING DIVISION
TRAINING AND EDUCATION
 CONTACT PRECAUTION
 PATIENT PLACEMENT
• Private Room/ Panel Screen

 WEAR GLOVES
• Wear Gloves when entering the
room
Remove gloves before leaving
patient room

NURSING DIVISION
TRAINING AND EDUCATION
 WASH HANDS
• Wash hands with antibacterial agent after glove
removal. Avoid recontamination of hands

 WEAR GOWN (OPTIONAL)

 Wear gown when entering patient room if you
anticipate contact with patient or environment.
 Remove gown before leaving the room

NURSING DIVISION
TRAINING AND EDUCATION
 PATIENT TRANSPORT

• Limit transport of patient to essential

purposes only.
• During transport, ensure precautions are
maintained to minimized risk of
transmission of organism.

NURSING DIVISION
TRAINING AND EDUCATION
 PATIENT CARE EQUIPMENT

• Dedicate use of noncritical patient

care equipment to a single patient.

• Clean and disinfect any common

equipment between patient

NURSING DIVISION
TRAINING AND EDUCATION
 DROPLET PRECAUTION
 PATIENT PLACEMENT
• Private Room, if possible. Panel Screen
• If cohorting patients, maintain
separation of three feet between
patient.
 WEAR MASK
• Wear regular mask if within three feet
of patient
NURSING DIVISION
TRAINING AND EDUCATION
 PATIENT TRANSPORT

 Limit transport of patient to essential

purposes only
 Use surgical mask on patient during
transport
 Notify area receiving patient

NURSING DIVISION
TRAINING AND EDUCATION
HAND HYGIENE

NURSING DIVISION
TRAINING AND EDUCATION
HAND HYGIENE

MICROBIAL FLORA OF THE

HANDS

• RESIDENT
• TRANSIENT
• PATHOGENS / INFECTIOUS

NURSING DIVISION
TRAINING AND EDUCATION
 HAND HYGIENE
5 Moments For Hand Hygiene

NURSING DIVISION
TRAINING AND EDUCATION
HAND HYGIENE
Steps in Hand Hygiene

NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE
EQUIPMENT

NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE
EQUIPMENT

Sequence for
Donning
PPE
• Gown first
• Mask or respirator
• Goggles or face
shield
• Gloves
NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

HOW TO DON A GOWN

• Select appropriate type and size
• Opening is in the back
• Secure at neck and waist

NURSING DIVISION
TRAINING AND EDUCATION
If gown is too small, use two gowns
– Gown #1 ties in front
– Gown #2 ties in back

NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

How to Don a Mask

• Place over nose, mouth
and chin
• Fit flexible nose piece over
nose bridge
• Secure on head with ties
or
elastic
• Adjust to fit
NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

How to Don a Particulate Respirator

• Select a fit tested respirator
• Place over nose, mouth and chin
• Fit flexible nose piece over nose
bridge
• Secure on head with elastic
• Adjust to fit

NURSING DIVISION
TRAINING AND EDUCATION
Perform a fit check
–Inhale – respirator should collapse
–Exhale – check for leakage around
face

NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

How to Don Gloves

• Don gloves last
• Select correct type and size
• Insert hands into gloves
• Extend gloves over isolation
gown cuffs

NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

Sequence for Removing PPE

• Gloves
• Face shield or goggles
• Gown
• Mask or respirator

NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

How to Remove Gloves (1)

• Grasp outside edge near
wrist
• Peel away from hand,
turning glove inside-out
• Hold in opposite gloved
hand

NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

How to Remove Gloves (2)

• Slide ungloved finger
under the wrist of the
remaining glove
• Peel off from inside,
creating a bag for both
gloves
• Discard
NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

Remove Goggles or Face

Shield
• Grasp ear or head pieces
with ungloved hands
• Lift away from face
• Place in designated
receptacle for
reprocessing or disposal
NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

Removing a Mask
• Untie the bottom, then top, tie
• Remove from face
• Discard

NURSING DIVISION
TRAINING AND EDUCATION
PERSONAL PROTECTIVE EQUIPMENT

Removing a
Particulate
Respirator
• Lift the bottom elastic
over your head first
• Then lift off the top
elastic
• Discard

NURSING DIVISION
TRAINING AND EDUCATION
 ALGORITHM ON HOW TO
REPORT
NEEDLE-STICK INJURY
VICTIM
NEEDLE STICK INJURY EXPOSURE

CLEAN WITH SOAP AND WATER

REPORT TO THE TEAM LEADER

IN THE UNIT

PROCEED TO EMERGENCY
ROOM AND GET PATIENT’S
MEDICAL RECORD

NURSING DIVISION
TRAINING AND EDUCATION
 GIVE PATIENT’S RECORD TO
E.R. NURSE

E.R. NURSE WILL ATTACH THE

FORM OF NEEDLE STICK INJURY
WITH INCIDENT REPORT
.

THE MOD FOR TREATMENT (TO DR. TANWANI, IF DUTY)

CONSULT THE MOD/ SOD FOR TREATMENT

GET MEDICINES TO PHARMACY

NURSING DIVISION
TRAINING AND EDUCATION
 ALGORITHM WHEN THERE IS
NEEDLE-STICK INJURY

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR HOUSEKEEPING SECTION

 All horizontal surface in patient areas

are wet-cleaned or damp-cleaned daily
 Uncarpeted floors are wet-cleaned daily
 The floors, corridors and other open
areas are cleaned once a day with
scrubbing solution that is often
changed.

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR HOUSEKEEPING
SECTION
 Contaminated linen and drapes are
handled cautiously to prevent
dispersal of organism.
 Services sinks, bathroom fixtures
and handwashing facilities are
thoroughly cleaned every shift with
appropriate disinfectant.

NURSING DIVISION
TRAINING AND EDUCATION
• Contaminated rooms should be
cleaned last. These rooms are
washed with soap and water
then disinfectant.

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR HOUSEKEEPING
SECTION

ENVIRONMENTAL CARE
• Cleaning schedule must be formulated
and followed
• Frictional cleaning(scrubbing) with
soap and water is a safe, quick, more
effective way to reduce microbial
contamination of surfaces

NURSING DIVISION
TRAINING AND EDUCATION
• Always wear gloves when cleaning
• Use a damp or wet cloth or mop for
walls, floors and halls. Avoid dry
sweeping and dusting as this
practices spread dust and
microorganisms in the air

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR HOUSEKEEPING
SECTION

ENVIRONMENTAL CARE

• Use separate cleaning equipment

for each area
• Change cleaning solution when
they are obviously dirty

NURSING DIVISION
TRAINING AND EDUCATION
• Clean and dry mops, cloth , brushes
and other housekeeping equipment
between uses
• Wash from top to bottom
• When using disinfectant follow dilution
instruction. Too much or too little water
may reduce the killing activity of
disinfectants

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR HOUSEKEEPING
SECTION

DOUBLE BUCKET TECHNIQUE

• BUCKET # 1 – SOAP & WATER

• BUCKET # 2 – DISINFECTANT

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR HOUSEKEEPING
SECTION

Procedure
1. Place wringer over bucket # 1 ( Soap
Solution )
2. Dip mop on bucket # 1. Wring. Mop
about 100 sq. ft.

NURSING DIVISION
TRAINING AND EDUCATION
1.Dip mop on bucket # 1. Wring. Dip mop on
bucket # 2 ( Disinfectant Solution ) & wring to
bucket # 1. Mop to already mop 100 sq. ft.
2.Continue mopping until area is finished or
until solution in bucket # 2 is gone.

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR LINEN
HANDLING
• Linens should be removed daily from
the client care units.
• Soiled linen should be handled with a
minimum of agitation during bed
making or while being changed in
order to prevent contamination of the
air with microorganisms.

NURSING DIVISION
TRAINING AND EDUCATION
• Soiled linen should never be thrown out
into the floor of the patient area, not
outside the patient area.

• Soiled linens from any area should be

bagged and place into carts in area outside
the client care area

NURSING DIVISION
TRAINING AND EDUCATION
• It should be placed in a yellow plastic
bag when endorsing to linen section.
If contaminated, soak the linen in Na
Hypochlorite (1:10) solution.

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR LINEN

TRANSPORTATION

• Soiled linens should be transported in a cart

that should be used exclusively for the
purpose.
• Laundry bag used in transporting soiled linen
from units to soiled linen room should be
changed every day.

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR LINEN

STORAGE
• Clean linen should be handled as little
as possible and should be kept in the
closets.
• Clean linen should be stored in a
manner that will protect it from
contamination, such as portable covered
cart or closets used solely for the
purpose of sorting clean linen.
NURSING DIVISION
TRAINING AND EDUCATION
• Shelves of carts/closets in which clean linen
is temporarily kept must be cleaned
regularly with Na Hypochlorite

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR LINEN

TRANSPORTATION

• Clean linen should be transported in

an enclosed linen cart solely for this
purpose.
• Clean linen that is transported in
canvas bags should never be placed
on the floor.

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR LINEN
PROPER HANDLING OF
CONTAMINATED LINEN
Used linen shall be considered dangerously
contaminated on the following:
• Hepatitis B
• Dysentery/Cholera
• Typhoid fever/Hepatitis A
• AIDS
• Infected burns
• Disseminated Staphylococcal infections
NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR LINEN
HANDLING

• Use of gloves, masks and gown

• Avoid direct contact with skin/clothing
• Avoid spillage/dripping from linen
• Decontaminate spillage of blood, body
fluids and secretions by pouring
appropriate amount of Na Hypochlorite

NURSING DIVISION
TRAINING AND EDUCATION
GUIDELINES FOR LINEN
HANDLING
• Place soiled contaminated linen in
separate containers provided.
• Close container with
contaminated/soiled linen properly.
Store in specified area until ready for
transport to linen room.
• Wash hands thoroughly with soap and
water after handling
contaminated/soiled linen.
NURSING DIVISION
TRAINING AND EDUCATION
 Thank You

NURSING DIVISION
TRAINING AND EDUCATION