Basics of IPC

Ministry of InteriorSECURITY FORCES HOSPITAL

MAKKAH

Prepared by:Dr. Ahmed Farouk

MD,EBFM,MRCGP,CICIPC Team Manager- SFHPM

Objectives:• How chain of infection work ?

• How to break the chain of infection ?

• Dangerous message about hand hygiene

• What is meant by the standard precautions?

BASICS OF IPC

• What is meant by transmission based precautions & how to implement?

• How can we deal with biological spills?

• How can we deal with any occupational exposure to patient blood or body fluids

• What is meant by medical waste cycle

BASICS OF IPC

CHAIN OF INFECTION

Agent

Reservoir

Place of Exit

Mode of Transmissio

n

Place of Entry

Susceptible Host

ISOLATION PRECAUTION

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TYPES OF PRECAUTIONS

1. Standard precaution

2. Transmission Baseda) Contact precautionb) Droplet precautionc) Airborne precaution

3. Protective environment

SFHM-IPC

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STANDARD PRECAUTION

Definition: IC practices that should be applied to all

patients regardless of suspected or confirmed diagnosis

SFHM-IPC 10

STANDARD PRECAUTION

Hand Hygiene PPE Cough Etiquette Pt. Placement

Pt. Care Equipment Safe Injection HK Linen Management

Lumbar puncture Infectious Waste Worker’s Safety

HAND HYGIENE

If you could see the germs

you’d wash your hands

HAND WASHING

INDICATIONS OF HAND WASHING

• Visibly dirty or contaminated hands with proteinaceous material, blood or other body fluids

• After caring for patients with diarrhea, including Clostridium Difficile associated diarrhea

• Before handling/preparing/ eating food

• After use of the toilet

Hand Washing Technique (40-60 Seconds)

1- Wet hands with warm water & apply enough liquid soap & rub palm to palm

بلل اليدين بالماء الدافئ -1والصابون السائل ثم دلك

باطن اليدين ببعضهما

2- Right palm over left dorsum with interlaced fingers and vice versa

دلك باطن اليد اليمنى على -2ظاهر اليد اليسرى ثم بالعكس

مع جعل االصابع متداخلة

3- Palm to palm with interlaced fingers

دلك باطن اليدين ببعضهما -3 واالصابع متداخلة

4 - backs of fingers to opposing palms with fingers interlocked & vice versa

دلك ظاهر االصابع بباطن اليد -4االخرى مع االمساك باالصابع ثم

العكس

5- Rotational rubbing of left thumb clasped in right palm and vice versa

قم بالدعك الدائرى لkالبهام االيسر -5ممسوكا بباطن اليد اليمنى ثم

العكس

6- Finally finger tips to clean center of palms by rotational rubbing & vice versa then rinse under running water ,dry hands by clean tissue & close the faucet with the drying tissue

أخيرا قم بالدعكk الدائرى لباkطن -6اليد اليمنى باطراف اصابع اليد

اليسرى ثم بالعكس ثم شطف اليدين بالماء الجارى ثم التنشيف باستخدام

مناشف ورقية ثم غلق الصنبور بها

Whenever hands visibly soiled

HAND RUB

INDICATIONS OF ALCOHOL HAND RUB

• All the times for hand hygiene except when hands are soiled (alcohol does not act on microbes in presence of dirt)

Alcoholic Hand Rub Technique (20-30 Seconds)

1- Apply Enough Amount of alcohol & rub palm to palm

ضخ كمية كافية من الكحول -1 ودلكk باطن اليدين ببعضهما

2- Right palm over left dorsum with interlaced fingers & vice versa

دلك باطن اليد اليمنى على -2ظاهر اليد اليسرى ثم بالعكس

مع جعل الصابع متداخلة

3- Palm to palm with interlaced fingers

دلكk باطن اليدين ببعضهما -3 واالصابع متداخلة

4 - backs of fingers to opposing palms with fingers interlocked & vice versa

دلك ظاهر االصابع بباطن اليد -4االخرى مع االمساك باالصابع ثم

العكس

5- Rotational rubbing of left thumb clasped in right palm and vice versa

قم بالدعك الدائرى لkالبهام االيسر -5ممسوكا بباطن اليد اليمنى ثم

العكس

6- Finally finger tips to clean center of palms by rotational rubbing & vice versa until dryness

أخيرا قم بالدعكk الدائرى لباkطن -6اليد اليمنى باطراف اصابع اليد

اليسرى ثم بالعكس حتى تجف بدون استخدام اى مناkشف

ADVANTAGES OF ALCOHOLIC HAND RUB OVER HAND WASH

• Reducing the microorganisms count on hands better than antimicrobial soap

• Easier to use

• Quicker to use

• Side effects negligible: AHR leave skin in better condition

NOTICE ON PRACTICES OF HAND HYGIENE

• Alcohol gel should not be used with antimicrobial soap concomitantly.

• Soiled hands should not be cleaned by Alcohol, it must be cleaned with hand washing.

• Hands must be washed after caring for diarrhea patients.

• Hot water must be avoided when washing hands, as repeated exposure to hot water may increase the risk of dermatitis.

THE 5 MOMENTS

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SURGICAL HAND PREPARATION

PERSONNEL PROTECTIVE EQUIPMENT

PPE

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Indications

Sterile gloves Non-sterile gloves Utility gloves• Before surgery• Before any invasive procedure that require aseptic technique.• Before wound dressing.• Mixing I.V. fluids and using multidose vials.

• When starting I.V lines or performing phlebotomy.• When changing or handling dressings.• When cleaning or handling soiled equipment or instruments.• When handling specimens and their containers.

• When handling medical waste.• When cleaning up spills of blood or body fluids.• When using chemicals

GLOVE USE

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Over head Aprons & Gowns Face, and Eye Protection

Disposable caps should be worn to confine

and contain hair during surgical procedures.

Use plastic aprons or gowns should be used during procedures that are likely to generate splashes of blood or

body fluids.

When there is risk of splashes or sprays of blood or body fluids into the face

and eyes of HCP.

SFHM-IPC

P.P.E

• Use a surgical mask alone when there is risk of exposure to droplets that might contain infectious agents. e.g. Neisseria meningitidis, Bordetella pertussis, and influenza virus.

• For airborne infectious agents such as M. tuberculosis a high filtration respiratory protective device is ideal (e.g. N95).

RESPIRATORY PROTECTION

COUGH ETIQUETTE

او • الس777777عال عن777777دبتغطي77ة ق77م العط77سبمندي77ل وفم77ك انف77ك

ورقىس7لة • ف7ى منديل7ك ض7ع

المهمالت

• Cover your mouth and nose with tissue when you cough or sneeze

• Discard your used tissue in the waste basket

الجزء • اس7777تخدم اوك7مك من الع7لوى

يدي7777ك • التس7777تخدمعن77د االن77ف لتغطي77ة

الكحة او العطس

• Or use your upper sleeve

• Don’t use your hands to cover during coughing or sneezing

ORأو

MEDICAL WASTE MANAGEMENT

MEDICAL WASTE MANAGEMENT

Health-care medical waste is a by-product of health care that includes(e.g.):

Sharps(in the safety box)

Infective and pathological waste

Any domestic waste contaminated by blood or the patient secretions.

MOH DISEASE NOTIFICATION

SFHM-IPC 33

SFHM-IPC 34

Suspect Case (patients who should be tested for MERS-CoV)• A person with fever and community-acquired pneumonia or acute respiratory

distress syndrome based on clinical or radiological evidence.2

OR• A hospitalized patient with healthcare associated pneumonia based on clinical and

radiological evidence.2

OR• A person with 1) acute febrile (≥38°C) illness, AND 2) body aches, headache, diarrhea,

or nausea/vomiting, with or without respiratory symptoms, AND 3) unexplained leucopenia (WBC<3.5x109/L) and thrombocytopenia (platelets<150x109/L)3.

OR• A person (including health care workers) who had protected or unprotected

exposure4 to a confirmed or probable case of MERS-CoV infection and who presents with upper5 or lower6 respiratory illness within 2 weeks after exposure.7

MERS-COV CASE DEFINITION

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Probable Case• A probable case is a patient in category I or II above

with absent or inconclusive laboratory results for MERS-CoV and other possible pathogens who is a close contact8 of a laboratory- confirmed MERS-CoV case or who works in a hospital where MERS-CoV cases are cared for.

Confirmed Case• A confirmed case is a suspect case with laboratory

confirmation9 of MERS-CoV infection

MERS-COV CASE DEFINITION

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EBOLA CASE DEFINITION Suspected Case• Illness in a person who has both consistent

symptoms and risk factors as follows:– Clinical criteria, which includes fever of greater than 38.6

C, and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage (gingival, nasal, cutaneous [petechiae, bruises, ecchymosis], gastrointestinal, rectal [gross or occult blood], urinary [gross or microscopic hematuria], vaginal, or puncture sites bleeding); AND

SFHM-IPC 38

– Epidemiologic risk factors within the past 3 weeks before the onset of symptoms, such as contact with blood or other body fluids of a patient known to have or suspected to have EVD; residence in—or travel to—an area where EVD transmission is active; or direct handling of dead or alive fruit bats, monkeys, chimpanzees, gorillas, forest antelope and porcupines from disease-endemic areas.

– Malaria diagnostics should also be a part of initial testing because it is a common cause of febrile illness in persons with a travel history to the affected countries.

EBOLA CASE DEFINITION

SFHM-IPC 39

SFHM-IPC 40

SFHM-IPC 41

SFHM-IPC 42

SFHM-IPC 43

SFHM-IPC 44

SFHM-IPC 45

PROTECT YOUR KIDS

DON’T TAKE BUGS WITH YOU TO HOME

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Any questions ?

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