Infection control is a discipline related to the prevention of nosocomial infections or health care, a sub-discipline of practical (not academic) epidemiology. This is an important, though often unrecognized and unsupported part, of the health care infrastructure. Hospital infection and epidemiology control is similar to public health practice, carried out within the limits of certain health-care delivery systems rather than directed to society as a whole. Anti-infective agents include antibiotics, antibacterials, antifungals, antivirals, and antiprotozoa.
Infection control addresses factors related to the spread of infection in health care arrangements (patient-to-patient, patient to patient and from staff to patient, or among staff), including prevention (through hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance), monitoring/investigating alleged or alleged spread of infection in certain health care settings (surveillance and outbreak investigation), and management (outbreaks of the pandemic). It is on this basis that the general title adopted in health care is "infection prevention and control."
Video Infection control
Infection control at a health facility
Aseptic technique is a key component of all invasive medical procedures. Similarly, infection control measures are most effective when Standard Precautions (health care) are applied because undiagnosed infections are common.
Hand hygiene
Independent study by Ignaz Semmelweis in 1846 in Vienna and Oliver Wendell Holmes, Sr. in 1843 in Boston established a link between the hands of health care workers and the spread of hospital-acquired disease. The US Centers for Disease Control and Prevention (CDC) states that "It has been well documented that the most important step to prevent the spread of pathogens is effective hand washing." In developed countries handwashing is mandatory in most health care settings and required by many different regulators.
In the United States, OSHA standards require employers to provide hand-access facilities that are easily accessible, and should ensure that employees are washing hands and other skin with soap and water or flush mucous membranes with water as soon as possible after contact with blood or other potential. infection material (OPIM).
In the UK, health care professionals have adopted 'Ayliffe Techniques', based on the 6-step method developed by Graham Ayliffe, JR Babb and AH Quoraishi.
Drying is an important part of the hand hygiene process. In November 2008, a non-peer-reviewed study presented to the European Tissue Symposium by the University of Westminster, London, compared bacterial levels present after the use of paper towels, warm air hand dryers and modern jet-air hand dryers.. Of the three methods, only paper napkins reduce the amount of bacteria in the hand, with the most effective "dry air through" towels.
The presenter also conducts tests to determine whether there is potential for cross contamination from other toilet users and the toilet environment as a result of each type of drying method. They found that:
- jet air dryers, which blow air out of the unit at a claimed speed of 400 mph, capable of blowing micro-organisms from the hands and units and potentially contaminating other small washroom users and a cottage environment up to 2 meters away
- the use of a warm air hand dryer spreading micro-organisms up to 0.25 meters from the dryer
- paper towels show no significant spread of micro-organisms.
In 2005, in a study conducted by TUV Produkt und Umwelt, different hand drying methods were evaluated. The following changes in the number of bacteria after hand drying were observed:
Sterilization
Sterilization is a process intended to kill all microorganisms and is the highest possible rate of microbial killings. Sterilization may be only heat, steam, or liquid chemistry. The effectiveness of sterilization (eg, steam autoclave) is determined in three ways. First, the mechanical indicators and gauges on the machine itself indicate proper machine operation. Both heat sensitive indicators or ribbons on the sterilization pouch are discolored that indicate the appropriate heat or steam level. And, third (most importantly) is a biological test in which very hot and chemical resistant microorganisms (often bacterial endospores) are chosen as standard challenges. If the process kills these microorganisms, sterilization is considered effective.
Sterilization, if done correctly, is an effective way to prevent the spread of bacteria. It should be used for cleaning medical instruments or gloves, and basically all kinds of medical items that come into contact with bloodstream and sterile tissue.
There are four main ways in which items can be sterilized: autoclaves (using high-pressure steam), dry heat (in the oven), using chemical sterilizers such as glutaraldehyde or formaldehyde solutions or by radiation (with the help of physical agents). The first two are the most widely used sterilization methods mainly because of their accessibility and availability. Steam sterilization is one of the most effective types of sterilization, if done correctly which is often difficult to achieve. Instruments used in health care facilities are usually sterilized by this method. The general rule in this case is that in order to perform effective sterilization, the steam must be in contact with all surfaces intended to be disinfected. On the other hand, dry heat sterilization, which is done with the help of the oven, is also an accessible type of sterilization, although it can only be used to disinfect instruments made of metal or glass. Very high temperatures required to perform sterilization in this way are able to melt an instrument that is not made of glass or metal.
Steam sterilization was carried out at a temperature of 121 C (250 F) with a pressure of 209 kPa (15 lbs/in2). In this condition, rubber items should be sterilized for 20 minutes, and wrap the goods of 134 C with pressure of 310 kPa for 7 minutes. Time is calculated once the required temperature has been reached. Steam sterilization requires four conditions to be efficient: adequate contact, high enough temperature, proper time and sufficient humidity. Steam sterilization can also be carried out at 132 C (270 F), under double pressure. Sterilization of dry heat is carried out at 170 C (340 F) for one hour or two hours at a temperature of 160 C (320 F). Sterilization of dry heat can also be done at 121 C, at least for 16 hours.
Chemical sterilization, also referred to as cold sterilization, can be used to sterilize instruments that can not normally be disinfected by the other two processes described above. Sterilized items with cold sterilization are usually that can be damaged by ordinary sterilization. Generally, glutaraldehyde and formaldehyde are used in this process, but in different ways. When using the first type of disinfectant, the instrument is immersed in 2-4% solution for at least 10 hours while an 8% formaldehyde solution will sterilize the item within 24 hours or more. Chemical sterilization is generally more expensive than steam sterilization and is therefore used for non-disinfectable instruments. Once the instrument is immersed in a chemical solution, they should be rinsed with sterile water which will remove residue from the disinfectant. This is the reason why needles and syringes are not sterilized in this way, because the residues left behind by chemical solutions that have been used to disinfect them can not be cleaned with water and they can interfere with the treatment given. Although formaldehyde is cheaper than glutaraldehyde, it also irritates the eyes, skin and respiratory tract and is classified as a potential carcinogen.
Other sterilization methods exist, although their efficiency is controversial. These methods include gas, UV, plasma gas, and chemical sterilization with agents such as peroxyacetic acid or paraformaldehyde.
Clean
Infections can be prevented from happening at home as well. To reduce their chances of contracting the infection, individuals are advised to maintain hygiene by washing hands after each contact with the questionable area or body fluids and by disposing of garbage periodically to prevent germs from growing.
Disinfection
Disinfection uses liquid chemicals on the surface and at room temperature to kill the disease that causes microorganisms. Ultraviolet light has also been used to disinfect the infected patient's rooms Clostridium difficile after disposal. Disinfection is less effective than sterilization because it does not kill bacterial endospores.
Personal protective equipment
Personal protective equipment (PPE) is clothing or special equipment worn by workers for the protection of hazards. The danger in health care settings is exposure to blood, saliva, or other body fluids or aerosols that can carry infectious agents such as Hepatitis C, HIV, or other body fluid pathogens. PPE prevents contact with potentially infectious substances by creating a physical barrier between potentially contagious substances and healthcare workers.
The US Occupational Safety and Health Administration (OSHA) requires the use of Personal Protective Equipment (APD) by workers to guard against blood-borne pathogens if there is reasonably anticipated exposure to blood or other potentially infectious substances.
The components of PPE include gloves, dresses, hats, shoe covers, face shields, CPR masks, eyeglasses, surgical masks, and respirators. How many components are used and how the components used are often determined by the rules or infection control protocols of the facility. Many or most of these items can be removed to avoid carrying infectious materials from one patient to another and to avoid difficult or expensive disinfection. In the US, OSHA requires the immediate removal and disinfection or disposal of PPE workers before leaving the work area where exposure to infectious material occurs.
Antimicrobial surface
Microorganisms are known to survive on non-antimicrobials in the animate touch surface (eg, bedrail, tray above bed, call button, bathroom hardware, etc.) For a long time. This can be very disturbing in a hospital setting where patients with immunodeficiency at increased risk for contracting nosocomial infection.
Products made with antimicrobial copper alloys (brass, bronze, cupronicles, copper-nickel-zinc, and others) surfaces destroy various microorganisms in a short time. The US Environmental Protection Agency has approved the registration of 355 different antimicrobial copper alloys and a synthetic copper hard surface that kills O157: H7, methicillin-resistant Staphylococcus aureus (MRSA) , Staphylococcus , Enterobacter aerogenes, and Pseudomonas aeruginosa in less than 2 hours after contact. Other investigations have demonstrated the efficacy of antimicrobial copper alloys to destroy Clostridium difficile, influenza A virus, adenovirus, and fungi. As a public hygienic measure other than routine cleaning, antimicrobial copper alloys are being installed in health care facilities in the UK, Ireland, Japan, Korea, France, Denmark and Brazil. Synthetic hard surfaces are being installed in the United States as well as in Israel.
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Vaccination of health care workers
Health workers may be exposed to certain infections during work. Vaccines are available to provide protection to workers in the health care setting. Depending on specific regulations, recommendations, work function, or personal preferences, health care workers or first responders may receive vaccinations for hepatitis B; influenza; measles, mumps and rubella; Tetanus, diphtheria, pertussis; N. meningitidis; and varicella.
Post-exposure prophylaxis
In some cases where vaccines are not available, post-exposure prophylaxis is another method of protecting health care workers exposed to life-threatening infectious diseases. For example, viral particles for HIV-AIDS can be deposited out of the blood through the use of antibody injections if given within four hours of significant exposure.
Supervision for infection
Surveillance is the act of investigating the infection using the CDC definition. Determining the presence of hospital-acquired infections requires an infection control practitioner (ICP) to review the patient chart and see if the patient has signs and symptoms of the infection. Definitions of surveillance exist for infections of blood flow, urinary tract, pneumonia, surgical site and gastroenteritis.
Supervision has traditionally involved significant manual assessments and manual data for assessing preventive measures such as isolation of patients with infectious diseases. More and more, computerized software solutions become available that assess incoming risk messages from microbiologists and other online sources. By reducing the need for data entry, software can reduce the workload of data from ICP, freeing them to concentrate on clinical monitoring.
In 1998, about a third of infections acquired from health care could be prevented. Monitoring and prevention activities are increasingly becoming a priority for hospital staff. The Study of the Efficacy of Nosocomial Infection Control (SENIC) by the US CDC found in the 1970s that hospitals reduced their nosocomial infection rate by 32 percent by focusing on surveillance and prevention activities.
Isolation and quarantine
In the context of health care, medical isolation refers to various physical measures taken to stop the spread of nosocomial infectious diseases. Various forms of isolation exist, and are applied depending on the type of infection and the agent involved, to overcome the possibility of spreading through airborne particles or droplets, by direct skin contact, or by contact with body fluids.
In cases where the infection is only suspected, the individual can be quarantined until the incubation period has passed and the disease manifests itself or the person remains healthy. Groups may undergo quarantine, or in the case of communities, a cordon sanitaire may be applied to prevent infection from spreading out of the community, or in the case of securities protection, into communities. Public health authorities can apply other forms of social distance, such as school closure, to control the epidemic.
Investigation of the outbreak
When a group of unusual diseases is recorded, the infection control team conducts an inquiry to determine whether there is a true outbreak, a pseudo-outbreak (due to contamination in the diagnostic testing process), or only random fluctuations in the frequency of the disease. If a true outbreak is found, the infection control practitioner tries to determine what allows the outbreak to occur, and to rearrange the condition to prevent the ongoing spread of the infection. Often, violations in good practice are responsible, though sometimes other factors (such as construction) can be a source of trouble.
The plague's investigation has more than one purpose. This investigation is done to prevent additional cases in the current outbreak, prevent future outbreaks, learn about new diseases or learn something new about old diseases. Convincing people, minimizing economic and social disturbances and teaching epidemiology are some other obvious epidemic inquiry objectives.
According to WHO, an outbreak investigation is intended to detect what causes an outbreak, how the pathogen agent is transmitted, where it all starts from, what carriers, what populations are at risk of being infected and what are the risk factors.
The results of an outbreak investigation are always made public in the means of reporting in which the findings are communicated to the authorities, the media, the scientific community and so on. These reports are usually used as pedagogical tools.
Training in infection control and epidemiology of health care
Practitioners can come from different streams of education. Many start out as nurses, some as medical technology (especially in clinical microbiology), and some as doctors (usually infectious disease specialists). Specialized training in infection control and epidemiology of health care is offered by professional organizations described below. Physicians who want to be infectious control practitioners are often trained in the context of communicable diseases.
In the United States, the Certification Council for Infection Control and Epidemiology is a private company that certifies infectious control practitioners based on their educational background and professional experience, together with testing their knowledge base with standardized tests. The credentials provided are CIC, Certification in Infection Control and Epidemiology. It is recommended that a person has 2 years Infection Control experience before applying for an exam. Certification must be updated every five years.
Hospital epidemiology courses (infection control in hospitals) are offered annually by the Centers for Disease Control and Prevention (CDC) and the Society for the Health Epidemiology of America.
Standardization
Australia
In 2002, the Royal Australian College of General Practitioners published revised standards for office-based infection control that included parts of immunization management, sterilization, and disease control. However, documents on personal hygiene of health workers are limited to hand hygiene, waste and linen management, which may not be sufficient as some pathogens are born in the air and may spread through airflow.
United States
Currently, federal regulations that describe infection control standards are found in 29 CFR Part 1910.1030 Blood-borne pathogens.
See also
- Infection Prevention and Management Center
- Computer viruses
- Cordon sanitaire
- Infectious diseases
- Nosocomial infections
- Sequestration protectors
- Quarantine
- Royal Australian College of General Practitioners
- Social distance
- Transmission (drug)
Footnote
- 22 Devnani M, Kumar R, Sharma RK, Gupta AK. A survey of handwashing facilities in the outpatient department of tertiary care nursing hospitals in India. J Infect Dev Ctries 2011; 5 (2): 114-118.
External links
- The Association for Professionals in Infection Control and Epidemiology consists primarily of infection prevention and professional control with a background of nursing or medical technology
- The Society for the Health Epidemiology of America is more weighty towards practitioners who are doctors or epidemiologists at the doctoral level.
- Regional Infection Control Network
- Certification Bodies for Infection Control and Epidemiology, Inc.
- Association for Professionals in Infection Control and Epidemiology
Source of the article : Wikipedia
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