Infection Prevention and Control: Difference between revisions
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=== Examples of Infection Control in Healthcare Facilities === | === Examples of Infection Control in Healthcare Facilities === | ||
[[File:Protect-Your-Hands.png|right|frameless]] | [[File:Protect-Your-Hands.png|right|frameless]] | ||
There are many areas in which infection control can be | There are many areas in which infection control can be implemented: <ref name=":0" /><ref name=":1" /><ref name=":2" /> | ||
* Hand hygiene<ref>Pittet D. The Lowbury lecture: behaviour in infection control. Journal of hospital infection. 2004 Sep 1;58(1):1-3.</ref><ref>Boyce JM, Pittet D. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infection Control & Hospital Epidemiology. 2002 Dec;23(S12):S3-40.</ref> | * Hand hygiene<ref>Pittet D. The Lowbury lecture: behaviour in infection control. Journal of hospital infection. 2004 Sep 1;58(1):1-3.</ref><ref>Boyce JM, Pittet D. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infection Control & Hospital Epidemiology. 2002 Dec;23(S12):S3-40.</ref> | ||
* Prevention of surgical site infections | * Prevention of surgical site infections | ||
* IPC to combat antimicrobial resistance | * IPC to combat antimicrobial resistance | ||
* Injection safety | * Injection safety | ||
* Burden of | * Burden of healthcare-associated infections | ||
* Ebola response and recovery | * Ebola response and recovery | ||
* IPC country capacity-building | * IPC country capacity-building | ||
* Prevention of sepsis and catheter-associated bloodstream infections | * Prevention of sepsis and catheter-associated bloodstream infections | ||
* Prevention of catheter-associated [[Urinary Tract Infection|urinary tract infections]].(CAUTI) | * Prevention of catheter-associated [[Urinary Tract Infection|urinary tract infections]]. (CAUTI) | ||
* Isolation precautions Multidrug-resistant organisms (MDRO) | * Isolation precautions Multidrug-resistant organisms (MDRO) | ||
* Intravascular catheter-related infection (BSI) | * Intravascular catheter-related infection (BSI) | ||
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To assist in the assessment of infection control programs and practices in acute care hospital the Centers for Disease Control and Prevention suggest that management can be divided into [https://www.cdc.gov/infectioncontrol/pdf/icar/hospital.pdf 4 sections]: | To assist in the assessment of infection control programs and practices in acute care hospital the Centers for Disease Control and Prevention suggest that management can be divided into [https://www.cdc.gov/infectioncontrol/pdf/icar/hospital.pdf 4 sections]: | ||
* Section 1: Facility Demographics | * Section 1: Facility Demographics | ||
* Section 2: Infection Control Program and Infrastructure | * Section 2: Infection Control Program and Infrastructure | ||
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If a suspected or confirmed case an infectious disease has attended your clinic, all surfaces that the person has come into contact with must be cleaned. | If a suspected or confirmed case an infectious disease has attended your clinic, all surfaces that the person has come into contact with must be cleaned. | ||
* The room where they were placed/isolated should not be cleaned or used for one hour and the door to the room should remain shut | * The room where they were placed/isolated should not be cleaned or used for one hour and the door to the room should remain shut | ||
* The person assigned to clean the room should wear gloves (disposable single use nitrile or household gloves) and a disposable apron (if one is available) then physically clean the environment and furniture using a household detergent solution followed by a disinfectant or combined household detergent and disinfectant for example one that contains a hypochlorite (bleach solution) | * The person assigned to clean the room should wear gloves (disposable single-use nitrile or household gloves) and a disposable apron (if one is available) then physically clean the environment and furniture using a household detergent solution followed by a disinfectant or combined household detergent and disinfectant, for example one that contains a hypochlorite (bleach solution) | ||
* Products with these specifications are available in different formats including wipes. | * Products with these specifications are available in different formats including wipes. | ||
* No special cleaning of walls or floors is required | * No special cleaning of walls or floors is required | ||
* Pay special attention to frequently touched flat surfaces, backs of chairs, couches, door handles or any surfaces that the affected person has touched. | * Pay special attention to frequently touched flat surfaces, backs of chairs, couches, door handles or any surfaces that the affected person has touched. | ||
* Discard waste including used tissues, disposable cleaning cloths)into a healthcare risk waste bag or if one is not available | * Discard waste including used tissues, disposable cleaning cloths)into a healthcare risk waste bag or if one is not available | ||
* Remove the disposable plastic apron (if worn) and gloves and discard into a healthcare risk waste bag. | * Remove the disposable plastic apron (if worn) and gloves and discard into a healthcare risk waste bag. | ||
* If a healthcare risk waste bag (yellow) is not available, place the waste in a small household waste bag and tie securely. Do not overfill. Then place the bag in a second household waste bag and tie securely. Store | * If a healthcare risk waste bag (yellow) is not available, place the waste in a small household waste bag and tie securely. Do not overfill. Then place the bag in a second household waste bag and tie securely. Store in a safe location. If the case is not confirmed the waste can be disposed of as per usual. If a case is confirmed public health will then advise you what to with the waste. | ||
* Once this process has been completed and all surfaces are dry the room can be put back into use. | * Once this process has been completed and all surfaces are dry the room can be put back into use. | ||
== Improving Social Determinants == | == Improving Social Determinants == | ||
Another important factor in the control of infectious diseases is to address and improve social determinants within societies. | Another important factor in the control of infectious diseases is to address and improve [[Determinants of Health|social determinants]] within societies. There is a direct link between a person's health and their environment. WHO have identified 3 "common interventions" for improving health conditions world wide<ref>World Health Organization (2013). [http://apps.who.int/iris/bitstream/handle/10665/84213/9789241548625_eng.pdf;jsessionid=97F39CFE3967A7FE93BA46E18B4418E9?sequence=1 The economics of social determinants of health and health inequalities: a resource book (PDF)]. World Health Organization. <nowiki>ISBN 978-92-4-154862-5</nowiki></ref> | ||
* Education - there is a strong link between health and education<ref>Von dem Knesebeck O, Verde PE, Dragano N. Education and health in 22 European countries. Social science & medicine. 2006 Sep 1;63(5):1344-51.</ref> | |||
Education | * Social Protection - Access to affordable health care and some form of social security system can also determine the health and behaviours in a community<ref>Chung H, Muntaner C. Welfare state matters: a typological multilevel analysis of wealthy countries. Health Policy, 2007, 80(2):328–339</ref> | ||
* Urban Development - How our villages, towns and cities are designed can have a big impact on health and the spread of diseases. Living in overcrowded environments or in housing that is damp that don't have adequate facilities and sanitation can increase the spread of infectious diseases.<ref>Thomson H, Atkinson R, Petticrew M, Kearns A. Do urban regeneration programmes improve public health and reduce health inequalities? A synthesis of the evidence from UK policy and practice (1980–2004). Journal of Epidemiology & Community Health. 2006 Feb 1;60(2):108-15.</ref> | |||
== Conclusion == | |||
There is no one solution to controlling the spread of infectious diseases and it does indeed require the interventions of Governments and a collaboration between these agencies, individuals and whole communities. Until certain factors can be controlled and behaviours changed the war against infectious diseases will continue to be a major health issue around the world. | |||
== Resources == | == Resources == | ||
Revision as of 19:38, 15 March 2020
Original Editor '- Rewan Elsayed Elkanafany
Top Contributors - Shaimaa Eldib, Kim Jackson, Naomi O'Reilly, Richard Benes, Rachael Lowe, Lucinda hampton, Wanda van Niekerk, Shreya Pavaskar, Rewan Elsayed Elkanafany, Tarina van der Stockt, Jess Bell, Admin, Khloud Shreif, Tony Lowe, Stacy Schiurring, Simisola Ajeyalemi, Vidya Acharya, Tolulope Adeniji and Laura Ritchie
Introduction[edit | edit source]
According to the World Health Organization (WHO), infection prevention and control (IPC) is a scientific approach and practical solution designed to prevent harm caused by infection to patients and health workers. It is a subset of epidemiology, but also serves an essential function in infectious diseases, social sciences and global health[1].
Effective IPC is a public health issue that is fundamental in patient safety and health system strengthening. The prevention of healthcare-associated infections (HAI), epidemics (including the 2013-2016 Ebola virus disease outbreak), and pandemics of international concern (ie. 2009 flu pandemic and the coronavirus disease 2019) are rooted in effective IPC measures[2]. A guiding principle on WHO's core components of IPC is that "access to health care services designed and managed to minimize the risks of avoidable HAI for patients and health care workers is a basic human right[2]." An infectious disease is defined as the successful transmission of pathogenic microorganisms, such as bacteria, viruses, parasites or fungi that are spread[3][4][5]:
- Directly
- between people by touching or exchanging body fluids, coughing or sneezing
- During childbirth
- Indirectly
- via contaminated objects, contaminated food or water
- by a vector such as a mosquito or a tic
- animal to human transmission (zoonotic diseases)
How Diseases Spread[edit | edit source]
Infection control and prevention is a global issue and there are many protocols and guidelines that can be followed to minimise the spread of infection between people, within a population and globally[2]. It is important to first understand that the spread of infectious disease there are three variables that are needed, this is known as the epidemiological triad[6]:
- The agent - this microorganism that causes the infection and can be in the form of bacteria, viruses, parasites or fungi
- The host - the target of the disease
- The environment - surroundings and conditions. These are external to the host
Controlling Infectious Diseases within Communities[edit | edit source]
The first step when looking at infection control can start at the community level by changing behaviour:
- Using condoms when having sex, especially with a new partner
- Regular hand washing
- Using insect repellants
- Ensuring up to date routine vaccinations and participating in immunisation programmes
- Taking prescribed medications such as antibiotics as directed by health professionals.
Medical Interventions[edit | edit source]
Importance of Vaccinations
Vaccinations have slowed down and in some cases eradicated certain diseases (name) and go some way into improving the immunisation of a community. This type of protection is known as herd immunity.
Antibicrobial Resistance
Environmental Measures[edit | edit source]
Modifying environments
Surveillance of Diseases
Food safety
Air quality
Infection Control and Health Care Facilities[edit | edit source]
Another important factor in controlling and preventing the control of infection is focusing on improving practices in healthcare facilities. Healthcare facilities are seen as a place where people visit when unwell and as such often have compromised immunity. It is therefore the duty of healthcare professionals worldwide to ensure the develop strategies and implement policies that protect those who may have lower immune defences; they have a duty to keep these vulnerable patients safe and free from infection.HAIs are one of the most common detrimental effects in care delivery and both the endemic burden and the occurrence of epidemics are a major public health problem. HAIs have a significant impact on morbidity, mortality[7] and quality of life and present an economic burden at the societal level.However, a large proportion of HAI are preventable and there is a growing body of evidence to help raise awareness of the global burden of harm caused by these infections, including strategies to reduce their spread.As, up to 7% of patients in developed and 10% in developing countries will acquire at least one HAI[2][8]
Steps to Improve Infection Control[1][edit | edit source]
- Leadership[9]
- connecting and coordinating[10]
- Campaigns and advocacy
- Technical guidance and implementation
- Capacity-building
- Measuring and learning
Examples of Infection Control in Healthcare Facilities[edit | edit source]
There are many areas in which infection control can be implemented: [1][4][5]
- Hand hygiene[11][12]
- Prevention of surgical site infections
- IPC to combat antimicrobial resistance
- Injection safety
- Burden of healthcare-associated infections
- Ebola response and recovery
- IPC country capacity-building
- Prevention of sepsis and catheter-associated bloodstream infections
- Prevention of catheter-associated urinary tract infections. (CAUTI)
- Isolation precautions Multidrug-resistant organisms (MDRO)
- Intravascular catheter-related infection (BSI)
- Organ transplantation Surgical site infection (SSI)
- Norovirus Pneumonia prevention Dialysis
- Infection Control in Healthcare Personnel
- Post exposure Prophylaxis in Healthcare Workers
To assist in the assessment of infection control programs and practices in acute care hospital the Centers for Disease Control and Prevention suggest that management can be divided into 4 sections:
- Section 1: Facility Demographics
- Section 2: Infection Control Program and Infrastructure
- Section 3: Direct Observation of Facility Practices (optional)
- Section 4: Infection Control Guidelines and Other Resources
Environmental Cleaning/Disinfection[edit | edit source]
If a suspected or confirmed case an infectious disease has attended your clinic, all surfaces that the person has come into contact with must be cleaned.
- The room where they were placed/isolated should not be cleaned or used for one hour and the door to the room should remain shut
- The person assigned to clean the room should wear gloves (disposable single-use nitrile or household gloves) and a disposable apron (if one is available) then physically clean the environment and furniture using a household detergent solution followed by a disinfectant or combined household detergent and disinfectant, for example one that contains a hypochlorite (bleach solution)
- Products with these specifications are available in different formats including wipes.
- No special cleaning of walls or floors is required
- Pay special attention to frequently touched flat surfaces, backs of chairs, couches, door handles or any surfaces that the affected person has touched.
- Discard waste including used tissues, disposable cleaning cloths)into a healthcare risk waste bag or if one is not available
- Remove the disposable plastic apron (if worn) and gloves and discard into a healthcare risk waste bag.
- If a healthcare risk waste bag (yellow) is not available, place the waste in a small household waste bag and tie securely. Do not overfill. Then place the bag in a second household waste bag and tie securely. Store in a safe location. If the case is not confirmed the waste can be disposed of as per usual. If a case is confirmed public health will then advise you what to with the waste.
- Once this process has been completed and all surfaces are dry the room can be put back into use.
Improving Social Determinants[edit | edit source]
Another important factor in the control of infectious diseases is to address and improve social determinants within societies. There is a direct link between a person's health and their environment. WHO have identified 3 "common interventions" for improving health conditions world wide[14]
- Education - there is a strong link between health and education[15]
- Social Protection - Access to affordable health care and some form of social security system can also determine the health and behaviours in a community[16]
- Urban Development - How our villages, towns and cities are designed can have a big impact on health and the spread of diseases. Living in overcrowded environments or in housing that is damp that don't have adequate facilities and sanitation can increase the spread of infectious diseases.[17]
Conclusion[edit | edit source]
There is no one solution to controlling the spread of infectious diseases and it does indeed require the interventions of Governments and a collaboration between these agencies, individuals and whole communities. Until certain factors can be controlled and behaviours changed the war against infectious diseases will continue to be a major health issue around the world.
Resources[edit | edit source]
The following resources expand further on the four sections mentioned above https://www.cdc.gov/infectioncontrol/pdf/icar/hospital.pdf
https://www.publichealthontario.ca/-/media/documents/checklist-clinical-office-core.pdf?la=en
References[edit | edit source]
- ↑ 1.0 1.1 1.2 WHO.infection prevention&control .Available from:https://www.who.int/infection-prevention/about/ipc/en/
- ↑ 2.0 2.1 2.2 2.3 World Health Organization. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. World Health Organization; 2016.
- ↑ Mayhall CG. Hospital epidemiology and infection control. Lippincott Williams & Wilkins; 2012 Feb 20.
- ↑ 4.0 4.1 CDC centers for disease control and prevention.infection control. Available from:https://www.cdc.gov/infectioncontrol/index.html
- ↑ 5.0 5.1 Wilson J. Infection control in clinical practice. Elsevier Health Sciences; 2006 Jun 21.
- ↑ US Department of Health and Human Services. Principles of Epidemiology in Public Health Practice Third Edition An Introduction to Applied Epidemiology and Biostatistics. Chapter 8, Lesson 1. Atlanta, Georgia, USA Accessed 15 March 2020
- ↑ Borg MA. Cultural determinants of infection control behaviour: understanding drivers and implementing effective change. Journal of Hospital Infection. 2014 Mar 1;86(3):161-8.
- ↑ Sydnor ER, Perl TM. Hospital epidemiology and infection control in acute-care settings. Clinical microbiology reviews. 2011 Jan 1;24(1):141-73.
- ↑ Gould DJ, Gallagher R, Allen D. Leadership and management for infection prevention and control: what do we have and what do we need?. Journal of Hospital Infection. 2016 Oct 1;94(2):165-8.
- ↑ Kretzer EK, Larson EL. Behavioral interventions to improve infection control practices. American journal of infection control. 1998 Jun 1;26(3):245-53.
- ↑ Pittet D. The Lowbury lecture: behaviour in infection control. Journal of hospital infection. 2004 Sep 1;58(1):1-3.
- ↑ Boyce JM, Pittet D. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infection Control & Hospital Epidemiology. 2002 Dec;23(S12):S3-40.
- ↑ Health portal Infection control, Available from: https://www.youtube.com/watch?v=QgqTW0FjN08 (last accessed 22.4.2019)
- ↑ World Health Organization (2013). The economics of social determinants of health and health inequalities: a resource book (PDF). World Health Organization. ISBN 978-92-4-154862-5
- ↑ Von dem Knesebeck O, Verde PE, Dragano N. Education and health in 22 European countries. Social science & medicine. 2006 Sep 1;63(5):1344-51.
- ↑ Chung H, Muntaner C. Welfare state matters: a typological multilevel analysis of wealthy countries. Health Policy, 2007, 80(2):328–339
- ↑ Thomson H, Atkinson R, Petticrew M, Kearns A. Do urban regeneration programmes improve public health and reduce health inequalities? A synthesis of the evidence from UK policy and practice (1980–2004). Journal of Epidemiology & Community Health. 2006 Feb 1;60(2):108-15.
