Ever-increasing number of drug resistant pathogens 1.

The failure of healthcare personnel to follow infection control guidelines 2.

Increased number of immunocompromised patients 3.
Major Factors Contributing to Healthcare-Associated Infections
The indiscriminate use of antimicrobial agents, which has resulted in an increase in
the number of drug- resistant and multidrug-resistant pathogens
1.
A false sense of security about antimicrobial agents, leading to a neglect of
aseptic techniques and other infection control procedures
2.
Lengthy, more complicated types of surgery 3.
Overcrowding of hospitals and other healthcare facilities, as well as shortages of
staff
4.
Increased use of less-highly trained healthcare workers, who are often unaware of
infection control procedures
5.
Increased use of anti-inflammatory and immunosuppressant agents, such as
radiation, steroids, anticancer chemotherapy, and antilymphocyte serum
6.
Overuse and improper use of indwelling medical devices 7.
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Medical devices supporting and monitoring basic body functions can
provide microbes access to normally sterile body fluids and tissues if
normal defensive barriers are bypassed.
The more debilitated the patient, accompanied with poor design and
management of a device, the higher will be the risk of bacterial and
fungal infection.
Urinary catheters
The use of the following is advisable to be discontinued on patients as
soon as medically feasible:
Additional Contributing Factors
Chapter 12: Healthcare Epidemiology
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Urinary catheters

Vascular catheters

Respirators

Hemodialysis

What can be done to Reduce the Number of Healthcare-

Associated Infections?
The primary way to reduce the number of HAIs is strict compliance with
infection control guidelines.
All healthcare workers should be critically aware of the problem of HAIs
and take appropriate measures to minimize the number of such
infections occurring within healthcare facilities.
Handwashing- the single most important measure to reduce the risks of
transmitting pathogens from one patient to another or to other parts of a
patient's own body.
Wash your hands before:
Prepare or eat food
Treat a cut or wound or tend to someone who is sick
Insert or remove contact lenses
Wash your hands after you:
Use the restroom
Handle uncooked foods, particularly raw meat, poultry, or fish
Change a diaper
Cough, sneeze, or blow your nose
Touch a pet, particularly reptiles and exotic animals
Handle garbage
Tend to someone who is sick or injured
Wash your hands in the following manner:
Use warm or hot running water
Use soap (preferably antibacterial)
Wash all surfaces thoroughly, including wrists, palms, back of hands,
fingers, and under fingernails (preferably with nail brush)
Rub hands together for at least 10 to 15 seconds
When drying, begin with your forearms and work toward your hands
and fingertips, and pat your skin rather than rubbing to avoid
chapping and cracking.
Other methods of reducing incidence of HAIs will be furthered
performed at the later part of the presentation.
Guidelines in Handwashing :
Infection Control
Infection control-pertains to the numerous measures taken to prevent infections
from occurring in healthcare settings
Infection control measures- designed to break various links in the chain of infection
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Asepsis - literally means without infection
Antisepsis - literally means against infection
Asepsis includes any action(aseptic techniques) taken to prevent infection or break
the chain of infection.
General cleanliness

Frequent and thorough handwashing

Isolation of infected patients

Disinfection

Sterilization

Actions include:
Two main Categories of Asepsis: Medical Asepsis and Surgical Asepsis
a clean technique

its goal is to exclude pathogens(disease causing microorganisms only)

exclude pathogens=reduce the number and its transmission

Includes precautionary measures to prevent pathogen transfer

1)direct (person to person)

2)indirect (through air, instruments, bedding, equipment, inanimate objects
Frequent and thorough handwashing

Personal grooming

Wearing of clean masks, gloves, gowns

Proper cleaning of supplies and equipment

Disinfection

Proper disposal of needles, contaminated materials, and infectious waste

Sterilization

Medical Aseptic Techniques:

Medical Asepsis
Disinfection
Disinfection describes the elimination of most or all pathogens (except bacterial
spores) from nonliving objects.
Objects are usually disinfected by liquid chemicals.
Disinfectants - used to disinfect inanimate objects (bedside equipment and
operating rooms.
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- cannot kill spores
- cannot be used on living tissue since they are strong chemical
substances
operating rooms.
Chemical Sterilants - kill bacterial spores with prolonged exposure times
High-level disinfectants - kill all microbes(including viruses), except large
numbers of bacterial spores
Intermediate-level disinfectants - might kill mycobacteria, vegetative bacteria,
some fungi, not necessarily bacterial spores
Low-level disinfectants - kill most vegetative bacteria, some fungi, and some
viruses(10 min exposure)
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Categories of Disinfectants
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Spaulding System for Classification of Instruments and Items for Patient Care
Earle H. Spaulding - devised a system to classify instruments and items for patient
care according to the degree of risk for infection that was involved.
Confer a high risk for infection if contaminated with any microbe.
Items must be sterile
Includes surgical instruments, cardiac and urinary catheters, implants, ultrasound
probes used in sterile body cavities
Items should be purchased as sterile or be sterilized using steam (ethylene dioxide
gas, hydrogen peroxide gas plasma, liquid chemical sterilants)
Critical Items
Contact mucous membranes or nonintact skin
Require high-level disinfection
Includes respiratory therapy and anesthesia equipment, some endoscopes,
laryngoscope blades, esophageal manometry probes, cytoscopes, anorectal
manometry catheters, and diaphragm fitting rings.
Disinfected using glutaraldehyde, hydrogen peroxide, ortho-phthalaldehyde, or
peracetic acid with hydrogen peroxide.
Semi critical Items
Come in contact with intact skin, but not mucous membranes
Noncritical patient care items
(bedpans, blood pressure cuffs, crutches, computers)
Noncritical environmental surfaces
(bed rails, some food utensils, bedside tables, patient furniture, floors)
Low-level disinfection
Disinfected using 70% to 90% ethyl or isopropyl alcohol, sodium hypochlorite
(household bleach diluted 1:500), phenolic germicidal detergent solution, iodophor
germicidal detergent solution, quaternary ammonium germicidal detergent solution.
Noncritical Items
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