B.Sc.

Nursing 3rd Sem Infection Control and Safety Bhushan Science

1
Student Helpline: 88189-52923
B.Sc. Nursing 3rd Sem Infection Control and Safety Bhushan Science

INDEX

Sr. No. Unit Page No.

1 Hospital Acquired Infections (HAI) 2-6

2 The Nursing Process 7-15

3 Hand Hygiene 16-18

4 Disinfection And Sterilization 19-29

5 Specimen Collection Review 30-34

6 BMW (Bio Medical Waste Management) 35-43

7 Antibiotic Stewardship 44-45

8 Patients Safety Indicators 46-69

9 IPSG (International Patient Safety Goals) 70-78

10 Safety Protocol 79-106

11 Employee Safety Indicators 107-117

2
Student Helpline: 88189-52923
B.Sc. Nursing 3rd Sem Infection Control and Safety Bhushan Science

UNIT 1
HOSPITAL-ACQUIRED INFECTIONS (HAI)

HAI (Hospital-Acquired Infections)

Definition:
• Hospital Acquired Infection, or nosocomial infection, is an infection acquired in a hospital
setting that was not present or in incubation at the time of admission. These infections are
usually exogenous and represent a significant risk in healthcare.
Causes:
1. Reduced Immunity:
• Patients with weakened immune systems due to underlying illnesses are more
susceptible to infections.
• Significance: Highlights the vulnerability of hospitalized patients to infections.
2. Environmental Contamination:
• Pathogens can be present in hospital bedding, utensils, equipment, and air and dust.
• Contamination may also occur in antiseptics and ointments.
• Significance: Demonstrates the importance of maintaining strict hygiene and
sterilization protocols.
3. Food and Water Contamination:
• Hospital food and water sources can become contaminated, leading to infection
outbreaks.
• Significance: Emphasizes the need for careful handling and monitoring of food and
water supplies in hospitals.
4. Antibiotic Resistance:
• Infections caused by antibiotic-resistant pathogens can be more severe and
complicate treatment.
• Significance: Underlines the challenges in treating nosocomial infections and the
importance of antibiotic stewardship.
Sources of Nosocomial Infections:
1. People: Patients, hospital staff, visitors.
2. Objects: Medical equipment, utensils, bedding.
3. Food: Hospital meals.
4. Water: Hospital water supply.
5. Air: Ventilation systems, dust particles.
Common Types of Hospital Acquired Infections:
1. Wound Infection:
• Occurs post-surgery.
• Pathogens vary based on the timing of infection.
• Significance: Indicates the need for proper wound care and aseptic techniques.
2. Urinary Tract Infections (UTIs):
• Often linked to catheterization.
• Common pathogens: E. coli, Proteus.

3
Student Helpline: 88189-52923
B.Sc. Nursing 3rd Sem Infection Control and Safety Bhushan Science

• Significance: Highlights the importance of careful catheter management.

3. Respiratory Infections:
• Common in patients with cardiopulmonary issues, aspiration, or those on
ventilation.
• Common pathogens: Staphylococcus aureus, gram-negative bacilli.
• Significance: Indicates the need for vigilance in respiratory care, especially for
ventilated patients.
4. Bacteremia and Septicemia:
• Often result from infected intravenous (IV) cannulae or surgical incisions ("cut downs").
• Common pathogens: Gram-negative bacilli, Staphylococcus epidermidis.
• Complications: Can lead to endocarditis and other severe systemic infections.
• Significance: Emphasizes the importance of aseptic techniques in IV therapy and
monitoring for signs of systemic infection.

BUNDLE APPROACH

Introduction
Device-associated infections (DAIs) are a significant concern in hospital settings, often leading
to increased morbidity and prolonged hospital stays. The bundle approach has been instrumental

4
Student Helpline: 88189-52923
B.Sc. Nursing 3rd Sem Infection Control and Safety Bhushan Science

in reducing these infections, focusing on a set of interventions that, when used together,
significantly improve patient outcomes.

DAIs Under Bundle Approach

1. Prevention of Urinary Tract Infection (UTI)
• Definition: A urinary tract infection (UTI) is an infection in any part of the urinary system.
The urinary system includes the kidneys, ureters, bladder and urethra.
• Common Causes: Primarily due to catheterization.
• Key Prevention Steps:
• Daily cleaning of catheter opening.
• Regular catheter cleaning with soap and water.
• Thorough rectal area cleaning post bowel movements.
• Keeping the drainage bag below bladder level.
• Regular drainage bag emptying (every 8 hours or when full).
2. Prevention of Surgical Site Infection (SSI)
• Definition:A surgical site infection is an infection that occurs after surgery in the part of
the body where the surgery took place.
• Causes: Factors like surgical technique, contamination, operation duration, environmental
conditions.
• Preventive Measures:
• Regular cleaning and disinfection of the operating room.
• Minimal handling and sterile draping by operating staff.
• Proper surgical attire for all in the surgical theatre.
• Surveillance of surgical wounds.
3. Prevention of Ventilator Associated Events (VAE)
• Definition:Mechanical ventilation is life-saving therapy for patients with critical illness
and respiratory failure and the complications arises due to the improper use of MV is
known as Ventilator Associated Events (VAE).
• Causes: Complications from mechanical ventilation (e.g., VAP, sepsis, ARDS).
• Prevention Strategies:
• Adequate disinfection of ventilator components.
• Avoiding routine tubing changes.
• Head-up patient positioning.
• Sterile tracheal suctioning.
• Limiting sedatives and consciousness-impairing medications.
• Daily trials for spontaneous awakening and breathing.
• Conservative fluid management.
• Early patient mobility and exercise.
• Low tidal volume ventilation.
• Strict asepsis for catheter insertion and maintenance.
4. Prevention of Central Line Associated Blood Stream Infection (CLABSI)
• Definition: CLABSI is a primary laboratory confirmed bloodstream infection in a patient
with a central line at the time of (or within 48-hours prior to) the onset of symptoms and
the infection is not related to an infection from another site.
• Cause:Resulting from germs entering the bloodstream through central lines.
• CDC Guidelines for Prevention:

5
Student Helpline: 88189-52923
B.Sc. Nursing 3rd Sem Infection Control and Safety Bhushan Science

• Proper hand hygiene and aseptic technique during insertion.

• Use of maximal sterile barriers.
• Optimal insertion site selection.
• Chlorhexidine (>0.5% with alcohol) for site preparation.
• Sterile dressing application over insertion site.
• Rigorous hand hygiene compliance.
• Regular chlorhexidine bathing in ICUs.
• Antiseptic scrubbing of access ports before use.
• Aseptic technique for dressing changes.
• Minimized catheterization duration.
• Staff training in catheter care.

SURVEILLANCE OF HAI (Hospital Acquired Infections)

Introduction to HAIs
• Definition: HAIs, or nosocomial infections, are acquired by patients during their stay in
healthcare facilities like hospitals and clinics.
• Causes: Exposure to infectious agents not present or incubating at admission time.
• Risks: Affect both patients and healthcare workers, impacting patient safety and public
health.
• Common Types: Include surgical site infections (SSIs), urinary tract infections (UTIs),
bloodstream infections, and respiratory infections.
Role of the Infection Control Team
1. Monitoring and Identification: Regular patient monitoring for HAIs.
2. Data Collection and Analysis: Gathering and analyzing infection rate and type data.
3. Implementation of Prevention Strategies: Developing and enforcing infection
prevention protocols.
4. Education and Training: Providing continuous infection control training to healthcare
staff.
Steps in HAI Surveillance
1. Definition and Identification of HAIs
• Adhere to universally recognized definitions for various HAIs.
• Train healthcare workers to recognize symptoms indicative of HAIs.
2. Surveillance and Case Identification
• Systematically screen patients for signs of HAIs.
• Use diagnostic tests and clinical assessments to confirm HAI cases.
3. Data Collection
• Gather comprehensive data on affected patients, including age, medical history, and the
nature of their current healthcare interventions.
• Document specific details about the infection, such as type, severity, and possible source.
4. Data Analysis
• Analyze the data to identify patterns or trends in HAIs.
• Determine which practices or environmental factors may be contributing to the spread of
HAIs.
5. Reporting
• Share findings with relevant departments within the healthcare facility.

6
Student Helpline: 88189-52923
B.Sc. Nursing 3rd Sem Infection Control and Safety Bhushan Science

• Report significant infection trends or outbreaks to public health authorities.

6. Implementation of Control Measures
• Based on data analysis, develop targeted infection control protocols.
• Enhance cleanliness and sterilization of the environment and equipment.
• Implement isolation measures for infected or at-risk patients.
7. Evaluation of Control Measures
• Regularly assess the impact of implemented control measures.
• Modify or enhance strategies based on ongoing evaluation results.
Role of Infection Control Committee
1. Development of Infection Control Policies
• Policy Formulation: Create and update infection control policies based on current best
practices and regulatory guidelines.
• Customization: Tailor policies to specific needs and conditions of the healthcare facility.
2. Surveillance and Monitoring of HAIs
• Data Collection: Oversee the collection of data on HAIs.
• Analysis and Interpretation: Analyze trends and patterns to identify potential areas for
improvement.
3. Implementation of Infection Control Practices
• Guideline Implementation: Ensure the implementation of standard infection control
guidelines throughout the facility.
• Monitoring Compliance: Regularly monitor adherence to infection control practices.
4. Education and Training
• Staff Training: Organize training programs for healthcare workers on infection prevention
and control practices.
• Ongoing Education: Provide updates on emerging infection control issues and new
guidelines.
5. Outbreak Management
• Identification and Response: Rapidly identify and respond to infection outbreaks.
• Containment Strategies: Implement measures to contain and control outbreaks.
6. Quality Assurance and Improvement
• Performance Evaluation: Regularly evaluate the effectiveness of infection control
measures.
7. Resource Management
• Allocation of Resources: Ensure appropriate allocation of resources (e.g., personnel,
equipment) for effective infection control.
• Budgeting: Assist in budgeting for infection control-related activities and resources.
8. Regulatory Compliance
• Adherence to Standards: Ensure the healthcare facility complies with national and
international infection control standards.
• Liaison with Authorities: Communicate with health authorities regarding infection
control matters and compliance.
9. Communication and Reporting
• Internal Communication: Facilitate effective communication among different
departments regarding infection control issues.
• External Reporting: Report infection data and outbreak information to relevant external
bodies, such as public health departments.

7
Student Helpline: 88189-52923
B.Sc. Nursing 3rd Sem Infection Control and Safety Bhushan Science

• Next Portion of
Notes will be
available in
• PAID VERSION
of Notes.
•

• Student Helpline
88189-52923
•

8
Student Helpline: 88189-52923