INFECTION CONTROL & STANDARD SAFETY MEASURES

INTRODUCTION

Hospital infection is also called Nosocomial infection. It is the single largest factor that adversely
affects both the patient and the hospital. The English word Nosocomial is derived from the Greek
NOSOKOMEION meaning "hospital". Nosocomial infection is that which develops in the
patients after more than 48 hours of hospitalization. Bacterial infections, which appear within
first 48 hours of admission, are considered as community acquired. Once the infectious agent
enters the host it begins to proliferate and reacts with the defense mechanisms of the body
producing infection symptoms and signs: pain, swelling, redness, functional disorders, rise in
temperature and pulse rate and leucocytosis.

Infection involves interaction between the animal body (host) and the injecting microorganism.
Practice or techniques that prevent transmission of infection protect clients and health care
workers from disease. Clients in all health care setting are at risks for acquiring infections
because of lower resistance to infectious microorganisms, increase exposure to numbers and
types of disease and causing microorganisms and invasive procedures.

NATURE OF INFECTION:

An infection is the entry and multiplication of an infectious agent in the tissue of a host.

 If the infectious agent (pathogen) fails to cause injury to cells or tissues, the pathogen is
colonizing the cells or tissues without causing harm.
 If the pathogens multiply and cause clinical signs and symptoms, the infection is
symptomatic.
 If the infectious disease can be transmitted directly from one person to another, it is a
communicable or contagious disease.

DEFINITION OF INFECTION:

1. Injurious contamination of body or parts of the body by bacteria, viruses, fungi, protozoa
and rickettsia or by the toxin that they may produce Infection may be local or generalized
and spread throughout the body.

2. According to Bailliere's Nurses Dictionary

Infection is the invasion and multiplication of microorganisms in body tissues, specially
that causing local cellular injury due to competitive metabolism, toxins, intracellular
replication or antigen-antibody response.
 3. Brunner And Suddarth's
Infection is a condition in which the host interacts physiologically and immunologically
with a microorganism.

4. Potter & Perry

An infection is the invasion of a susceptible host by pathogens or microorganisms
resulting in disease.

BASICS OF INFECTION CONTROL

 Prevention of nosocomial infection is the responsibility of all individuals and services.

provided by healthcare setting.
 To practice good asepsis, one should always know: what is dirty, what is clean, what is
sterile and keep them separate.
 Hospital policies & procedures are applied to prevent spread of infection in hospital.

PRINCIPLES

 Client safety in the health care environment requires the reduction of microorganism
transmission.
 Infection control practices are directed at controlling or eliminating sources of infection
in the health care agency or home.
 Nurses are responsible for protecting clients and themselves by using infection control
practices.
 Nurses and clients must be educated on the types of infections, modes of transmission,
risks for susceptibility, and infection control practices required to control or prevent
further transmission.

CHAIN OF INFECTION

The chain of infection describes the phenomenon of developing an infectious process. There
must be an interactive process that involves the agent, host, and environment. This interactive
process must involve several essential elements, or" links in the chain," for transmission of
microorganisms to occur. The six essential links (elements)in the chain of infection. Without the
transmission of microorganisms, an infectious process cannot occur. Therefore, knowledge about
the chain of infection for an infectious process permits control or elimination of the
microorganism by breaking the links in the chain of infection.
[Link] agent:

The development of an infectious disease depends on the number of organisms present; their
virulence, or ability to produce disease; their ability to enter or survive in the host; and the
susceptibility of the host.

2. Reservoir:

Places where microorganisms can survive, multiply, and await transfer to a susceptible host are
called reservoirs. Common reservoirs are humans and animals (host), insects, food, water, and
organic matter or inanimate surfaces (fomites).

3. Portal of exit:

After microorganisms find a site to grow and multiply, they must find a portal of exit if they are
to enter another host and cause disease. Microorganisms can exit through a variety of sites such
as skin and mucous membranes, respiratory tract, gastrointestinal tract, reproductive tract, and
blood.

4. Mode of transmission:

There are many modes for transmission of microorganisms from the reservoir to the host.
Although the major mode of transmission of microorganisms is the hands of the health care
worker, almost any object within the environment can become a means of transmitting
pathogens. The mode of transmission is the process that bridges the gap between the portal of
exit of the biological agent from the reservoir of source and the portal of entry of the susceptible
"new" host. Most biological agents have primary mode of transmission; however, some
microorganisms may be transmitted by more than one mode. Almost anything in the
environment can become a potential means of transmitting infection, depending on the agent.
The most important and frequent mode of transmission is contact transmission, which involves
the direct physical transfer of an agent from an infected person to a host through direct
contact with a contaminated object or close contact with contaminated secretions Sexually
transmitted diseases are examples of diseases spread by direct contact.

Airborne transmission occurs when a susceptible host contacts droplet nuclei or dust
particles that are suspended in the air. Vehicle and vector borne transmission are indirect
modes of transmission, because transmission occurs by an intermediate source.
 Vehicle transmission occurs when an agem is transferred to a susceptible host by
contaminated inanimate objects such as water, food, milk, drugs, and blood Vector
borne transmission occurs when an agent is transferred to a susceptible hom by animate
means such as mosquitoes, fleas, ticks, lice, and other animals.

5. Portal of entry:

Organisms can enter the body through the same route they use for exiting. Common portals of
entry include non intact skin, mucus membranes, genitourinary tract, gastrointestinal tract and
respiratory tract.

6. Susceptible host:

Susceptibility to an infectious agent depends on the individual's degree of resistance to

pathogens. An infection does not develop until an individual becomes susceptible to the strength
and numbers of microorganism capable of producing infection.

STAGES OF INFECTION:

1. Incubation period: It is the time interval between entrance of pathogen into the body and
appearance of first symptoms. (e.g. chicken pox - 2-3 weeks; common cold - 1-2 days; influenza
- 1-3days; mumps - 15-18 days).
2. Prodromal stage: Interval from onset of nonspecific signs and symptoms (malaise, low-grade
fever, fatigue) to more specific symptoms.

3. Illness stage: Interval when client manifests signs and symptoms specific to type of infection.

4. Convalescence: Interval when acute symptoms of infection disappear. Length of recovery

depends on severity of infection and client's general state of health; recovery may take several
days to months.

Breaking the Chain of Infection

Nurses focus on breaking the chain of infection by applying proper infection control practices to
interrupt the mode of transmission. The chain of infection can also be broken by interrupting or
blocking the agent, portal of exit, or portal of entry or by destroying the agent or decreasing the
host's susceptibility.

SURGICAL ASEPSIS

Commonly used disinfectants and germicides Bacillocide:

It contains formaldehyde glutaraldehyde, alkylurea derivatives and benzalkonium chloride. Use

2% solution by dissolving 200ml of the concentrate in 10 liters of water. It is used for
disinfecting surfaces and for spraying rooms. The fans and air conditioners should be put off for
30 minutes and surfaces should be kept wet with bacillocide for 30 minutes for good efficacy

Korsolex: It contains formaldehyde and glutaraldehyde. One part of the concentrate is mixed
with 9 parts of water to prepare 10% solution. For disinfection the solution should remain in
contact for 20 minutes and for sterilization for 4 hours.

Cidex: -It is a 2% solution of flutaraldehyde with an activator. The solution should remain in
contact for 20 minutes for disinfection and 4 hours for sterilization.

Savlon: lit is a mixture of cetrimide, chlorhexidinegluconate and isopropyle alcohol. Use 1:100
solution for equipments and furniture and 1:30 solution for treating dirty wounds and
disinfecting catheters or thermometers.

Sterilium: -It contains 2- propanolol, 1- propranolol and ethyl hexadechyle dimethyl ammonium
ethyl surfate. Rub 2-3ml of sterilium on the palms and backs of the hands for 30 seconds and
allow it to dry, for disinfection of hands. It can be used in between nursing care or after handling
the babies. It should not replace thorough hand washing before entering the NICU

Betadine: It is 7.5% solution of povidone iodine and used for preparation of skin and
disinfection of wounds. For skin preparation, leave it to dry for 60 seconds before undertaking
the procedure.
Formalin: (40% formaldehyde aqueous solution) is used for fumigation.

PREVENTION
1. Fumigation: In centers where excellent housekeeping and septic routines are maimained,
fuantgation does not provide any additional benefit. Doors, windows walls and floors are
scrabbed thoroughly with wasp and water. The oxygen and central saction lines are shut off. The
fans and air conditioners are put off. The ventilator outlets, air conditioner vents and gaps in
doors and windows should be sealed airtight For effective fumigation 30 ml of formalin (40%
formaldehyde) in 90mwater is needed for a room of 30 cubic meters (1000 cubic feet) capacity
Formalin can be sprayed with the help of a vaporizer (Oticare) for 6 hours. After fumigation, the
doors and windows are kept open till all the formalin fumes are allowed to escape. The left over
formalin should be removed and 4-6 ounces of ammonium hydroxide is poured in the vaporizer
which is plugged on for faster climination of formalin [Link] vaporizer is not available,
formalin can be boiled or treated with 250 gm potassium permanganate and allowed to evaporate
for 12 hours. Formalin should not be poured over the potassium permanganate as this may lead
to explosion.

II. Isolation:-

Isolation technique is intended to confine the microorganisms within a given and recognized
area. There are number of isolation techniques and precautions used to prevent the spread of
infection.

Respiratory isolation

Respiratory isolation is indicated in situations where the pathogens are spread on droplets from
the respiratory tract. In this type of isolation, masks are generally worn by the nurses. Gowns are
also worn when caring for small infants because of the possibility of drooling by the infants.
When it is possible clients are taught to cover their noses and mouths with several layers of
tissue paper or handkerchief. If tissue paper is used they should be disposed properly. Restrict
the number of visitors. Precautions must be taken while collecting the sputum specimens from
the clients. The nurse suffering from respiratory diseases should not attend to the client.

Isolation

Enteric solation is indicated when the pathogens are admitted in the faeces. For this type of
isolation it is not necessary to wear a mask, but it is recommended that gloves and gowns be
worn while handing soiled articles.

Thorough hand washing should be emphasized both by the clients and nurses. The soiled articles
such as linen should be disinfected before it is sent to dhobi.
 Wound and skin isolation

This type of isolation is for pathogens which are found in wounds and can be transmitted by the
contact with the wounds or by contact with the articles contaminated with the wound discharges.
Usually gowns and gloves are worn in this type of isolation. Important point to note is the safe
disposal of dressings and discharges from the wounds and the disinfection of articles. Strict
isolation techniques should be followed while caring for clients with abscesses, boils, infected
burns, gas gangrene anthrax, rabies, tetanus, venereal diseases, scabies etc. All the articles used
for these clients should be kept separate

Great care should be taken by the nurses to prevent the cuts or abrasions on their hands. Frequent
and thorough washing reduces the chances of infection.

Blood isolation

This type of isolation is intended to prevent transmission of pathogens that are found in the
blood. Therefore, any equipment that comes in contact with the client's blood should be carefully
disinfected before touching another object or person. Use of mosquito nets are also emphasized
to prevent this type of infection.

III. BARRIER PROTECTION: Materials that protect the health care worker from infection.

PERSONAL PROTECTIVE EQUIPMENT

PPE is designed to protect employees from workplace injuries or serious illnesses resulting from
contact with chemical, radiological, physical, or mechanical or other workplace hazards.

PPE WHEN TO WEAR POINTS TO KEEP IN MIND

Gloves Wear sterile gloves when handling sterile Wearing clean or sterile gloves
procedures.  Wash hands
 Slip each hands into glove, pulling
snugly over the fingers to ensure a
good fit.
 Pull glove over the wrist as far as it
will go to maximize coverage.
Utility gloves :
 Don’t use them to touch patient,
patient care items, or anything g
near patient.
 Use the same utility gloves for the
 Wear utility gloves when cleaning or same task.
managing waste  Use separate gloves for dirty and
clean task.
 Wash with detergent and bleach at
the end of the shift.
Eye wear Protect eye when anticipating splash of  The eye wear surrounds the rim of
infectious body fluids. the whole eyes without any gap.
 This infect if there is a splash of
potentially infectious fluid on it.
 Wash thoroughly before we use
 If eye wear is not available make
use of face shield / visor.
Gowns and Protect skin when risk of splashing or  Wash hands after removal of gown
aprons spraying of blood or body fluid contact is  Disinfect the cotton cloth gown
expected using impervious / plastic gowns.  Soak in bleaching solution (1%) for
Prevent soiling of clothing during procedures 20 mins then wash and sundry. OT
that may involve contact with blood. and labour room gown would need
to sterilize, disposable gown need
not be sterilized.

Mask (Cloth Protect nose and mouth from potential  Cover both the nose and the mouth
and paper) splashes of infectious fluid. during procedures and patient-care
Use when handling patients with respiratory activities.
infections and while doing any invasive  While wearing a mask, make sure it
procedures. is fitting properly over the nose,
mouth, face, lower and below the
jaw line in a tight enough fit (face
seal) to prevent air leakage.
 Change for each procedure.
 Replace if wet or contaminated.
 Not worn under the chin or
dangling around the neck after use.
 When removing hold mask by the
strings/ties as the centre of the
mask is most contaminated.
 Dispose immediately after use.

 Wash hands after disposing the

mask.
Caps Used to keep the hair and scalp covered so  Should be large enough to cover all
that flakes of skin and hair are not shed into hair.
the wound during surgery.

Footwear Worn during procedures and patient care  Slippers are not sufficient
activities when large particle droplet spatter protection.
or sprays of blood or body fluid is anticipated.  If foot wear does not completely
 cover the foot then put a plastic
cover over it and secure it with a
rubber band.
 Footwear should be fluid proof.
 They should be washable and
easily disinfected.

[Link] WASHING: Protects both health personnel's and patients.

The main forms are -

A. Social handwashing-Done for simple cleaning of hands with soap and water. Reduces the
transient flora. A modification is careful hand washing which is done immediately after touching
a patient or after contamination. All areas of the hand up to the wrist are cleaned by rubbing for
at least 2 minutes.

B. Hygienic handdisinfection :After social handwashing, to get a more sustained effect,

especially while caring for infected patients in special care units like ICUs and neonatal units.
70% ethyl alcohol hand disinfectants may be rubbed thoroughly over the hands. This effectively
kills all transient flora, the action is fast and short-lived, hence has to be repeated after touching
each patient.

C. Surgical hand disinfection-Preoperative washing hands by surgeon. Done with antibacterial

soap e.g containing chlorhexidine or an iodophore, followed by 70% alcoholrub. Hands are
scrubbed thoroughly for 5-10 minutes up to the elbows, taking care to scrub nails and interdigital
areas.

PREVENTION OF CROSS INFECTION

Cross infection refers to the transmission of a pathogenic organism from one person to another. It
is a common and important mode of infection with many varieties of organisms, including
streptococcal and other bacterial diseases, viral hepatitis A and some other fecal-oral infections,
such as scabies, fungus infections, pinworms, and roundworms. The preventive measures include
constant surveillance, maintenance of sanitary conditions, and prompt intervention whenever an
infection is detected. The best way to prevent cross infections is by rigorous observance of
personal hygiene at all times, and through the use of barrier nursing. sanitary practices, and other
pertinent procedures.

HOSPITAL WASTE MANAGEMENT

Hospital waste is "Any waste which is generated in the diagnosis, treatment or immunization of
human beings of animals or in research" in a hospital.

Color codes and type of containers used for disposal of Biomedical waste are as follows-

COLOUR TYPE OF WASTE CATEGORY TREATMENT

CODING CONTAINER OPTIONS
Yellow Plastic bags Human and animal waste, Incineration/deep
microbial and biological waste burial
and soiled wastes.

Red Disinfected Microbiological and biological Autoclave/ chemical

container/plastic bag waste, soil waste, solid waste treatment

Blue/ Plastic bag, puncture Waste sharp and solid waste Autoclave/chemical
White/ proof container treatrment destruction
Transparent and shredding

Black Plastic bag Discard medicine, cytotoxic Disposal in secured

drugs, incineration ash and landfills.
chemical waste

Green Plastic container General waste such as office Disposed in secured

waste, food waste and garden landfills.
waste

HOSPITAL INFECTION CONTROL PROGRAMME

The main aim of the hospital infection programme is to lower the risk of an infection during the
period of hospitalization.

THREE ASPECTS

 Development of an effective surveillance system to know the risk of nosocomial

infection.
 Development of policies and procedures to reduce risk of nosocomial infections.
 Maintenance of continuing education programme from hospital personnel

BASIC ELEMENTS

 Providing a system of identification and reporting of infections and providing a system

for keeping records of infections.
  Providing for good hospital hygiene, aseptic technique and sterilization and disinfection
practices.
 Providing for personnel orientation and continuing education programme in infection
prevention and control.
 Providing for co-ordination with all departments and with medical/ nursing audit
committee in quality assurance.

Responsibility of hospital administrator/Head of health care facility

The hospital administrator/head of hospital should-

 Provide the funds and resources for infection control programme

 Ensure a safe and clean environment
 Ensure the availability of safe food and drinking water
 Ensure the availability of sterile supplies and material, and
 Establish an infection control committee and team.

INFECTION CONTROL ORGANIZATIONS IN A HOSPITAL

Infection control organizations are essential features of an infection control programme.

These organizations are-

1. Infection Control Team (ICT)

Each hospital will be having their own infection control team and committee. The infection
control team includes three main posts they are

Chairperson- He is the head of the infection control team. The designation of chairperson is
he/she should be registered doctor may be microbiologist.

Coordinator- He is the member of infection control team. The designation of the coordinator
should be registered doctor, HOD of surgery and medicine preferably may be HOD of other
department.

Surviellent- He/she may be the Nursing superintendent of that hospital

Functions of infection control team:

 Detects, investigates nosocomial infections.
 Investigation of environmental problems related to hospital infection.
 Detects community acquired infections in the hospital and refers to the appropriate
authority for follow-up
 Prompts initiation by physicians of hospitals infection report.
 Assist in development and review of infection control procedures, to be forwarded to the
central committee annually.
  Monitoring the hospital policy compliance on isolation procedures
 Development and implementation of in-service orientation program related to infection
control
 Monitoring the effectiveness of infection control programs.
 Guiding and monitoring of hospital infection through the cleaning department company,
catering division, water supply department and other environmental
2. Infection Control Committee (ICC)

The infection control committee includes all the in charge staffs of all the department of hospital
like medical, nursing, paramedical, class four workers etc. The infection control officer is the
mConduct periodical review of statistics on nosocomial infections.

 Carry out evaluation of routine surveillance activities including reports on bacteriological

swab counts of critical areas surveyed.
 Supervise epidemiological investigations.
 Review current policies.
 Convey infection control information to hospital staff.
3. Infection Control Officer (ICO)

The Infection Control Officer is usually a medical microbiologist or any other interest in
hospital associated infections

Functions

 Secretary of Infection Com responsible for recording m meetings,

 Consultant member of ICC
 Identification and reporting antibiotic sensitivity.
 Regular analysis and dissemination of antibiotic resistance data, emerging laboratory
findings;
 Initiating surveillance of detection of outbreaks,
 Investigation of outbreak
 Training and education in infection control procedures and practice

4. Infection Control Doctor (ICD)

The ICD must be a registered medical practitioner. In the majority of countries, the role is
performed either by a medical microbiologist or hospital epidemiologist. Hospital consultants in
other disciplines (e.g. infectious diseases) may be appointed. Irrespective of their professional
background, the ICD should have knowledge and experience in asepsis, hospital epidemiology,
infectious disease, microbiology, sterilization and disinfection, and surveillance. It is
recommended that one ICD is required for every 1,000 beds.

Role and responsibilities of the ICD (Infection Control Doctor)

  Serves as a specialist advisor and takes a leading role in the effective functioning of the
ICT.
 Should be an active member of the hospital Infection Control Committee (ICC) and may
act as its Chairman.
 Assists the hospital ICC in drawing up annual plans, policies and long-term programmes
for the prevention of hospital infection.
 Advises the chief executive/hospital administrator directly on all aspects of infection
control in the hospital and on the implementation of agreed policies.

5. Infection Control Nurse (ICN)

The day-to-day activities of surveillance can be best handled by a sufficiently senior and
experienced full-time nurse, with special training in hospital infection control activities. In very
large hospitals, there should be at least one infection control nurse for every 250 beds.

TASKS OF INFECTION CONTROL NURSE:

She directly reports to the infection control officer (ICO) and briefs him every day on occurrence
of a case and related matters. Early and complete reporting is the sheet anchor of any hospital
infection control programme. Therefore, the infection control sister must be authorized to report
any actual or suspected infection immediately, to initiate a culture and sensitivity test, institute
appropriate isolation procedure if it is so requires, and notify the physician incharge of the
patient. She should also have direct access to the hospital administrator on matters of serious
breaches of control practices discovered by her.

Her activities will include the following:

 Daily visit to all wards and patient holding units.

 Checking ward sister's report register for tell-tale records suggestive of infection.
 Collection and tabulation of daily data of incidence of hospital infection. Recorded data
of all infections should include the identification and location of the patient, the type of
infection, the cultures taken and the results (when known), any antibiotics administered,
and the identity of the physician responsible for the care of the patient.
 Ensuring that the samples of blood, stool, sputum, urine, swab- are collected and
dispatched to the laboratory in time. Laboratory records are an important surveillance
tool and data source. The data is gathered by the infection control nurse during ward
rounds.
 Initiating the hospital infection control form while documenting for nosocomial
infections, the registration form used should be different from the routine investigation
forms, so that minimum time is wasted in getting the culture and sensitivity reports.
 Compilation of ward wise, discipline wise or procedure wise statistics.
 Daily visit to laboratory to ascertain results of previous days samples.
 Monitoring and supervision of the infection among hospital staff.
  Training of nursing aides and paramedical personnel on correct use of hygiene practices
and aseptic techniques.
 Assist in bacteriological studies of all cases.

6. Infection Control Manual (ICM)

It is recommended that each hospital develops its own infection control manual based upon
existing documents but modified, for local circumstances and risks.

EFFECTIVE CONTROL MEASURES

1. People

It is the people in hospitals rather than the physical environment which constitutes the reservoir
of infection. Nurses should follow hand washing techniques properly and they should also guide
other staffs, students to follow the procedure of hand washing which includes social hand
washing, followed by procedural hand wash. All the steps of hand washing should be followed
properly. Following the habit of procedural hand wash after touching each child will helps to
prevent cross infection. Always use liquid soap instead of solid soap for hand washing.

2. Aseptic Techniques

Strict adherence to aseptic techniques in various invasive procedures. Insertion and removal of
catheters, surgical tubing's, drainage tubes and packs need strict no-touch techniques even while
they are done outside of operation theaters in nursing units.

3. Segregation of contaminated Instruments

There must be a system for keeping the contaminated pieces of linen, sputum cups, bedpans,
urinals and similar items separately to minimize chances of getting mixed up with clean items.

4. Isolation policy

Availability of adequate number of trained nurses is crucial for prevention of nosocomial

infection. Isolation facilities for patients with communicable diseases and those vulnerable to
infection. Such facilities must be made available in ICU, nurseries, burn unit, transplant unit, etc.
Strict control on wearing of mask, gown and gloves must be exercised while attending to such
patients. All articles taken for patient use must be treated appropriately.

5. Masking and Gowning and Glowing

 Gloves should be worn especially while dealing with HIV infected patients.
 As for any surgical procedure lumbar puncture, Gown and Glove should be worn by the
person who conducts the procedure.
 Gowns should be washed and Autoclaved daily.
6. Disinfection Practices

Different kinds of disinfectants vary in their reaction to different kinds of micro-organisms.

Phenolic compounds are active against gram-negative organisms. Quaternary ammonium
compounds against staphylococci, streptococci, and lodophores and hypochlorites have a broad
spectrum of action. Selection of appropriate disinfectant for different purpose is important. The
following should be checked.

 Appropriate choice
 Appropriate concentration
 Appropriate contact time
 Appropriate method of use

7. Sterilization Practices

An efficient CSSD ensures supply of properly sterilized articles to all users in the hospital. Each
sterilization must be monitored through the use of heat- sensitive tapes. All steam and ethylene
oxide sterilizers should be checked at least once each week with a suitable live spore preparation
by the laboratory. Instruments which come in contact with mucous membranes but are
disinfected rather than sterilized before use, such as endoscopes, and anesthesia equipment may
be bacteriologically sampled on a spot check basis to ensure adequacy of disinfection.

8. Prevention of Injuries.

 After using the disposable needles, never recap them to potential risk of injury they
should be disposed off uncapped.
 Injection files and cotton swabs should be used for breaking ampoules.
 Scissors and blades should be handled with extreme care.
 Needles should never be left on the bed, table, chair, nurse's station etc.
 Heavy duty gloves should be used while handling and washing sharp instruments and
glass ware.

Post exposure protocol for needle stick injury:

 Don't panic.
 Don't squeeze the injured site
 Wash with soap and water immediately.
 Report to the casualty and provide proper history of exposure for immunization.
Post exposure protocol regimen for HIV:

 (Basic regimen)
 Zidovudine [There is risk for79% of infection]
 (Expanded regimen)
 It goes for 28 days + basic regimen

Post exposure prophylaxis regimen for Hepatitis infection:

 If vaccinated no problem.
 If not vaccinated previously take Immunoglobulin's immediately then take hepatitis
vaccine regimen for 6 months.

9. Outpatient Department

In outpatient department separate arrangements for receiving and examining patients suspected
of having significant acute communicable condition should be made.

10. Dietary service

Storage of food articles and appropriate temperatures in refrigerators and deep freezers must be
checked. Control of rodents and insects is a must to prevent contamination of stored food and
supplies Fruits and vegetables eaten raw must be thoroughly washed before consumption.

11. Handling the laboratory specimens

 The specimens should be collected in screw capped plastic disposable container without
soiling laboratory forms.
 Never pipette blood or other body fluid with your mouth.

12. Handling the blood spills

 The spill should be covered with cotton, news paper or other absorbent material.
 Pour 1% of Hydro chlorate solution or bleach solution over the spill
 Wipe the spill soaked area after 20 minutes.
 Discard the soiled materials in a polythene lined waste bag(red bag)
 The soiled floor should be cleaned with the detergents.

13. Housekeeping routines

 Dry dusting and sweeping should be avoided; it is preferable to vacuum cleaner to suck
the dust from the floor, walls and equipments.
 Wet mopping of floors with soap and water containing 3% phenol should be carried out
at least thrice daily
  The waxing of surfaces and use of oil in water for mopping may limit dissemination of
microorganisms.
 The walls should be wiped or sprayed with 2% bacillocide once a week
 The sinks should be washed with 3% phenol or 5% Lysol at least once a day.

14. Air hygiene in operation theaters

Clogging of air filters of the AC system renders the ventilation in operation theaters and such
other areas infective. Air filters should be frequently cleaned. Periodical smoke studies should be
carried out for air movement in operation theaters and checking that the AC system is achieving
the desirable number of air changes per hour.

15. Termination Disinfection

Termination disinfection of isolation rooms must be carried out thoroughly on the principle as
operating rooms before permitting the room for reuse. At such times, the staff must use the same
precautions (cap. mask, gown, gloves) used for nursing in such isolation rooms.

16. Developing a sense of awareness

Developing in all hospital workers a high sense of awareness, and training and retraining in the
precautionary measures, prevention and control.

17. Prevention of occupational exposure

 Cover all the cuts and abrasions with water proof dressings.
 Use gloves when handling instruments or equipments.
 Do not recap needles after use
 Never manipulate any sharp that involves directing the point of the needle towards any
part of the body.
 Disposal sharps immediately.
 Refer to the needles stick injury guidelines.
 Health care workers with skin condition must seck the advice of occupational health
nurse.
 Advice junior staffs and students to inform to seniors to be reported for any sign of
occupational exposure.

18. Management of patient care equipments

 Do not reuse single patients equipments to other patients.

 Patient care equipments should be decontaminated as per the decontamination policy.
 Wear protective clothing's when handling the contaminated articles.
 Do not use single use equipments again
 Patient related equipments such as pumps, Drip stands etc must be kept clean.
19. Waste disposal

 Nurses should have thorough information and knowledge regarding Biomedical and
general waste management.
 There should be provision for foot operated bins adjacent to each baby unit for disposal
of used materials and soiled linens
 Plastic bags should be kept as hampers in the dust bins and they should be sealed before
their removal.
 The dust bin should be mopped with 3% of phenol every day,
 To have supervision over segregation of waste in appropriate color bags according to
CDC recommendations
 Knowledge and practice regarding transportation of waste should be essential.

CONCLUSION:

Good health depends in part on a safe environment. Practices or techniques that control or
prevent transmission of infection help to protect clients and health care workers from disease. By
practicing infection prevention and control techniques, the nurse can avoid spreading
microorganisms to clients.

Effective infection control and standard safety measures are crucial in preventing the spread of
infections and ensuring a safe environment for patients, healthcare workers, and others. By
following established protocols, using personal protective equipment (PPE), and maintaining
good hygiene practices, we can significantly reduce the risk of infection transmission and
promote a culture of safety.

BIBLIOGRAPHY:

Book Reference:

 K. Deepak, C.C. Saratha, B.P. Kumar Mithu; A Comprehensive Text Book on Nursing
management; 2nd Edition; EMMESS Medical Publishers; pg: 513-523.
 Potter and Perry; Fundamentals of Nursing; 6th Edition; Elsevier Publications;
pg: 773-777
Website Reference:

 Arora D; SCRIBD; 2020; Infection Control and Standard Safety Measures;

Available from: [Link] -
standard-safety-measures-doc

INDEX

Sl no. Topics Page no.

Introduction
Nature of Infection
Definition of Infection
Basics of Infection Control
Principles
Chain of Infection
Stages of infection
Breaking the chain of Infection
Prevention of infection
Standard Safety Measures (PPE)
Prevention of Cross Infection
Hospital Waste Management
Hospital Infection Control Programmes
Infection Control Organizations in a Hospital
Tasks of Infection Control Nurse
Effective Control Measures
Conclusion
Bibliography
 ASSIGNMENT
ON
INFECTION CONTROL AND STANDARD
SAFETY MEASURES
SUBJECT- NURSING MANAGEMENT

SUBMITTED TO: SUBMITTED BY :

Ms. Manju Chapagain Ms. Priyanka Chakraborty

Assistant Professor [Link] Nursing 1st year

Dept of Medical surgical Nursing Roll no. 11

DATE OF SUBMISSION: 06\06\2025