Health Care Epidemiology
&
Infection Prevention and
Control
Lemmwell Bryan T. Adante, RN, MAN
Topic Outline
Healthcare
01 Introduction 02 Associated
Infection
Infection
03 Prevention &
Control
04 Conclusions
01
Introduction
Introduction
Healthcare Epidemiology
•Occurence, determinants and distribution
of disease
•Focuses on infection control & HAIs
prevention
•Includes activities to improve patient-care
outcomes
Introduction
Healthcare Epidemiology Activities
•Surveillance
•Risk Reduction Programs
•Policy Development & Implementation
•Education of Healthcare Personnel
•Cost-benefit Assessment of prevention
and Control programs
•Measures to Break the Chain of Infection
02
Healthcare-
Associated
Infections
Categories of Infectious Diseases
Hospital Acquired Infections Community Acquired
(HAIs) Infections
•Infections acquired •Infections that are
inside the hospital acquireds outside
•Infections acquired in healthcare facilities
other hospital care •Present or incubating at
facilities the time of admission
•Erupts 14 days after
discharge
Categories of Infectious Diseases
Iatrogenic Infections
•Infections induced by
physicians or other
healthcare workers
•Results from medical or
surgical treatment
•E.g., SSI and UTI
Frequency of HAIs
Morbidity:
● 1.7 million or 1 in every 20 hospitalized
patients in the U.S. (2002)
● 722,000 or 1 in every 25 patients (2011)
● 5.7% to 19.1% for pediatric patients in
the Philippines (2015)
Mortality:
● 98,987 in 2002
● 75,000 in 2011
Causative Agents of HAIs
Most common Other Causative
agents of HAIs Agents
Clostridium Pseudomonas
difficile Acinetobacter
Staphylococcu CRE
s aureus VRE
Klebsiella MRSA
Pneumoniae & MRSE
oxytoca Candida
Escherichia
coli
Modes of Transmission
Contact Droplet Airborne
Transmission Transmission Transmission
Direct or indirect Transmission through Transmission through
transmissions respiratory droplets airborne droplet nuclei
that are more than 5 ir small particles that re
micrometer in size lesser or equal to 5
micrometers in size
Most Common HAIs
Anaerpbic, spore-forming, Gram-postive bacillus.
C. Difficile-associated Produces enterotoxin and cytotoxin. A sever form
gastrointestinal disease is known as Psuedomembranous colitis (PMC).
The most comon are catheter-associated
UTI urinary tract infections (CAUTI)
Infection that occurs after surgery in the part
Surgical Site Infections of the body where surgery took place
acute bronchitis, pneumonia, acute exacerbations of
LRTI chronic obstructive pulmonary disease/chronic
bronchitis (AECB), and acute exacerbation of
bronchiectasis
BSI Also known as septicemia. The most common BSI are
caused by CLABSI
Patients that Most Likely to Develop HAIs
Vulnerable patients in •Patients with cystic
hospital settings: fibrosis
•Elderly patients •Patients having organ
•Women in labor & transplant
delivery •Patients undergoing
•Premature infants & steroids, anticancer,
newbornd antilypmhocyte serum or
•Surgical & burn patients radiation
•Patients with diabetes & •Immunocompromised
cancer patients
•Patients who are •Patients with indwelling
paralyzed or HD or devices
catheterization
Major Factors Contributing to HAIs
An ever-increasing The failure of healthcare
number of drug-resistant personnel to follow
pathogens infection control
guidelines
An increased number of
immunocompromised
patients
Major Factors Contributing to HAIs
Additional Contributing Factors
Indiscriminate use of antimicrobial agents
A false sense of security antimicrobial agents
Lengthy, more complicated types of surgery
Overcrowding of hospitals and other healthcare
facilities as well as shortages of staff
Increased use of less highly trained health care
workers
Increased use of anti-inflammatory and
immunosuppresant agents
Overuse and improper use of indwelling medical
devices
Reducing the Number of HAIs
Wash Your Hands Before You
Prepare or eat Treat a cut or Insert or
food wound or tend remove contact
to someone lenses
who is sick
Reducing the Number of HAIs
Wash Your Hands After You
Use the Handle Change a
restroom uncooked diaper
foods
Cough, sneeze Touch a pet Handle Garbage
or blow your
nose
Tend to
someone who
is sick or
injured
Infection
03 Prevention &
Control
Pertains to the numerous measures that
are taken to prevent infections from
occuring within healthcare settings.
These preventive measures include
actions to eliminate or contain
reservoirs of infection, interrupt
transmission of pathogens and
protect persons from becoming
infected – in short, they are ways to
break various links in the chain of
infection.
IPC Control
Measures
Medical
Asepsis
(Clean Technique)
Involves procedures and practices
that reduce the number and
transmission of pathogens. Includes
hadnwashing, grooming, PPE,
cleaning of supplies and equipments,
disfenction, proper disposal of
needes, contaminated materials and
infectious waste, and sterilization.
Categories of Infectious Diseases
Disinfection Spaulding System
•The use of chemical agents • Developed by Earle H.
to kill microorganisms Spaulding
Categories of Disinfectants • For classification of Instruments
• Chemical Sterilants and Items for Patient Care
• High-level • According to the degree of risk
• Intermidiate-level for infection
• Low-level • Still being used to determine of
items needs to be sterilized or
disinfected
Categories of Infectious Diseases
Critical Items Semicritical Items
High risk for infection if they are These items are in contact with
contaminated with any microbes. mucous membranes or nonintact
Includes surgical instruments, skin and require high-level
catheters, implants and disinfection. Includes respiratory
ultrasound probes. therapy and anesthesia equipment,
some endoscopes, laryngoscope
blades, esophageal manometry
probes, cytoscopes, ano-rectal
manometry catheters & diapraghm
fitting rings
Categories of Infectious Diseases
Non-Critical Items
Are those that come in contact with non-intact
skin, but not mucous membranes. Includes two
subcategories:
Non-critical patient-care items (bedpans, blood
pressure cuffs, crutches, computers, etc.)
Non-critical environmental surfaces (e.g., bed
rails, some food utensils, bedside tables, patient
furnitures, floors, etc.
Surgical
Asepsis
(Sterile Technique)
Includes practices used to render and
keep objects and areas sterile (i.e.,
free of microbes). These techniques
are practiced in the operating rooms,
labor and delivery areas, and during
invasive procedures
Other Surgical Aseptic Techniques
Surgical scrubbing of hands and fingernails
Wearing of sterile PPEs
Using sterile solutions and dressings
Using sterile drapes and creating a sterile field
Using heat-sterilized surgical instruments
Regulations Pertaining to Health Care
Epidemiology and Infection Control
Post exposure follow-up
Record keeping for bloodborne pathogens
Needlestick injuries and other sharps
Universal precautions
Latex allergy
Bloodborne infections
Labeling and signs
Safety Precautions
Standard Precautions Standard Pracautionary
Minimum prevention practices Measures
that apply to all patient-care Vaccination
setting, regardless of confirmed Hepa B
or suspected status of the Influenza (annually)
patient. MMR
Varicella
Based on the principles that all
DPT
blood, body fluids, secretions,
Menigococcal Vaccine
excretions, nonintact skin, and Handwashing
mucous membranes may
contain transmissible infectious
agents.
Safety Precautions
Standard Pracautionary Measures
Handwashing
Gloves
Isolation gowns
Masks
Respiratory protection
Eye protection
Patient-care equipment
Environmental control
Linens
Disposal of sharps
Safety Precautions
Transmission-Based Types of Transmission Based
Precautions Precaution:
are the second tier of basic Contact
infection control and are to be Droplet
used in addition to Standard Airborne
Precautions for patients who
may be infected or colonized
with certain infectious agents for
which additional precautions are
needed to prevent infection
transmission.
Safety Precautions
Patient Placement Handling of Food and Eating
Whenever possible, single- Utensils
occupancy for patients who Use high-quality, fressh food
might be contaminate the Proper refrigeration and storage
hospital or who do not assist in Proper disposal
maintaining appropriate hygiene Hand hygiene before and after food
handling
or environmental control.
Cover heair, clean clothes and aprons
Airborne Infection Isolation
Periodic health examination
Rooms (AIIR)
Self isolation
Protective environments
Environmental sanitation
(Reverse Isolation)
Properly washing cooking and eating
utensils
Safety Precautions
Handling Fomites Medical Waste Disposal
Use disposable equipment and Any receptacle used fro
supplies decomposable solid or liquid water or
Disinfect or sterilize equipment refuse must be constructed so that it
Use individually per patient does not leak and must be equipped
Use single use thermometers or with a soled, tight fitting cover, unless it
glass thermometers that can be can be maintained in a sanitary
cleaned or sterilized condition without cover.
Empty bedpans and urinals All sweepings must be removed as
properly often as necessary
Place bed linen and soiled clothing The facility must address the handling
in bags and send to laundry and disposal of potentially contaminated
items
Conclusion
• HAI can add several weeks to a patient’s
hospital stay
• May lead to serious complications and
even death
• Medical insurance companies rarely
reimburse hospitals for costs associated
with HAIs
• Cross-infections are sadly common
• HAI can be avoided through proper
education and compliance to IPC
standards
• All HCW must fully comprehend the
problem of HAIs
• They must personally do in everything in
their power to prevent HAIs from occuring
THE END
Thank you for listening!
Awesome
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