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Patient Safety & Infection Control in Healthcare Facilities

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by

Steffie Mendaglio

on 30 January 2013

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Transcript of Patient Safety & Infection Control in Healthcare Facilities

History
Patient Safety & Infection Control: A Brief Introduction
Why Care About Infection Control?
Chain of Infection
Protection and Preventative Measures
The Limitations
Ethics of Infection Control
Conclusion Seminar Outline Ahmed Zaki, Muneeb Mohammed, Steffie Mendaglio Patient Safety & Infection Control in Health Care Facilities 1867 Joseph Lister : Developed antiseptics Establish standards to prevent transmission
Secure lowest rate of hospital acquired infection
Protects staff and visitors from unnecessary risks Goal: Improve patient safety, lower infection rates, and lower patient mortality.

How: Infection Control (IC) 1867 1861 1854 1840 1796 Joseph Lister : Developed antiseptics Louis Pasteur
Germ Theory of disease Role of environment :
Florence Nightingale Ignaz Semmelweis: Medical Handwashing Edward Jenner: Developed the vaccine Timeline “The discipline of patient safety is the coordinated efforts to prevent harm, caused by the process of health care itself, from occurring to patients.” Patient Safety: A Brief Introduction Typically caused by:
- Bacteria or viruses
- Human contact with an infected surface
- Airborne transmission “Policies and procedures used to minimize the risk of spreading infections, especially in hospitals and human or animal health care facilities” Infection Control: A Brief Introduction Mission: Every patient receives safe health care, every time, everywhere.

Goal: Is prevention and protection of the public

How:
Set clear national standards
Effective delivery through clinical governance
Strong monitoring mechanisms
Patient involvement Patient Safety Wrong-Site Surgery

Medication Errors

Health Care-Acquired Infections

Falls

Readmissions

Diagnostic Errors Patient Safety Challenges - Establish standards to prevent transmission

- Secure lowest rate of hospital acquired infection

- Protects staff and visitors from unnecessary risks Goal: Improve patient safety, lower infection rates, and lower patient mortality.



How: Infection Control (IC) Hospitals are imperative

Elderly typically have chronic diseases

Variety of diseases and patients

Close quarters; spreading is easy!

Prolonged treatment/Dying is expensive! Why Should We Care? - Cleaning and disinfecting strategies
- Cleaning spills of blood and body substances
- Carpeting and cloth furnishings
- Flowers and plants in patient-care areas
- Special pathogens
- Nosocomial infections are common! When to Implement Infection Control Organism
- Bacteria, fungi, viruses, etc.
- Specific properties: aerobic/anaerobic; resistance

Reservoir
- Where is it found when not causing infectious
diseases?
- Animals, water supply, human intestines Chain of Infection in Health Care Facilities Portal of Exit
- Means of leaving the reservoir
- Bodily fluids; use of contaminated food or water

Transmission
- Direct contact
- Indirect contact Chain of Infection Chain of Infection Portal of Entry
- Means of entering the host
- Oral, inhaled, inset bite, break in skin

Vulnerable Hosts
- People with compromised immune systems
- Those with exposure to such microbes - Drug-resistant bacteria
- Infections are difficult to treat
- Greatest concern in public places like hospitals, schools, nursing homes
- Skin infections causing necrotizing
fasciitis and form abscesses Methicillin Resistant Staphylococcus aureus (MRSA) Organism: Methicillin Resistant S. aureus
Reservoir: Patient infected or carrying MRSA
Portal of exit: drainage from the open wound
Transmission: MRSA transferred on to hands by indirect contact
Portal of Entry: Violation in skin integrity and other openings
Vulnerable Host: Young children, seniors, immune compromised patients Chain of Infection of MRSA Understanding it is important in devising mechanisms to prevent possible diseases
Disrupting the process at any step will prevent an outbreak
Greatest success in breaking the chain occurs through:
- Hygiene, to prevent exit or transmission
- Treatment, to prevent entry or susceptibility Breaking the Chain of Infection Illnesses caused by improper IC

Patients free from this infection prior to
being admitted

Infection occurs within 48 hours after hospitalization Nosocomial Infections Contact transmission
Direct contact is more common mode of transmission
Droplet Transmission
Coughing, sneezing, and talking
Airborne Transmission
Can be inhaled from evaporated droplets
Common vehicle transmission
Food, water, contaminated equipment
Vector borne transmission
Mosquitoes, rodents, etc. Transmission Routes of Nosocomial Infections Higher quality of care and patient safety

Lower costs for patients because they will get sick less

Less burden on hospitals

Less likely for healthcare providers to get sick Preventive Measures – Purpose Higher quality of care and patient safety

Lower costs for patients because they will get sick less

Less burden on hospitals

Less likely for healthcare providers to get sick Preventive Measures – Purpose Washing Hands is the most important method for IC

Soap has no antiseptic qualities, but makes the skin slick

Sanitizers act as alternatives for when hand washing facilities are unavailable Hand Hygiene - PPE improve personal and patient safety in the healthcare environment
- OSHA defines PPE as “specialized clothing or equipment, worn by an employee for protection against infectious materials.”
- Wearing PPE does not eliminate the need to wash hands Personal Protective Equipment Gloves
Masks
Eye protection
Clothes

Different situations may require the use of different PPE’s, so it is important to use the correct PPE for the correct situation Different types of PPE Medical equipment split up into 3 categories:
Critical items (surgical instruments)
Semi-critical items (endoscopes)
Non-critical items (blood pressure cuff) Medical Equipment Devices that are used only once then disposed

Over 800,000 needlestick incidents occur in US hospitals each year—most AFTER needle was used, 1/3 during disposal Single-use devices Image from Bennett and Brachman’s Hospital Infections Measures taken to prevent diseases from spreading

Degrees of Isolation

Reverse Isolation

1877 – Healthcare providers started
practicing isolation

Newer hospitals are built with
more single-patient rooms and
separate entrances Isolation Isolation Video To what extent can one restrict the freedom of one patient to protect others?
What if that person is dying?

Do patients have the right to refuse care?

Do sick people have to make others aware that they have a contagious
infection?

Should there be consequences for people who knowingly spread diseases? Ethics In Hong Kong, 241 non-infected and 13 infected staff exposed to patients with SARS were surveyed about use of mask, gowns, gloves, and hand washing. All infected omitted at least one.
The Institute of Medicine in 1999 reported the results of two patient safety studies which showed that between 44,000 and 98,000 Americans die each year as a result of medical errors and misdiagnosis, resulting from patient safety problems. The Facts Preventative methods must constantly be improved

Progress has been made, but there is still much to do… So, What Does This Mean?
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