Module 12

• Health care epidemiology 


  It is the study of the occurrence, determinants, and distribution of health and disease within health care settings.
• Infection control and the prevention of health care￾associated infections

  The primary focus of health care epidemiology?
• Health care-associated infections (HAIs)


  Acquired within health care facilities
• Community-acquired infections


  Acquired outside of health care facilities
• Gram-positive bacteria


  Staphylococcus aureus, coagulase-negative staphylococci, Enterococcus spp., and Clostridium difficile.
• Gram-negative bacteria


  Escherichia coli, Pseudomonas aeruginosa, Enterobacter spp., and Klebsiella spp.
• 70% of HAIs


  Involve drug-resistant bacteria
• Handwashing 


  It is the single most important measure to reduce the risks of transmitting pathogens from one patient to another or from one anatomic site to another on the same patient.
• Infection control 


  The numerous measures taken to prevent infections from occurring in health care settings.
• Asepsis 


  It means "without infection".
• Medical asepsis 


  Precautionary measures necessary to prevent direct transfer of pathogens from person to person and indirect transfer of pathogens through the air or on instruments, bedding, equipment, and other inanimate objects (fomites)
• Surgical asepsis or sterile technique


  Practices used to render and keep objects and areas sterile.
• Surgical aseptic techniques 


  Practiced in operating rooms, in labor and delivery areas, and during invasive procedures.
• Medical asepsis 


  A clean technique
• Surgical asepsis 


  A sterile technique
• Goal of medical asepsis 


  Exclude pathogens
• Goal of surgical asepsis 


  Exclude all microbes
• Standard precautions 


  Are to be applied to the care of ALL patients in ALL health care settings, regardless of the suspected or confirmed presence of an infectious agent.
• Transmission-Based Precaution


  Are used for patients who are known or suspected to be infected or colonized with highly transmissible or epidemiologically important

  pathogens.
• Direct contact 


  Transfer of microorganisms from body surface to body surface.
• Indirect contact 


  Transfer of microbes through a contaminated intermediate object.
• Norovirus 


  Can remove from precautions once asymptomatic for two days.
• Clostridium difficile infection


  Remains in precautions for duration of hospitalization.
• Adenovirus gastroenteritis


  If diapered or incontinent
• Type N95 respirator


  It is is used when Airborne Precautions are indicated.
• Airborne Infection Isolation Room 


  It is under negative pressure. The preferred placement for

  patients who are infected with pathogens that are spread via airborne droplet nuclei (5 µm or less in diameter), and therefore require Airborne Precautions.
• Protective environments 


  The room is under positive pressure. Patients who are especially

  vulnerable to infection.
• Fomites 


  Are nonliving, inanimate objects, other than food, that may harbor and transmit microbes.
• Follow OSHA standards


  For disposal of medical wastes
• Specifically designed puncture-resistant containers (“sharp containers”)


  Dispose sharps in?
• Alcohols (60-90%)


  Denature proteins; Equipment & rubber stopper disinfection.
• Chlorine compounds


  Denature proteins; Floors, countertops, BSCs
• Glutaraldehyde


  Interferes with DNA, RNA, and protein synthesis; Disinfection of medical equipment
• Iodine compounds


  Disrupt protein and nucleic acid structure; Mainly used as an antiseptic
• Phenolic compounds


  Disrupts cell walls & inactivate enzymes; Floors, countertops, BSCs
• Quaternary ammonium compounds


  Inactivation of enzymes, disruption of cell membranes; Hospital environment such as floors, furniture, and walls
• Infection Prevention and Control Committee (IPCC) 


  It is composed of representatives from most of the hospital’s departments.
• Chairperson 


  It is usually an infection control professional such as an epidemiologist or infectious disease specialist, an infection control nurse, or a microbiologist.