Manual of Infection Prevention and Control

Author(s):  
Nizam Damani

The Manual of Infection Prevention and Control provides practical guidance on all aspects of healthcare-associated infections (HAIs). It outlines the basic concepts of infection prevention and control (IPC), modes of transmission, surveillance, control of outbreaks, epidemiology, and biostatistics. The book provides up-to-date advice on the triage and isolation of patients and on new and emerging infectious diseases, and with the use of illustrations, it provides a step-by-step approach on how to perform hand hygiene and how to don and take off personal protective equipment correctly. In addition, this section also outlines how to minimize cross-infection by healthcare building design and prevent the transmission of various infectious diseases from infected patients after death. The disinfection and sterilization section reviews how to risk assess, disinfect and/or sterilize medical items and equipment, antimicrobial activities, and the use of various chemical disinfectants and antiseptics, and how to decontaminate endoscopes. The section on the prevention of HAIs reviews and updates IPC guidance on the prevention of the most common HAIs, i.e. surgical site infections, infections associated with intravascular and urinary catheters, and hospital- and ventilator-acquired pneumonias. In view of the global emergence of antimicrobial resistance to the various pathogens, the book examines and provides practical advice on how to implement an antibiotic stewardship programme and prevent cross-infection against various multi-drug resistant pathogens. Amongst other pathogens, the book also reviews IPC precautions against various haemorrhagic and bloodborne viral infections. The section on support services discusses the protection of healthcare workers, kitchen, environmental cleaning, catering, laundry services, and clinical waste disposal services.

2018 ◽  
Vol 1 (1) ◽  
pp. 46
Author(s):  
Erna Tsalatsatul Fitriyah ◽  
Meidiana Dwidiyanti ◽  
Luky Dwiantoro

Background: Infectious diseases have become one of the world’s serious problems including in Indonesia. Infectious diseases can originate from the community and hospital environment. Health workers performing inappropriate medical procedures could also be a cause of transmission of infectious diseases. Infection prevention and control nurses (IPCNs) as the pioneers of prevention and infection control in hospitals have not optimally played their roles.   Purpose: This study aimed to explore the roles of IPCNs and their constraints in preparing for emerging infectious diseases. Methods: The present study employed a qualitative design with the hermeneutic phenomenological approach. The samples were seven IPCNs for the primary participants, and two Infection Prevention and Control Officers (IPCOs) and 13 Infection Prevention and Control Link Nurses (IPCLNs) as the triangulation participants. The data were collected using in-depth semi-structured interviews analyzed using a content analysis technique.   Results: The results identified two themes: (1) IPCNs played roles as clinical practitioners, activity coordinators, administrators, and educators, and (2) the roles of IPCNs had not been optimal due to the lack of support from the hospital management, insufficient infrastructure, weak monitoring and evaluation, and the unavailability of appropriate rewards and  punishment.Conclusion: The majority of participants in this study agreed that IPCNs had tried well to play their roles. However, various obstacles were encountered, which hindered the IPCNs in performing their roles.


2020 ◽  
Author(s):  
Elisa Gentilotti ◽  
Pasquale De Nardo ◽  
Boniface Nguhuni ◽  
Alessandro Piscini ◽  
Caroline Damian ◽  
...  

Abstract Background. Surgical site infections are a leading cause of morbidity and mortality after caesarean section, especially in Low and Middle Income Countries. We hypothesized that a combined infection prevention and control with antimicrobial stewardship joint program would decrease the rate of post- caesarean section surgical site infections at the Obstetrics & Gynaecology Department of a Tanzanian tertiary hospital. Methods. The intervention included: 1. formal and on-job trainings on infection prevention and control; 2. evidence-based education on antimicrobial resistance and good antimicrobial prescribing practice. A second survey was performed to determine the impact of the intervention. The primary outcome of the study was post-caesarean section surgical site infections prevalence and secondary outcome the determinant factors of surgical site infections before/after the intervention and overall. The microbiological characteristics and patterns of antimicrobial resistance were ascertained.Results. Total 464 and 573 women were surveyed before and after the intervention, respectively. After the intervention, the antibiotic prophylaxis was administered to a significantly higher number of patients (98% vs 2%, p<0.001), caesarean sections were performed by more qualified operators (40% vs 28%, p=0.001), with higher rates of Pfannenstiel skin incisions (29% vs 18%, p<0.001) and of absorbable continuous intradermic sutures (30% vs 19%, p<0.001). The total number of post-caesarean section surgical site infections was 225 (48%) in the pre-intervention and 95 (17%) in the post intervention group (p<0.001). A low prevalence of gram-positive isolates and of methicillin-resistant Staphylococus aureus was detected in the post-intervention survey. Conclusions. Further researches are needed to better understand the potential of a hospital-based multidisciplinary approach to surgical site infections and antimicrobial resistance prevention in resource-constrained settings.


Author(s):  
Jennifer J. R. Ellison ◽  
Lesia R. Boychuk ◽  
David Chakravorty ◽  
A. Uma Chandran ◽  
John M. Conly ◽  
...  

Abstract Objective: To understand how the different data collections methods of the Alberta Health Services Infection Prevention and Control Program (IPC) and the National Surgical Quality Improvement Program (NSQIP) are affecting reported rates of surgical site infections (SSIs) following total hip replacements (THRs) and total knee replacements (TKRs). Design: Retrospective cohort study. Setting: Four hospitals in Alberta, Canada. Patients: Those with THR or TKR surgeries between September 1, 2015, and March 31, 2018. Methods: Demographic information, complex SSIs reported by IPC and NSQIP were compared and then IPC and NSQIP data were matched with percent agreement and Cohen’s κ calculated. Statistical analysis was performed for age, gender and complex SSIs. A P value <.05 was considered significant. Results: In total, 7,549 IPC and 2,037 NSQIP patients were compared. The complex SSI rate for NSQIP was higher compared to IPC (THR: 1.19 vs 0.68 [P = .147]; TKR: 0.92 vs 0.80 [P = .682]). After matching, 7 SSIs were identified by both IPC and NSQIP; 3 were identified only by IPC, and 12 were identified only by NSQIP (positive agreement, 0.48; negative agreement, 1.0; κ = 0.48). Conclusions: Different approaches to monitor SSIs may lead to different results and trending patterns. NSQIP reports total SSI rates that are consistently higher than IPC. If systems are compared at any point in time, confidence on the data may be eroded. Stakeholders need to be aware of these variations and education provided to facilitate an understanding of differences and a consistent approach to SSI surveillance monitoring over time.


Author(s):  
Nizam Damani

The chapter examines various types of isolation precautions and provides practical advice on infection prevention and control (IPC) measures to be taken on isolation of patients of new and emerging infectious diseases. In an alphabetical order, it lists IPC precautions, modes of transmission of infections, incubation periods, periods of infectivity, and the duration of isolation for various infectious diseases and multidrug- resistant microorganisms (MDROs). The well-illustrated chapters explain how to properly don and take off various types of personal protective equipment. It reviews the most up-to-date information on the various aspects of hand hygiene, including hand washing and proper use of alcohol-based hand rub products. Practical advice is also given on injection safety, how to prevent transmission of infection after death and prevention of infection by healthcare building design which also includes ventilation of operating theatres.


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