Nosocomial infections.ppt

SOURCES:1.Patients own flora - Endogenous (50%) Auto-Infection ( Greatest source of potential danger)2.Environment - Exogenous(15%) (Air-5%; Instruments-10%) 3.Another Patient/Staff - Cross Infection (35%) Chains of infection Infectious agents Reservoirs Portals of exit Modes of transmission Portals of entry Susceptible hosts Infectious agents Common bacteria Mycobacteria Chlamydia/Rickettsia Virus Fungi Parasites Mode Exogenous infection (cross or horizontal infection) 外因性（交叉性）感染 Endogenous infection (Self or latent infection) 內因性（自身或潜在性）感染 Risks factors for the invasion of colonizing pathogens can be categorized into 3 areas: ■ Iatrogenic ■ Organizational ■ Patient related Hand Hygiene Easy, timely access to both hand hygiene and skin protection is necessary for satisfactory hand hygiene. A study by Pittet showed a 20% increase in compliance by using feedback and encouraging the use of alcohol hand rubs Hand Hygiene Techniques Alcohol hand rub Routine hand wash 10-15 seconds Aseptic procedures 1 minute Surgical wash 3-5 minutes Hand Care Nails Rings Hand creams Cuts abrasions “Chapping” Skin Problems Hand hygiene is the simplest, most effective measure for preventing hospital-acquired infections. * Before any invasive surgical procedure First wash – 5 minutes Subsequent washes – 3 minutes using an antimicrobial skin cleaner containing 4% chlorhexidine or povidone-iodine Surgical wash Before any nonsurgical procedures that require aseptic technique (such as inserting IV catheters) One minute using an antimicrobial soap or skin cleanser Aseptic procedures Before eating or smoking. After going to the toilet Before significant patient contact Before injection, venepuncture Before and after routine use of gloves After handling items soiled with blood or body substances 10 – 15 seconds using a neutral pH soap Routine hand wash Non-water cleansers or