توجواب لقای ایهرسئوال

شودبی ازتوحل مشکلوقال قیل

ازدعای فرازیعرفه کانی • اخشاک اجعلنی اللهم

اراکبتقواک • واسعدنیبمعصیتک • والتشقنینفسی • فی غنای اجعلنی اللهمقلبی • فی والیقینفی • واالخالص

بصری. والنورفی عملیدینی فی والبصیرت

Antimicrobial resistance research center Mazandaran university of medical sciences, Sari, Iran

NOSOCOMIAL INFECTIONS

CONTROLDR.BABAMAHMOODI

HOSPITAL TERMINOLOGY• INFECTION• DISINFECTION• STERILIZATION• CLEANING• DECONTAMINATION• GERMICIDE• ANTISEPTICS• CRITICAL,SEMICRITICAL,NON-CRITICAL ITEMS• CHEMICAL DISINFECTANTS(H,M,L) LEVEL

• ISOLATION

ISOLATION

PURPOSEprevent the transmission of microorganisms from infected or

colonized patients to other 1-

patients. 2-hospital visitors. 3- health care workers.

Isolating patients 1-Expensive.

2-Time-consuming.

3-often uncomfortable for patients. 4-may impede care

ISOLATIONShould be implemented only when necessary

Failure to isolate 1-Morbidity. 2-Mortality. 3-

expensive. ,

Expensive 1-Costs of an investigation of an outbreak

2- Excess length of stay. 3-The indirect costs of

lost productivity .

practice of isolating patients1-separate infectious disease

hospitals.2-to separate wards for these

patients. 3- ultimately to providingprecautions in the general hospital environment.

ISOLATING ROOMS1-single-patient

rooms.2 -double-patient

rooms.

(Guidelines for isolation(2007 CDC

1-standard precautions, which

apply to all patients. 2-transmission-based

precautions.

TRANSMISSION -BASEDprecautions. to patients which apply with documented or suspected infection or colonization with certain microorganisms.

Standard PrecautionsAll patients maypotentially be colonized or infected with organisms that can transmitted wherever behealth care is provided.

STANDARD PRECAUTIONSgloves should be worn to touch any of the following:

blood, all body fluids, secretions, and excretions. except sweat,

regardless of whether they are visibly bloody, non intact skin, and mucous membranes.

STANDARD PRECAUTIONSHands should be washed immediately after

-gloves are removed,

-before and after patient contact. with items in the patient’s and after

contact environment that may be contaminated.

Two new elements of standard precautions

1-In Lumbar puncture wear masks to prevent contamination

of the spinal needle or the procedure site with the oral flora of

the operator, which may occur when

the operator is talking.

Two new elements of standard precautions2-respiratory hygiene, which includes instructing

patients to cover their nose and mouth with a tissue when coughing or sneezing.

placing a surgical mask on the coughing patient in common areas.

and spatially separating patients with respiratory infections from other patients when feasible.

-using hand hygiene after contact with respiratory secretions.

.

STANDARD PRECAUTIONS1-gloves2-HAND WASHING. 3-mask with eye protection4-gown5-Needles and syringes.

HAND HYGIENE•Hand hygiene is the single most important factor in preventing

nosocomial infections.

HAND HYGIENEIt prevents transmissionof pathogens by contact and the fecal-oral route

HAND HYGIENEThe principles of hand

washing are based on the work of

Semmelweis.

HAND HYGIENEhand washing remains the single most importantmeans to prevent transmission of nosocomial pathogens.

HAND HYGIENEIt has been estimated that an increase in hand washingcompliance by 1.5- to 2.0-fold would result in a 25% to 50%decrease in the incidence of HAIs.

microorganisms on hands

1-transient flora2-resident flora

Transient flora1-Are important causes of HAIs.

2-These organisms are acquired primarily by contact. 3- Loosely attachedto the skin

4-Easily washed off.

RESIDENT FLORA1-organisms of low virulence

(e.g., coagulase-negative staphylococci, Micrococcus, Corynebacterium)

2-that are rarely transmitted to patients except when introduced by invasive procedures

3 -Not easily removed through hand washing.

Purpose of hand washing Remove the transient flora recently acquired

by contact with patients or environmental surfaces.

HANDS OF HCWSHAIs have been attributed to bacterial contamination of artificial fingernailstherefore, they should not be worn by health care workers.

Alcohol-based hand rubsthe recommended agents for hand hygienein the health care setting.

washing with soap1-visibly soiled, washing with soap(antimicrobial or non antimicrobial )

and water . 2-Clostridium difficile diarrhea.

CDC suggests that soap and water be used because of the poor sporicidal activity of .alcohols

ALCOHOL -BASED HAND RUBS

WHEN1-before and aftercontact with patients. 2-immediately after removing gloves.

Wall-mounted dispensersalcohol-based, waterless hand rubs

should be installed in all hospital and

outpatient rooms .In areas in which this is not feasible, individual health care workersshould carry small containers of waterless agents.

GLOVES1-to prevent contamination

of the hands with microorganisms .2-to prevent exposure of the health care

Worker to blood-borne pathogens. 3 -to reduce the risk of transmission

of microorganisms from the hands of the health care worker to the patient

GLOVES1-gloves do not replace the need for hand hygiene

2-gloves should be changed during the careof a patient when moving from a contaminated or body site (e.g., wound perineal care) to a clean body site.

3-Gloves have small perforations that may allow to contaminate the hands.

-not as a substitute for hand hygiene.

Transmission-Based precautions

patients based on a suspectedor confirmed clinical syndrome.

a specific diagnosis, or colonization or infection with epidemiologically important organisms.

IMPORTANTIt is important to note that

transmission-based

precautions are always implemented in conjunction with standard precautions.

TRANSMISSION-BASED PRECAUTIONS

•Three types•1-Airborne

•2-Droplet borne•3-Contact borne

ISOLATION CATEGORYA few diseases varicella,

SARS, MERS-COV require more than one isolation category.

TB-TRANSMISSION• COUGH• LAUGH• SPEAKS• SNEEZES• SPITS• SIGNS

امام حسین)ع(این را 5کسیکه خصلت

لذت اززندگی باشد نداشتهنمیبرد.

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