hospital acquired

HOSPITAL HOSPITAL INFECTIONSINFECTIONS

illustratedillustrated

Dr.T.V.Rao MDDr.T.V.Rao MD

What are Hospital acquired What are Hospital acquired infectionsinfections

An infection acquired in hospital by a patient who was admitted for a reason other than that infection . An infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility

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Nosocomial InfectionsNosocomial Infections

NosocomialNosocomial comes from the comes from the GreekGreek word word nosokomeionnosokomeion meaning hospital meaning hospital ((nososnosos = = diseasedisease, , komeokomeo = to take = to take care of). This type of infection is also care of). This type of infection is also known as a known as a hospital-acquired hospital-acquired infectioninfection (or more generically (or more generically healthcare-associated infectionshealthcare-associated infections). ).

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Nosocomial Infections on Nosocomial Infections on Public HealthPublic Health

Nosocomial infections are widespread. They are important contributors to morbidity and mortality. They will become even more important as a public health problem with increasing economic and human impact

Crowding a Major FactorCrowding a Major Factor Increasing numbers

and crowding of people. More frequent impaired immunity (age, illness, treatments). New microorganisms.

Increasing bacterial resistance to antibiotics contributed as emerging problem

When the Nosocomial When the Nosocomial infections manifestinfections manifest

Majority of such infections Majority of such infections become evident during their become evident during their stay in the Hospital or some stay in the Hospital or some

times only after their times only after their discharge from the patient. discharge from the patient.

How and When Hospital How and When Hospital acquired infections occuracquired infections occur..

Nosocomial infectionsNosocomial infections are are infectionsinfections which are a result of treatment in a which are a result of treatment in a hospitalhospital or a healthcare service unit, or a healthcare service unit, but secondary to the patient's original but secondary to the patient's original condition. Infections are considered condition. Infections are considered Nosocomial if they first appear 48 Nosocomial if they first appear 48 hours or more after hospital admission hours or more after hospital admission or within 30 days after discharge. or within 30 days after discharge.


Commonly occurring Commonly occurring Microorganisms in Microorganisms in

Hospital InfectionsHospital Infections

Microorganisms and Microorganisms and Nosocomial InfectionsNosocomial Infections

The patient is exposed to a variety of microorganisms during hospitalization. Contact between the patient and a microorganisms does not by itself necessarily result in the development of clinical disease — other factors influence the nature and frequency of Nosocomial infections.

Urinary tract InfectionsUrinary tract Infections

Escherichia coliEscherichia coli Klebsiella, Klebsiella,

Serratia,Proteus Serratia,Proteus sppspp

Pseudomonas Pseudomonas aeruginosaaeruginosa

Enterococcus sppEnterococcus spp Candida albicansCandida albicans

Respiratory InfectionsRespiratory Infections

Haemophilus Haemophilus influenzaeinfluenzae

Streptococcus Streptococcus pneumoniapneumonia

Staphylococcus Staphylococcus aureusaureus

EnterobacteriaceaeEnterobacteriaceae Respiratory virusesRespiratory viruses Fungi, Candida sppFungi, Candida spp Aspergillus's sppAspergillus's spp

Skin sepsis and WoundsSkin sepsis and Wounds

Staph aureus Staph aureus Streptococcus Streptococcus

pyogenespyogenes E.coliE.coli Proteus sppProteus spp Anaerobic bacteriaAnaerobic bacteria Enterococcus sppEnterococcus spp Coagulase negative Coagulase negative

StaphylococcusStaphylococcus

Gastro Intestinal Gastro Intestinal InfectionsInfections

Salmonella Salmonella serotypesserotypes

Clostridium Clostridium difficiledifficile

Norwalk like Norwalk like virusesviruses

Drug Resistance – Drug Resistance – Nosocomial InfectionNosocomial Infection

The likelihood of exposure leading to infection depends partly on the characteristics of the microorganisms, including resistance to antimicrobial agents, intrinsic virulence, and amount (inoculum) of infective material.

PathophysiologyPathophysiology

Within hours of admission, colonies Within hours of admission, colonies of hospital strains of bacteria develop of hospital strains of bacteria develop in the patient's skin, respiratory in the patient's skin, respiratory tract, and genitourinary tract. Risks tract, and genitourinary tract. Risks factors for the invasion of colonizing factors for the invasion of colonizing pathogens can be categorized into 3 pathogens can be categorized into 3 areas: iatrogenic, organizational, and areas: iatrogenic, organizational, and patient-related patient-related

Iatrogenic riskIatrogenic risk

Iatrogenic risk factors Iatrogenic risk factors include pathogens on include pathogens on the hands of medical the hands of medical personnel, invasive personnel, invasive procedures (eg, procedures (eg, incubation and incubation and extended ventilation, extended ventilation, indwelling vascular indwelling vascular lines, urine lines, urine catheterization), and catheterization), and antibiotic use and antibiotic use and prophylaxis. prophylaxis.

OrganizationalOrganizational

Organizational risk Organizational risk factors include factors include contaminated air-contaminated air-conditioning systems, conditioning systems, contaminated water contaminated water systems, and staffing systems, and staffing and physical layout of and physical layout of the facility (eg, the facility (eg, nurse-to-patient nurse-to-patient ratio, open beds ratio, open beds close together). close together).

Patient associatedPatient associated

Patient risk factors Patient risk factors include the severity include the severity of illness, underlying of illness, underlying immunocompromiseimmunocompromised state, and length d state, and length of stay.of stay.

Prolonged stay in Prolonged stay in the hospital is a the hospital is a Major Major contributing contributing factorfactor

Routes of Transmission of Routes of Transmission of InfectionInfection

A susceptible host A susceptible host and appropriate and appropriate inoculum of inoculum of infecting infecting microorganism microorganism with an with an appropriate route appropriate route of transmission of transmission contributed in contributed in majority of casesmajority of cases


Air – borne routeAir – borne route From respiratory tract From respiratory tract

via talking, coughing, via talking, coughing, sneezingsneezing

From the skin by From the skin by natural shedding of the natural shedding of the skin scales during skin scales during would dressing or bed would dressing or bed making.making.

From aerosols from From aerosols from equipment, respiratory equipment, respiratory apparatus, air-apparatus, air-conditioning plants.conditioning plants.


Contact spreadContact spread In direct contact spread In direct contact spread

from person to personfrom person to person By indirect contact By indirect contact

spread via spread via contaminated hands or contaminated hands or equipment.equipment.

Clothing of staff,Clothing of staff, Urinary catheters, Urinary catheters,

contaminated with contaminated with hands of the operator hands of the operator may introduce may introduce organisms, or patients organisms, or patients own flora from urethra own flora from urethra may contribute to may contribute to infection. infection.


Food borne spreadFood borne spread From hospital From hospital

kitchen, or in special kitchen, or in special diets, infant feeds, diets, infant feeds, kitchen, or kitchen, or commercial suppliescommercial supplies

Mechanical vectors Mechanical vectors flies, cockroaches or flies, cockroaches or insects, or rodents insects, or rodents act as carriers of act as carriers of infection.infection.


Blood borne spreadBlood borne spread

The accidental The accidental transmission of transmission of infections as HIV, infections as HIV, HBV,and HCV by HBV,and HCV by needle stick injuries needle stick injuries is documentedis documented

Syphilis and malaria Syphilis and malaria a concern in high a concern in high prevalence areasprevalence areas

Self Infections and Cross Self Infections and Cross infectionsinfections

Lower bowel surgery,Lower bowel surgery, Self infection may Self infection may

occur due to flora from occur due to flora from nose, Staphylococcus nose, Staphylococcus may be introduced may be introduced into wounds.into wounds.

Cross infection Cross infection between patients between patients occur due to spread occur due to spread of Staphylococcus of Staphylococcus or coli formsor coli forms

Other contributing Other contributing factorsfactors

Surgeons punctured Surgeons punctured surgical gloves, or surgical gloves, or moistened gown, moistened gown, imperfectly imperfectly sterilized surgical sterilized surgical instruments, or by instruments, or by airborne theatre airborne theatre dust. Faulty wound dust. Faulty wound dressings may dressings may cause infections.cause infections.

Patients own flora too Patients own flora too infectiveinfective

Self infection Self infection from patient’s from patient’s own flora from own flora from Bowel can be Bowel can be major major contributor of contributor of infections in infections in bowel surgery.bowel surgery.

Other Source of Hospital Other Source of Hospital InfectionsInfections

Hospital environment, Hospital environment, includes defective includes defective constructions,constructions,

PeoplePeople

their behaviour has their behaviour has great impact.great impact.

Objects, food, water, Objects, food, water, Air in the hospital too Air in the hospital too contribute to contribute to infections.infections.

Cross InfectionCross Infection Many different

bacteria, viruses, fungi and parasites may cause Nosocomial infections. Infections may be caused by micro organism acquired from another person in the hospital (cross-infection) or may be caused by the patient’s own flora (endogenous infection).

Used/Contaminated Syringes a Used/Contaminated Syringes a great threat in Developing worldgreat threat in Developing world

Some organisms may be acquired from an inanimate object or substances recently contaminated from another human source (environmental infection).


Primary Etiological agents Primary Etiological agents causing Hospital Infectionscausing Hospital Infections

Nosocomial Nosocomial infections are infections are primarily caused primarily caused by opportunists , by opportunists , particularly by particularly by

Staphylococcus Staphylococcus aureusaureus

Enterococcus Enterococcus spp. spp.

Escherichia coli Escherichia coli

Pseudomonas Pseudomonas sppspp. .

Changing trends in infection Changing trends in infection etiologyetiology

With advances in more elaborate surgery and With advances in more elaborate surgery and intensive care, with combined use of broad intensive care, with combined use of broad spectrum antibiotics and spectrum antibiotics and immunosuppresevive drugs, immunosuppresevive drugs, Gram Negative Gram Negative bacteria increased in importancebacteria increased in importance

Pseudomonas aeruginosaPseudomonas aeruginosa gained gained importance in causing infection in importance in causing infection in compromised patients.compromised patients.

They exhibit natural resistance to antibiotics They exhibit natural resistance to antibiotics and antisepticsand antiseptics

Emerging Infectious Emerging Infectious AgentsAgents

A group of A group of Microbes that Microbes that played no role in played no role in the past have the past have emerged.emerged.

1 1 Coagulase Coagulase negative negative StaphylococciStaphylococci

2 2 Acinetobacter Acinetobacter baumaniibaumanii

Microbes from Microbes from EnvironmentEnvironment

The dissemination The dissemination from environment from environment such as cooling such as cooling towers and hot towers and hot water system is water system is proving a threat proving a threat with with LegionellaLegionella pneumophilapneumophila causing infections causing infections of respiratory of respiratory systemssystems


Virus too play a Important Virus too play a Important rolerole

Awareness on risk Awareness on risk of Blood born of Blood born viruses includingviruses including

Hepatitis B, C Hepatitis B, C and HIVand HIV essential essential

CMV virusCMV virus in in association with association with organ and cellular organ and cellular transmissiontransmission

Iatrogenic Spread a Iatrogenic Spread a ConcernConcern

The possible risk of The possible risk of iatrogenic spread iatrogenic spread of Prions causing of Prions causing Cruetzfeldt-Jacob Cruetzfeldt-Jacob disease is a disease is a concernconcern


Common sites associated Common sites associated with etiological agentswith etiological agents

Urinary tract Urinary tract Surgical wounds Surgical wounds Respiratory tract Respiratory tract Skin (especially burns) Skin (especially burns) Blood (bacteraemia) Blood (bacteraemia) Gastrointestinal tract Gastrointestinal tract Central nervous system Central nervous system


Collection of Data in Cross Collection of Data in Cross InfectionsInfections

Always collect information and Always collect information and document information ondocument information on

1 Patient details1 Patient details 2 Site and extent of infection2 Site and extent of infection 3 Date of admission – operative procedure 3 Date of admission – operative procedure first recognition of infectionfirst recognition of infection 4 Specimen and laboratory isolates and 4 Specimen and laboratory isolates and typing resultstyping results 5 Ward and staff details.5 Ward and staff details. Doctorrao’s ‘e’ learning seriesDoctorrao’s ‘e’ learning series

Prevention and ControlPrevention and Control

The basic responsibility of any good The basic responsibility of any good hospital remain with establishment of hospital remain with establishment of good infection control policies, which good infection control policies, which can always be achieved with can always be achieved with

1 1 An infection control committeeAn infection control committee

2 2 An Infection teamAn Infection team


Infection control Infection control committeecommittee

Should meet Should meet regularly to regularly to formulate and formulate and update policies for update policies for the whole hospital on the whole hospital on all matter which all matter which have bearing on have bearing on infection control and infection control and to mange outbreaks to mange outbreaks of Nosocomial of Nosocomial infectioninfection


Infection Control TeamInfection Control Team Which will function Which will function

under the guidance under the guidance of Infection control of Infection control Doctor.Doctor.

A Medically qualified A Medically qualified Microbiologist,Microbiologist, who will take who will take responsibility of day responsibility of day to day for the to day for the policies formulatedpolicies formulated


The Functions of the The Functions of the CommitteeCommittee

To do surveillance and infection To do surveillance and infection monitoring of hygiene practices.monitoring of hygiene practices.

Educate the Medical and Paramedical Educate the Medical and Paramedical staff on policies relating to staff on policies relating to prevention of infection, and safe prevention of infection, and safe procedures procedures


Infection Control NurseInfection Control Nurse

Is the key member of Is the key member of the teamthe team

Maintain the close Maintain the close working relations working relations between Microbiology between Microbiology Laboratory, different Laboratory, different clinical services and clinical services and supportive services supportive services like laundry, like laundry, pharmacy and pharmacy and engineeringengineering


All are campaigners of Safe All are campaigners of Safe practicespractices

It is the minimal It is the minimal responsibility of responsibility of the members to the members to campaign on campaign on issues related to issues related to safe practices safe practices including including Hand Hand washing washing


Decontamination and Decontamination and SterilizationSterilization

Fundamental Fundamental importance lies with importance lies with supply of sterile supply of sterile instruments, dressings instruments, dressings and fluids.and fluids.

A availability of single A availability of single use syringes, needles, use syringes, needles, catheters and drainage catheters and drainage bags to be assured and bags to be assured and planned for the regular planned for the regular supplies .supplies .


Aseptic techniquesAseptic techniques A no touch technique A no touch technique

when dealing with when dealing with sterile equipment sterile equipment coupled with strict coupled with strict personal hygiene.personal hygiene.

A strict rules laid when A strict rules laid when dealing the patients in dealing the patients in the operation theatre the operation theatre and other procedures and other procedures such as wound dressing such as wound dressing and insertion of IV and and insertion of IV and urinary catheters.urinary catheters.

Cleaning and Cleaning and DisinfectionDisinfection

Basic cleaning, waste Basic cleaning, waste disposal, and laundry disposal, and laundry carry priority. carry priority.

The use of chemical The use of chemical disinfectants for wall disinfectants for wall floors, and furniture is floors, and furniture is warranted in special warranted in special circumstances, such as circumstances, such as spillages, of body fluids spillages, of body fluids from patients with from patients with blood born viral blood born viral infectionsinfections


Care of Mop Heads and Care of Mop Heads and other itemsother items

All the Mop heads and All the Mop heads and cloths used in crucial cloths used in crucial areas should be heat areas should be heat disinfected and stored disinfected and stored in dry places after use.in dry places after use.

Bed pans washers and Bed pans washers and disinfectants and disinfectants and dishwashers should be dishwashers should be monitored to ensure monitored to ensure reliable performancereliable performance


Skin disinfection and Skin disinfection and AntisepticsAntiseptics

Hand washing is a Hand washing is a most important most important procedure which procedure which should be practiced by should be practiced by health care worker, health care worker, gram – ve bacteriagram – ve bacteria on the hands of the on the hands of the staff is an important staff is an important factor in the spread of factor in the spread of hospital infectionhospital infection


Hand washingHand washing

Thorough hand Thorough hand washing after any washing after any procedure involving procedure involving nursing care or close nursing care or close contact with the contact with the patient is essential.patient is essential.

Alchool based hand Alchool based hand antiseptics gaining antiseptics gaining importance where importance where washing with water washing with water and soap are not and soap are not practicable.practicable.

Wearing a GloveWearing a Glove

Gloves may be worn Gloves may be worn for any dirty contact for any dirty contact procedure such as procedure such as emptying a urinary emptying a urinary cans, or bed pans, cans, or bed pans, however it should not however it should not be forgotten gloved be forgotten gloved hand may also hand may also become colonized by become colonized by transient hospital flora.transient hospital flora.


Disinfection policiesDisinfection policies All the hospitals should create All the hospitals should create

disinfection policies which suit disinfection policies which suit circumstances and economic resources.circumstances and economic resources.

The procedures and products should have a The procedures and products should have a limited range of options, and limited range of options, and chemicals to chemicals to be used only in desired circumstancesbe used only in desired circumstances..

The policies should take into consideration The policies should take into consideration surgical instruments, heat disinfection, surgical instruments, heat disinfection, Laundry, crockery and cleaning of floors and Laundry, crockery and cleaning of floors and furniturefurniture


Importance of StaffImportance of Staff Staff should have Staff should have

well understood well understood responsibilities.responsibilities.

Effective Effective implementation of implementation of policy requires , policy requires , motivated staff, with motivated staff, with training,training,

Regular updating as Regular updating as new methods become new methods become available available


Prophylactic antibioticsProphylactic antibiotics Wide spread and Wide spread and

haphazard use of haphazard use of antibiotics hasten antibiotics hasten emergence of antibiotic emergence of antibiotic resistant bacteria.resistant bacteria.

Rational antibiotic Rational antibiotic prophylaxis plays an prophylaxis plays an important role in infection important role in infection controlcontrol

Antibiotic policy limits Antibiotic policy limits the use of broad the use of broad spectrum agents, and is spectrum agents, and is important in both important in both prophylaxis and prophylaxis and treatment.treatment.

Protective ClothingProtective Clothing

Different activities Different activities within the hospital within the hospital require different require different degrees of protection degrees of protection to staff and patients.to staff and patients.

In operation theatre In operation theatre the wearing of sterile the wearing of sterile gowns, gloves, head gowns, gloves, head gear and face mask gear and face mask minimizes the minimizes the shedding of shedding of microorganisms.microorganisms.

Barrier NursingBarrier Nursing

Barrier nursing is Barrier nursing is highly essential highly essential when soiling of when soiling of clothing is clothing is anticipated, and anticipated, and dealing with dealing with communicable communicable diseases, eg in diseases, eg in EBOLA and EBOLA and MARBURG MARBURG infections.infections.

Other MeasuresOther Measures

Gloves, face mask, and Gloves, face mask, and goggles are indicated goggles are indicated in specific procedures.in specific procedures.

The use of the above The use of the above should confirm to should confirm to international standards international standards and the staff should be and the staff should be trained in their proper trained in their proper use and disposaluse and disposal

Isolation in Infectious Isolation in Infectious DiseasesDiseases

Practiced as a source Practiced as a source isolation and to protect isolation and to protect the susceptible or the susceptible or immunocompromised.immunocompromised.

It needs a highly It needs a highly disciplined approach by disciplined approach by all staff to ensure that all staff to ensure that none of the barriers to none of the barriers to transmission are transmission are breached.breached.

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Cubicle IsolationCubicle Isolation In which patient In which patient

nursed alone in a nursed alone in a room separated by room separated by door and corridor from door and corridor from other patients confers other patients confers a substantial a substantial measures of measures of protection.protection.

Desirable to supply Desirable to supply clean, filtered air is clean, filtered air is supplied to room with supplied to room with facilities for own toilet facilities for own toilet and washing facilitiesand washing facilities

Critical SituationsCritical Situations In some critical In some critical

situations such as bone situations such as bone marrow transplant marrow transplant units, where air borne units, where air borne contamination with contamination with environmental fungal environmental fungal spores is a problem the spores is a problem the efficiency of an air efficiency of an air filtration may be filtration may be increased and laminar increased and laminar airflow maintained as airflow maintained as barrier around the barrier around the patientpatient


Trexler isolatorTrexler isolator

Stringent isolation Stringent isolation such as a plastic such as a plastic tent or tent or TrexlerTrexler isolator, is required isolator, is required only for patients only for patients with highly with highly contagious contagious infections.infections.

Hospital building and Hospital building and DesignDesign

Routine maintenance of Routine maintenance of the Hospital building is the Hospital building is important, ensuring that important, ensuring that surfaces wherever surfaces wherever possible are smooth, possible are smooth, impervious and easy to impervious and easy to clean.clean.

All constructions around All constructions around the existsting Hospitals the existsting Hospitals generate fungal spores generate fungal spores and bacterial spores and bacterial spores with have impact on with have impact on specialized units serving specialized units serving immunocompromised immunocompromised patientspatients

Legionnaires’ disease Legionnaires’ disease preventionprevention

The risk of The risk of Legionnaires’ disease Legionnaires’ disease is reduced by regular is reduced by regular flushing all outlets and flushing all outlets and installing water installing water supplies that circulate supplies that circulate below 20below 2000c for the cold c for the cold and above 60and above 6000c for the c for the hot circuithot circuit


EquipmentEquipment

All the equipment in All the equipment in contact with patients contact with patients need decontamination need decontamination and sterilizationand sterilization

Heat is a preferred Heat is a preferred method.method.

However heat However heat sensitive to the sensitive to the sterilized with sterilized with chemical and other chemical and other newer emerging newer emerging methodsmethods

Personnel care of Health CarePersonnel care of Health Care WorkersWorkers

All health care workers All health care workers should screened for should screened for possible possible communicable communicable diseases before diseases before employment, and employment, and offered immunization offered immunization against against Hepatitis B Hepatitis B Viral infectionViral infection..

An education on An education on Universal Health Universal Health Precautions is Precautions is highly essentialhighly essential


Needle Stick InjuriesNeedle Stick Injuries

Who sustain needle Who sustain needle stick injuries from stick injuries from potentially potentially contaminated contaminated sources should sources should have access to have access to advise and advise and post post exposure exposure prophylaxisprophylaxis with with antiviral agents or antiviral agents or immunization.immunization.

Monitoring of the Monitoring of the Environment ?Environment ?

Routine Routine Microbiological Microbiological monitoring of the monitoring of the environment is of environment is of little benefit,little benefit,

But monitoring of But monitoring of the Air conditioning the Air conditioning plants, and plants, and machinery used for machinery used for disinfection and disinfection and sterilization is sterilization is essentialessential


Screening of Staff or Screening of Staff or PatientsPatients

Microbiological Microbiological screening of staff and screening of staff and patients not patients not undertaken routinely undertaken routinely but it may be needed but it may be needed for specific purpose to for specific purpose to detect carriers or MRSA detect carriers or MRSA and Hepatitis viruses in and Hepatitis viruses in those performing some those performing some types of surgery or types of surgery or where transmission to where transmission to patients has occurred.patients has occurred.

Surveillance and Role of Surveillance and Role of Microbiology LaboratoriesMicrobiology Laboratories

The detection and identification of The detection and identification of hospital infection incidents or hospital infection incidents or outbreaks rely on the laboratory data outbreaks rely on the laboratory data that alert the infection control team that alert the infection control team to unusual cluster of infection, called to unusual cluster of infection, called as ‘as ‘alert organismalert organism’ system.’ system.


SurveillanceSurveillance Identification of Identification of MRSA MRSA

&& ESBL ESBL and timely and timely information to information to clinicians will help the clinicians will help the ongoing events in the ongoing events in the Hospital warrant to Hospital warrant to track the events on track the events on source of outbreaks source of outbreaks and action to control and action to control the similar situations the similar situations in futurein future


Practical Teaching to Practical Teaching to StaffStaff

Regular visits to wards Regular visits to wards are also important to are also important to record data on infected record data on infected patients from whom no patients from whom no specimens have been specimens have been received and to received and to respond to problems as respond to problems as they occur.they occur.

Such visits will bring in Such visits will bring in grater human grater human interaction with interaction with paramedical staff and paramedical staff and deliver the practical deliver the practical teaching.teaching.


Efficacy of Infection Efficacy of Infection controlcontrol

The Following measures will certainly The Following measures will certainly control the infectionscontrol the infections

1 1 SterilizationSterilization 2 Hand washing2 Hand washing 3 Closed drainage systems for 3 Closed drainage systems for

urinary catheters.urinary catheters. 44 Intravenous catheter careIntravenous catheter care 5 Peri operative antibiotic 5 Peri operative antibiotic

prophylaxisprophylaxis for contaminated wounds, and for contaminated wounds, and care of equipment used in respiratory care of equipment used in respiratory therapy.therapy.

Measures proved to be Measures proved to be ineffectiveineffective

Chemical Chemical disinfection of disinfection of floors, walls, and floors, walls, and sinkssinks

Routine Routine environmental environmental monitoring is monitoring is losing its losing its concernsconcerns..

What is most ImportantWhat is most Important

Effective surveillance Effective surveillance and action by the and action by the infection control team infection control team have shown to reduce have shown to reduce infection rates.infection rates.

One important role of One important role of the team is to the team is to monitor compliance monitor compliance and practices known and practices known to be effective.to be effective.

Saving the Costs in Saving the Costs in prevention if Infectionsprevention if Infections

With raising With raising economic costs in economic costs in running safe running safe hospitals eliminate hospitals eliminate the many the many rituals rituals or less effectiveor less effective practices that they practices that they may even increase may even increase the incidence or the incidence or cost of cross cost of cross infection.infection.

Created for benefit of Created for benefit of Health care workers Health care workers

in the Devloping in the Devloping WorldWorld


Dr.T.V.Rao MDDr.T.V.Rao MD

EmailEmail

[email protected]@gmail.com

hospital acquired

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