Manual of Infection Control Procedures

Cover......Page 1
Half-title......Page 3
Dedication......Page 4
Title......Page 5
Copyright......Page 6
Foreword to the Second Edition......Page 9
Foreword to the First Edition......Page 11
Preface to the Second Edition......Page 15
Preface to the First Edition......Page 17
Acknowledgements......Page 19
Contents......Page 21
Abbreviations......Page 27
Glossary of Infection Control Terms......Page 29
1. Causative agent......Page 33
2. Reservoir of infection......Page 35
3. Portal of exit......Page 36
4. Mode of transmission......Page 37
Body’s defense mechanisms......Page 38
Strategies to control health care associated infection......Page 39
References and further reading......Page 40
Infection Control Doctor (ICD)......Page 41
Infection Control Nurse (ICN)......Page 42
Infection Control Committee (ICC)......Page 43
Infection control link nurse......Page 44
Education and training......Page 45
Risk management in infection control......Page 46
References and further reading......Page 47
3 Design and Maintenance of Health Care Facilities......Page 49
The general hospital environment......Page 50
Patient’s accommodations......Page 51
Source isolation room......Page 52
Protective isolation room......Page 53
Ultra clean air theatre......Page 54
Cooling towers and water system......Page 55
References and further reading......Page 56
Incidence of various nosocomial infections......Page 59
Surveillance of nosocomial infection......Page 60
Methods of surveillance......Page 61
Management of an outbreak......Page 62
Look back investigations......Page 67
References and further reading......Page 68
Cohort studies......Page 71
Case-control studies......Page 72
Cross-sectional (prevalence) surveys......Page 73
Rates......Page 74
Relative risk, absolute risk and individual risk......Page 75
Bias......Page 76
Confounders......Page 77
Measures of central tendency......Page 78
Measures of dispersion......Page 80
Chi-square test......Page 81
Confidence Intervals (CI)......Page 82
Sensitivity and specificity......Page 83
References and further reading......Page 84
Methods of decontamination......Page 87
Risks of infection from equipment......Page 89
Chemical disinfectants......Page 90
Chlorine-based disinfectants......Page 91
Phenolics......Page 92
Quaternary ammonium compounds (QAC)......Page 96
Triclosan......Page 97
Peracetic acid......Page 98
Ortho-phthaladehyde (OPA)......Page 100
Disinfection of flexible fibreoptic endoscopes......Page 101
Chemical disinfectants......Page 102
Cleaning and disinfection of the endoscope......Page 103
Problems due to inadequate decontamination......Page 104
Environmental cleaning......Page 105
Cleaning of environmental surfaces......Page 106
Cleaning method and equipment......Page 108
Cleaning and disinfection of medical equipment......Page 110
Decontamination of equipment prior to inspection, service or repair......Page 111
References and further reading......Page 122
7 Isolation Precautions......Page 127
Airborne precautions......Page 128
Contact precautions......Page 129
Practical issues and considerations......Page 130
Door sign......Page 131
Linen......Page 132
Clinical waste......Page 133
Deceased patients......Page 135
References and further reading......Page 145
APPENDIX I......Page 146
8 Prevention of Infections Caused by Multi - resistant Organisms......Page 151
References and further reading......Page 152
Source of infection......Page 153
Control measures......Page 154
Infection control precautions......Page 155
Patient’s movement......Page 156
Clearance of MRSA carriage......Page 158
References and further reading......Page 159
Infection control measures......Page 162
References and further reading......Page 164
Infection control precautions......Page 166
References and further reading......Page 167
TUBERCULOSIS (TB)......Page 169
Infection control precautions in hospital......Page 172
Multi-drug resistant tuberculosis (MDR-TB)......Page 175
References and further reading......Page 178
Clostridium difficile INFECTION......Page 179
References and further reading......Page 181
LEGIONNAIRES’ DISEASE......Page 183
References and further reading......Page 186
GASTROINTESTINAL INFECTIONS AND FOOD POISONING......Page 187
References and further reading......Page 191
Emergency action......Page 192
Management of contacts......Page 194
Immunization of contacts......Page 195
References and further reading......Page 196
VARICELLA ZOSTER VIRUS (VZV)......Page 197
References and further reading......Page 200
CREUTZFELDT-JAKOB DISEASE (CJD)......Page 201
Methods of decontamination......Page 203
References and further reading......Page 205
VIRAL HAEMORRHAGIC FEVERS (VHFs)......Page 207
Infection control and precautions......Page 209
References and further reading......Page 210
References and further reading......Page 211
Infection control measures......Page 212
Scabies......Page 213
Infection control measures......Page 214
References and further reading......Page 215
Hepatitis B virus (HBV)......Page 217
Hepatitis C virus (HCV)......Page 218
Hepatitis D virus (HDV)......Page 219
Clinical features......Page 220
HIV testing......Page 221
Routes of transmission......Page 222
Risks to patients from HCWs......Page 224
Responsibility of HCWs......Page 225
Surgical procedure......Page 226
Protection of the newborn......Page 230
References and further reading......Page 231
Occupation Health Department......Page 235
Pre-employment assessment......Page 236
Management of sharps injury......Page 237
Risk factors for acquiring blood-borne viral infections......Page 238
Management of the exposed person......Page 239
Source patients or individual......Page 241
Hepatitis B virus (HBV)......Page 242
Protection against tuberculosis......Page 245
Rubella......Page 247
Cytomegalovirus (CMV)......Page 248
Varicella-zoster virus (chickenpox and shingles)......Page 249
Parvovirus (erythrovirus) B19......Page 250
References and further reading......Page 256
12 Hand Hygiene and Personal Protective Equipment......Page 259
Procedure......Page 260
Hand drying......Page 263
Hand cleaning preparations......Page 264
Hand care......Page 265
Compliance......Page 266
Types of gloves......Page 267
Latex allergy......Page 269
Aprons and gowns......Page 271
References and further reading......Page 272
Surveillance......Page 277
Pre-operative showers......Page 280
Antibiotic prophylaxis......Page 283
Surgical hand scrub......Page 284
Theatre wear......Page 285
Skin disinfection......Page 286
Duration of operation......Page 287
Other factors......Page 288
References and further reading......Page 289
Sources of infection (Fig. 14.1)......Page 293
Pathogenesis of infection......Page 294
Monitoring and surveillance of catheter-related infection......Page 295
Selection of catheter type......Page 296
Aseptic techniques......Page 297
In-line filters......Page 300
Replacement of catheters......Page 301
Device reprocessing......Page 302
References and further reading......Page 303
Consideration prior to catheterization......Page 305
Drainage bag......Page 306
Emptying the drainage bag......Page 308
Use of antimicrobial agents......Page 310
Re-use of catheters......Page 311
References and further reading......Page 312
Pathogenesis......Page 315
Strategy for prevention......Page 317
References and further reading......Page 321
FOOD AND CATERING SERVICES......Page 323
Cook-chill food production systems......Page 324
Food trolleys......Page 325
Hospital kitchen......Page 326
Ice machines......Page 327
References and further reading......Page 328
General principles to prevent infection......Page 330
High-temperature wash......Page 331
Staff uniforms......Page 332
Air-fluidized beds......Page 333
References and further reading......Page 334
Definition and categorization of clinical waste......Page 335
Methods for safe handling of clinical waste......Page 336
Methods for safe use, handling and disposal of sharps......Page 337
Treatment methods......Page 340
Reference and further reading......Page 342
PEST CONTROL......Page 344
References and further reading......Page 345
INTERNET RESOURCES......Page 347
BOOKS......Page 349
epinet InCONTROL......Page 353
Index......Page 355