Infection control in Radiology Srinivas Rao Khorfakhan hospital Radiographer

1. Infection Control InInfection Control In
RadiologyRadiology
Presented ByPresented By
RAORAO

2. Talk PlanTalk Plan
 IntroductionIntroduction
 InfectionInfection
 Infection ControlInfection Control
 Nosocomial InfectionNosocomial Infection
 Routes of TransmissionRoutes of Transmission
 Droplet - AirborneDroplet - Airborne

3. Talk plan:Talk plan:
 Personal Protective Equipments (PPE)Personal Protective Equipments (PPE)
 Precautions and Guidelines in RadiologyPrecautions and Guidelines in Radiology
 Hand WashingHand Washing
 Waste ManagementWaste Management

4. IntroductionIntroduction
 Infection control in radiology is one of the mainInfection control in radiology is one of the main
step to prevent infection as we receive differentstep to prevent infection as we receive different
patients of all age group with different disease.patients of all age group with different disease.
Development of various imaging modalities hasDevelopment of various imaging modalities has
increased the procedures & patients flowincreased the procedures & patients flow
increased. So infection control is vital in anyincreased. So infection control is vital in any
radiology department.radiology department.

5. Infection :Infection :
 An invasion of pathogens or Micro organismsAn invasion of pathogens or Micro organisms
into the body that are capable of producinginto the body that are capable of producing
Diseases.Diseases.

6. Infection Control:Infection Control:
 It includes all of the practices used to preventIt includes all of the practices used to prevent
the spread of micro organisms that could causethe spread of micro organisms that could cause
disease in a person.disease in a person.
 Infection Control Practices help to protectInfection Control Practices help to protect
clients and Healthcare providers from Diseaseclients and Healthcare providers from Disease
by reducing or eliminating sources of Infection.by reducing or eliminating sources of Infection.

7. Nosocomial InfectionNosocomial Infection
 An infection acquired in hospital by a patientAn infection acquired in hospital by a patient
who was admitted for a reason other than thatwho was admitted for a reason other than that
infection.infection.
 Infections that become clinically evident after48Infections that become clinically evident after48
hours of hospitalization are considered hospitalhours of hospitalization are considered hospital
acquired infections.acquired infections.

8. Nosocomial infectionsNosocomial infections
Most nosocomial infections are transmitted by healthMost nosocomial infections are transmitted by health
care workers and clients as a result of Direct contact.care workers and clients as a result of Direct contact.
Mode of transmission means of spread.Mode of transmission means of spread.
> Travel by air> Travel by air
> Contact> Contact
> Droplet> Droplet

9. Infection can spreadInfection can spread
 Through Indirect and Direct contactThrough Indirect and Direct contact
> Touching objects/persons> Touching objects/persons
> Sneezing or coughing> Sneezing or coughing
> Air borne particles> Air borne particles

10. DropletDroplet
 Respiratory droplets are generated when aRespiratory droplets are generated when a
person coughs, sneezes ,speaks during aperson coughs, sneezes ,speaks during a
procedure that generates aerosols eg ; suctionprocedure that generates aerosols eg ; suction
chest physiotherapy. Droplet particles greaterchest physiotherapy. Droplet particles greater
than 5 micron in daimeter , travel less than 1than 5 micron in daimeter , travel less than 1
metre. Eg influenzametre. Eg influenza

11. AirborneAirborne
 Transmission of the disease spread by airTransmission of the disease spread by air
particles less than 5 micron in diameterparticles less than 5 micron in diameter andand
travel greater than 1 meter .travel greater than 1 meter .
eg TB , Measleseg TB , Measles

12. Routes of transmissionRoutes of transmission
 Airborne (droplet nuclei)Airborne (droplet nuclei)
Very small particles of Evaporated droplets or dustVery small particles of Evaporated droplets or dust
with infectious agent maywith infectious agent may
-remain in air for long time-remain in air for long time
-travel farther than droplets-travel farther than droplets
-become Aerosolised during procedures-become Aerosolised during procedures
Eg T.b tuberculosis ,measles ( rubella)Eg T.b tuberculosis ,measles ( rubella)

13. Routes of transmissionRoutes of transmission
 Droplet :large droplets within-1meter(3 feet)Droplet :large droplets within-1meter(3 feet)
transmit infection via –coughing ,sneezingtransmit infection via –coughing ,sneezing
talking ,medical procedures. eg Diptheria ,talking ,medical procedures. eg Diptheria ,
pertusis (whooping cough) meningiococcalpertusis (whooping cough) meningiococcal
meningitismeningitis

14. Standard PrecautionsStandard Precautions
 These are the minimum standard of precautionsThese are the minimum standard of precautions
to be Applied to all people Accessing Healthto be Applied to all people Accessing Health
Care Services Regardless of their Diagnosis orCare Services Regardless of their Diagnosis or
presumed infectious status ,there by reducingpresumed infectious status ,there by reducing
the risk of transmission of organisms from boththe risk of transmission of organisms from both
recognized and unrecognized sources.recognized and unrecognized sources.

15. These precautions apply toThese precautions apply to
 Blood and all body substances (except sweat)Blood and all body substances (except sweat)
 Acutely or chronically non-intact skin andAcutely or chronically non-intact skin and
 Mucous membranes including eyesMucous membranes including eyes

16. Standard precautions must beStandard precautions must be
considered whenconsidered when
 Providing direct patient careProviding direct patient care
 Handling blood or body substancesHandling blood or body substances
 Performing invasive procedures includingPerforming invasive procedures including
Cannulation or CatheterisationCannulation or Catheterisation
 Risk of splash or splatter to mucous membranesRisk of splash or splatter to mucous membranes
 Providing care that can include coughingProviding care that can include coughing
 Handling and disposal of waste or sharpsHandling and disposal of waste or sharps
 Handling or preparation of foodHandling or preparation of food

17. Additional precautionsAdditional precautions
 These precautions are designed for patientsThese precautions are designed for patients
known or suspected to be infected withknown or suspected to be infected with
pathogens for which additional precautions ,inpathogens for which additional precautions ,in
addition to standard precautions are needed toaddition to standard precautions are needed to
interrupt transmission of those pathogens ininterrupt transmission of those pathogens in
health care facilities.health care facilities.

18. Additional Precautions :Additional Precautions :
 Taken in Addition to Standard Precautions.Taken in Addition to Standard Precautions.
 Limit patient movementLimit patient movement
 Isolate or Cohort patientsIsolate or Cohort patients
 Gown +Gloves for patientsGown +Gloves for patients
 Remove immediately after contactRemove immediately after contact
 Do not touch eyes, nose, mouth with handsDo not touch eyes, nose, mouth with hands
 Avoid contaminating environmental surfacesAvoid contaminating environmental surfaces

19. Precaution Levels :Precaution Levels :
 All levels require Hand HygieneAll levels require Hand Hygiene
 StandardStandard
 Transmission based PrecautionsTransmission based Precautions
 1. Contact1. Contact
 2. Droplet2. Droplet
 3. Air borne3. Air borne

20. Additional precautions areAdditional precautions are
implemented for pathogens spreadimplemented for pathogens spread
byby
 Airborne > 1metre particles less than 5 micronAirborne > 1metre particles less than 5 micron
in diameter.in diameter.
 Droplet < 1 metre particles greater than 5Droplet < 1 metre particles greater than 5
micron in diameter.micron in diameter.
 Contact with people or with contaminatedContact with people or with contaminated
surfaces or by any combination of these routessurfaces or by any combination of these routes

21. Personal protective equipmentPersonal protective equipment
(PPE)(PPE)
 When used properly can protect you fromWhen used properly can protect you from
exposure to infectious agents.exposure to infectious agents.
 Know what type of PPE is necessary for theKnow what type of PPE is necessary for the
duties you perform and use it correctly.duties you perform and use it correctly.

22. Types of PPETypes of PPE
 GLOVESGLOVES
 GOWNSGOWNS
 MASKSMASKS
 BOOTS OR OVERSHOESBOOTS OR OVERSHOES
 EYE PROTECTIONEYE PROTECTION

23. Types of PPETypes of PPE
 GlovesGloves
Different type of gloves-housekeeper glovesDifferent type of gloves-housekeeper gloves
-clean gloves-clean gloves
-sterile gloves-sterile gloves
Work from clean to dirty avoid touchWork from clean to dirty avoid touch
contamination-eye ,mouth ,nose surfacescontamination-eye ,mouth ,nose surfaces
Change gloves between patientsChange gloves between patients

24. Gloves:Gloves:
 Don gloves lastDon gloves last
 Select correct type and sizeSelect correct type and size
 Insert hands into glovesInsert hands into gloves
 Extend gloves over gown cuffsExtend gloves over gown cuffs

25. Types of PPE :Types of PPE :
 GOWNS:GOWNS:
 Fully covered torsoFully covered torso
 Have long SleevesHave long Sleeves
 Fit Snuggly at the wristFit Snuggly at the wrist

26. Surgical maskSurgical mask
 Place over nose, mouth and chinPlace over nose, mouth and chin
 Fit flexible nose piece over nose bridgeFit flexible nose piece over nose bridge
 Secure on head with ties or elasticSecure on head with ties or elastic
 Adjust to fitAdjust to fit

27. Type of PPEType of PPE
 Masks and Respirators: Barriers and FiltrationMasks and Respirators: Barriers and Filtration
 Surgical MasksSurgical Masks
 Cotton , paper – Protect against body fluids andCotton , paper – Protect against body fluids and
large particles.large particles.
 Respirators mask (N-95) – Protect against smallRespirators mask (N-95) – Protect against small
droplets and other Airborne particles.droplets and other Airborne particles.

28. Masks : PPEMasks : PPE
 Masks 3 Types : Disposible, reusable, respiratorsMasks 3 Types : Disposible, reusable, respirators
 Classified 9 Types N95, N99, N100, R95, R99,Classified 9 Types N95, N99, N100, R95, R99,
 R100, P95, P99 P100R100, P95, P99 P100
 Letter indicates oil ResistanceLetter indicates oil Resistance
 Number indicates percentage - %Number indicates percentage - %
 N= Not resistantN= Not resistant
 R= Some resistantR= Some resistant
 P= Strongly resistantP= Strongly resistant

29. Types of PPE:Types of PPE:
 Face shieldFace shield
 GogglesGoggles

30. Types of PPETypes of PPE
 Boots or Over Shoe :Boots or Over Shoe :
 Eye ProtectionEye Protection

31. PPE – For Standard PrecautionsPPE – For Standard Precautions
 Wear IfWear If
 Gloves : Touching respiratory secretions ,Gloves : Touching respiratory secretions ,
contaminated items or surfaces and body fluids.contaminated items or surfaces and body fluids.
 Gowns : Soiling clothes with patient bodyGowns : Soiling clothes with patient body
fluids , secretions or excretions.fluids , secretions or excretions.
 Eye protection/ masks : procedures are likely toEye protection/ masks : procedures are likely to
generate splashes/ spray or blood , body fluids,generate splashes/ spray or blood , body fluids,
Secretions & Excretions.Secretions & Excretions.

32. Infection Control: RadiologyInfection Control: Radiology
 Hand HygieneHand Hygiene
 PPE use and TrainingPPE use and Training
 Written Protocol / PlanWritten Protocol / Plan
 All Equipments should be cleaned betweenAll Equipments should be cleaned between
casescases
 Infected patient should be placed AppointmentInfected patient should be placed Appointment
at the end of list.at the end of list.
 Area & patient divided clean - dirtyArea & patient divided clean - dirty

33. Sequence for PPESequence for PPE
 1.Hand Hygiene1.Hand Hygiene
 2. Gown2. Gown
 3. N95 particulate respirator3. N95 particulate respirator
 perform seal checkperform seal check
 Hair coverHair cover
 Goggles or face shieldGoggles or face shield
 GlovesGloves

34. Sequence for Removing PPESequence for Removing PPE
 Remove in anteroom when possibleRemove in anteroom when possible
 GlovesGloves
 Hand hygieneHand hygiene
 Gown (and apron if worn)Gown (and apron if worn)
 GogglesGoggles
 MaskMask
 Cap( if worn)Cap( if worn)
 Hand hygieneHand hygiene

35. Hand hygieneHand hygiene
 Proper hand washing removes many of theProper hand washing removes many of the
micro organismmicro organisms that would be transferred bys that would be transferred by
the hands from one item to another always washthe hands from one item to another always wash
hands between patients.hands between patients.

36. Hand HygieneHand Hygiene
 It is the single most important procedure forIt is the single most important procedure for
preventing the transfer of micro organisms andpreventing the transfer of micro organisms and
therefore preventing the spread of nosocomialtherefore preventing the spread of nosocomial
infections.infections.

37. Hand HygieneHand Hygiene

38. Hand HygieneHand Hygiene
 My 5 moments for Hand Hygiene are :My 5 moments for Hand Hygiene are :
1) Before Touching patient1) Before Touching patient
2) Before Clean Aseptic Procedures2) Before Clean Aseptic Procedures
3) After Body Fluid Exposure Risk3) After Body Fluid Exposure Risk
4) After Touching A Patient4) After Touching A Patient
5) After Touching Patient Surrounding.5) After Touching Patient Surrounding.

39. Hand HygieneHand Hygiene
 Hand Hygiene can be performed 2 waysHand Hygiene can be performed 2 ways
1) Use of water and antimicrobial soap( germ1) Use of water and antimicrobial soap( germ
killing soap) and washing for at least 15 seconds.killing soap) and washing for at least 15 seconds.
2) Use of an Alcohol based hand rub2) Use of an Alcohol based hand rub
Hand Sanitizers – Alcohol percentage ethanol orHand Sanitizers – Alcohol percentage ethanol or
Isopropyl need to be in 60% to 90%Isopropyl need to be in 60% to 90%
concentrations.concentrations.

40. Hand SanitizersHand Sanitizers
1. Gels1. Gels
2. Rinses2. Rinses
3. Foams3. Foams
Storage: Alcohol based hand rub temperature 21-Storage: Alcohol based hand rub temperature 21-
24 degrees away from high temperature or24 degrees away from high temperature or
flames.flames.
Select little fragrance due to respiratory problem.Select little fragrance due to respiratory problem.

41. Aseptic technique- 2 TypesAseptic technique- 2 Types
 Medical Asepsis – clean technique, proceduresMedical Asepsis – clean technique, procedures
used to reduce and prevent spread of microused to reduce and prevent spread of micro
organisms handwashing.organisms handwashing.
 Surgical Asepsis- sterile technique proceduresSurgical Asepsis- sterile technique procedures
used to eliminate microorganisms sterilizationused to eliminate microorganisms sterilization

42. Hand hygieneHand hygiene
Indication for hand hygieneIndication for hand hygiene
1. Routine care1. Routine care
Minimum requirementMinimum requirement
Plain soap with water orPlain soap with water or
alcohol based handalcohol based hand
sanitizer.sanitizer.
2. Care of patient with2. Care of patient with
DiarrheaDiarrhea
Plain soap and waterPlain soap and water
3. Surgical procedure3. Surgical procedure Antimicrobial soap andAntimicrobial soap and
water or alcohol based handwater or alcohol based hand
Sanitizer. AntimicrobialSanitizer. Antimicrobial
soaps contains one of thesoaps contains one of the
antiseptic agents –antiseptic agents –
Chlorhexidine, ethanol orChlorhexidine, ethanol or
isopropyl alcohol 60-90%isopropyl alcohol 60-90%

43. Waste ManagementWaste Management
 Handle all waste carefullyHandle all waste carefully
 Separate clinical from general wasteSeparate clinical from general waste
 Safe handling and disposal of sharps in a sharpSafe handling and disposal of sharps in a sharp
container leak proof ,tamper resistant clearlycontainer leak proof ,tamper resistant clearly
label Biological Hazards. Discard when 2/3 full.label Biological Hazards. Discard when 2/3 full.
 Do not recap needlesDo not recap needles

44. ConclusionConclusion
 Infection control is a major issue in todaysInfection control is a major issue in todays
health care sector, by following proper handhealth care sector, by following proper hand
hygiene and proper protective equipments andhygiene and proper protective equipments and
Up to date guidelines and manuals helps our dayUp to date guidelines and manuals helps our day
to day practice in reducing Hospital Acquiredto day practice in reducing Hospital Acquired
Infections.Infections.

45. thank youthank you