1. INFECTION PREVENTION
& CONTROL
Patient Safety Unit
Quality in Medical Care Section
Ministry of Health Malaysia
@ Secretariat, Patient Safety Council Malaysia
In Collaboration with :
Patient Safety Module Technical Committee
1
2. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
PART 1: INFECTION PREVENTION
& CONTROL
Healthcare Associated Infection (HCAI)
Cause of Infection and Transmission Route
Hand Hygiene
Standard Precaution
Transmission Based Precaution
Needle Stick Injury
HCAI Preventive Bundle
2
3. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
OBJECTIVES
3
Demonstrate the devastating effects of
inadequate infection prevention & control in
health-care settings
Apply required knowledge in preventing and/or
minimizing infection
Perform appropriate behaviors required to
prevent health care associated infections
4. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
Definition of Health Care Associated
Infection (HCAI)
This includes infections that are acquired in the hospital, but appear only
after discharge, as well as occupational infections among health-care staff
4
What it is
HCAI?
Infection acquired in a hospital by
a patient who was admitted for a
reason other than that infection
and/or
infection occurring in a patient in a
hospital or other facility in whom
the infection was not (latently)
present at admission.
6. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
MOST FREQUENT SITES OF INFECTION
AND THEIR RISK FACTORS
(Distribution based on MOH data)
PNEUMONIA
Mechanical ventilation, Aspiration and
Nasogastric tube
Central nervous system depressants
Antibiotics and anti-acids
Prolonged health-care facilities stay
Malnutrition
Advanced age
Surgery
Immunodeficiency
37%
BLOOD STREAM INFECTIONS
Vascular catheter
Neonatal age
Critical care
Severe underlying disease
Neutropenia
Immunodeficiency
New invasive technologies
Lack of training and supervision
30%
SURGICAL SITE INFECTIONS
Inadequate antibiotic prophylaxis
Incorrect surgical skin preparation
Inappropriate wound care
Surgical intervention duration
Type of wound
Poor surgical asepsis
Diabetes
Nutritional state
Immunodeficiency
Lack of training and supervision
17%
URINARY TRACT INFECTIONS
Urinary catheter
Urinary invasive procedures
Advanced age
Severe underlying disease
Urolitiasis
Pregnancy
Diabetes
7%
LACK OF
HAND
HYGIENE
6
7. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
Direct contact
transmission
Indirect transmission
Droplet transmission
Airborne transmission
Percutaneous exposure
CAUSES OF INFECTION AND
TRANSMISSION ROUTE
7
8. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
5 WAYS TO PREVENT HCAI
8
Hand Hygiene
•Hand washing
•Hand rubbing
PPEs
•Gloves
•Goggle/ Face Shield
•Gown & Mask
Sterilization/
disinfection of
equipment,
devices &
instruments
‘Single use’
medical
devicesEnvironmental
Cleanliness
•increased levels of
cleaning during
outbreaks
12. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
STANDARD PRECAUTIONS
• Set of infection control practices used to
prevent transmission of diseases that can be
acquired bt contact with blood, body fluids,
non-intact skin (including rashes) , and
mucous membranes.
•Meant to reduce risk of transmission of
bloodborne and other pathogens from both
recognized and unrecognized sources.
12
13. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
13
ELEMENT OF STANDARD PRECAUTIONS
Hand
hygiene
Wearing gloves
Wearing gown
or apron
Mask, eye
protection and
face shield
Waste
Management
1 2
3 4
5
14. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
14
ELEMENT OF STANDARD PRECAUTIONS
Needles and
other sharps
Respiratory
hygiene
Patient care
equipment
Linen
Management
Management of
spills
6 7
8 9
10
15. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
TRANSMISSION-BASED PRECAUTIONS
•When treating patients who are known or
suspected of being infected or colonized with
infectious agents.
•Applied according to the clinical syndrome and
the likely etiologic agents, and then modified
based on test results.
•These precaution are to be implemented in
conjunction with standard precaution
15
16. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
16
• Herpes Zoster
• Measles
• Mycobacterium
Tuberculosis
• Varicella
Pneumonia
TYPE OF
TRANSMISSION-BASED
PRECAUTIONS
1
17. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
17
•Diphtheria - Pharyngeal
•Epiglotittis -Haemophilus Influenza
•Meningitis (haemophilus influenza,
meningococcal, fungal)
•Pneumonia
•Mumps
•Influenza
•MersCoV
TYPE OF
TRANSMISSION-BASED
PRECAUTIONS
2
18. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
18
TYPE OF
TRANSMISSION-BASED
PRECAUTIONS
3
•Herpes Simplex
•Herpes Zoster
•Methycillin-Resistance Staphylococcus
Aureus (MRSA)
•Extended Spectrum Beta Lactamase
(ESBL)
•Carbapenem Resistance
Enterobacteriaceae (CRE)
•Streptococcal Disease – skin, wound,
burns
•Typhoid (Salmonella Typhii)
•Varicella Zoster
19. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
19
Role of Junior Doctors
Be immunized against
Hepatitis B
Practice standard
precaution including Hand
Hygiene
Act as role model for good clinical
practice and patient safety and
encourage others to use
appropriate precautions
Take appropriate precaution
when you are ill to avoid
infecting patients/
contaminating environment
1 2
3 4
20. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
20
Know What To Do After Needle
Stick/Sharp/Splash Injury
Wash the injury site under running water
DO NOT SQUEEZE – causing hyperaemia
and inflammation
If splash injury from body fluids or blood to
wash under running water (i.e eyes,
nostrils, eczematous skin
5
21. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
HCAI PREVENTIVE CARE BUNDLE
21
Ventilator Associated
Pneumonia Care Bundle
Catheter Associated
UTI Care Bundle
Surgical Site Infection Care
Bundle
Central Venous Catheter Care
Bundle
22. PATIENT
SAFETY
UNIT
MEDICAL CARE QUALITY
SECTION
MEDICAL DEVELOPMENT
DIVISION
ADOPTED FROM THE WHO
PATIENT SAFETY
CURRICULUM GUIDE
(MULTIPROFESSIONAL
ACKNOWLEDGEMENT
• DR SURAYA AMIR HUSIN
• DR ISMALIZA ISMAIL
• DR SYAMHANIN ADNAN
• DR AFAF AZIZAN
• MATRON SUHAILY OTHMAN
22
