1. PATIENT SAFETY AND
INFECTION CONTROL
Presenter:
Shamsadeen A. Muhammad

2. Learning Objectives
1. Recognize patient safety as an important
nursing responsibility in global health care
systems.
2. Apply required knowledge in preventing
and/or minimizing infection.
3. Perform appropriate behaviors required to
prevent health care associated infections.
4. Demonstrate required competence to provide
patients with safe care.

3. Introduction to Patient Safety:
Definition
 Patient safety is a discipline in the health care
sector that applies safety science methods
toward the goal of achieving a trustworthy
system of health care delivery. Patient safety is
also an attribute of health care systems; it
minimizes the incidence and impact of, and
maximizes recovery from, adverse events
(Emanuel et al., 2008) .

4. Introduction to Patient Safety:
Background
 Adverse medical events are widespread and
preventable (Emanuel et al., 2008) .
 Much unnecessary harm is caused by healthcare errors and system failures.
– Ex. 1: Hospital acquired infections from poor
hand-washing.
– Ex. 2: Complications from administering the
wrong medication.

5. Introduction to Patient Safety:
Goal
Prevent and/or minimize the adverse
events and eliminate preventable
harm in health care.
All health care professionals
including nurses are responsible for
ensuring patient safety

6. Introduction to Patient
Safety:
This unit of patient safety will
focus on Infection Control

7. Global Infection Problems
According to WHO (2005),
o On average, 8.7% of hospital patients suffer
health care-associated infections (HAI).
o In developed countries: 5-10%
o In developing countries:
– Risk of HAI: 2-20 times higher
– HAI may affect more than 25% of patients
o At any one time, over 1.4 million people
worldwide suffer from infections acquired while
in hospital.

8. Health Care-Associated Infections
(HAI)
According to WHO:
o HAI is also called “nosocomial”.
o HAI is defined as:
– 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.

9. Impacts of Health Care-Associated
Infections (HAI)
HAI can:
 Increase patients’ suffering.
 Lead to permanent disability.
 Lead to death.
 Prolong hospital stay.
 Increase need for a higher level of care.
 Increase the costs to patients and hospitals.

10. Preventing infections
Requires health care providers who
have:
– Knowledge of common infections
and their vectors
– An attitude of cooperation and
commitment
– Skills necessary to provide safe
care

11. Required Knowledge
Knowledge of the extent of the
problem;
Knowledge of the main causes,
modes of transmission, and types of
infections.

12. Required Attitudes
Being an effective team player.
Commitment to preventing HAIs

13. Required Skills
 Apply universal precautions*
 Use personal protection methods
 Know what to do if exposed
 Encourage others to use universal precautions
 Report breaks in technique that increase
patient risks
 Observe patients for signs and symptoms of
infection

14. One more important thing!
Protect Yourself
Be sure you have been immunized
against Hepatitis B since it is very
easy to transmit!

15. Main Sources of Infection
 Person to person via hands of health-care
providers, patients, and visitors
 Personal clothing and equipment (e.g.
Stethoscopes, flashlights etc.)
 Environmental contamination
 Airborne transmission
 Hospital staff who are carriers
 Rare common-source outbreaks

16. Main Routes for infections
 Urinary tract infections (UTI)
-Catheter-associated UTIs are the most frequent,
accounting for about 35% of all HAI.
 Surgical infections: about 20% of all HAI
 Bloodstream infections associated with the use of an
intravascular device: about 15% of all HAI
 Pneumonia associated with ventilators: about15% of
HAI

17. Four Ways to Prevent HAI
1. Maintain cleanliness of the hospital.
2. Personal attention to handwashing
before and after every contact with a
patient or object.
3. Use personal protective equipment
whenever indicated.
4. Use and dispose of sharps safely.

18. Prevention through Handwashing
 Handwashing: the single most important
intervention before and after patient contact.
 Required knowledge and skills:
– How to clean hands
– Rationale for choice of clean hand practice
– Techniques for hand hygiene
– Protect hands from contaminants
– Promote adherence to hand hygiene guidelines

19. Five moments for hand hygiene
Before patient contact.
Before an aseptic task.
After body fluid exposure even if
wearing gloves!
After patient contact.
After contact with patient
surroundings.

20. Your 5 moments for HAND HYGIENE

21. How to Clean Hands
 Remove all wrist and hand jewelry.
 Cover cuts and abrasions with waterproof
dressings.
 Keep fingernails short, clean, and free
from nail polish.

22. Effective Handwashing Technique
 Wet hands under tepid running water
 Apply soap or antimicrobial preparation
– solution must have contact with whole
surface area of hands
– vigorous rubbing of hands for 10–15 seconds
– especially tips of fingers, thumbs and areas
between fingers
 Rinse completely
 Dry hands with good quality paper towel.

23. How to use waterless handrub
Apply a palmful of product in cupped hand
Rub hands palm to palm
Right palm over left hand with interlaced fingers
Palm to palm with fingers interlaced
Backs of fingers to opposing palms with fingers
intelocked
 Rub between thumb and forefinger
 Rotational rubbing, backwards and forwards with
clasped fingers of right hand in left palm and vice versa
 Once dry your hands are safe.
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24. Personal Protective Equipment 1
Gloves, aprons, gowns, eye
protection, and face masks
Health care workers should wear a
face mask, eye protection and a
gown if there is the potential for
blood or other bodily fluids to splash.

25. Personal protective equipment 2
 Masks should be worn
– if an airborne infection is suspected or
confirmed
– to protect an immune compromised
patient.

26. Gloves
Gloves must be worn for:



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all invasive procedures
contact with sterile sites
contact with non-intact skin or mucous membranes
all activities assessed as having a risk of exposure to
blood, bodily fluids, secretions and excretions, and
handling sharps or contaminated instruments.
Hands should be washed before and after gloving

27. Safe Use and Disposal of Sharps
 Keep handling to a minimum
 Do not recap needles; bend or break
after use
 Discard each needle into a sharps
container at the point of use
 Do not overload a bin if it is full
 Do not leave a sharp bin in the reach of
children

28. Act to Minimize
Spread of Infection-1
Before contact with each and every
patient:
– clean hands before touching a
patient
– clean hands before an aseptic task

29. Act to Minimize
Spread of Infection-2
After contact with each and every patient:
– clean hands after any risk of exposure
to body fluids
– clean hands after actual patient
contact
– clean hands after contact with patient
surroundings

30. Summary-1
1. Know the main guidelines in each of
the clinical environments you are
assigned.
2. Accept responsibility for minimizing
opportunities for infection
transmission.
3. Let staff know if supplies are
inadequate or depleted.

31. Summary-2
1. Educate patients and families/visitors
about clean hands and infection
transmission.
2. Ensure patients on precautions have
same standard of care as others:
– frequency of entering the room
– monitoring vital signs

32. Thank you for listening

33. References
o World Health Organization. (2010). WHO Patient Safety Curriculum
Guide for Medical Schools.
o World Health Organization. (2010). Topic 1: What is patient safety?
o World Health Organization. (2010). Topic 9: Minimizing infection
through improved infection control.
o Emanuel, L., Berwick, D., Conway, J., Combes, J., Hatlie, M.,
Leape, L., Reason, J., Schyve, P., Vincent, C., & Walton, M.
(2008). What exactly is patient safety? Advances in Patient Safety,
Vol. 1: Assessment. Retrieved from
http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?
book=aps2v1&part=advances-emanuel-berwick_110
o Burke, J. P. (2003). Infection control — A problem for patient
safety. The New England Journal of Medicine, 348, p. 651-656.