Presentation11 Com Types Preven Nosocom

7/28/2019 Presentation11 Com Types Preven Nosocom

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Prevention of common endemic

Nosocomial Infections

Dr. A. A. Wegdan


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Preoperative measuresfor personnel

Wear operative room attire.

Surgical scrub.

Barrier devices.

Aseptic techniques.

Preoperative measures for Patient

Very short hospitalization.

Required investigations before admission. Improve the general condition/treat infections.

The basic patient preparation (shower/hair trimming).

Administration of prophylactic antibiotics.

Proper patient preparation/draping on table.

1. Surgical site infections:


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Operating Room environment

A good circulation and a good design.

High quality O.R. management.

A policy of cleaning the O.R.

Availability of a waste disposal system.

1. Surgical site infections:


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The main objectives are to:

1. Reduce colonization

Using local antimicrobial agents.

Reduce antacids H2 blockers.

Selective decontamination of digestive tract. Reduce aspiration.

2. Prevent transmission of pathogens

Aseptic technique for suctioning.

Care of mouth.

Disinfection of respiratory equipment.

Avoiding stagnation of liquid in tubes.

2.Nosocomial respiratory infections


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3. Prevent Transmission through a ventilator Proper cleaning and sterilization, or disinfection of re-

usable devices.

Use efficient filters.

Sterile water should be used for humidifiers.

4. Prevent Person to Person Transmission Restrict to standard precautions.

Care of tracheostomy.

Proper suctioning of respiratory secretions.

2.Nosocomial respiratory infections


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a. Peripheral catheter- Minimize patient exposure to peripheral catheterization.

- That could be through:

Insertion only if necessary. Early removal if not used.

Maximum duration for an adult is< 96 h.

Daily inspection of the insertion site and

immediate removal if infection is suspected. Hand disinfection before insertion.

Skin disinfection before insertion.

3. Infections associated with intravascular

lines


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b. Central Venous Catheter A written protocol for using CVC.

The indications of insertion/duration of CVC be limited.

Continuous education of health-care workers. The protocol should contain information about:


lines


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3.Infections associated with intravascular

lines

1- Precautions for insertion:

Surgical conditions (mask, cap, sterile gowns and

gloves), large sterile drapes

Skin disinfection Limit the use of the venous line

Insertion sites

- subclavian (if more than 5-7 days), jugular,

femoral.- tunneling of CVC for jugular or femoral site.


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lines

2- Type of catheter:

Polyurethane, silicone (better than Teflon or PVC)

Mono-lumen = multi-lumen Coated catheters

- With silver chlorhexidine-sulfadiazine: possible.

- With heparin: less thrombosis.


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lines

3- Use in aseptic conditions

Daily clinical surveillance.

No scheduled systematic replacement.

CVC dressing:

- Date placement.

- Occlusive dressing

- Every seven days if using transparent dressing.

- Two days if using gauze.

- Replacement of administration sets at 72 hours.


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lines

4- Replacement of the lines

The CDC now recommends leaving CVC

catheters in as long as necessary.

Or optimum 72 hrs.

Except if blood transfusion or lipid perfusion

(change/day)


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To succeed in reducing UTI the following recommendations

should be followed:

1. Personnel

2. Catheter Use

3. Hand washing

4. Catheter Insertion5. Closed Sterile Drainage

6. Irrigation

7. Specimen Collection

8. Urinary Flow

9. Meatal Care10. Catheter Change Interval

11. Spatial Separation of Catheterized Patients

12. Bacteriologic Monitoring

4. Urinary tract infections


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Presentation11 Com Types Preven Nosocom

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