Infection Prevention and Control

Introduction

Infection prevention and control (IPC), as defined by the World Health Organization (WHO), is a scientific approach and practical solutions aimed at preventing infection-induced harm to patients and health workers. It is a subset of epidemiology but also plays an important role in epidemiology Disease Social Sciences and Global Health [1].

Effective IPC is a public health concern and is fundamental to patient safety and health system strengthening. Prevention of healthcare-associated infection (HAI) epidemics (including the 2013-2016 Ebola virus disease outbreak) and epidemics of international concern (eg; 2009 influenza pandemic and COVID-19) are rooted in effective IPC measures [2]. The guiding principle of the core components of the WHO IPC is that access to health care services designed to minimize the avoidable risk of HAI to patients and health care workers is a fundamental human requirement Right [2].

Strengthening the global IPC is critical to combating antimicrobial resistance in HAIs and responding to disease outbreaks. A study published in 2021 looked at WHO’s IPC core components and found that most participating countries had IPC plans and guidelines in place, but few Set aside necessary resources to support these plans. There is a need to move from planning to implementation and monitoring, especially in low-income countries [3].

The Spread of Infectious Disease

Infection is defined as the successful spread of pathogenic microorganisms such as bacterial viruses or fungi:[4][5][6][7]

• Directly:

• • From person to person
  • via respiratory droplets (such as coughing or sneezing)
  • Through body fluids
  • Direct exposure to infectious agents in the environment
  • During delivery from mother to fetus (transplacental/perinatal) .

• Indirectly:

• • Biological – Vector or Intermediate host (eg; Zika Virus) .
  • Device – Vector or Vehicle (eg; Pestilence – Yersinia Pestis transmitted by mosquitoes) .
  • Airborne (for example, Tuberculosis)

Epidemiological Triad

In humans, diseases occur when certain microbial pathogens multiply in the body and cause a process in the body and potentially infectious disease. The spread of infectious diseases requires three variables known as the epidemiological triad[8]:

• The Agent – Microorganisms that cause infection and can be bacterial parasites or fungi
• The Host – The target of the disease
• Environment – Environment and conditions (these are external to the host) .

[9]

Infection Spread in Healthcare

Healthcare facilities whether hospitals or primary care clinics are a high-risk setting for infection due to the presence and number of potentially exposed individuals. One in ten patients develop an infection during treatment[10] but effective prevention and control of infection reduce health-related diseases by at least 30%[10]. In the healthcare setting the three factors important for the spread of infection are the following[11]:

• Source – areas where pathogens live (e.g. sinks hospital equipment countertops medical devices).
  • Environmental – care areas sinks hospital equipment countertops medical equipment.
  • People – patients healthcare professionals or visitors.

• Susceptible Person – A person (Patient Health Professional or Soldier) who is not vaccinated or does not have a specific infectious disease or an individual whose immune system is compromised / immunodeficient[11].
  • In addition, vulnerability may be increased in individuals due to underlying medical conditions medications and important treatments and procedures that increase the risk of infection (eg surgery).

• Infection – The means by which germs are transmitted to a susceptible person
  • Exposure includes through medical devices or susceptible individuals (such as MRSA or VRE)
  • Spray or splash (such as whooping cough)
  • Inhalation of aerosolized particles (such as tuberculosis or measles)
  • Introduction of bloodborne pathogens (eg, HIV HBV HCV) by sharps injury

Control Communicable Diseases in the Community

Infection control and prevention is a global issue and there are many protocols and guidelines that can be followed to minimize the spread of infection between human populations and on a global scale [2]. Identifying high-risk groups such as children, the elderly and those with chronic diseases can It can also help guide relevant strategies to protect these vulnerable groups. The first steps towards infection control can start at the community level through behavioral changes, including:

• Regular hand washing
• Proper use of masks (to protect and prevent the spread of respiratory infections)
• Using insect repellents
• Make sure you are up to date with routine vaccinations and participate in immunization schedules
• Take prescription medicines, such as antibiotics, as directed by a health professional
• Social distancing – avoiding contact with others
• Using a condom especially when having sex with another partner

Other measures that can be taken to limit expansion in the area include environmental measures such as:

• Modifying environments
• Surveillance of diseases
• Food safety
• Air quality

Medical Interventions

As well as simple steps for disease prevention and control, there are biochemical interventions that can be used to accelerate the recovery process and in some cases completely suppress infection.[12] ] The development of antiviral drugs and vaccines has been shown to be rapid recovery slows growth and in some cases eradicates infectious diseases from the entire population.

Antibiotics

Antibiotics are prescribed for infection and help the body’s natural defense system to eliminate disease-causing bacteria. It is designed to kill bacteria or prevent them from reproducing. But antibiotic overuse and mutation of bacteria to generate resistance[13]. In these cases, aggressive chemotherapy or a combination of one or more antibiotics is required.

Vaccinations

Vaccines are designed to boost immunity to specific diseases. Vaccines work by injecting a small amount of the virus or virus that causes the disease into the host to create a natural immune response. The introduction of routine vaccines has slowed and in some cases eliminated it certain diseases such as polio measles measles and rubeola (measles). Chicken pox vaccine is also available but this is not routinely given and is given to those at risk of spreading the disease to those with compromised immune systems[14]. This is due to the fact that it is is common in children under 10 years of age and symptoms are usually mild; this approach enables the development of natural immunity and helps to improve the resistance of a community[15]. This protection is known as herd immunity[16].

Antivirals

Antibiotics do not protect against infectious diseases caused by viruses, such as influenza HIV herpes and hepatitis B. In these cases, antiviral drugs are most effective at slowing disease progression and boosting the immune system. Unfortunately Antibiotics Viruses can mutate over time and become resistant to these antiviral drugs [13].

Infection Control in Healthcare Facilities

Another important element in infection control and prevention is improving healthcare facility practices. Healthcare professionals around the world have a responsibility to ensure they develop strategies and implement policies to protect those who may be immunocompromised in order to maintain Susceptible patients are protected from healthcare-associated infections (HAIs). Globally, up to 7% of patients in developed countries and 10% of patients in developing countries will acquire at least one HAI[2][17].

HAI is one of the most common deleterious effects in care delivery, and both the endemic burden and the occurrence of epidemics are a major public health concern. HAI has a major impact on morbidity, mortality [18] and quality of life, as well as an economic burden at the societal level. However, a large proportion of HAI is preventable, and accumulating evidence is helping to improve understanding of the global burden of harm caused by these infections, including strategies to reduce their transmission [11].

[19]

Steps to Improve Infection Control

The Centers for Disease Control and Prevention (CDC) [20] recommend two layers of precautions to prevent the spread of infection in healthcare settings: (1) standard precautions and (2) transmission-based precautions [21][6] .

Standard precautions for all patient care:

• Perform hand hygiene[22][23][24]
• Use personal protective equipment (PPE) to prevent exposure to infection
• Follow respiratory hygiene/cough etiquette principles
• Ensure proper patient placement and isolation precautions [25]
• Proper handling of cleaning and disinfection of patient care equipment and medical devices
• Handle and sanitize textiles and clothing with care
• Follow safe injection practices and dispose of sharps/needles properly
• Keeping healthcare workers safe with IPC and post-exposure prophylaxis
• Prevention of intervention-associated infection (catheter-associated urinary tract infection intravascular catheter-associated infection surgical site infection)
• Implementation of special isolation measures in the diagnosis of some syndromes [25]
• Improving communication among health care workers, especially when referring potentially infectious patients [26]
• In pediatric or outpatient settings, efforts should be made to reduce infections from contaminated toys. Families could be encouraged to bring their own toys[26]

Transmission-Based Precautions

In addition to standard precautions for patients with infectious diseases, transmission-based precautions [27] are used to prevent transmission:

• Contact precautions
• Droplet precautions
• Airborne precautions

[28]

The Centers for Disease Control and Prevention (CDC) provides additional details and guidance on transmission and isolation-based precautions:

• Precautions Based on Communicable Diseases: Centers for Disease Control and Prevention

Planning for Infection Prevention in Critical Care

The CDC[29] suggests that assessment and infection control programs and practices in acute care hospitals can be divided into 4 categories:

• Section 1: Facility Demographics
• Part 2: Infection Control Plan and Infrastructure
• Section 3: Direct Observation of Facility Practices (Optional)
• Section 4: Infection Control Guidelines and Additional Resources

They produced an infection prevention and control assessment tool for acute care hospitals designed to assist in the evaluation of infection control programs and practices in acute care hospitals.

Environmental Cleaning and Disinfection

Evidence supports the important role of environmental cleaning in controlling the spread of organisms such as S. aureus, vancomycin-resistant enterococci, norovirus, Clostridium difficile, and Acinetobacter, especially in hospitals and healthcare settings. [30]

If someone with a suspected or confirmed case of an infectious disease has visited your clinic, you must clean all surfaces that person has touched.

• The room they are placed/quarantined in should not be cleaned or used for one hour and the door to the room should remain closed.
• Persons designated to clean the room should wear gloves (disposable disposable nitrile or household gloves) and disposable aprons (if available) before using a household cleaner solution and disinfectant or a combination household cleaner to disinfect the environment and furniture perform physical cleaning Cleaners and disinfectants, such as those containing hypochlorite (bleach solution) [31]. Products with these specifications come in different forms, including wet wipes.
• No special cleaning of walls or floors is required.
• Pay special attention to frequently touched surfaces, chair backs, couches, doorknobs, or any surface that the affected person has touched.
• Discard waste (including used tissues, disposable cleaning cloths) in the medical risk waste bag (yellow).
• Remove the single-use plastic apron (if worn) and gloves and dispose of them in a medical risk trash bag.
• If medical risk bags are not available, place waste in small household waste bags and tie them tightly. Do not overfill. Then place the bag in a second household waste bag and tie it tight. Store in a safe place. If the situation is not confirmed, the waste can be disposed of as usual. if When a case is confirmed, Public Health will advise you on how to dispose of this waste.
• Once the process is complete and all surfaces are dry, the room is ready to be used again.

Infection Control Programmes Globally

WHO guidance on core components of IPC programs at country and institutional levels [2] aims to strengthen countries’ capacity to develop and implement effective technology and behavior change interventions. They form a key part of WHO’s strategy to prevent current and future threats Drugs from infectious diseases such as Ebola can enhance the resilience of health services, help combat antimicrobial resistance (AMR) and improve the overall quality of health care delivery. They are also designed to support countries in developing their own national agreements for IPC and AMR action plans Support healthcare organizations in developing or enhancing their own IPC methodologies.

[32]

The executive summary of the minimum requirements for the core components provides an excellent summary to present and facilitate expert consensus on the minimum requirements for an IPC program at the national and health care facility levels, based on available evidence and in the context of WHO Core components.

Infection Control in Disaster and Conflict Environments

To protect yourself and your patients, the principles of the IPC remain critical during emergencies. This is especially important given the unsanitary conditions in post-disaster and post-conflict camps, which can create a risk for infectious diseases and Wound infection. Due to the high incidence of complex open trauma requiring surgery in a suboptimal surgical environment, there is an increased risk of wound infection, which is further exacerbated by limited resources, including clean (potable) water and medical supplies Consumables present significant challenges to rehabilitation professionals in many disaster and conflict settings. [33]

Additional IPC precautions will be taken when working in areas where communicable diseases (e.g. Cholera, Diphtheria, Ebola, Middle East Respiratory Syndrome (MERS)) have been identified as a risk. Make sure you have specialized training and additional PPE as needed. [33]

Improving Social Determinants

Another important factor to consider when controlling infectious diseases is addressing and improving the social determinants of health in societies. There is a direct link between a person’s health and their environment. WHO identifies three common interventions to improve health Global conditions [34]:

• Education – There is a strong link between health and education [35].
• Social Protection – Access to affordable healthcare and some form of social safety net can also determine the health and behavior of a community [36].
• Urban development – the way our villages, towns and cities are designed can have a major impact on health and the spread of disease. Living in overcrowded conditions or living in damp and/or inadequate facilities and sanitation can increase the spread of infectious diseases disease [37].

Conclusion

There is no one way to control the spread of infectious disease, and effective IPC does require government intervention and collaboration between individuals in healthcare facilities and the community. The war on infectious disease until some risk factors are addressed and behavior changed Disease will continue to be a major and costly health problem worldwide.

Resources

The following resources further expand on the four sections above:

• Infection Control Assessment Tool (2019) – CDC
• IPAC Clinical Office Practice Checklist: Core Elements (2019) – Public Health Ontario
•