Dr.T.V.Rao MD

1Hand Hygiene and

Prevention of Infections in icu care

DR.T.V.RAO MD

Dr.T.V.Rao MD

2Health care Associated Infections

Healthcare-associated infections affect 1.4 million patients at any time worldwide, as estimated by the World Health Organization. In intensive care units, the burden of healthcare-associated infections is greatly increased, causing additional morbidity and mortality.

Dr.T.V.Rao MD

3Multi Drug Resistant Microbes can be reduced with Hand hygiene

Multidrug-resistant pathogens are commonly involved in such infections and render effective treatment challenging. Proper hand hygiene is the single most important, simplest, and least expensive means of preventing healthcare-associated infections

Dr.T.V.Rao MD

4CDC Says

According to the Centers for Disease Control and Prevention and World Health Organization guidelines on hand hygiene in health care, alcohol-based hand rub should be used as the preferred means for routine hand antisepsis. Alcohols have excellent in vitro activity against Gram-positive and Gram-negative bacteria, including multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci

Dr.T.V.Rao MD

5Our Hands are always Contaminated with

Microbes

Dr.T.V.Rao MD

6OPTIMAL HAND HYGEINE

Correct hand hygiene includes washing hands with soap and water or using alcohol-based hand sanitizers (preferred). Hand hygiene procedures should be performed before and after any and all direct patient contact – even when gloves are used.

Dr.T.V.Rao MD

7OPTIMAL HAND HYGEINE

Direct patient contact includes: examination of patient, specimen collection, and all procedures. Hands should be cleaned before and after contact with the patient’s immediate environment or medical equipment. Hand hygiene practices should be performed before and after eating, sneezing, coughing, and using the restroom.

Dr.T.V.Rao MD

8Every bed should have

Every bed should have attached alcohol based anti-microbial instant hand wash solution source, which is used before caregiver (doctor/Nurse/relative/Paramedical) handles the patient

Dr.T.V.Rao MD

9Water basin

Water basin at all bedside has not proven popular and successful because of poor compliance by one and all and also for reasons of space constraints and maintenance issues.

Dr.T.V.Rao MD

10An operation room style sink

An operation room style sink with Elbow or foot operated water supply system with running hot and cold water supply with antiseptic soap solution source should be there at a point easily accessible and unavoidable point, where two people can wash hands at a time

Dr.T.V.Rao MD

11How you enter a ICU

All entrants (Irrespective of Doctors or nurses should don mask and cap in ICU and ideally an apron which should be replaced daily)

Dr.T.V.Rao MD

12No dirty/soiled linen

No dirty/soiled linen/material should be allowed to stay in ICU for long times for fear of spread of bad odour, infection and should be disposed off as fast as possible. Dirty linen should be replace regularly at fixed intervals.

Dr.T.V.Rao MD

13All surrounding to be clean

All surroundings of ICU should be kept absolutely clean and green if possible for obvious reasons

Dr.T.V.Rao MD

14Care of the Catheters

While the epidemiology of catheter infections is well described in western literature, data from Indian hospitals is scarce. Though one study of intermediate-term central catheters in children reports rates of catheter associated bloodstream infection of 1.3/1000 catheter days. The definitions of catheter infections are very variable in the published studies and need to be standardised

Dr.T.V.Rao MD

15Catheters as source of Infection

The high frequency of fungal colonisation of catheter tips and candidemia (about 45%) in a paediatric study is also unusual and requires further evaluation.

Dr.T.V.Rao MD

16Surveillance of Catheter associated Infections

All Institutions and intensive care units should measure CABSI rates (A) 2. For purposes of surveillance all BSIs count as CABSI

Dr.T.V.Rao MD

17Indication for culturing Blood

Blood cultures are to be drawn only when BSI is clinically suspected (and preferably before antibiotics are started) (A) Routine cultures of vascular catheter tips are not recommended

Dr.T.V.Rao MD

18Implementation of Standard Operating procedures

Standard methodology for blood culture, vascular catheter-tip culture and calculation of CABSI rates are encouraged

Dr.T.V.Rao MD

19Hand washing a great priority

Practical approaches to promote hand hygiene in the intensive care unit include provision of a minimal number of hand rub dispensers per bed, monitoring of compliance, and choice of the most attractive product. Lack of knowledge of guidelines for hand hygiene,

Dr.T.V.Rao MD

20Increased use of Alcohol in Health care

Multidisciplinary programs to promote increased use of alcoholic hand rub lead to an increased compliance of healthcare workers with the recommended hand hygiene practices and a reduced prevalence of nosocomial infections.

Dr.T.V.Rao MD

21Give everyone a Clean Hand

Dr.T.V.Rao MD

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Program file Created by Dr.T.V.Rao MD for Medical and Paramedical Professionals for improving the

health care in Intensive care Units Email

doctortvrao@gmail.com