5 Marks –

Define Hospital Acquired Infection
Hospital acquired infection is an infection acquired by a patient during hospital stay.
It was not present or incubating at the time of admission.
It appears after 48 hours of hospital admission.
It may occur after discharge also.
It is also called nosocomial infection.
It increases morbidity and mortality.
It prolongs hospital stay.
It increases cost of treatment.
It is a major public health problem.
Prevention is essential.

Sources of Hospital Infection
Patients are the main source of infection.
Hospital staff may act as carriers.
Visitors can transmit infection.
Contaminated instruments are sources.
Hospital environment like air and water.
Soiled linen and bedding.
Medical devices like catheters.
Operation theatres.
Biomedical waste.
Poor sanitation contributes.

Modes of Transmission of Hospital Infection
Direct contact between patients.
Contact with infected hospital staff.
Droplet infection by coughing or sneezing.
Airborne transmission in wards.
Vehicle borne through food and water.
Fomite borne through instruments.
Blood borne through injections.
Urinary catheters and IV lines.
Surgical procedures.
Poor hand hygiene increases spread.

Susceptible Hosts in Hospital Infection
Elderly patients.
Newborn babies.
Immunocompromised patients.
Malnourished patients.
Postoperative patients.
Patients with chronic diseases.
Patients with catheters.
Burn patients.
ICU patients.
Long hospital stay increases risk.

Common Organisms Causing Hospital Infection
Staphylococcus aureus.
Escherichia coli.
Klebsiella.
Pseudomonas aeruginosa.
Proteus species.
Streptococcus.
Enterococci.
Candida.
Clostridium difficile.
Multidrug resistant organisms.

Universal Precautions
Universal precautions are safety measures to prevent infection.
Applied to all patients.
Hand washing before and after procedures.
Use of gloves.
Use of masks and gowns.
Safe handling of sharps.
Proper disposal of biomedical waste.
Use of protective equipment.
Prevention of blood exposure.
Protects patients and health workers.

Role of Hand Washing in Infection Control
Hand washing is the simplest method of infection control.
Removes microorganisms from hands.
Prevents cross infection.
Done before and after patient contact.
Uses soap or alcohol-based hand rub.
Essential for hospital staff.
Reduces hospital acquired infections.
Cost-effective method.
Improves patient safety.
Mandatory practice.

Disinfection and Sterilization – Definitions
Disinfection is destruction of pathogenic organisms.
It does not kill spores.
Used for inanimate objects.
Examples include phenol and chlorine.
Sterilization is destruction of all microorganisms.
Includes spores and viruses.
Used for surgical instruments.
Methods include autoclaving.
Ensures asepsis.
Important for infection control.

Role of Nurse in Infection Control
Maintains aseptic techniques.
Ensures hand hygiene.
Uses protective equipment.
Follows isolation procedures.
Monitors patient infections.
Educates patients and attendants.
Ensures proper waste disposal.
Reports infections early.
Maintains cleanliness.
Plays key role in prevention.

10M

Hospital Acquired Infections – 10 Marks

Definition
Hospital acquired infection is an infection acquired during hospital stay which was not present or incubating at the time of admission.

Magnitude of problem
Common in all hospitals
Increases morbidity and mortality
Prolongs hospital stay
Increases treatment cost
Causes antibiotic resistance

Types of hospital acquired infections
Urinary tract infections
Respiratory infections
Surgical site infections
Blood stream infections
Skin and soft tissue infections

Common risk factors
Prolonged hospital stay
Use of invasive devices
Poor hand hygiene
Overcrowding
Improper sterilization

Importance
Major public health problem
Indicator of quality of hospital care
Needs strict prevention and control Sources and Modes of Transmission of Hospital Infections – 10 Marks

Sources of infection
Patients with active infection
Carriers among hospital staff
Visitors
Hospital environment
Contaminated instruments
Soiled linen and waste

Modes of transmission

Contact transmission
Direct contact between patients
Indirect contact through staff hands

Droplet transmission
Coughing and sneezing

Airborne transmission
Dust and droplet nuclei

Vehicle borne transmission
Food, water, blood

Fomite borne transmission
Equipment and instruments

Importance
Understanding sources and transmission helps in prevention and control

Factors Influencing Hospital Infections – 10 Marks

Host related factors
Age – elderly and newborn
Immunity status
Malnutrition
Chronic illness

Hospital related factors
Overcrowding
Poor ventilation
Inadequate sanitation
Improper waste disposal

Procedure related factors
Surgical procedures
Catheterization
Ventilators
Intravenous lines

Staff related factors
Poor hand hygiene
Lack of training
Non-use of protective equipment

Importance
Identification of factors helps in reducing infection rates

Universal Precautions – 10 Marks

Definition
Universal precautions are infection control measures applied to all patients.

Principles
Treat all blood and body fluids as infectious
Protect health care workers and patients

Components
Hand washing
Use of gloves
Use of masks and gowns
Safe injection practices
Safe handling of sharps
Proper waste disposal

Importance
Prevents cross infection
Reduces occupational exposure
Protects health workers
Essential in hospitals

Role of Hospital Infection Control Committee – 10 Marks

Composition
Medical superintendent
Microbiologist
Nursing superintendent
Infection control nurse
Hospital staff representatives

Functions
Formulation of infection control policies
Surveillance of hospital infections
Monitoring antibiotic use
Training hospital staff
Outbreak investigation

Importance
Reduces hospital infections
Improves quality of care
Ensures patient safety

Methods of Prevention and Control of Hospital Infections – 10 Marks

Administrative measures
Infection control committee
Standard protocols

Environmental measures
Clean wards
Proper ventilation
Safe water supply

Personal measures
Hand hygiene
Protective equipment

Technical measures
Sterilization and disinfection
Aseptic techniques

Patient related measures
Isolation
Early diagnosis and treatment

Importance
Reduces morbidity and mortality

Disinfection and Sterilization in Hospitals – 10 Marks

Disinfection
Destroys pathogenic organisms
Does not kill spores
Used for floors and surfaces

Methods
Chemical disinfectants
Chlorine, phenol, alcohol

Sterilization
Destroys all microorganisms
Includes spores and viruses

Methods
Autoclaving
Dry heat
Chemical sterilization

Importance
Prevents hospital infections
Ensures patient safety

Biomedical Waste Management in Hospitals – 10 Marks

Definition
Biomedical waste is waste generated during diagnosis and treatment.

Categories
Infectious waste
Sharps
Pathological waste
Chemical waste

Segregation
Color coded bins
At source of generation

Disposal methods
Incineration
Autoclaving
Deep burial

Importance
Prevents infection spread
Protects health workers
Protects environment

Surveillance of Hospital Infections – 10 Marks

Definition
Surveillance is continuous collection and analysis of hospital infection data.

Types
Passive surveillance
Active surveillance

Components
Data collection
Analysis
Interpretation
Feedback

Uses
Early outbreak detection
Monitoring infection trends
Evaluation of control measures

Importance
Foundation of infection control program

20M

20 Marks Question 1
Hospital Acquired Infections – Definition, Sources, Modes of Transmission, Factors Influencing, and Prevention & Control

Definition
Hospital acquired infection is an infection acquired by a patient during hospital stay.
It was not present or incubating at the time of admission.
It usually appears after 48 hours of admission.
It may appear after discharge also.
It is also called nosocomial infection.

Magnitude and Importance
Common in all hospitals
Increases morbidity and mortality
Prolongs hospital stay
Increases cost of treatment
Leads to antibiotic resistance
Indicates quality of hospital care

Sources of Hospital Infection

Human sources
Infected patients
Carriers among hospital staff
Visitors

Non-human sources
Contaminated instruments
Hospital environment
Air, water, food
Soiled linen and bedding
Biomedical waste

Modes of Transmission

Contact transmission
Direct contact between patients
Indirect contact through hands of staff

Droplet transmission
Coughing and sneezing

Airborne transmission
Dust and droplet nuclei

Vehicle borne transmission
Food, water, blood

Fomite borne transmission
Instruments, catheters, ventilators

Factors Influencing Hospital Infections

Host related factors
Age – newborns and elderly
Low immunity
Malnutrition
Chronic diseases

Hospital related factors
Overcrowding
Poor ventilation
Inadequate sanitation
Improper waste disposal

Procedure related factors
Surgery
Catheterization
Ventilators
Intravenous lines

Staff related factors
Poor hand hygiene
Lack of training
Non-use of protective equipment

Prevention and Control Measures

Administrative measures
Hospital infection control committee
Standard guidelines and protocols

Environmental measures
Clean wards
Proper ventilation
Safe water supply

Personal measures
Hand hygiene
Use of gloves, masks, gowns

Technical measures
Proper sterilization and disinfection
Aseptic techniques

Patient related measures
Early diagnosis and treatment
Isolation of infected patients

Conclusion
Hospital acquired infections are preventable.
Strict infection control practices reduce morbidity, mortality, and improve quality of care.

20 Marks Question 2
Hospital Infection Control – Organization, Functions, and Preventive Measures

Introduction
Hospital infection control aims to prevent and reduce hospital acquired infections.
It protects patients, staff, and visitors.

Organization of Hospital Infection Control

Hospital Infection Control Committee
Medical superintendent
Microbiologist
Nursing superintendent
Infection control nurse
Clinicians from major departments

Infection Control Team
Microbiologist
Infection control nurse
Support staff

Functions of Infection Control Committee

Policy formulation
Formulation of infection control guidelines

Surveillance
Monitoring hospital infection rates
Early detection of outbreaks

Training
Training of doctors, nurses, and staff
Promoting hand hygiene

Antibiotic policy
Monitoring antibiotic use
Preventing drug resistance

Outbreak investigation
Identification of source
Implementation of control measures

Preventive Measures

Standard precautions
Hand washing
Use of protective equipment
Safe injection practices

Environmental control
Clean wards and operation theatres
Proper ventilation
Safe water supply

Sterilization and disinfection
Autoclaving of instruments
Chemical disinfection

Biomedical waste management
Segregation at source
Safe disposal

Isolation measures
Isolation of infected patients

Importance
Reduces hospital infection rates
Improves patient safety
Enhances quality of hospital care

Conclusion
Effective hospital infection control requires organization, surveillance, staff training, and strict preventive practices.

20 Marks Question 3
Biomedical Waste Management in Hospitals – Categories, Segregation, Disposal, and Importance

Definition
Biomedical waste is waste generated during diagnosis, treatment, or immunization of patients.

Sources of Biomedical Waste
Hospitals
Laboratories
Operation theatres
Blood banks
Research institutions

Categories of Biomedical Waste

Infectious waste
Pathological waste
Sharps
Chemical waste
Pharmaceutical waste

Segregation of Biomedical Waste

Segregation at source
Color coded containers

Yellow category
Human anatomical waste
Soiled waste

Red category
Contaminated plastic waste

White category
Sharps

Blue category
Glassware

Disposal Methods

Incineration
Autoclaving
Microwaving
Chemical treatment
Deep burial

Importance of Biomedical Waste Management

Prevents spread of infection
Protects health care workers
Prevents needle stick injuries
Protects environment
Prevents reuse of contaminated items
Legal and ethical responsibility

Role of Hospital Staff

Doctors
Nurses
Waste handlers
Hospital administration

Conclusion
Proper biomedical waste management is essential for infection control, environmental safety, and protection of health care workers.