Infection Control In Healthcare Facilities

Infection control is a critical aspect of healthcare delivery, particularly in hospitals and pharmacies where patients with various illnesses and weakened immune systems are treated and it helps to prevent the spread of infections and ensure the safety of patients, and visitors. The system not only prevents the spread of infections but also protects healthcare workers, and ultimately saves lives. 

Infection control (IC) refers to a set of practices and procedures implemented to prevent the transmission of infectious diseases within healthcare settings such as hospitals and pharmacies. It involves a comprehensive approach that includes surveillance, prevention, and control measures. The primary goal is to minimise the risk of healthcare-associated infections (HAIs) and maintain a safe environment for patients, healthcare workers, and visitors.

Components

Hand hygiene is considered the most important measure in infection control. It is not uncommon that we frequently touch the face, eyes, nose, and mouth without even realising it. Therefore, there are chances that microorganisms enter the body, so having clean hands becomes essential to prevent it.  Healthcare workers are trained to follow proper hand hygiene practices, including handwashing with soap and water or using alcohol-based hand sanitizers. However, compliance was found to have occurred only 2/3rd of the time. The most neglected instance is when a provider touches the patient's surroundings which have only about 40 per cent compliance.

Healthcare workers are provided with appropriate PPE, such as gloves, masks, gowns, and eye protection, to protect themselves and patients from potential infections. It is also crucial in preventing the transmission of infections between patients and healthcare workers. The need for personal protective equipment (PPE) varies depending on the type of service provided. Health workers particularly in the Intensive Care Unit (ICU) should wear different protection from people working in different wards, pharmacies, or labs. Higher protection is needed in places where the chances of acquiring infection are greater. 

Proper disposal of medical waste is crucial to prevent the spread of infections. Hospitals and pharmacies have specific protocols for segregating, handling, and disposing of different types of waste. However, following those protocols need continuous timely upgrade and implementation with appropriate training. Medical equipment, instruments, and surfaces are regularly sterilized or disinfected to eliminate or reduce the presence of microorganisms. This includes using autoclaves, chemical disinfectants, and other appropriate methods. Safe disposal of infectious waste, thus, is crucial to prevent the spread of infections to healthcare workers, patients, and the community.

Patients with contagious infections are placed in isolation rooms or designated areas to prevent the spread of the infection to others. Healthcare workers follow specific precautions when caring for these patients. Healthcare workers are encouraged to receive necessary vaccinations to protect themselves and patients from vaccine-preventable diseases, such as influenza and hepatitis. Hospitals and pharmacies should have surveillance systems in place to monitor and track HAIs. This helps identify trends, implement preventive measures, and improve patient safety. Healthcare workers should receive regular education and training on infection control practices, including updates on new guidelines and protocols. This ensures that they are aware of the latest recommendations and can implement them effectively.

Regular cleaning and maintenance of hospital and pharmacy environments are essential to prevent the accumulation and spread of infectious agents. It is important to note that the specific infection control measures may vary among different hospitals and pharmacies depending on their size, resources, and patient population. However, the overall goal remains the same: to prevent infections and ensure patient safety. Regular cleaning and disinfection of patient rooms, equipment, and common areas are essential to eliminate pathogens and reduce the risk of cross-contamination. Proper sterilization and disinfection of medical instruments and equipment are vital to prevent the transmission of infections during invasive procedures. 

Antibiotic stewardship is another essential component in which hospitals and pharmacies promote the appropriate use of antibiotics to prevent the development of antibiotic resistance. This includes implementing guidelines for prescribing antibiotics and monitoring their usage. Effective infection control measures significantly reduce the incidence of HAIs, which can lead to prolonged hospital stays, increased healthcare costs, and even mortality. Infection control systems protect patients from acquiring infections during their hospital stay, ensuring their safety and well-being. 

By implementing infection control practices, healthcare workers are safeguarded from exposure to infectious diseases, reducing the risk of occupational infections. Infection control systems (ICS) in hospitals play a crucial role in preventing the spread of infectious diseases to the community, particularly during outbreaks or pandemics. Hospitals with robust infection control systems are perceived as safer and more reliable, attracting patients and maintaining a positive reputation.

Challenges

The most important challenge in implementing ICS is compliance. Ensuring consistent adherence to infection control protocols by healthcare workers can be challenging due to various factors, including time constraints, lack of awareness, and resistance to change. Implementing and maintaining effective infection control systems requires adequate resources, including funding, trained staff, and access to appropriate equipment and supplies. 

Continuous education and training programmes are necessary to keep healthcare workers updated on the latest infection control practices and guidelines. The emergence of antimicrobial-resistant pathogens poses a significant challenge to infection control efforts, requiring the development of new strategies and antimicrobial stewardship programs. Therefore, continuous education, training, and investment in infection control infrastructure are essential to safeguard the well-being of patients and healthcare workers alike.

(Dr. Lohani is the clinical director at the Nepal Drug and Poison Information Centre. lohanis@gmail.com)