Prevention of Infection in ICU

Dr. K. Vinodan

Nosocomial infections are on the rise in the Intensive care. This has led to increased hospital stay, increased morbidity and mortality, increased pressure on beds, emerging antibiotic resistance and rising health care costs. Infection prevention largely depends on placing barriers between a susceptible host (person lacking effective natural or acquired protection) and the microorganisms. Protective barriers are physical, mechanical or chemical processes that help prevent the spread of infectious microorganisms from person to person (patient, healthcare client or health worker); and or equipment, instruments and environmental surfaces to people. Recommendations and guidelines provided by the EPIC 2 (Evidence based Practice in Infection Control)2007 and CDC Guidelines 2008 include: 1. Basic Hygiene - Standard Precautions, 2. Adherence to Device Policies, 3. Formulation and practice of Antibiotic Policies, 4. Selective Decontamination of the Digestive tract, and 5.cSurveillance. Standard Precautions are designed for use in caring All people, All fluids, All surfaces, and used at All the time. Consider every person (patient or staff ) as potentially infectious and susceptible to infection. Strictly adhere to the following guidelines: Wash hands; Use handrubs; Wear gloves; Use Physical barriers; Apply

Antiseptic agents; Use safe work practices ; Safely dispose of infectious waste materials and Process instruments, gloves and other items after use. Hand washing is probably the single most important means of preventing the transmission of infections in the ICU. The purpose of hand washing is to mechanically remove s oil and debris from the skin and reduce the number of transient microorganisms. Fast acting antiseptic handrubs do not require use of water to remove transient flora, reduce resident microorganisms and protect the skin. Most contain 6090% alcohol, an emollient and often an additional antiseptic (e.g. 24% chlorhexidine gluconate) that has residual action. Use of an antiseptic handrub is more effective in killing transient and resident flora than handwashing with antimicrobial agents or plain soap and water, is quick and convenient to perform, and gives a greater initial reduction in hand. It is important to remember that Hand washing should be done first, followed by hand scrubbing . These preventive strategies may only be effective over prolonged periods if they can be integrated into the behaviour of all staff members who are involved in patient care. Infection control measures are to be viewed as a priority and have to be integrated fully into the continuous process of improvement of the quality of  ICU care.