An infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. This includes infection acquired in hospital but appearing after discharge, and also occupational infection among staff of the facility.

1. By: Ms. Priyanka Wandhe-Faculty
Department of Business Administration,
Dhanwate National College, Nagpur.

2. HOSPITAL ACQUIRED INFECTION
 DEFINITION :
An infection occurring in a patient in a
hospital or other health care facility in whom the
infection was not present or incubating at the time
of admission. This includes infection acquired in
hospital but appearing after discharge, and also
occupational infection among staff of the facility.

3. Types of Hospital Acquired Infection
Contact Transmission
• Direct Contact Transmission
• Indirect Contact Transmission
Droplet Transmission
Common Vehicle Transmission
Vector Borne Transmission
Blood borne spread
Self Infections and Cross infections

4. Other sources of Infection
Patient Apparatus
Formites
Staff
Endogenous
Other Patients
Air

5. Greater exposure to hospital atmosphere, long stay.
Inadequate ventilation, faulty design of wards and Ots.
Non availability of isolation rooms for infected case and clear utility
room.
Over crowding in hospital wards, floor beds and rush in O.P.D.
The use of indwelling catheters.
Factors Increasing Hospital Acquired Infection

6. Contd…
Intimate contact between staff, patient, relatives. No fixed
time schedule for visitors.
In adequate and substandard aseptic procedures.
Failure of healthcare workers to wash their hands.
Overuse of antibiotics.
Poor sterilization, laundry, and kitchen services.

7. Factors influencing Development of Hospital
Acquired Infection
1. THE AGENT-THE MICROBIAL
AGENT:
Organisms Percentage
E.coli 20%
Staphylococcus aureus 11%
Other staphylococci 11%
Pseudomonas 9%
Klebsiella 9%
Proteus 8%
Others/Mixed 32%
Organisms responsible for human infection

8. 2. The Host: Patient Susceptibility:
Important patient factors influencing acquisition of infection include:-
Extreme of age
Immunosuppressant
Underlying disease like:-
Tuberculosis
Diabetes
Severe anemia
Malignancy
Renal failure, AIDS, diagnostic and therapeutic intervention.

9. 3. The Environment
Other patient, hospital staff or
visitors, food, water, dust and other
contaminated inanimate articles.
Drug resistance microorganisms and
change from non-pathogenic strain to
pathogenic are found commonly.

10. 4. Bacterial resistance
• Emergence of multi drug resistant
strains, many strains of Pneumococci,
Staphylococci, Enterococci and
Tuberculosis are currently resistant to
most of all antimicrobials which where
once effective.

11. NOSOCOMIAL INFECTION SITES
Urinary Infection.
Surgical Site Infection.
Respiratory Tract Infection.
Nosocomial Pneumonia.
Nosocomial Bacteraemia & septicemia.
• Skin & soft tissue infection
• Gastroenteritis
• Infection of eye
• Other infection of reproductive organs following child birth.
Other Nosocomial Infection:

12. High Risk Areas in Hospital
Nurseries
Intensive care unit
Dialysis unit
Organ transplant unit
Burn unit
Isolation ward
Cancer ward
Operation theatres
Delivery rooms
Post-operative ward

13. Causes of Hospital Acquired Infection
Urinary bladder catheterization
Surgery and wound
Intravenous (IV) procedures
Biomedical waste
Lack of Awareness

14. SIGNS & SYMPTOMS OF HOSPITAL ACQUIRED
INFECTION
Increased TLC count (High white blood
cell count).
Fever.
Rapid Breathing.
Mental Confusion.
Hypotension.
Reduced urine output.

15. Contd…
Swelling.
Redness.
Tenderness at the site of Infection.
Coughing.
Dyspnoea.
Haematurea and Skin infections etc.

16. Diagnosis of Hospital Acquired Infection is
based on the following:
Symptoms and signs of patient.
Examination of wounds and
catheter entry sites.
Review of procedures that might
have led to infection.
Laboratory test results(WBC
count High).

17. MANAGEMENT OF HOSPITAL ACQUIRED
INFECTION
The basic responsibility of any good hospital remains with establishment of
good infection control policies and proper management which can always be
achieved with:- Hospital Acquired Infection Control Committee.
Composition of Hospital Acquired Infection Control Committee consists of
the following:-
Chairperson
Physician
Microbiologist
Nursing Staff
Central Sterilization Service
Laundry Service
Food Service
House Keeping Service

18. PREVENTION & CONTROL OF
HOSPITAL ACQUIRED INFECTION
Extensive infection control programmes.
Aseptic (sterile) techniques.
Frequent Hand washing.
Early signs of infection are to be identified.
Antibiotics should be used only when necessary.
Frequent changing of dressings.
Isolation of Infected patients.
Awareness Programmes for Staff.

19. Contd…
Standard Guidelines by WHO:-
• Frequent Hand Wash after contact with
infective material and after removing gloves.
• Wear gloves.
• All sharps should be handled with extreme
care.
• Disposal and Segregation of biomedical waste.

20. Research Approach
 The approach towards studying the awareness level
about HAI is to gain maximum knowledge about various
preventive facilities in an organization.
 During the study, various documents, Personnel
Manuals and SOP available in the organization were
studied.
 To study the compliance of these facilities and to study
the response of the nursing staff, RMO, Micro biology
Lab technicians on the preventive facilities, personal
interviews will be carried out with the staff members,
and accordingly observations can be done.

21. RESEARCH METHODOLOGY
REPORT PREPARATION AND PRESENTATION
DATA PREPARATION AND ANALYSIS
FIELD WORK OR DATA COLLECTION
RESEARCH DESIGN AND FORMULATION
DEVELOPMENT OF AN APPROACH TO THE PROBLEM
PROBLEM DEFINATION

22. To study the current rate and know the prevalence of HAI in hospital.
To identify HAI in the region, analysis and interpretation of data, observation and
evaluation of patient care practices, monitoring equipments and the environment
in order to generate infection surveillance data.
To apply control measure and provide the highest possible standards of infection
control within the limitations of available resources, prospective study to monitor
the problem, evaluate the control measure and detect future recurrences and
provide education.
To provide suggestions for prevention of HAI.
Objectives of the study

23. Hypothesis of the study
Application of study of Hospital Acquired Infection improves
the hygienic conditions of the organization.
The management is doing very admirable job in providing
preventive facilities to all the patient, visitors and the staff of
the organization.

24. Tools For Data Collection
PRIMARY DATA COLLECTION:
• Questionnaire
• Personal interview
• Observation
SECONDARY DATA COLLECTION:
• Hospital information system.
• Collection of data of discharged patients on the
basis of non infected and infected patients from
infection control nurse.
• Internet.
• Books and Magazines.
• Journals.

25. Research Design for the study
Descriptive Research Design
Exploratory Research Design
Sample Size taken for the study
Male & Female Nurses:- 60
Lab. Technicians:- 10
Residential Medical Officers:-10

26. Limitations of the study
The data will be collected through questionnaire. the
response from the respondent may not be accurate, they
may be bias and could be influenced by external factors.
The sample size taken for the study and the results
drawn may not be accurate.
Limited time span of the project.

27. DATA ANALYSIS AND INTERPRETATION
SITE:-
ORGANISM
HAP VAP UTI WOUND
INFECTION
TOTAL
STAPHYLOCOCCI ----- 1 2 ----- 3
PSEUDOMONAS ----- 2 1 ----- 3
KLEBSIELLA
PROTEUS
SPECIES
5 2 ----- ----- 7
E.COLI 4 ----- ----- ----- 4
STREPTOCOCCUS
----- ----- ----- ----- -----
ACINETOBACTER
----- ----- ----- ----- -----
SALMONELLA ----- ----- ----- ----- -----
SHIGELLA ----- ----- ----- ----- -----
CANDIDA 1 ----- ----- ----- 1
TOTAL 10 5 3 ----- 18

28. 0
1
2
3
4
5
6
7
Rate of Comparision of
Microorganisms
ORGANISM
0
1
2
3
4
5
6
7
8
9
10
Rate of Comparision of
Nosocomial site
SITE
Interpretation: It was observed that the
rate of microorganism i.e
Klebsiella proteus spp. was high as
compared to other microorganisms.
Interpretation: It was observed that the
rate of Nosocomial site i.e Hospital
Acquired Pneumonia was high as
compared to other SITE.

29. High Risks Areas found in Hospital for HAI
WARD
No.
TOTAL
Pt.516
VAP HAP UTI WOUND
SWAB
WARD
WISE
RATE
D/W 67 ---- 2 1 ---- 3 4.48%
3rd
G/W
70 ---- 1 ---- ---- 1 1.43%
2nd
G/W
128 ---- ---- 1 ---- 1 0.78%
5th
G/W
90 ---- 1 ---- ---- 1 1.11%
ICU 82 5 1 1 ---- 7 8.54%
PICU/
NICU
42 ---- ---- ---- ---- ---- ----
CTR 18 ---- 3 ---- ---- 3 16.67%
POST
CATH
19 ---- 2 ---- ---- 2 10.53%
TOTAL 516 5 10 3 ---- 18 3.49%

30. Interpretation: It was observed that the rate of Hospital Acquired
Infection was higher in the month of Jan (5.15%) and least in the
month of Feb (1.18%).
HOSPITAL ACQUIRED INFECTION
 TOTAL No. OF ADMISSIONS=516
 TOTAL No. OF HOSPITALACQUIRED INFECTION=18
18/516*100=3.49%
0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
6.00%
Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16
5.15%
1.81%
3.01%
3.52%
3.21%
3.49%

31. OBSERVATIONS
0
10
20
30
40
50
60
Nursing Staff aware about HAI...
NOT AWARE
MOD.AWARE
FULL AWARE
Full
Aware
95%
Mod. Aware
5%
Not
Aware
0%
Nursing Staff
Interpretation:
It was found that 95%
nursing staff is full aware and 5%
nursing staff is mod. aware about
Hospital Acquired Infection.

32. 0
1
2
3
4
5
6
7
8
9
10
RMO's aware about HAI...
NOT AWARE
MOD.AWARE
FULL AWARE
Full Aware
97%
Mod. Aware
3% Not Aware
0%
RMO
Interpretation:
It was found that 97% RMO is
full aware and 3% RMO is mod.
aware about Hospital Acquired
Infection.

33. 0
1
2
3
4
5
6
7
8
9
10
Micro.Lab.Technicians aware about HAI...
NOT AWARE
MOD.AWARE
FULL AWARE
Full Aware
90%
Mod. Aware
6%
Not Aware
4%
Micro Lab. TechInterpretation:
It was found that 97%
Micro.Lab.Tech.is full
aware,6%Micro.Lab.Tech is mod.
aware and 4% Micro. Lab. Tech is not
aware about hospital Acquired
Infection .

34. CASE STUDY
 Name: Mr. N. P. Sinha (16175)
 Date of Admission: 25/08/10
 Source of History: Colleagues
 Chief Complaints: Patient admitted with alleged H/O trapping of
clothes in machine and sustaining trauma to chest and abdomen at
around 12P.M. while at work at Ordinance factory, Ambazari.
 Injuries: LW Right eyebrow abrasion of abdomen over chest and
abdomen contusion Left knee medical aspect, LW Right forehead.
 Diagnosis: Polytrauma/Industrial trauma

35. FINDINGS OF THE STUDY
 Lack of proper hand hygiene.
 Lack of awareness about the sterile ways.
 Lack of knowledge about disinfectants, handling
the infected cases.
 Don’t have Isolation wards.
 Improper segregation & Disposal of Biomedical
Waste.
 Needles: Not using needle destroyers.
 Blood spills: Blood spills not handled properly.

36. CONCLUSION
 The data collected comprising in the table was found that most of the staff that is
nursing staff, RMO, Miro. Lab-Technicians have awareness about HAI.
 The remaining of the staff partially is not aware because of the lack of training
regarding HAI, lack of hand hygiene practices etc.
 The management has well established the norms of HAI by providing the preventive
facilities to the staff.
 The live case study of Mr. N.P. Sinha which the researcher have undergone during
my project work, it was found that due to the irresponsible behavior of organization
towards the live case, hence it was found that the severity regarding infection of the
patient was increasing day by day and because of this, finally the patient crushed
down.
 Thus, the effective and efficient awareness, training and teaching among the staff
should be there so that it will decrease the death rate, decrease the health care cost,
decrease the antibiotic resistance and thereby increasing the patient turnover and
hence helps to improve the image of hospital and the hygienic conditions of the

37. SUGGESTIONS
 Proper coordination.
 On job training sessions should be interactive.
 Increase awareness, monitoring, surveillance and
participation regarding Hospital Acquired Infection.
 Hand hygiene practices (hand wash and hand
disinfectant).
 No brooms only wet mops to be used.
 Isolation of the patient with HIV, HBs Ag should be
followed strictly.
 Needles care.
 Antibiotic protocols should be followed properly.
 An early sign of symptoms should be detected for further
diagnosis.