TUGAS EPIDEMIOLOGI

PATIENT SAVETY “NOSOCOMIAL INFECTIONS”

Disusunoleh :Kelompok 5

No. Nama NPM

1 Ida Bagus Yudyantara 13700098

2 Novia Chandra P. 13700100
3 Muhammad Iqbal 13700104
4 Fithrotul Dwi A. 13700106
5 Ni Komang Tri Utami H. 13700108
6 Bagus Putu Anom Nugraha P. 13700110
7 Lita Cahayati 13700112
8 Eka Mutiara Putri 13700114
9 Sri Uminingsih 13700116
10 Teguh Adi Partama 13700118
11 Novy Vivianty 13700120

Dosen Pembimbing : Andiani, dr.,M.Kes

FAKULTAS KEDOKTERAN

UNIVERSITAS WIJAYA KUSUMA SURABAYA

TAHUN AKADEMIK 2015 / 2016

 NOSOCOMIAL INFECTION

A. DEFINITION

Nosocomial infections are one of the health problems experienced by hospitals that
can lead to death so that hospitals need to provide quality services to the standards that have
been determined and should be applied to all the hospital’s officers These infections are
particularly a lot of the in-patients in hospitals. One example that is common and is the most
common nosocomial infection cases are cases of surgical site infections acquired as a result
of a less sterile environment in the hospital. This has become more concern for health care
workers in hospitals. In receiving medical care are abundant infections caused by bacteria,
fungi, and viruses. Treated patients must adhere to guidelines for infection prevention
treatment used to ensure safety. Many hospitals have procedures in healthcare settings to
ensure the safety of health care patients ith introduced systematic safety processes.

B. INFECTION OF NOSOCOMIAL INFECTIONS

Nosocomial infections began to cause germs out from the source through a certain
place, then the specific modes of transmission into the specific place in the other patients.
Because many hospital patients are susceptible to infections (especially people living with
HIV who have weakened immune systems) can be infected and falling ill 'extra'. This disease
germs out of the patient and continue the chain of transmission again.

Various factors involved in hospital infections

1. Microorganisms infectious agents

Each infection can be obtained from the patient or hospital staff, there are some
specific pathogenic organisms were mainly related to hospital infections and some that rarely
cause infections in other environments. Their role as a cause of hospital infections, depending
on the pathogenic virulence (ability of a species or strains cause disease), and the number of
them, also depend on the resilience of the patient, and because many patients in hospitals that
resistance is less, caused by disease or their treatment , organisms which are relatively
harmless in healthy people can cause illness in hospital.

Outbreaks of infection (infection epidemic) can be caused by agents (substances,

force or principle which can cause effects) of certain infectious diseases, usually caused by
the influx of patients infected or presence of a carrier in the treatment room. Outbreaks of
infection may also occur through a tremendous error in aseptic or sterile supplies (eg,
contamination of eye drops or intravenous fluids)

2. Patients or Staff

Patients or Staff Member Host susceptibility, and virulence (degrees pathogenic

microorganism, progress is measured by the degree to cause disease). A patient can have a
general resistance is weak, for example in infants, before antibodies are formed and when the
tissue that produces antibodies developed rudimentary, or weak resistance may be associated
with a disease (such as diabetes or leukemia uncontrolled or severe burns), or poor nutrition,
or with a certain forms of treatment, such as the use of immunosuppressive drugs.

Not only patients, but the staff (including laboratory staff) can be exposed to a
particular danger of infection with virulent organisms.The risk of infection among staff
members through contamination with blood and exudates (mixture of serum, cell or damaged
cells coming out of blood vessels into the tissues, usually as a result of due to inflammation.
Risk in most hospitals is very low.

3. Environment

Place when the patient is handled have an important influence on the likelihood of
infection were obtained as well as on the nature of such infection. A wide dideversy of
microorganisms, including virulent strain, may be encountered in hospital where many
people, including some with infection, were collected, these organisms are likely to include
the majority of antibiotic resistant bacteria that can thrive that the use of antibiotics aimedat
the suppression of bacteria sensitive

Method of Transmitting of Infection in the Hospital

 The first method where hospital acquired infections can be transmitted is direct contact.
Direct contact is a physical or actual touching of an infected person, animal, or other
reservoir of infection. Infection is most often transmitted through hand contact with the
infection
 The socond method indirect contact transmission. The physical presence of the infected
host does not have to be present for the infection to spread. Bedding, clothing, toys,
handkerchiefs, and all the surgical instruments can serve as a vector in the spread of
infection
 Another method of transmission is through droplet spread. A patient infected sneezing,
coughing, singing,and sometime even talking can spread the infection, although droplets
usually do not travel more than a few feet away from the source, they are still the method
of transmission of infection. Although they are much less common, airbone infectioncan
remain suspended in air for long periods of time. Inhaling these particles can lead to
transmission of infection. The last method of transmission in through the vehicle, such as
water, food, or biological product. This can occur through ingestion, inoculation, or by
deposits in the skin or mucous membranes. Part of the reason for hospital acquired
infection is very difficult to stop because they have a lot of media are transmitted. A
hospital personnel must be extremely diligent in the process of strilization to avoid
complications

C. PREVENTION OF NOSOKOMIAL INFECTION

 Nosocomial infections prepention must attention of risk factors that cause example
related medical measures should be careful, the role of health workers who care for patients,
medical equipment and health facilities in hospitals. Strategies to prevent nosocomial
infections is divided into several, namely: education-based, processes, and systems.

One of nosocomial infection prevention strategies mentioned above is about

education. This education is given both to health workers who care for patients and the
patients themselves. The easiest thing that can be done by the relevant parties is one of them
is to maintain hygiene while in the hospital environment. This clean behavior for example
doing simple hand washing with soap or an antiseptic such as alcohol available in the hospital
before and after contact with a variety of good things with patients, medical equipment and
facilities at the hospital. Besides medical measures cautious and appropriate standard
operating procedures are also important in minimizing the occurrence of a disease in the
hospital.

Nosocomial infections are a serious problem facing the hospital because it can result
in losses that hospitals need to do prevention and control program that can improve the
quality of the hospital is to improve the operational measures that include:

1. Standard Precautions

A. Washing hands

Hand washing should be done with running water, using soap by way of rubbing
hands for 15 to 20 seconds. On the condition of the hospital should be routinely conduct hand
washing for example: holding tools are dirty, touching the patient, fluid blood, other body
fluids, as well as intensive contacts within yamg time with patients, taking blood samples,
when checking the blood pressure, other vital signs are also currently out of the isolation unit
so as to avoid infection or disease.

B. The use of personal protective equipment

The most well is made of materials which have been processed or synthetic material
that is impervious to liquids. The tools used to protect themselves in the hospital such as
gloves , gowns , aprons , masks and eye protection . Gloves are used to protect the patient
from bacteria or viruses from the hands of hospital personnel and also used to avoid the
possibility of direct contact with blood or body fluids , mucous membranes when performing
invasive medical procedures and in patients who are known to have a contagious disease.
One pair of gloves should be used for each patient in order to avoid cross-contamination.
Masks are used to prevent splashes of blood or body fluids such as spray that comes out when
health workers speaking , sneezing and coughing . The mask is removed after use for 20
minutes continuously or masks already appears dirty or damp . Eye and face protectors must
be worn on the procedure that has the possibility of splash of blood or body fluids . Eye
protection should be clear , not easy dewy , does not cause distortion , and there is a cover
side. Use of protective gown to protect clothes and skin of healthcare workers. Apron made
of rubber or plastic as a waterproof barrier and apron worn under the gown when cleaning the
patient at risk of spillage of blood or body fluids .

C. Safety Practices
Safety practices associated with the use of sharp instruments such as needles and
scalpels . When using a sharp instrument to avoid removing the needle or closing needle has
been used.

D. patient care
Frequent patient care includes measures : use of urinary catheters , intravascular
tool use , blood transfusions , nasogastric tube installation , use and maintenance ventilator
incision .

E. The use of antiseptics

In addition to the things mentioned above on the prevention of nosocomial
infections , the prophylactic use of antibiotics and the use of an appropriate antibiotic and an
indication of the appropriate standards is an important measure as well and plays a major role
in the prevention and treatment of nosocomial infections this . Antiseptic solution can be used
for hand washing , especially in surgery , skin cleansing prior to surgery or other invasive
measures . Dirty tools , surgical gloves and other items used back can be processed with the
decontamination , cleaning and sterilization or high-level disinfection ( HLD) to control the
infection. Decontamination and cleaning are two control precautions are very effective to
minimize the risk of infection transmission . Cleaning can be done using a liquid soap and
water to kill microorganisms . Use protection when cleaning tools. Sterilization should be
made to tools that direct contact with blood or other body fluids and jaringan4 . Sterilization
can be performed using high pressure steam ( autoclafe ) , dry heat ( oven ) , chemical and
physical sterilization.

2. Transmission Based Precautions

a. Handling soiled linen and clothing

Handling soiled linen and clothing become important because of linen contaminated
by a highly pathogenic microorganisms, the risk of transmission can be minimal if the linen is
handled properly.

b. Isolation
In addition, patients with a disease that can spread through the air needs to be
treated in isolation rooms to prevent the direct or indirect transmission. Some of the
requirements in the implementation of isolation for patients with infectious diseases are as
follows:
• a special room which is always closed,
• Wash hands with soap or an antiseptic solution before and after entering the room,
• use a mask and gloves and protective clothing,
• special eating utensils for the patient,
• laboratory tests of materials placed on a sterile sealed,
• after use syringe is inserted in a special place and discarded,
• complete inspection tool, the handling of the instrument properly, the number of visitors is
limited and patient rooms are cleaned daily

While the prevention of nosocomial infections when viewed in terms of the process
and the system must be done through analysis or epidemiological studies on the risk factors
of nosocomial infections in every hospital. It became one powerful way to analyze a
nosocomial infection in order to prevent and mitigate them.
In every hospital now many special unit to prevent and control nosocomial
infections this. The unit is precisely what an important role in the control of nosocomial
infections in every hospital because the units here that houses the things associated with
nosocomial infections. The main task of this unit has been described as above on matters of
prevention of nosocomial infections ranging from education, and monitoring of processes and
systems that are running the hospital regarding nosocomial infections. When this unit
programs can be run with both the incidence of nosocomial infections can be controlled and
suppressed so that loss and things that are not desirable due to nosocomial infections can be
avoided.
 CONCLUSION

Nosocomial infections are one of the health problems experienced by hospitals that
can lead to death, so that hospitals need to provide quality services to the standards that have
been determined and should be applied to all the hospital personnel. Nosocomial infections
can be caused by several factors such as, microorganisms as agents of disease, patient or staff
members who have previously contracted and the environment that is around the hospital
itself.

Prevention of nosocomial infections must see of risk factors that cause example
related medical measures should be careful, the role of health workers who care for patients,
medical equipment and health facilities in hospitals. Strategies to prevent nosocomial
infections is divided into several, namely: education-based, processes, and systems. To
prevent the hospital also must improve the operational follow include:
1. The standard precautions, such as washing hands, use of personal protective equipment,
safety practices, patient care and the use of antiseptics
2. Vigilance based transmission and transmission, such as the handling of soiled linen and
clothing as well as isolation of patients with dead-harm.
 DAFTAR PUSTAKA

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http://spiritia.or.id/, diakses tanggal 13 Februari 2011
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