How do you prevent infection in a busy ward?

Infections caught in the facility kill patients who came in with something else, and they put you and your colleagues at risk. Every clinical panel asks about infection prevention and control, and an IPC focal person often sits on it. They want three things: the standard precautions you follow every day, what you do differently when the ward is full and the supplies are low, and one real story with a result. The weakest answer is “I always wear gloves”: gloves worn from one patient to the next carry infection between them.

• Hand hygiene at the five moments: before touching a patient, before a clean or aseptic task, after body fluid exposure, after touching a patient, after touching the patient's surroundings. Alcohol rub between patients; soap and water when hands are visibly dirty and after diarrhoea patients.
• PPE for the task, not by habit: gloves for blood and fluids, changed between patients; an apron for splashes; a mask for coughing patients and suspected TB or measles. Take them off correctly, then clean your hands again.
• Sharps: never recap a needle; the safety box stands where the injection is given; seal it at three-quarters full. A needle-stick injury is reported the same hour so PEP can start.
• Waste: three bins, general, infectious and sharps, colour-coded, emptied before they overflow, and taken to the incinerator or the facility's disposal route.
• Equipment and surfaces: decontaminate reusable instruments in 0.5% chlorine, clean, then sterilise or high-level disinfect; wipe beds and trolleys between patients; single-use items are used once.
• Isolation and triage: suspected cholera, measles and TB are separated at the door and cohorted; a cholera patient has an own bucket and latrine, and chlorine solutions are ready every morning.

The busy ward is where hand hygiene collapses: 30 patients, two nurses, a queue of attendants. Say what you do then. Keep alcohol rub at every bed so you clean between patients, not at the sink at the end of the row. Brief the cleaner and the attendants each morning; relatives who feed patients spread more than staff do. Run a weekly audit of ten observations and put the percentage on the wall; teams improve what they can see. Watch the stock card for soap, rub, gloves and chlorine and order at a two-week minimum; if something runs out, report it the same day rather than working without it.