JCI Accreditation Standards for Hospitals

Section II. Health Care Organization

Management Standards

Prevention & Control of Infections

(PCI)
 Prevention & Control of Infections
SCOPE

A. Program Leadership & Coordination

B. Focus of the Program
C. Isolation Procedures
D. Barrier Techniques & Hand Hygiene
E. Integration of the Program with Quality
Improvement & Patient Safety
F. Education of Staff about the Program
 A. Program Leadership & Coordination
1. One or more individuals oversee all infection
prevention & control activities. The individual is
qualified in IC practices thru education, training,
experience, or certification.
2. There is a designated coordination mechanism for all
infection control activities that involves physicians,
nurses, & others as appropriate to the size and
complexity of MMC.
3. The Infection Control Program is based on current
scientific knowledge, accepted practice guidelines,
and applicable law and regulation.
4. The MMC leaders provide adequate resources to
support the Infection Control Program.
 B. Focus of the Program
5. MMC designs & implements a comprehensive
program to reduce the risks of health care-
associated infections in patients & health
care workers.
6. MMC establishes the focus of the health
care-associated infecton prevention and
reduction program.
7. MMC identifies the procedures & processes
associated with the risk of infection &
implements strategies to reduce infection risk.
 C. Isolation Procedures

8. MMC provides barrier precautions and

isolation procedures that protect patients,
visitors and staff from communicable diseases
& protects immunosuppressed patients from
acquiring infections to which they are uniquely
prone.
 D. Barrier Techniques & Hand Hygiene

9. Gloves, masks, eye protection, other

protective equipment, soap, and
disinfectants are available and used correctly
when required.
 E. Integration of the Program with
Quality Improvement & Patient Safety

10. The infecton control process is integrated with

MMC's overall program for quality
improvement & patient safety.
 F. Education of Staff about the
Program

11. MMC provides education on infection control

practices to staff, doctors, patients, & as
appropriate, family & other caregivers.
MMC Infection Control Program
 ICC Local 7036
ID Section Chief: Vilma M. Co, MD
ICC Chair: Salvador Abad Santos, MD
Hospital Epidemiologist: Maricel Gler, MD
ICC Nurses: Rosanna Santillan, RN
Alex Mendoza, RN
• Pharmacy
• Nursing service • Laboratory
• Medicine (ICU/telemetry) • Pulmonary
• Pediatrics • Dietary
(Nursery/PICU)
• Radiology
• Surgery (OR)
• Housekeeping
• OB-GYN (DR)
• Facility Management/
• IHC-ER Engineering
 Cardiac cath / cardiac rehabilitation Dept. Head
Auxilliary members:

Nuclear medicine Dept. Head

Hearing & dizziness clinic Dept. Head
Eye Center Dept. Head
Mcf Photherapy & laser center Dept. Head
Neurophysiology & sleep disorders Dept. Head
Physical Medicine & rehabilitn center Dept. Head
Breast Clinic Dept. Head
Medical Records Dept. Head
Social Health Department Dept. Head
Purchasing Department Dept. Head
Security Dept. Head
 Topics:

1. Basic Principles of Hospital Infection Control

• Standard precautions
• Transmission-based precautions
• Proper waste disposal

2. Antimicrobial stewardship
3. Surveillance of nosocomial infection at MMC
. Other ICC activities
– Employees Health Program
– Pandemic preparedness program
 ISOLATION
PRECAUTIONS
Guideline for Isolation Precautions in Hospitals
Centers for Disease Control & Prevention
Hospital Infection Control Practices Advisory Committee

(January 1996; updated 2004, 2007)

 Isolation Precautions
2-Level Approach
• Standard Precautions
– Designed to reduce the risk of
transmission of bloodborne pathogens
– Primary strategy to be used on all patients
regardless of diagnosis
• Transmission-Based Precautions
– Applied to selected patients based on
suspected or confirmed diagnosis
– Always implemented in conjunction with
standard precautions
 Standard Precautions

1. Hand hygiene
2. Use of gloves, gown, mask*, eye protection,
face shield
3. Safe injection practices
4. Patient care equipment
5. Environmental control
6. Respiratory Hygiene/Cough Etiquette
 STANDARD PRECAUTIONS
1. Hand Hygiene

POLICY:
• All MMC staff and personnel follow the World
Health Organization guidelines on hand
hygiene in health care to reduce transmission
of pathogenic microorganisms in the healthcare
setting.
 Hand Hygiene Technique
1. Palm to palm
2. Palm of right hand back
of left hand and vice
1. versa

2.
 Hand Hygiene Technique
3. Palm to palm with
fingers interlaced
4. Back of fingers to
3. opposing palms with
fingers interlocked

4.
 Hand Hygiene Technique
5. Rotational rubbing of
right thumb clasped in
left palm and vice versa
6. Rotational rubbing
5. backwards and forwards
with clasped fingers of
right hand in left palm
and vice versa

6.
 Standard Precautions
1. Hand hygiene
2. Use of gloves, gown, mask*, eye protection,
face shield
3. Safe injection practices
4. Patient care equipment
5. Environmental control
6. Respiratory Hygiene/Cough Etiquette

* Use of masks for insertion of catheters or

injection of material into spinal or epidural
spaces via lumbar puncture procedures
 Standard Precautions
2. Gloves

• Clean, non-sterile gloves should be worn:

– Wear gloves when touching blood, body fluids,
secretions, excretions, and contaminated
items.
– When performing venipuncture & other
vascular access procedures
– Wash hands after removing your gloves
 Standard Precautions
Gowns
• Gowns or aprons should be worn during:
– procedures that are likely to generate
splashes of blood or other body fluids
 Standard Precautions
Mask
• Masks & protective eyewear, goggles or face
shields should be worn during:
– procedures that are likely to generate
splashes/droplets of blood or other body
fluids to prevent exposure of mucous
membrane of the mouth, nose, & eyes.
 Standard Precautions

1. Hand hygiene
2. Use of gloves, gown, mask*, eye protection,
face shield
3. Safe injection practices
4. Patient care equipment
5. Environmental control
6. Respiratory Hygiene/Cough Etiquette
 Standard Precautions
3. Safe injection practices
• Take precautions to prevent injuries caused by
needles, scalpels & other sharp instruments or
devices during procedures
 when cleaning used sharp instruments
 during disposal of used needles
 when handling sharp instruments after procedures

Needles should not be :

recapped
purposely bent or broken by hand
manipulated by two hands (1- hand scoop
technique if required can be done)
 INFECTION CONTROL COMMITTEE
Needlestick Injury/Mucous Membrane Exposure

N-Stick Injury/MM Exp According to Job Title

Jan-Dec 2007
Injuries/Exposure

60 56
50
40
No. of

30
20
10 9 8
0 3 1 2 5 1 1 1 1
SN /A ch er
n
en
t nt ch sth nt k
N e BM t d d e e e ta ler
T C In es
i tu r T
A
n
sul C
ed R S se on
M L a C
Months
N-Stick injury
according to job
title
 INFECTION CONTROL COMMITTEE
Needlestick Injury/Mucous Membrane Exposure

N-Stick Injury/MM Exp According to Type of Exposure

Jan-Dec 2007

30
Injuries/Exposure

25 25
20
17 17
No. of

15
10 10 12
9
5
0
After care intra-op disposal recapping Bld others
splashes

Months
N-Stick injury
according to job
 INFECTION CONTROL COMMITTEE
Needlestick Injury/Mucous Membrane Exposure

N-Stick Injury/MM Exp (Jan -Dec 2007)

15
Injuries/Exposures

14
11
10 10
No. of

9
8 8
7 7
5 5 5
3
2
0
Jan Feb Mar Apr may June July Aug Sept Oct Nov Dec

Months
N-Stick
 RISK OF TRANSMISSION OF
BLOODBORNE INFECTION

OCCUPATIONAL RISK OF
EXPOSURE TRANSMISSION
HIV 0.3%
(or 1 in 300 chance of
infection)
Hepatitis B Virus (HBV) 30%

Hepatitis C Virus (HCV) 3%

Occupational Health & Bloodborne Pathogens

• Risk of exposure to blood borne viruses

(hepatitis B, hepatitis C, HIV) increases if
occupation involves handling blood & body fluids
in combination with needles, syringes & other
sharp instruments .
• Treatment of these infections is not always
successful hence emphasis must remain on
PREVENTION.
• The MOST EFFECTIVE MEANS of preventing
transmission of blood borne pathogens is to
prevent exposure to Needlestick Injuries
(NSI).
 Accidental Exposure

• DO NOT IGNORE THIS

EXPOSURE!
• Take immediate first aid measures
• Report to Industrial Health Clinic or the
Emergency Room
• Write an incident report
 Standard Precautions

1. Hand hygiene
2. Use of gloves, gown, mask*, eye protection,
face shield
3. Safe injection practices
4. Patient care equipment
5. Environmental control
6. Respiratory Hygiene/Cough Etiquette
 Standard Precautions
4. Patient care equipment

• Soiled patient-care equipment

– Wear gloves if visibly contaminated &
practice routine hand hygiene
• Environmental Contact
– Follow procedure for routine care, cleaning &
disinfection of environment surface,
especially frequently touched surfaces in
patient-care areas.
• Handling soiled or contaminated linens
– Always use gloves when handling linen.
 Standard Precautions

1. Hand hygiene
2. Use of gloves, gown, mask*, eye protection,
face shield
3. Safe injection practices
4. Patient care equipment
5. Environmental control
6. Respiratory Hygiene/Cough Etiquette
 Standard Precautions
5. Environmental control

• Prioritize single-patient room if at increased risk

of transmission of infection & likely to
contaminate the environment
• Isolation unit
 Standard Precautions

1. Hand hygiene
2. Use of gloves, gown, mask*, eye protection,
face shield
3. Safe injection practices
4. Patient care equipment
5. Environmental control
6. Respiratory Hygiene/Cough Etiquette
 Standard Precautions
5. Respiratory Hygiene/ Cough Etiquette

• a new component of Standard Precautions.

• applies to any person with signs of illness
i.e., cough, congestion, rhinorrhea,
or increased production of respiratory
secretions
 Respiratory Hygiene/
Cough Etiquette
Elements :
1. Education of healthcare facility staff, patients,
and visitors;
2. Posted signs, in language(s) appropriate to the
population served, with instructions to patients
& accompanying family members or friends;
3. Source control measures (e.g., covering the
mouth/nose with a tissue when coughing and
prompt disposal of used tissues, using surgical
masks on the coughing person when tolerated)
 Respiratory Hygiene/
Cough Etiquette

• 4) hand hygiene after contact with respiratory

secretions; &
• 5) spatial separation, ideally >3 feet, of persons
with respiratory infections in common waiting
areas when possible.

* Healthcare personnel who have a respiratory

infection are advised to avoid direct patient
contact, especially with high risk patients. If this
is not possible, then a mask should be worn
while providing patient care
RESPIRATORY ETIQUETTE
COVER YOUR COUGH

Cover your mouth

Cover
Cover your mouth &&
your mouth & Cough or sneeze into OR
nose
nose with
with
nose with a
a tissue
tissue
amouth
tissue &
Cover
paper your
when you cough your upper sleeves, not
paper
paper
nose when
when you
you cough
with a tissuecough Then throw your used into your hands. (if no You may put on a
or
or sneeze.
sneeze. tissue paper in the surgical mask to protect
or sneeze.
paper when you cough tissue paper is
or sneeze. trash can. available) others.

Clean your hands after coughing by sneezing

OR
Using Alcohol
Hand Hygiene
based hand
Technique using
cleaner.
soap & water

INFECTION CONTROL COMMITTEE

INFECTION CONTROL is…
POLICY:
All healthcare providers across the
continuum of care follows the Guideline for
Isolation Precautions to prevent
transmission of infectious agents in the
healthcare setting as outlined in the MMC
Infection Control Manual.
Isolation Precautions
2-Level Approach
Standard Precautions
Designed to reduce the risk of transmission of
bloodborne pathogens
Primary strategy to be used on all patients
regardless of diagnosis
Transmission-Based Precautions
Applied to selected patients based on
suspected or confirmed diagnosis
Always implemented in conjunction with
standard precautions
Transmission- based precautions

 Based on 3 major modes of transmission:

A. Airborne Precautions
D. Droplet Precautions
C. Contact Precautions
 Some diseases may require more than one
isolation category
Known or Suspected Diseases or
Pathogens
Airborne
Measles
Tuberculosis, pulmonary or laryngeal
Varicella (chickenpox)
Zoster (disseminated)
SARS
Viral hemorrhagic fever
Scenarios Requiring
Airborne Precautions

Vesicular rash
Maculopapular rash + coryza + fever
Cough, fever, upper lobe pulmonary infiltrate
Cough, fever, any pulmonary infiltrate in an HIV
patient (or patient at risk for HIV)
 Airborne Precautions

Private room, keep door closed at all times

Negative air-pressure ventilation, externally
exhausted or HEPA filtered air if recirculated
Fitted respirator masks (N95 respirator) worn
by susceptible HCW
Susceptible HCW should wear mask or avoid
entering room
Patient should wear mask when transported out
of isolation room
Known or Suspected Diseases or
Pathogens

Droplet
Diphtheria (pharyngeal), Pertussis
Meningococcal infections
HI meningitis, epiglottitis, pneumonia
Influenza
Mumps, Rubella (postnatal)
Mycoplasma pneumonia
Parvovirus B19
Adenovirus (infants, children)
Streptococcal (group A) pharyngitis,
pneumonia, scarlet fever
Scenarios Requiring
Droplet Precautions

Meningitis
Petechial or ecchymotic rash with fever
Paroxysmal or severe persistent cough (periods
of pertussis activity)
Droplet Precautions

Private Room, may cohort patients with same

diseases; if not possible have a distance of 3 feet
between patients and visitors
Patient should leave the room only when
necessary; If patient required to leave the room,
must wear a surgical mask
Use mask (standard surgical mask) if within 3 feet
of patient
Rm 867-881
 Contact Transmission

Two Modes:
Direct- body surface to body contact and physical
transfer of micro-organisms; when doing physical
exam, turning patients, giving the patient a bath, etc
Indirect- contact of a susceptible host with a
contaminated intermediate object (needles,
instruments, dressings, hands)
 Known or Suspected Diseases
or Pathogens
 Contact
 Abscess (drainage not contained)
 Grp A Streptococcal major skin, burn or wound infection
 Furunculosis (infants, children); Impetigo
 MDR bacteria (e.g. MRSA, VRE, GISA, GRSA) infection
or colonization
 Clostridium difficile colitis
 Escherichia coli 0157:h7 colitis
 Rotavirus
 Shigella (diapered/incontinent patients)
 Hepatitis A
Known or Suspected Diseases
or Pathogens
 Contact
 Conjunctivitis, acute viral
 Adenovirus (infants, children)
 Parainfluenza infection (infants, children)
 Rubella, congenital
 HSV (neonatal, disseminated, severe primary
mucocutaneous)
 Varicella
 Zoster (disseminated/immunocompromised)
Scenarios Requiring
Contact Precautions
Abscess or draining wound that cannot be covered
Skin, wound or UT infection in patient with recent
hospital or nursing home stay
History of infection/colonization with MDR organisms
Acute diarrhea
Vesicular rash
Respiratory infections in infants & young children
 Contact Precautions

Private room; cohorting permissible (Ensure

that the patient are physically separated (>3
feet) from each other and provide curtain)
Clean, nonsterile gloves at all times
Handwashing after glove removal
Gowns at all times, unless patient is continent &
contact of clothing with patient or
environmental surfaces is not anticipated
Remove gloves & gowns before leaving room
Transmission-Based Precautions for
Hospitalized Patients

Category Single Mask Gown Gloves

Room
AIRBORNE Yes, neg. Yes No No
air P vent
DROPLET Yes* Yes, for No No
close
contact
CONTACT Yes* No Yes Yes

*Cohorting acceptable
What Type of PPE Would You Wear?
PPE Use in Healthcare Settings

 Giving a bed bath?

Generally none
 Transporting a patient in a wheel chair?
Generally none required
 Taking vital signs?
Generally none
 Drawing blood from a vein?
Gloves
 Cleaning an incontinent patient with diarrhea?
Gloves w/wo gown
 Responding to an emergency where blood is spurting?
Gloves, fluid-resistant gown, mask/goggles/face shield
 Suctioning oral secretions?
Gloves & mask/goggles or a face shield +/-gown
 Irrigating a wound?
Gloves, gown, mask/goggles or a face shield
ANTIBIOTIC
POLICIES
 ANTIBIOTICS
• 2nd most commonly used class of drugs in
hospital formularies
• 30% of hospitalized patients receive
antimicrobial agents (Bryan, 1989)
• 10-40% expenditures of hospital pharmacy
budget (Bryan,1989, Salama1996)
• 40-50% of antibiotic use in the hospitals is
inappropriate

PHICS Problem-Based Module 5: Common Medical Errors (CME) on Antibiotic Usage and Antibiotic Resistance
 ICC – Subcommittee on
Antimicrobial Usage
Composition :
• Infectious disease physicians
• Hospital epidemiologist
• Laboratory – Microbiologist
(Quarterly antibiogram)
• Pharmacist
(Antibiotic usage)
 Antimicrobial Stewardship
• defined as appropriate selection, dosing
& duration of antimicrobial therapy to
achieve optimal efficacy in managing
infections
Shlaes DM, Gerding DN, John JF, et al.
Guidelines for the Prevention of Antimicrobial Resistance in Hospitals
Clinical Infectious Disease. 1997; 25: 584-599

• an important tool in the effort to reduce

inappropriate use of antimicrobials and
subsequent development of both resistant
microorganisms and drug-related adverse
events.
Antibiotic Stewardship Program
POLICY:
• Usage of specific antimicrobials
(depending on the MMC quarterly
antibiogram) in the hospital is monitored
by the Infection Control Committee-
Subcommittee on Antibiotics. Any
antimicrobial included in the monitored list
is dispensed by the Pharmacy Department
only upon completion of the Antibiotic
Request Form (appendix 1).
 Antibiotics monitored
a.Imipenem/Meropenem/Ertapenem
b.Piperacillin-Tazobactam / Ticarcillin-
Clavulanate / Cefoperazone-Sulbactam
c.Ceftriaxone/ceftazidime/cefotaxime
d.Cefepime
e.Ciprofloxacin
f. Vancomycin
g.Linezolid
h.Tigecycline
 Surveillance of
Nosocomial Infections
at MMC
 Definition
Nosocomial infection:
Infection acquired in a medical setting in
the course of medical treatment.

Criteria for diagnosis:

 Not found on admission
 Temporally associated w/ admission or
procedure at a health-care facility
 Was incubating at admission but related to
a previous procedure or admission to same
or other health-care facility.
Four main sites of infections

• Lower respiratory tract

• Urinary tract
• Bloodstream
• Surgical wound sites

ICU, telemetry, PICU, NICU

 Goals of Surveillance

• to define endemic rates

• to identify increases in infection rates
• to identify specific risks
• to inform hospital personnel of the risks of
the cares or procedures they provide
 SURVEY
• Incidence Rate (I)
No. of infections acquired in a month
=
No. of patients discharged in a month
 SURVEY
• Prevalence Rate (P)
No. of infections (ACTIVE) in hospitalized
patients at the time of the survey
No. of patients present at the time of the
survey
Overall Infection Rate
per 1000 patients days
of High Risk Areas

20

10

0 Marc
Jan Feb April May June July Aug Sept Oct Nov Dec
h
NICU 2 0 0 0 0 0 0 0 0 0 0 0
PICU 0 0 16.13 0 0 0 0 0 17.24 0 0 0
ICU 8 2.89 0 16.95 0 0 2.57 0 0 0 0 0
TELE 0 0 0 0 0 0 0 0 0 0 0 0

NICU PICU ICU TELE

 Policy on reporting of communicable
diseases to the Health Dept.
POLICY:
• Communicable diseases that are of public
health importance shall be reported by the
Medical records Section to the Department of
Health through the Makati Health Department
as mandated by law.
• Makati City Ordinance No. 379 “Requiring Medical
Practitioners in Private Medical Clinics, Hospitals and Clinical Laboratories
in Makati, to report to the Municipal Health Officer of Makati, all cases of
communicable diseases diagnosed and treated in their facilities within 24
hours and to submit monthly reports of such cases.”
• Republic Act No. 3573 or the Law of Reporting of
Communicable Diseases & DOH Circular No. 176 s
2001 Revised List of Notifiable or Reportable Diseases.
 REPORTING OF
COMMUNICABLE DISEASES
1. Anthrax 18. Malaria
2. Chlamydia 19. Measles
3. Cholera 20. Meningitis
4. Conjunctivitis 21. Meningococcal disease
5. Dengue Fever 22. Mumps
6. Diphtheria 23. Pertussis
7. E. coli 24. Poliomyelitis
O157:H7(enterohemorrhagic) 25. Rabies
8. Encephalitis 26. Roseola
9. Enteric/Typhoid/paratyphoid 27. Rubella (German measles)
fever
10. Gonorrhea 28. Salmonellosis /Shigellosis
11. H. influenzae (Invasive type) 29. Streptococcal (invasive)
disease
12. Hepatitis (A, B, C) 30. Syphilis
13. HIV/AIDS 31. Tetanus
14. Influenza 32. Toxic Shock Syndrome
15. Legionella 33. Tuberculosis
16. Leprosy (pulmonary/extrapulmonary)
17. Leptospirosis 34. Varicella (Chickenpox
 PROPER
WASTE DISPOSAL

Health Care Waste Management Manual

Department of Health
 Color-coding for Waste Segregation:
METRO MANILA ORDINANCE No. 16: regulation of
hospital waste disposal in Metro Manila

 Black
 Green
 Yellow
 Orange
 Red/Lavander
 Clear Plastic
 BLACK
(Non-infectious Dry Waste)
 Paper & paper products
(used paper, paper cups,
tetra packs, boxes)
 Plastic IV Fluids
 Packaging materials
(styropore, aluminum, plastic,
candy/food wrapper)
 Diaper
 GREEN
(Non-infectious Wet Waste)

 Kitchen left-over food

 Used cooking oil
 Fish entrails, scales & fins
 Fruits & vegetable peelings
 Non-infectious left-over foods
 YELLOW
(Infectious & Pathological Waste)

 Gauze, swabs, cotton soaked in

blood/body fluids from wound
dressings, immunization, Pap
smear, etc.
 Foreign bodies removed from
body parts
 Placenta, umbilical cord
 ORANGE
(Radioactive/Nuclear Waste)
 1125 (Iodine 125)
 H3-Thymidine
 Cesium –137
 Things contaminated with
these radioactive materials
(gloves, tissue papers,
swabs, gauze, test tubes,
syringes, etc.)
 Used x-ray films, developers,
fixers
 RED/Lavander
hazardous waste
cytotoxic/ antineoplastic agents or
drugs used for cancer chemoRx,
vials & bottles containing such
agents
solusets & IV tubing's used for their
infusion
Insecticides
used batteries
 Clear Plastic Bags

All other vials & used I.V. bottles

 Employees Health Program
 Annual P.E.
 Hepatitis B vaccination
 Yearly influenza vaccination
 Screening/monitoring for TB
 Chest x-ray
 PPD baseline, Tuberculin test for PPD (-)
 Sputum AFB smear/culture for CXR (+)
 Monitoring for other communicable diseases
 FLU VACCINATION FOR 2007

Category # of staff who Total # of Staff Percentage

received flu per Category
vaccine
Nurses 527 878 60.02%
Non-Nurses 477 705 67.66%
Interns 15 72 21%
Residents 69 191 33%
Consultants 29 320 9.06%
 ICC Subcommittees

• Antibiotic Usage
• HACT (HIV/AIDS Core Team)
• Task Force on Emerging Infections
*********************************************
MMC ICC Manual
SARS Manual
Pandemic Influenza Preparedness
Manual
 Pandemic Influenza Preparedness Manual

MMC Task Force on Pandemic Influenza Preparedness Program

Infection Control Committee
December 2006
 Preparedness Program
Organizational Chart
Administration
MMC Task Force • President / Medical Director
on Emerging Infections • Management Committee
• Quality Director

Information,
Hospital Emergency
Education & Isolation Surveillance
Operations Response
Communications
 Task Force on Emerging/Re-emerging Infections
• Information, Education & Communications Team
Team Leader: Benjamin N. Alimurung, MD
Co-Team Leader: Vilma M. Co, MD
Thelma E. Tupasi, MD
Eric Nubla, MD

• Hospital Operations Team • Emergency Response Team

TL: Vilma M. Co, MD
Co-TL: Marilou P. Furio, RN (Nursing)
Mila Uy (Quality Service)
Noel Rosas, MD (Therapeutics)
Hazel Docuyanan (Pharmacy)
Nida Euste (Purchasing)
Ana Dugang (Dietary)
Ma. Sheila Tumlos (Personnel)
Carlito B. Soliman (Finance)
Rolando Alicante (Security)
• Surveillance Team
TL: Maricel Gler, MD
Co-TL: Ma. Lourdes Gozali, MD (PIDS)
Rose Cabuhat, MD (CHWC)
Alex Mendoza, RN (ICC)
Alice Cacpal (Microbiology lab)
TL: Johnny B. Sinon, MD
Co-TL: Bernard Cueto, MD (EP Officer)
Rosanna Santillan, RN (ICC)
Arsenia Cruz, RN (ER)
Jose V. Cruz, Jr., MD (Psych)
• Isolation Team
TL: Salvador Abad Santos, MD
Co-TL: Alipio Abad, Jr., MD (Pulmonary)
Dennis Garcia, MD (Pedia IDS)
Severina Mallari (Housekeeping)
Engr. Marlon Pilante (FMED)
Gemma Matira (Radiology)
Secretariat: Rosanna Santillan, Alex Mendoza
Maricel Bulasa
Infection Control & Prevention

Thank you!