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PubMed1993

Job analysis 1992: infection control practitioner.

The Certification Board of Infection Control directed its Research Subcommittee to compose a Job Analysis Committee in 1991. This 9-member Job Analysis Committee, in collaboration with Applied Measurement Professionals, Inc., conducted a job analysis of ICPs during 1992. The reassessment of the previous Certification Board of Infection Control task analysis, formation of a job-analysis survey tool, and the actual job-analysis process and its results are described in this article. The previous and newly revised test specification outlines are compared. The national Certification Examination for Infection Control for November 1993 will reflect the efforts of this endeavor.

Canada↗

PubMedDate not supplied

Pennsylvania dental hygienists' knowledge, attitudes, and infection control practices in relation to AIDS and AIDS patients.

PURPOSE: Limited documentation is found on dental hygienists' attitudes toward acquired immunodeficiency syndrome (AIDS) patients and their knowledge and practice of clinical infection control to prevent disease transmission to themselves and their patients. The purpose of this paper was to survey practicing Pennsylvania dental hygienists to document 1) their infection control practices; 2) their attitudes towards AIDS patients; and 3) their knowledge of clinical infection control practices. METHODS: A self-administered survey questionnaire, with fixed-alternative responses, was mailed in January 1991 to a random sample (N = 300) of licensed, practicing Pennsylvania dental hygienists. The questionnaire comprised eight multiple-choice questions for demographic purposes and 89 Likert-type questions eliciting information in five areas: AIDS-related knowledge, attitudes toward AIDS patients, knowledge of recommended Centers for Disease Control and Prevention (CDC) infection control measures, individual infection control measures, and individual laboratory infection control measures. Means and modes for individual questions and for specific categories were determined and analyzed utilizing Spearman rho correlation coefficients (p < .05). Mean scores were also tabulated for actual operator/laboratory infection control practices for both a routine patient and an AIDS patient. Those scores were analyzed utilizing the Wilcoxen signed-ranks test. RESULTS: Two hundred twenty questionnaires were returned for a 73.3% initial response rate. One hundred fifty-four of those returned were usable, for a 64% response rate. Results indicated that 94.2% of surveyed dental hygienists had comprehensive knowledge about AIDS and 92% had comprehensive knowledge of CDC-recommended infection control procedures. Eighty-five percent of respondents possessed a moderate or high feeling of worry concerning treatment of AIDS patients. The majority of surveyed dental hygienists routinely practiced the use of glasses, masks, and gloves; the use of disposable items; and surface disinfection of light handles, instrument bracket trays, and patient chair switches. Knowledge of recommended infection control procedures for dentistry was found to be associated (r = .22) with adherence to recommended infection control practices. Accurate knowledge about AIDS showed a weak (r = -.088) and nonsignificant relationship with dental hygienists' attitudes toward AIDS patients. Use of recommended infection control practices was found to be associated (r = -.20) with less fear concerning the treatment of AIDS patients. In addition, dental hygienists' infection control practices varied according to their perception of patient HIV status. CONCLUSIONS: Since Pennsylvania dental hygienists, within the limitations of this study, appear not to follow CDC guidelines on proper and responsible operatory/laboratory aseptic techniques stringently, and to differentiate infection control procedures based on perceived patient HIV status, recommendations are that 1) the Commonwealth of Pennsylvania should mandate that all Pennsylvania-licensed dental hygienists take at least one state-approved course on operatory/laboratory infection control every two years to qualify for relicensure; 2) all dental and dental hygiene education institutions and professional organizations should place more emphasis on strict adherence to the various agency recommended clinical guidelines for infection control; and 3) all dental hygienists should continually strive to update their own knowledge of current infection control practices.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Training needs of infection control professionals in long-term care facilities in Virginia.

BACKGROUND: Infection control professionals from area long-term care facilities contacted us and asked for help in securing infection control training. To determine whether there was sufficient statewide need to warrant University activity, we conducted a needs assessment. METHOD: An eight-page questionnaire was mailed to 220 infection control professionals in nursing homes statewide. The instrument focused on training needs and also on training accessibility issues. Ninety-nine completed questionnaires were returned for a 41% response rate. RESULTS: The infection control professionals who responded came from a representative group of long-term care facilities throughout the state. Ninety-three percent indicated that they were "very interested" or "interested" in a series of sessions addressing a wide variety of long-term care infection control topics. Ninety-nine percent of the respondents indicated that it was "extremely important" or "important" for any such training to focus specifically on long-term care facilities. CONCLUSIONS: Considerable need for infection control training was expressed by infection control professionals in Virginia long-term care facilities. Such training must be relevant to long-term care facilities and should meet accessibility requirements.

Attitude of Health Personnel↗

PubMed1999

A survey of the implementation of health service guidelines on arrangements for infection control in health trusts in the West Midlands.

A good hospital infection control programme can reduce hospital acquired infection, which causes considerable morbidity, mortality, and cost. NHS trusts in the West Midlands were surveyed to assess progress in implementing national infection control guidelines. All 25 acute trusts replied but only 13 of 21 trusts for the community or for mental health (MH). Twenty-four acute trusts had access to an infection control nurse (ICN), but ICNs were responsible for an average of 520 acute beds, twice as many as usually recommended. Seven (of 13) community/MH trusts had only informal arrangements for access to an ICN. Six acute trusts had no formal arrangements for covering ICN leave. All 25 acute trusts had access to an infection control doctor, but on-call cover in eight required this individual to be permanently available. All acute trusts had a hospital control of infection committee, but in only 10 did a senior member of management regularly attend. Twenty-four acute trusts had an outbreak control plan but only 13 had been updated as recommended. The NHS performance management structure needs to be utilised to ensure that these deficiencies are rectified. It would be wise to investigate implementation of national guidance in NHS trusts in other regions.

England↗

PubMed2003

[Infection control in Hamamatsu Medical Center].

Since the department of Infection Control was established in Hamamatsu Medical Center, a 615-bed community teaching hospital, we have been practicing infection control program including surveillance, coping with needle stick injuries, introducing Interlink system, PPD testing and influenza vaccination to the health care workers. One of the obstacles in the practice of the hospital infection has been a cost, and the infection control does not progress as long as this can't be solved. The infection control, which we have been carrying out so far, seems to have a lot of unnecessary practices. If we stop those practices, considerable cost can be reduced because the hospital infection is achieved in the entire hospital and can be shifted to the practice which is necessary. Although identification of the unnecessary practices is very difficult, EBM (Evidence based medicine) provides us with useful information. "The re-distribution of the cost" referring to EBM seems to be very important to progress infection control.

Cross Infection↗

PubMed1988

Infection control organization in hospitals in England and Wales, 1986. Report of a survey undertaken by a Hospital Infection Society working party.

Questionnaires were distributed to hospitals in order to obtain information regarding arrangements for infection control. Returns were obtained from 180 of 200 (90%) health districts in England and Wales covering 95% of 'acute' and 85% of 'other' hospital beds listed in the Hospitals Year Book. The results demonstrated that some form of infection control organization was present in all districts, 98% had control of infection officers and 92% control of infection committees. The proportion of health districts with an infection control nurse had risen from 64% in 1979 to 89%, and the regional variation seen in 1979 was no longer marked. The major commitment of medical microbiologists to infection control was underlined.

Cross Infection↗

PubMed2002

A systematic audit of economic evidence linking nosocomial infections and infection control interventions: 1990-2000.

BACKGROUND: Nosocomial infections (NIs) are a serious patient safety issue. Infection control personnel are responsible for implementing interventions to reduce this risk. The purpose of this systematic review was to audit the published economic evidence of the attributable cost of NIs and interventions conducted by infection control professionals and to evaluate the methods used. Economic evaluation methodology and recommendations for standardization are reviewed. METHODS: A search of MEDLINE and HealthSTAR with medical subject headings or text words "nosocomial infections," "infection control," or "hospital acquired infections" cross-referenced with "costs," "cost analysis," "economics," or "cost-effectiveness analysis" was conducted. Published review articles were also searched. Inclusion criteria included articles published between 1990 and 2000 that contained an abstract and original cost estimate and were written in English. Results were standardized into a common currency. RESULTS: Fifty-five studies were eligible. Approximately one quarter examined NIs in intensive care patients (n = 13). Most studies were conducted from the hospital perspective (n = 48). The costs attributable to bloodstream (mean = $38,703) and methicillin-resistant Staphylococcus aureus infections (mean = $35,367) were the largest. CONCLUSIONS: Increased standardization and rigor are needed. Clinicians should partner with economists and policy analysts to expand and improve the economic evidence available to reduce hospital complications such as NI and other adverse patient/staff outcomes.

Cost-Benefit Analysis↗

PubMedDate not supplied

Strategies for dental clinic infection control.

The application of proper infection control procedures helps to protect practitioners, patients and the community. The goal is to minimize the spread of potentially pathogenic micro-organisms and to remove and/or kill organisms that have contaminated objects and surfaces. Dental practitioners are aided in this process by the generation of rules, guidelines and recommendations by regulatory agencies and professional organizations. Ideally, each office/clinic would generate and maintain a written set of infection control procedures.

Cross Infection↗

PubMed1996

Nurses' infection-control practice: hand decontamination, the use of gloves and sharp instruments.

Infection is an acknowledged hospital problem. Micro-organisms are disseminated mainly via hands but there is evidence that hand decontamination, the most important means of prevention, is performed too seldom, and not always after activities likely to result in heavy contamination. Nurses themselves are exposed to risks of infection, chiefly through contact with blood and body fluids, yet it has also been reported that gloves are not always worn during contact with patients' secretions and that the handling and disposal of sharp instruments may be performed unsafely. The study reported in this paper documents nursing behaviour in relation to hand decontamination, the use of gloves and sharps, taking into consideration a number of variables which could influence practice: availability of the expertise afforded by an infection-control nurse, clinical setting, nursing workload, knowledge and the resources available to control infection. Hands were decontaminated after 28.78% of patient contacts. Hands were decontaminated after 49.85% of activities likely to result in heavy contamination. Performance was related to nursing workload and the availability of hand decontaminating agents, especially when the nurses became busy. Use of gloves when they were available also proved good, with little evidence of wasteful use. The handling and disposal of sharps were commendable for most subjects but a few grossly unsafe incidents were nevertheless witnessed, apparently not associated with any of the variables examined.

Analysis of Variance↗

PubMed1986

Recommended infection-control policies for patients with human immunodeficiency virus infection. An update.

HIV is not readily transmitted to health care workers, even after accidental parenteral exposure to infected blood. Existing guidelines for reducing exposure to blood and other body fluids will protect workers who care for patients infected with this pathogen. New infection-control guidelines for patients with AIDS are therefore not required. Awareness of the potential for nosocomial transmission of HIV has resulted in a renewed respect for the principles and practice of infection control. The procedures that the task force recommended to prevent contact with body fluids will reduce exposure not only to HIV but also to other potentially contagious pathogens in the health care environment. Implementation and enforcement of these guidelines for all patients could greatly reduce the incidence of nosocomial and occupationally acquired infections.

Acquired Immunodeficiency Syndrome↗

PubMed2003

[Role of the surgeon in the hospital infections control committees].

Hospital-acquired infections are the ones that develop within hospital stay or appear after discharge. These infections are associated with an increased rate of morbidity and mortality, longer hospital stay and higher hospital costs and Hospital Infections Control Committees have been founded to prevent it. In this review, we intended to investigate the role of the surgeon in this committee.

Committee Membership↗

PubMed1995

Management constraints in infection control.

Critical care patients are at risk for developing endogenous and exogenous nosocomial infections. Essential components of an infection-control program in the critical care environment are the structural design of the critical care unit and the surveillance, prevention, and control of infection functions. Management strategies include employee infection control and education. Knowledge and education are the most important management tools in the control of infection in the critical care environment.

Humans↗

PubMed2001

The organization of infection control in Germany.

The authors outline the organization of infection control in Germany, focusing on official regulations, the training of infection control staff, and functions of the infection control committee and the availability of guidelines.

Cross Infection↗

PubMed1987

A measurement of the efficacy of nosocomial infection control using the 95 per cent confidence interval for infection rates.

From 1981 through 1985, the authors studied the changes in monthly nosocomial infection rates at the University of Virginia Hospital in Charlottesville, Virginia using the 95% confidence interval for infection rates as a marker of the efficacy of infection control activities. For a 99-month baseline period, monthly infection rates were calculated and the 95% confidence interval was established. In the 60 study months, each monthly rate was compared with the 95% confidence interval for that particular month. At the end of each study year, the monthly infection rates were incorporated into the existing confidence interval. Of 60 monthly rates during the study period, 30 were below the confidence interval (p less than 0.00001), two were above the confidence interval (p = 0.23), and 28 were within the confidence interval. Since there was no reduction in surveillance activity, patient case-mix index, or laboratory sensitivity for organism recovery, these results suggest that monthly nosocomial infection rates at this hospital have decreased when compared with the baseline period. The use of the 95% confidence interval may provide a measure of the efficacy of infection control activities, suggest temporal intervals requiring more intensive infection surveillance, and provide a method for examining the variability in monthly infection rates.

Cross Infection↗

PubMed2001

Implementing and evaluating a rotating surveillance system and infection control guidelines in 4 intensive care units.

BACKGROUND: In clinical practice, scientific evidence about infection control is often ignored and hygiene rituals are followed. METHODS: Within an evidence-based infection control program, a quarterly rotating surveillance program for nosocomial infections was implemented in 4 intensive care units (ICUs) at the Aachen University Hospital, Germany. RESULTS: For the first time, the unit-specific nosocomial infection situation was made clear to the clinical staff by interpretive feedback of the surveillance data. This led to an increased awareness of infection control and a critical review of hygiene practices. After the first surveillance period, the hygiene practices of each ICU were revised and modified. The Centers for Disease Control and Prevention/Hospital Infection Control Practices Advisory Committee guidelines for the prevention of nosocomial infections were adopted and established in tight collaboration with the ward staff. CONCLUSIONS: Within the surveillance process, communication and team spirit between infection control and patient care personnel showed a remarkable improvement. Awareness and compliance with hospital hygiene and infection control practices could be raised without directive interaction.

Attitude of Health Personnel↗

PubMed1991

Current status of nosocomial infection control in extended care facilities.

The 1980s saw the birth and growth of the distinct field of infection control in the extended care facility (ECF). Major advances in the field during the last decade have been surveys documenting the magnitude of the problem of ECF nosocomial infections, descriptive studies of ECF nosocomial infections, descriptive studies of ECF epidemics, development of ECF infection control programs, and recognition of the unique problems of the ECF infection control program. As the field matures, areas that should receive additional attention during the upcoming decade include: analysis of the risk factors and consequences of ECF nosocomial infections; analysis of resident and institutional variables that predict nosocomial infection; and studies on the efficacy of both infection control programs and specific infection control measures. ECF infection control programs have benefited a great deal from hospital infection control, but ECF infection control problems are quite different and demand unique solutions.

Cross Infection↗

PubMedDate not supplied

Infection control practices of Rhode Island dental hygienists and certified dental assistants.

PURPOSE: Limited studies document the infection control practices of dental hygienists and dental assistants even though both groups play a vital role in the prevention of disease transmission in the dental office. The purpose of this study was to survey Rhode Island registered dental hygienists and certified dental assistants to (1) determine their current infection control practices; (2) to document attendance at an infection control course; and (3) to identify the need for additional infection control education. METHODS: In October of 1993 a fixed-response survey was mailed to a random sample of 267 registered dental hygienists (RDHs) and 260 certified dental assistants (CDAs) in Rhode Island. Data were analyzed using descriptive statistics, cross-tabulations, and the chi-square statistic. RESULTS: Responses were received from 171 RDHs and 153 CDAs for adjusted response rates of 64% and 59%, respectively. Most responding RDHs and CDAs were wearing gloves but substantially fewer were utilizing one of the two acceptable combinations of personal protective barriers. Other procedures that were not always practiced by a substantial number of respondents included the use of disposable barriers, following recommended handwashing protocol, utilizing appropriate procedures for disinfection and sterilization of dental instruments and handpieces, updating medical histories, and biological monitoring of sterilization equipment. Although the majority of both groups reported having attended an infection control course within the past year, having written infection control protocols in place, and being satisfied or very satisfied with the level of infection control, many recommended procedures were not practiced routinely. CONCLUSIONS: These findings indicate that lack of compliance with infection control guidelines is multifactorial. Even though there is a need for continuing infection control education for dental hygienists and certified dental assistants, education alone is not the answer.

Chi-Square Distribution↗

PubMed2001

Role of the clinical microbiology laboratory in infection control--a Danish perspective.

Clinical microbiology laboratories in Denmark are located in hospitals and staffed by clinical microbiologists who are clinically trained medical doctors. Each county has its own clinical microbiology unit, serving a population of 0.3-0.6 million. The responsibilities of clinical microbiology unit cover many different aspects of infection control. They include detection of outbreaks of hospital-acquired infections, screening for multi-resistant organisms, advice to clinicians about disinfection, sterilization and isolation procedures, and the rational use of antibiotics. Clinical microbiologists work closely with infection control nurses. Together they form the infection control team, which is the executive part of the local infection control committee. The infection control team is also the main body responsible for the development of guidelines, which are approved by the regional infection control committee. The local microbiology laboratories work in close contact with the National Department of Hospital Hygiene and other reference laboratories at the State Serum Institute. The present structure of infection control was established 25 years ago. The main aim at that time was to decentralize infection control and establish facilities as close to clinicians and patients as practically possible. This has solved most basic problems related to infection control, and compliance by clinicians has been fairly good. However, the present organization will not meet future requirements for standardization and documentation of quality. Currently a national standard for infection control is being prepared. It consists of a main standard defining requirements for the management system and 12 subsidiary standards defining requirements for specific areas of infection control. Adoption of the standard will undoubtedly require additional resources for infection control at a local level, and some organizational changes may also be needed. Infection control should be maintained as an integrated part of clinical microbiology.

Cross Infection↗