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PubMed1988

Validating the certification process for infection control practice.

Approximately 5 years ago a task analysis was conducted by the Certification Board of Infection Control (CBIC) to describe infection control practice. This task analysis served as the basis for development of the certification examination. This article describes the process used to update and revalidate the original task analysis to ensure the continued validity and job relatedness of the certification process. Using a modified Delphi technique, several panels of representative expert infection control practitioners (ICPs), a total of 29 persons, participated in an iterative process to define the practice dimensions of infection control and to link these practice dimensions to the certification examination. In general, there was a high level of congruence between respondents on the original task analysis and the expert panels, although a few differences in practice were identified among ICPs in extended care facilities and a few new tasks were identified. In addition, a revised content outline for the examination was created by placing clusters of knowledge statements together around common themes.

Certification↗

PubMed1999

Is infection control an academic study?

This editorial aims to answer the question of whether infection control is an academic specialty. By considering the consequences of a lack of infection control in terms of patient morbidity and mortality and hence cost, it is easy to establish the importance of the area. Infection control embraces not only developing policies for preventing the physical spread of a micro-organism but also prophylactic therapy such as vaccination and therapeutic measures such as antibiotics. Infection control not only applies to localized infection in hospital due to antibiotic resistant microbes but also to the community. Bacteria such as Helicobacter pylori and Chlamydia pneumoniae and the viruses hepatitis B, hepatitis C, human lymphotropic virus type 1, Epstein-Barr viruses and human papilloma virus have been implicated in diseases not previously thought to have an infectious origin. Coping with these problems is clearly an academic area.

Bacterial Typing Techniques↗

PubMed2005

Infection control and quality health care in the new millennium.

Health care-associated infection remains a major issue of patient safety. It complicates a significant proportion of patient care deliveries, adds to the burden of resource use, and contributes to unexpected deaths. Early infection control pioneers showed that surveillance and prevention programs can be successful and have set the scene for today's infection control activities. Parameters for success include those to recognize and explain health care-associated infections and implement interventions to decrease infection rates and limit antimicrobial resistance spread. Current major challenges facing infection control programs are reviewed with an emphasis on recent trends in health care delivery systems, together with some vision on future activities and interactions toward such changes. Benchmarking of infection rates is considered inevitable, and, thus, surveillance strategies, adapted to changing health care systems, should improve and emphasize intervention and standardization. Major challenges for the future include antimicrobial use and control of resistances, new materials, emerging pathogens, infection control issues related to transgenic therapy, massive and complete immunosuppression and xenotransplantation, prion diseases, use of fully computerized patient record and data-mining-derived epidemiology, development of evidence-based recommendations for infection control and prevention, addressing cost constraints and newly apparent health care system trends, and health care worker behavior modification.

Cost-Benefit Analysis↗

PubMed1996

Revision of the anaesthetic aspects of an infection control policy following reporting of hepatitis C nosocomial infection.

Following the report by the N.S.W. Health Department of five cases of nosocomial hepatitis C infection allegedly caused by contaminated circuitry, a revision of the existing infection control policy was undertaken. Review of the existing policies of other organizations and the published scientific data in this area was the basis of the revision. The final policy as it pertains to anaesthesia requires universal precautions, disposal or decontamination and high level disinfection of instruments and apparatus that come into contact with patients or blood or body substances and protection of the breathing circuit by a filter with disposal or high-level disinfection of all parts of the circuit not so protected for every patient.

Anesthesiology↗

PubMed2005

Roles of infection control nurses in university hospitals.

OBJECTIVE: To evaluate the roles of infection control nurses (ICNs) in university hospitals. MATERIAL AND METHOD: Interviewing 23 ICNs in 6 university hospitals applying for hospital accreditation during March and April 2002. RESULTS: The ICNs had an average work experience of 11.3 years. The roles relatively well carried out by the ICNs were: administration, outbreak investigation, personnel health, education, consultation. Better performance was needed in the roles of presenting surveillance data to infection control committee, research and analyzing the needs and expectation of patients related to IC. CONCLUSION: Infection control nurses in university hospitals could perform their roles relatively well. However, better roles in surveillance, research and quality improvement need to be developed.

Adult↗

PubMed1998

A survey of infection control professional staffing patterns at University HealthSystem Consortium institutions.

BACKGROUND: Proper staffing of infection control departments has long been a topic of interest. The most complete report on the subject, the Study on the Efficacy of Nosocomial Infection Control, was published in 1985. To provide current benchmarking comparison data for expected staff reductions at the University of Michigan Health System, a survey of University HealthSystem Consortium members was performed. METHODS: A survey tool was developed to obtain general demographic, staffing, and case-mix information. An infection control professional at each institution was contacted to obtain most of the information. Additional information was obtained from standard references. RESULTS: Responses were obtained from 45 University HealthSystem Consortium members (67%). Full-time equivalent ratios were based on the following parameters and compared for the institutions: number of occupied beds (according to occupancy rate, median 137 occupied beds/full-time equivalent), number of intensive care unit beds (median 28 beds/full-time equivalent), number of admissions or discharges (median 6686 admissions/full-time equivalent), number of ambulatory care visits (median 104,426 visits/full-time equivalent), and case-mix index (median 1.75). CONCLUSIONS: Many institutions are using benchmarking comparison data to make decisions regarding staff reductions. This survey provides preliminary data for determining the "best practice" in staffing for infection control departments. More information may be needed to evaluate other factors that affect infection control professionals' workload.

Academic Medical Centers↗

PubMed1998

Nosocomial infections in a rural regional hospital in a developing country: infection rates by site, service, cost, and infection control practices.

OBJECTIVE: To assess the prevalence of nosocomial infections at a rural government hospital from 1992 to 1995. DESIGN: Retrospective review of data from 1992 to 1995 regarding rates of nosocomial infections, cost to government, and infection control practices. SETTING: 653-bed rural hospital providing primary and tertiary care. PATIENTS: Patients admitted to the hospital between 1992 and 1995 who were found with hospital-acquired infections during their stay. INTERVENTIONS: None. RESULTS: Over the 4-year period, 7,158 nosocomial infections were identified from 72,532 patients (10.0/100 admissions). High nosocomial infection rates were found on the intensive-care unit (67/100 admissions), urology (30/100 admissions), neurosurgery (29.5/100 admissions), and newborn nursery (28.4/100 admissions). Urinary tract infections (4.1/100 admissions) accounted for most nosocomial infections (42%), followed by postoperative wound infections (26.8%) with a rate of 2.6/100 admissions. Nosocomial pneumonias and bloodstream infections also were common with 13.2% and 8.0%, respectively. The highest rates occurred on the intensive-care unit for both pneumonia (26.4/100 admissions) and bloodstream infection (7.0/100 admissions). The cost to the government for nosocomial infections was estimated at US $697,000 annually (US $1=$6 Trinidad and Tobago). Poor infection control practices, inadequate handwashing facilities, lack of supplies, and nonexistent garbage cans on most wards were quite evident. CONCLUSIONS: Strict adherence to proper infection control practices, such as handwashing techniques, and improvement of facilities are crucial steps in preventing cross-infections in the hospital environment. Implementing these measures may substantially reduce the massive drain on the hospital budget in treating nosocomial infections. The saved revenue could go toward improvement of ward facilities and reduction of overcrowding, thus further reducing cross-infection.

Cross Infection↗

PubMed2002

The organization of hospital infection control in Turkey.

This article describes the current organization of infection control in Turkey in regard to regulations, functions and responsibilities of infection control committees and the national NosoLINE project. Also, incidence and prevalence of hospital infections and antimicrobial resistance in Turkey are reported.

Cross Infection↗

PubMed2000

Infection control training: evaluation of a computer-assisted learning package.

An evaluation of the training module of an interactive infection control computer-assisted learning (CAL) software program was carried out with ward-based nurses, third-year medical students and infection control personnel. All nursing staff, 87% of the medical students and all infection control staff found the programme easy and enjoyable to use. The module was accessed 3101 times on the hospital network in 18 months with usage settling to between 100-150 times per month. There was a higher level of use by night-duty and weekend staff. Medical students gained as much infection control knowledge from using the CAL package (increase in correct responses from 63.5% to 83.4%;P<0.0001) as they did from a formal lecture (increase in correct responses from 62.1% to 79.5%;P<0.0001). We conclude the training module which is accessible on the hospital wards and across the academic network, is a convenient and effective way for staff and students to gain a basic understanding in evidence-based infection control practices, at locations and times suitable for them.

Attitude of Health Personnel↗

PubMed1997

The clinical microbiology laboratory and infection control: emerging pathogens, antimicrobial resistance, and new technology.

The clinical microbiology laboratory is an essential component of an effective infection control program. Laboratory personnel have a broad range of technologies, from traditional methods of detecting and identifying organisms to modern molecular typing methods, that they can use to support and enhance the efforts of the infection control staff. If the infection control team applies these technologies appropriately, it can prevent problems and solve nosocomial mysteries efficiently. In this era of cost-containment, staff members in the laboratory and in the infection control program must work hard to communicate their unique and shared goals, needs, and problems. If the laboratory and infection control personnel cooperate and collaborate rather than compete, both programs will be successful and the patients and the hospital will benefit because the risk of nosocomial infections and the frequency of resistant organisms will be reduced.

Bacterial Typing Techniques↗

PubMed1984

Infection control surveillance in a rehabilitation hospital.

Infection control surveillance in a rehabitation setting is essential to quality assurance because of the high number of infection risk factors found in this patient population. These factors include longer length of stay, high incidence of urinary tract instrumentation, and high incidence of skin lesions, including decubital and stump wounds. A surveillance process is described which offers timely access to each infected patient's diagnosis, treatment, and follow-up, and results in simplified hospital-wide antibiotic monitoring. Quality assurance problems identified through this surveillance plan involved specimen collecting and reporting errors, nursing-procedure inadequacies, and organism misidentification. These and other examples illustrate the distinctive role an infection control program can play in quality monitoring and problem solving in a rehabilitation hospital.

Cross Infection↗

PubMed1991

Education programmes for infection control in Canada.

Formal educational programmes for infection control personnel in Canada are limited and most courses have been directed at infection control practitioners (ICPs). Most ICPs report that their preparation comes from in-post training. Although there have been several short, non-credit courses available in the past, the only course available for ICPs at the present time is an intensive 1-week course. Surveys of nurses and ICPs suggest that they prefer flexibly scheduled university credit courses which will not only prepare them for their positions but also enable them to meet entry-to-practice requirements as recommended by the board of the Canadian Nurses Association. The future development of courses for ICPs must endeavour to meet these needs. Moreover, the educational needs of physicians and other health professionals working in this field have not been well identified or addressed and it is clear that educational programmes must also be developed for these health professionals.

Canada↗

PubMed2006

[Inequalities in the conditions of infection control in dentistry offices in a southeastern Brazilian city].

The study analyzed infection control conditions in dentistry offices in Cariacica, Espírito Santo, Brazil. Data pertaining to interviewees, location and type of office, setting, equipment, and materials were obtained by direct observation in all the registered services and in twenty unlicensed establishments operated by "non-graduate dentists". For grouped analysis of infection control measurements in each establishment, a composite indicator based on 19 variables was developed, such that the lower its value, the better the infection control. The results referred to 113 offices. Infection control in offices of "non-graduate dentists" (xICI = 23.05, dp = 11.86) was four times worse than for private offices. Public dental care services (xICI = 16.27; dp = 6.96) occupied an intermediate position. Conditions were also four times worse in dentistry offices located in peripheral urban areas. There was a clear-cut division in sanitary conditions within dental care as a whole. A large proportion of the population depending on dental care from unlicensed dentists is exposed to increased risk of cross-infection.

Brazil↗

PubMed1991

Nursing aspects of infection control in developing countries.

The quality of the infection control programme in developing countries is determined by the resource allocation to the health sector and the health care delivery system. These depend to a great extent on the socio-economic development of the country. Morbidity and mortality from communicable infections, such as diarrhoeal diseases and malaria are high. There is often an irregular water and electricity supply. Essential material resources, e.g. paper towels, gowns, gloves, masks and disinfectants may not be available and some disposable materials have to be re-used. Most hospitals have no infection control programme due to the lack of awareness of the problem or absence of trained personnel in infection control practices. Developing countries differ in many ways from each other, often having dissimilar cultures and languages and state of socio-economic development. Solutions will emerge only if there is co-operation between countries and provision of assistance, where appropriate, from wealthier countries.

Cross Infection↗

PubMed1986

Infection control--present and future.

Infection rates remain high in hospitals throughout the world and studies have shown that about 1 in 10 patients in hospital at any one time have an acquired infection. Prevalence studies carried out in different European countries have shown remarkably consistent infection rates despite considerable variations in infection control activities and facilities, e.g. England and Wales 9.2%, Sweden 10.5%, Denmark 10.4% and 12.1%, Norway 9.0%, Belgium 9.3%, W. Germany 9.8%, Italy 6.8% and Spain 12.0%. However, cross-infection, particularly staphylococcal, has decreased considerably in our own hospital over the past 15 years, although the overall infection rate has not changed.

Central Supply, Hospital↗

PubMed2006

Substantial differences in preparedness for emergency infection control measures among major hospitals in Japan: lessons from SARS.

Emergency infection control measures are essential in hospitals. Although Japan was spared from the 2003 epidemic of severe acute respiratory syndrome (SARS), hospitals were placed on high alert. The actual preparedness level of hospitals can be determined by examining individual perceptions among the hospital healthcare workers (HCWs). The objective of this study was to assess the level of preparedness of emergency infection control measures in Japan and to quantify the differences in preparedness across institutions and disciplines. From July to September 2003, a questionnaire survey concerning the perceptions of risks and countermeasures and knowledge about SARS was distributed at seven tertiary hospitals. Disciplines were categorized as emergency room (ER)/intensive care unit (ICU), surgical, medical, and "others". Of the 9978 questionnaires administered, 6929 valid responses were received and analyzed. After adjusting for age, sex, and job category, specific institutional measures (I-scores) were found to be more indicative of the level of preparedness across institutions and disciplines than were measures of overall effectiveness (E-scores) or knowledge of preventive measures (K-scores). In particular, the difference in I-scores was much more substantial across institutions than across disciplines. Across disciplines, surgical ranked lower than ER/ICU or medical. In conclusion, substantial differences in emergency infection control measures, as perceived by HCWs, exists among hospitals in Japan, with the differences across institutions exceeding those across disciplines. To achieve a higher level of preparedness for infectious diseases, institutions should designate and implement effective emergency infection control measures.

Disaster Planning↗

PubMed2001

Using research to improve infection control practice.

Research into nurses' knowledge of infection control provided the basis for a hospital training programme. A combined approach by occupational health and infection control specialists developed an appropriate needs-based programme.

Education, Nursing, Continuing↗

PubMed1995

Progress with establishing and implementing standards for infection control in the UK.

The process of agreeing standards for infection control in England and Wales is described. To ensure ownership of these standards an extensive consultation exercise was undertaken. Further development has been left to Infection Control Teams (ICTs) and the relevant health care workers. Management and Consultants in Communicable Disease Control were also sent the standards to further encourage support for their implementation. The results of a questionnaire of ICT resources and activities is alluded to and these data will be a valuable point of reference to monitor changes in the status quo of a rapidly changing health service.

Communicable Disease Control↗