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PubMedDate not supplied

[Changes of the elastomer impression materials after their immersion in some disinfection agents for AIDS infection control purposes].

In achieving infection control in the dental office and the dental laboratory it has been suggested that impressions made in the dental office should be disinfected before they are send to the dental laboratory. In this study we examined the solubility and the linear changes of some elastomer impression materials after their immersion in disinfection agents after ten, twenty and forty minute time intervals. The disinfection agents used were: 75% alcohol, domestic chlorine 10%, the agent sterile pack (isopropyl alcohol) and 2% activated glutaraldehyde (SIDEX). Water was used as control. Our findings show that all types of elastomer impression materials appear to suffer insignificant changes both linear and weight-wise but polyether impression materials show significant changes in almost all the disinfection agents that were used and the time intervals that were studied.

Acquired Immunodeficiency Syndrome↗
PubMed1998

The effectiveness of the "Clean-Area-System" for infection control in the dental clinic.

The use of effective infection control procedures and universal precautions in dental clinics, prevents cross contamination that could extend to dental health care workers and patients. The present study was initiated to investigate airborne environmental contamination in the dental clinic by viable cell count of oral streptococci grown on Mitis-Salivarius and blood agar plates. The reduction of the contamination by the "Clean-Area-System" was evaluated. "Andersen-Microbe-Sampler-Apparatus" and "Laser-Particle-Counter-System" were used for sampling and counting the bacterial cells and airborne dust, respectively. Numbers of viable cells counted as total colony forming units (CFUs) in the dental clinic were found to be significantly higher than those in the waiting room and the research laboratory. We found that the "Clean-Area-System" significantly reduced the CFUs grown on blood agar plates (p < 0.05), and that using the "Clean-Area-System" combined with the "Extra-Oral-Vacuum-Aspirator" is desirable in dental procedures such as cavity preparation. The "Extra-Oral-Vacuum-Aspirator" reduced airborne environmental contamination during tooth cutting and ultrasonic scaling procedures. In non-grinding procedures, this system proved to be very useful for infection control in the operative area. The authors concluded that the combined use of "Clean-Area-System" (dust collection ablation) and "Extra-Oral-Vacuum-Aspirator" (absorb dust ablation) was effective to reduce airborne environmental contamination in the dental clinic. We also fully confirmed that oral streptococci were an adequate indicator in the assessment for infection control in dental institutions.

Air Conditioning↗
PubMed2002

Survey of infection control training program graduates: long-term care facility and small hospital practitioners.

Graduates of a 2-day basic training course in infection control were surveyed. Respondents were generally from Midwestern long-term care facilities and small hospitals. These infection control practitioners had multiple roles in addition to infection control, most notably employee health and quality assurance. Infection control practitioners demonstrated significant job stability. The vast majority of institutions where survey respondents were employed followed recommended infection control practices.

Career Mobility↗
PubMedDate not supplied

Design, devices, and discipline in operating room infection control.

The prevention of surgical infection in the operating theatre is a complex pursuit. Every facet of activity, whether it is part of the surgical act itself or a remote activity with indirect effects on the surgical operation, constitutes part of the whole realm of infection control. These many facets may be divided into four main components, all interdependent: (a) the surgeon and his team (surgical technique; adherence to surgical anatomic, physiologic, and aseptic principles; discipline); (b) education and communiction--a functioning infections committee, repeated tutorials for all prefessional and technical operating room personnel, constant review of methods and systems, effective reporting of offenses, enforcement of discipline; (c) dependable support services--sterilizing techniques, barrier materials, apparel, laundry methods; materials handling and processing methods; efficiency and personal hygiene of all techincal and support personnel; discipline; and (d) environmental factors--architecture, engineering, and air handling; electrical and mechanical requirements; communication; discipline).

Air Microbiology↗
PubMed1999

Infection control and changes in management of hospitals: the European experience.

The general setting for the management of many European hospitals has undergone enormous changes during the last five to 10 years, especially with respect to economic, personnel and technical resources. This change has had a serious influence on the practice of infection control. To get an insight of the problems infection control practitioners in Europe today have to face, hospital epidemiologists representing nine European countries were asked to answer a questionnaire. In most countries, new laws on communicable disease prevention and infection control in hospitals have been implemented during the last few years. In conjunction with the widespread introduction of quality assurance and the accreditation of hospitals, organizational aspects of infection control have gained importance. However, budget restrictions and the growing competition between institutions are major challenges. In general, there has been a remarkable influence of the documented changes on the practice of infection control in European hospitals. Facing this situation, infection control practitioners should abandon unproven measures and implement those that are evidence-based, to prevent hospital acquired infection (HAI). Cost reducing initiatives, like the use of well designed multi-use devices and the reuse of disposables should be considered and scientifically assessed.

Cross Infection↗
PubMed1999

Joint Commission standards for long-term care infection control: putting together the process element. Joint Commission on Accreditation of Healthcare Organizations.

Infection control in long-term care is being recognized more and more as the essential entity it has always been. As a surveyor for the long-term care program of the Joint Commission on Accreditation of Healthcare Organizations, I have noted that some confusion exists in the field as to what aspects of an infection control program are to be surveyed at specific standards. The standards are designed to allow flexibility to ensure that infection control programs meet the specific needs of the resident population and that these programs can continue to evolve. This article attempts to provide some clarity for the infection control professionals who are preparing for Joint Commission survey.

Cross Infection↗
PubMed1999

Infection control practices across Canada: do dentists follow the recommendations?

This study investigated provincial and territorial differences in dentists' compliance with recommended infection control practices in Canada (1995). Questionnaires were mailed to a stratified random sample of 6,444 dentists, of whom 66.4% responded. Weighted analyses included Pearson's chi-square test and multiple logistic regression. Significant provincial and territorial differences included testing for immune response after hepatitis B virus (HBV) vaccination, HBV vaccination for all clinical staff, use of infection control manuals and post-exposure protocols, biological monitoring of heat sterilizers, handwashing before treating patients, using gloves and changing them after each patient, heat-sterilizing handpieces between patients, and using masks and uniforms to protect against splatter of blood and saliva. Excellent compliance (compliance with a combination of 18 recommended infection control procedures) ranged from 0% to 10%; the best predictors were more hours of continuing education on infection control in the last two years, practice location in larger cities (> 500,000) and sex (female). Clearly, improvements in infection control are desirable for dentists in all provinces and territories. Extending mandatory continuing education initiatives to include infection control may promote better compliance with current recommendations.

Canada↗
PubMed1995

Training the work force--models for effective education in infection control.

The education of hospital staff for infection control is really a form of adult education in which there are two important priorities: to teach what the student wants to know and to deliver knowledge that the student can use. Techniques developed in the industrial and commercial fields can be adapted to deal with these issues in the hospital. A 'total quality management' customer survey for infection control was conducted to identify services that are considered helpful by hospital staff and to identify topics that they want to know about. A 'task analysis' was carried out to determine the tasks performed by different categories of staff, because an education programme that focuses on tasks the staff performed, will be delivering knowledge that they can use. Finally, a scheme for identifying strategic areas for education, when a guideline is implemented, is described.

Adult↗
PubMed2004

Using indicator development to revise infection control activities in an acute NHS trust.

AIM: This paper describes a 2-year project to facilitate improved infection control within an acute National Health Service trust. BACKGROUND: Organizational support, broad ownership of issues and adequate resources are needed to enable good infection control to underpin improvements in care. METHOD: Development of indicators, agreed at a stakeholder workshop, was used as a focus. The Infection Control Team was expanded. RESULTS: The team has a wider skills base and can deliver proactive and reactive services in closer collaboration with clinicians, especially modern matrons. The infection control committee has been reconstituted and become more effective. There have been demonstrable health and financial gains over 2 years, and improved performance against national standards. CONCLUSION: Focusing on indicator development enabled key stakeholders to gain a collective appreciation of the issues that the trust faced, increased ownership of agreed actions and rooted infection control activity in trust mechanisms for monitoring and business planning.

Hospitals, Public↗
PubMed1995

Infection control and human immunodeficiency virus: perceptions of risk among nurses and hospital domestic workers.

In December 1993 the first case of patient-to-patient transmission of human immunodeficiency virus (HIV), at a doctor's surgery in New South Wales, was documented. In an environment of heightened anxiety about HIV transmission and the adequacy of infection-control measures taken by health providers, it is important to explore perceptions of occupational risk of exposure to infection among hospital workers, reasons why hospital domestic workers sometimes depart from standard procedure in infection control, and how they regard the patients who have infectious diseases. In this study, at an infectious diseases hospital where there is an acute awareness of such issues, nurses had accurate knowledge about control of infection, including HIV, but had limited trust of that knowledge. They gave rationales for why they sometimes departed from infection-control procedures. They had low levels of fear of homosexuals and of acquired immune deficiency syndrome. The hospital domestic workers had lower levels of accurate knowledge about infection control, including HIV, and less trust of that knowledge and of protection by health provider from occupational exposure to infection. They had low levels of fear of homosexuals and HIV. Both groups sought regular, small-group, interactive education programs on infection control and HIV to allow them to discuss their concerns. Participatory education of workers should include eliciting concerns of participants, and should discuss concerns regarding administrators' and educators' interests in their safety and wellbeing.

Adult↗
PubMed1998

Infection control in the outpatient setting.

This article discusses aspects of ambulatory care that increase the difficulty of practicing infection control in this setting or that require infection control staff to use different methods than they would use in the inpatient setting. The article reviews basic infection control precautions that apply to the outpatient setting in general and specific precautions that apply to dialysis centers and physical therapy programs. The article also describes outbreaks that have occurred in the outpatient setting, defines the deficiencies in infection control practice that caused the outbreaks, and discusses methods to prevent transmission of pathogens in the outpatient setting.

Ambulatory Care Facilities↗
PubMed2000

A data mining system for infection control surveillance.

Nosocomial infections and antimicrobial resistance are problems of enormous magnitude that impact the morbidity and mortality of hospitalized patients as well as their cost of care. The Data Mining Surveillance System (DMSS) uses novel data mining techniques to discover unsuspected, useful patterns of nosocomial infections and antimicrobial resistance from the analysis of hospital laboratory data. This report details a mature version of DMSS as well as an experiment in which DMSS was used to analyze all inpatient culture data, collected over 15 months at the University of Alabama at Birmingham Hospital.

Alabama↗
PubMed2001

Developing an infection control for anaesthetic equipment.

Hospital risk management demands the development of broad and inclusive infection control policies. This is particularly true for anaesthetic equipment where appropriate recommendations on decontamination measures remains a difficult subject for infection control teams since there are no national guidelines. It is a topic which has perhaps been neglected in hospital infection control policies despite the widespread use of anaesthetic equipment in many clinical areas outside the theatre complex. This article offers practical guidance when preparing an infection control policy for anaesthetic equipment. The cost effectiveness of single patient use items versus reprocessing equipment is discussed. The importance of a multi-disciplinary approach, especially where the evidence base is weak, is highlighted.

Anesthesiology↗
PubMed1993

Prevalence of infections and use of antibiotics among hospitalized patients in Mauritius. A nationwide survey for the planning of a national infection control programme.

As part of a programme for improving hospital infection control in Mauritius a nationwide survey, including a prevalence study, was carried out in order to identify characteristics of the hospitals, the population, and the infections. Community-acquired infections were three times more prevalent than nosocomial infections: 15.0% and 4.9%, respectively. Surgical wound infection was by far the most common nosocomial infection, with a prevalence rate of 8.2 per 100 operations, followed by urinary tract infection with a low rate of 0.8 per 100 admissions. The survey showed that these hospitals in Mauritius housed mainly a young population (mean of 36.8 years for females and 39.4 years for males) with few risk factors for acquiring nosocomial infection. Although diabetes mellitus is prevalent in Mauritius the diagnosis of diabetes was not associated with nosocomial infection. The spectrum of operations offered was limited, and Caesarean section was the most prevalent operation. The amount and types of antibiotics used in hospitalized patients were recorded. More than one third of the patients received antibiotic treatment at the time of the survey, which is comparable to figures reported from large teaching hospitals in Western Europe. The information gathered from the survey, the interviews and the inspection were used to establish priorities for a collaborative programme for improved infection control. It included the draft of a set of custom-made guidelines, which were eventually studied by staff members from hospitals in Mauritius during a training period in Denmark. We believe that a prevalence survey is useful for initiating infection control programmes in hospitals in developing countries.

Adult↗
PubMed1995

Infection control programmes--are they cost-effective?

Infection control (IC) programmes are cost-effective in the long-term but much depends on the available resources and the support from management. The funding of IC programmes at present is linked to the Microbiology Department and a separate budget needs to be established. The best use of resources is to apply a risk assessment to each situation which presents and to adapt protocols accordingly. For example, the treatment of a carrier or an infected patient with methicillin-resistant Staphylococcus aureus cost 374 pounds and 2454 pounds, respectively in 1993, the major portion of the cost being due to an increased length of stay which was two days and 10 days, respectively. It is more cost-effective to treat carriers. The other cost-effective investment is in education and reinforcement of simple messages. Formal lectures seem to be the least effective way of producing long-term effect; frequent ward visits or contacts are most effective. Also, there is better compliance when there is a perceived risk to the staff themselves. The availability of the IC team to advise helps reduce waste and therefore cost. This is particularly true of antibiotic usage where it was noted that without guidance, the antibiotic usage increased by 2000 pounds per month when compared to a similar period in the previous year. The available provisions for IC programmes in the UK are utilized exceptionally well when compared with other countries.

Anti-Bacterial Agents↗
PubMed1990

Infection control in the nursing home: the physician's role.

Infection control in the nursing home or long-term care facility is an increasingly complex activity. The high rates (approximately 15%) and special risks (group activities, crowding) for nosocomial infection demand special attention by attending physicians. Some specific responsibilities include: recognition of infection; knowledge and use of basic infection control principles; appropriate antibiotic use; review of immunizations; facilitation of communications among office, hospital, and long-term care facility; and involvement with infection control program(s).

Allied Health Personnel↗
PubMed1995

Evaluation of infection control measures in preventing the nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis in a New York City hospital.

OBJECTIVE: To evaluate the efficacy of Centers for Disease Control and Prevention (CDC)-recommended infection control measures implemented in response to an outbreak of multidrug-resistant (MDR) tuberculosis (TB). DESIGN: Retrospective cohort studies of acquired immunodeficiency syndrome (AIDS) patients and healthcare workers. The study period (January 1989 through September 1992) was divided into period I, before changes in infection control; period II, after aggressive use of administrative controls (eg, rapid placement of TB patients or suspected TB patients in single-patient rooms); and period III, while engineering changes were made (eg, improving ventilation in TB isolation rooms). SETTING: A New York City hospital that was the site of one of the first reported outbreaks of MDR-TB among AIDS patients in the United States. PARTICIPANTS: All AIDS patients admitted during periods I and II. Healthcare workers on nine inpatient units with TB patients and six without TB patients. RESULTS: The epidemic (38 patients) waned during period II and only one MDR-TB patient presented during period III. The MDR-TB attack rate among AIDS patients hospitalized on the same ward on the same days as an infectious MDR-TB patient was 8.8% (19 of 216) during period I, decreasing to 2.6% (5 of 193; P = 0.01) during period II. In a small group of healthcare workers with tuberculin skin test data, conversions during periods II through III were higher on wards with than without TB patients (5 of 29 versus 0 of 15; P = 0.15), although the difference was not statistically significant. CONCLUSIONS: Transmission of MDR-TB among AIDS patients decreased markedly after enforcement of readily implementable administrative measures, ending the outbreak. However, tuberculin skin-test conversions among healthcare workers may not have been prevented by these measures. CDC guidelines for prevention of nosocomial transmission of TB should be implemented fully at all US hospitals.

AIDS-Related Opportunistic Infections↗