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PubMed2004

Infection control in cystic fibrosis.

Over the past 20 years there has been a greater interest in infection control in cystic fibrosis (CF) as patient-to-patient transmission of pathogens has been increasingly demonstrated in this unique patient population. The CF Foundation sponsored a consensus conference to craft recommendations for infection control practices for CF care providers. This review provides a summary of the literature addressing infection control in CF. Burkholderia cepacia complex, Pseudomonas aeruginosa, and Staphylococcus aureus have all been shown to spread between patients with CF. Standard precautions, transmission-based precautions including contact and droplet precautions, appropriate hand hygiene for health care workers, patients, and their families, and care of respiratory tract equipment to prevent the transmission of infectious agents serve as the foundations of infection control and prevent the acquisition of potential pathogens by patients with CF. The respiratory secretions of all CF patients potentially harbor clinically and epidemiologically important microorganisms, even if they have not yet been detected in cultures from the respiratory tract. CF patients should be educated to contain their secretions and maintain a distance of >3 ft from other CF patients to avoid the transmission of potential pathogens, even if culture results are unavailable or negative. To prevent the acquisition of pathogens from respiratory therapy equipment used in health care settings as well as in the home, such equipment should be cleaned and disinfected. It will be critical to measure the dissemination, implementation, and potential impact of these guidelines to monitor changes in practice and reduction in infections.

Cystic Fibrosis↗

PubMed1995

Infection control in public hospitals.

Public hospitals face challenging infection control problems that differ from those in other hospitals. This article reviews some of the unique aspects of infection control in public hospitals, including governance, physical plant, patient mix, communicable diseases, and employee issues, and suggests management strategies.

Facility Design and Construction↗

PubMed2006

Poor hospital infection control practice in hand hygiene, glove utilization, and usage of tourniquets.

BACKGROUND: Hospital-acquired infection often occurs because of lapses in accepted standards of practice on the part of health care personnel. The aim of this study is to attract attention on poor hospital infection control practice in venepuncture and use of tourniquets and emphasize the importance of hand hygiene. METHODS: Overall compliance with hygiene during usage of tourniquets and routine patient care before and after implementation of a hospital infection control measures was evaluated. RESULTS: According to the questionnaire, only 26.9% of respondents always washed their hands both before and after venepuncture. In the second step of the study, based on direct observation, hands were washed both before and after venepuncture on only 41 (45.1%) occasions. Failure to remove gloves after patient contact was observed on 23.1% occasions. CONCLUSION: Our survey reveals poor infection control practice in hand hygiene, glove utilization, and usage of tourniquets and the implementation of infection control measures produced a moderate improvement in compliance with them.

Cross Infection↗

PubMed1996

The development of an infection control link-nurse programme in a district general hospital.

Management of hospital-acquired infection is costly, and a vital part of risk management. It is also closely linked with the quality of patient care. Information regarding hospital-acquired infection is increasingly being sought by both purchasers and providers. This paper describes the setting up and development of an infection control link-nurse system over a four-year period in a district general hospital. It gives practical details of methodology and problems encountered. Emphasis is given to the incorporation of infection control principles into ward and departmental standard setting. Having set up the system, subsequent monitoring of the process by a clinical audit programme is described. The importance of the responsibility of staff, at ward and departmental level, in high-level infection control practice is discussed.

Hospitals, District↗

PubMed1999

[Tuberculosis infection control practice in hospitals from the viewpoint of occupational health].

Several outbreaks of tuberculosis (TB) among health care workers were reported recently in Japan. To assess the current situation of TB infection control practice in hospitals in Japan from the viewpoint of occupational health, we carried out a cross sectional survey by mail-questionnaires. The questionnaires with closed and open-ended questions to ask situation of TB infection control program in hospital were mailed to 542 hospital chiefs in and around Tokyo, Kantoh district. 269 replies were received. We analyzed them especially focussing on the prevention of TB among health care workers. Out of 269 hospitals replied, 39 of them had wards and/or beds designated for tuberculosis patients, 223 did not have, and 7 were unknown. 102 (38.9%) had set written tuberculosis infection control programs or guidelines, only 21 (53.8%) have set them even in hospitals with TB beds. 110 (42.0%) hospitals had triage system for identifying patients with active TB in the outpatient setting. Although, most health care workers underwent annual health check programs including chest X-rays, only 67 (25.6%) of the hospitals provide tuberculin skin test to their new recruits. 165 (63.0%) of hospitals admit that undiagnosed patients with respiratory symptoms may stay with immuno-compromised patients in the same room. Since administrative management, staff education, environmental control in work place, personal infection control and individual health care should be carried out from the viewpoint of occupational health, we showed concrete steps of these in this paper. We recommend that a TB infection control manager in each hospital should be designated, and that TB infection control program and/or guideline should be made. Environmental control in work place to prevent infection should be more prioritized in Japan.

Cross Infection↗

PubMed1997

Diploma in Hospital Infection Control (Dip HIC)

The London School of Hygiene and Tropical Medicine (LSHTM) has established a Diploma in Hospital Infection Control (Dip-HIC). The course for this new Diploma is run under the auspices of the Hospital Infection Society (HIS) and the Public Health Laboratory Service (PHLS) and will commence in October 1997. The aim of this course is to provide infection control staff with systematic training in the sciences relevant to hospital infection control which will allow them to provide, and to take responsibility for, a broad-based infection control service. Topics will include the epidemiology of infectious diseases, clinical microbiology, health care economics, statistics, surveillance methods and patient management. The course will be multi-disciplinary and open to UK and overseas students, both medical and non-medical.

Certification↗

PubMed1996

Impact of an infection control program in a specialized preschool.

BACKGROUND: The purpose of this study was to design and implement a comprehensive infection control program and measure its effects on the number and types of infectious illnesses experienced by children attending a specialized preschool program. METHODS: Participants in the study were children with Down syndrome enrolled in a school-based early intervention program. The ages of the children ranged from 6 weeks to 5 years. Through a series of parental questionnaires, the number and types of infections in the children were chronicled for a year before and a year after the implementation of an infection control intervention program. Interventions included infection control lectures, handouts, posters, and attention to environmental cleaning and disinfection, with an emphasis on toys. Compliance with these measures was monitored and recorded. RESULTS: During the interventional year the median number of total illnesses/child/month decreased significantly from the baseline year (0.70 vs 0.53, p < 0.05), with a trend toward a decrease in the number of respiratory illnesses (0.67 vs 0.42, p < 0.07). Significant decreases were also seen for the median number of physician visits (0.50 vs 0.33, p < 0.05), courses of antibiotics administered (0.33 vs 0.28, p < 0.05), and days of school missed as a result of respiratory illness (0.75 vs 0.40, p < 0.05). CONCLUSIONS: This study demonstrates a decrease in infection rates with the implementation of a comprehensive educational and environmental infection control program in a day care setting.

Child, Preschool↗

PubMed1998

Today's minimal requirements for a practical dental office infection control and exposure control program.

The current climate in society regarding infectious diseases in general, and herpes, hepatitis, and HIV infections in particular, dictates that today's dental practices must use effective infection control techniques. The Occupational Safety and Health Administration continues to inspect, cite, and fine health care facilities. More states are implementing regulations concerning the operation of health care facilities. Patients are becoming more sophisticated in their scrutinizing of the dental and medical professions' approach to asepsis. Media coverage of exposure incidents is becoming more intense. All these factors leave dentists no choice; they must implement appropriate infection control techniques. The life-time cost of effective infection control is far less than one malpractice settlement. Implementation of an effective infection control program to promote dental asepsis can be cost-effective. In addition, it can be a practice builder.

Asepsis↗

PubMed1988

Infection control in critical care.

Most common nosocomial infections in the intensive care setting are nosocomial urinary tract infections, nosocomial pneumonia, and intravascular line-related infections. Patients in the intensive care setting rapidly become colonized by nosocomial gram-negative organisms. The colonization of the patient precedes actual infection and provides some indicator of the microflora of the intensive care unit as well as early warning of the potential for outbreaks in the unit. Infection control in the intensive care unit is of vital importance in preventing colonization of microbes as well as in the recognition and interruption of outbreaks of nosocomial infections. In this article are discussed nosocomial infections in patients in the intensive care unit from the infection control standpoint.

Critical Care↗

PubMed1993

Infection control for the dental hygienist of the nineties. Part 2: Sterilization, operatory asepsis, and instrument recirculation.

Adaptation of state-of-the-art infection control practices by the dental hygienist and all oral care team members is an essential component of clinical practice, but time consuming as well. In a busy practice, some clinicians and staff personnel may implement infection control shortcuts that might save time, but compromise safety. Additionally, since microorganisms cannot be seen, some staff may have a difficult time relating to the real threat of cross infections in the oral care environment and resist complying with recommended protocols. Dental hygienists, as licensed oral care specialists, are ideal candidates for leadership roles in office infection control policies and procedures. Through the use of consistent and conscientious infection control measures, the dental hygienist can serve as a role model to others in the oral care setting and, at the same time, help ensure a safe working environment. As an office leader in infection control the dental hygienist should strive to stay current as new products, technologies and protocols are continually evolving.

Asepsis↗

PubMed2001

The role of the infection control nurse as a clinical nurse specialist or advanced nurse practitioner.

The specialty of infection control is examined regarding the role of the infection control nurse and the educational requirements for practitioners in this field in relation to post titles of clinical nurse specialist and advanced nurse practitioner. Whilst not fulfilling all the role constituents of a clinical nurse specialist, the infection control nurse is seen as more akin to a clinical nurse specialist than an advanced nurse practitioner.

Cost-Benefit Analysis↗

PubMed2005

Redesigning an infection control application to support an enterprise model.

As the demands on hospital infection control teams increase, it becomes less efficient for them to use paper-based surveillance methods. The existing electronic infection control surveillance system at our largest facility was not designed to support a multi-hospital model. Our goal was to redesign the application using generic, open source technologies, and make it flexible enough to support the infection control surveillance needs of the entire enterprise.

Cross Infection↗

PubMedDate not supplied

Infection control activities in six hospitals: a comparison.

Using a case study design, the aim of this research was to assess and evaluate the activities of the infection control departments in six hospitals. An additional aim was to examine the knowledge base of nursing staff in the clinical setting with regard to hospital policy and systems of infection control audit. The results from the study indicate that five hospitals used an infection control audit tool based on the same content. Nursing staff in the clinical areas that were surveyed had limited knowledge with regards to infection control policies, budgets and risk assessment. The value of education to improve standards of infection control within these hospitals was clearly demonstrated.

Hospital Administration↗

PubMed2004

Guidelines for infection control in dental health care settings--2003.

BACKGROUND: The Centers for Disease Control and Prevention, or CDC, is the lead federal agency for disease prevention in the United States. It has been 10 years since CDC infection control guidelines for dental health care settings were last published. During those 10 years, new technologies and issues have emerged, and other CDC infection control guidelines for health care settings have been updated. RESULTS: In light of these developments, CDC collaborated with experts in infection control to revise its infection control recommendations for dental health care settings. Existing guidelines and published research pertinent to dental infection control principles and practices were reviewed. This article provides background information, describes the process used to create these guidelines, and lists the new recommendations. CLINICAL IMPLICATIONS: CDC believes that dental offices that follow these new recommendations will strengthen an already admirable record of safe dental practice. Patients and providers alike can be assured that oral health care can be delivered and received in a safe manner.

Blood-Borne Pathogens↗

PubMed2000

Study of nosocomial respiratory infections and nurses' performance related to infection control measures in artificially ventilated patients.

The aim of this study was to assess nurses' performance related to control and prevention of nosocomial respiratory infection in artificially ventilated patients and to estimate incidence and the causative microorganisms of such infection. The study was conducted on 30 ventilated patients and 30 nurses who were responsible for their care. An observation checklist was used to assess nurses' practices regarding daily care activities, ventilator decontamination, use of universal infection control measures and maintenance of the patients' care environment. A second sheet was developed to estimate incidence of nosocomial respiratory infection and identification of the causative microorganisms. A third sheet was designed to help in daily assessment of the patient's health condition. The study revealed a high incidence of nosocomial respiratory infections (83.3%) and pseudomonas was the causative agents in more than one-fourth of the cases. Moreover, nurses' infection control practices were inadequate.

Adult↗

PubMedDate not supplied

Skin penetration operators' knowledge and attitudes towards infection control.

OBJECTIVES: To assess the knowledge and attitudes of owners/managers of commercial skin-penetration premises regarding infection control. METHODS: A telephone survey was conducted with a randomly selected sample of 874 owners/managers. RESULTS: Participants appeared to lack knowledge of essential infection-control practices. Less than 39% correctly identified recommended disinfection procedures, and between 12% to 67% were not aware of inappropriate sterlization procedures. Almost all participants accepted the need for guidelines. Half acknowledged a need to improve their infection-control compliance, and most accepted having their premises regularly checked by the councils. CONCLUSIONS: There is a considerable opportunity to increase infection-control compliance among skin-penetration operators.

Adult↗

PubMed1994

A multimedia system for infection control education.

We developed a computer system for infection control education utilizing multimedia including video presentation. To evaluate the efficiency of the system, trial sessions were held among dental students attending final year of clinical courses. According to our results of comparison between pre and post assessment tests among these students, we concluded that this system has a great potential and advantages for achieving certain level of knowledge of infection control in limited amount of time.

Computer-Assisted Instruction↗

PubMed1991

The use of personal computers in hospital infection control.

The storage, retrieval and analysis of hospital infection data is best performed by using computers. Many laboratory mainframe systems have infection control modules and there are some commercial programs for personal computers (PCs). An alternative is to use business and statistical PC software. Because of their large customer base these programs are reliable and easy to use yet extremely sophisticated and flexible, and they can be easily customized for use in infection control. Many combinations of software and hardware are available but the ones described here have been used successfully for several years at the Prince of Wales Hospital in Hong Kong.

Computer Graphics↗