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Results for “Infection Control”

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At least 451 records · Page 25Linked to original sources

PubMed2005

Nursing and infection-control issues during high-frequency oscillatory ventilation.

OBJECTIVES: To review the specific nursing and infection-control issues that arise during the care of patients receiving high-frequency oscillatory ventilation (HFOV). DATA SOURCE: Published articles, governmental guidelines, and hospital procedures and practices. DATA SUMMARY: Nurses, respiratory therapists, and other clinicians caring for patients receiving HFOV need to be aware of specific differences in patient assessment, including close observation for symmetric chest-wall vibrations. In addition, management of sedation with or without neuromuscular blockade and effective communication with the patients are essential nursing skills needed with the use of HFOV. From an infection-control standpoint, HFOV is considered a high-risk respiratory procedure because of the inability to effectively filter all respiratory secretions. Appropriate infection-control precautions, including patient location and use of personal protective equipment, need to be considered when implementing HFOV in the intensive care unit. CONCLUSIONS: Important infection-control and nursing issues exist that are specific to the use of HFOV. These issues should be addressed with appropriate staff education before the implementation of HFOV in an intensive care unit.

High-Frequency Ventilation↗

PubMed1999

Putting infection control principles into practice in home care.

Implementing sound, rational infection control practices in home care has been challenging since guidelines, standards, and most references have been developed for the acute care setting. This article provides guidance for adapting appropriate infection control interventions for patient care practices to the home care setting. Such practices include handwashing, home infusion therapy, respiratory care, wound care, urinary tract care, and isolation precautions. Assessment of the home care environment, cleaning and reprocessing of equipment, surveillance, implications for occupational health, and program design are also discussed.

Home Care Services↗

PubMed1999

Vancomycin-resistant enterococci in intensive-care hospital settings: transmission dynamics, persistence, and the impact of infection control programs.

Vancomycin-resistant enterococci (VRE) recently have emerged as a nosocomial pathogen especially in intensive-care units (ICUs) worldwide. Transmission via the hands of health-care workers is an important determinant of spread and persistence in a VRE-endemic ICU. We describe the transmission of nosocomial pathogens by using a micro-epidemiological framework based on the transmission dynamics of vector-borne diseases. By using the concept of a basic reproductive number, R0, defined as the average number of secondary cases generated by one primary case, we show quantitatively how infection control measures such as hand washing, cohorting, and antibiotic restriction affect nosocomial cross-transmission. By using detailed molecular epidemiological surveillance and compliance monitoring, we found that the estimated basic reproductive number for VRE during a study at the Cook County Hospital, Chicago, was approximately 3-4 without infection control and 0.7 when infection control measures were included. The impact of infection control was to reduce the prevalence from a predicted 79% to an observed 36%. Hand washing and staff cohorting are the most powerful control measures although their efficacy depends on the magnitude of R0. Under the circumstances tested, endemicity of VRE was stabilized despite infection control measures, by the constant introduction of colonized patients. Multiple stochastic simulations of the model revealed excellent agreement with observed pattern. In conjunction with detailed microbiological surveillance, a mathematical framework provides a precise template to describe the colonization dynamics of VRE in ICUs and impact of infection control measures. Our analyses suggest that compliance for hand washing significantly in excess of reported levels, or the cohorting of nursing staff, are needed to prevent nosocomial transmission of VRE in endemic settings.

Anti-Bacterial Agents↗

PubMed1994

Nurses' views of infection control: an interview study.

An interview study was conducted among 173 nurses in two hospitals to explore their views concerning infection risks to themselves and patients and to identify any problems they perceived in safely performing infection control precautions during routine activities. Subjects were interested in the topic of infection control and keen to perform optimally, but perceived difficulties related to lack of expert guidance whether or not they had access to an infection control nurse. In one hospital subjects identified shortages of vital equipment (gloves, appropriate handwashing agents), and this was corroborated on a checklist used independently to document the availability of resources. When the opinions of nurses working in intensive care, surgical and medical units were compared, few differences emerged other than those explained by variation in supplies of equipment, except that intensive care unit nurses were more likely to rate their patients and themselves as particularly at risk of infection, Nurses who had been qualified longer, with more than 3 years experience in their specialty, were more conscious of infection risks.

Cross Infection↗

PubMed1990

Infection control practices and beliefs of Minnesota dental hygienists and dental assistants.

To obtain comprehensive information about the knowledge, attitudes, and practices of Minnesota dental hygienists and registered dental assistants, a questionnaire was mailed to random samples of both groups in the fall of 1988. Most assistants and hygienists claimed to always wear gloves, but substantially fewer indicated always wearing a mask. Use of eye protection showed even lower compliance, with less than half of either group routinely using protective eyewear or a face shield. Assistants and hygienists reported incurring numerous needlesticks and instrument injuries. A contributing factor may be that many staff were still recapping needles with an unprotected hand. Most people who had not been vaccinated against hepatitis B said that they would be immunized if their employer or health insurance paid for it. Less than one-half of either group felt knowledgeable about infection control. Only one-third of assistants and less than one-half of hygienists claimed to be familiar with the Centers for Disease Control's "Recommended Infection Control Practices for Dentistry." This is consistent with assistants' and hygienists' reported infection control related behaviors. Other than gloving, many recommended infection control measures--masking, wearing protective eyewear and uniforms, hepatitis B immunization, and proper handling of sharps--were not employed by a substantial number of respondents. Many respondents indicated insufficient knowledge to safely and effectively care for patients with hepatitis B, hepatitis B carriers, or individuals infected with the human immunodeficiency virus (HIV). This is reflected in the relatively small percentages of respondents who indicated willingness to treat these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Communicable Disease Control↗

PubMed1989

Surveillance for quality assessment: I. Surveillance in infection control success reviewed.

This review of the use of surveillance by infection control practitioners (ICPs) in nosocomial infection control programs has identified key components that have led to and supported its continued application and success. These include: Surveillance targeting of events (diseases); Early development of standardized definitions; Wide acceptance of these criteria; Advocacy, leadership and education of methodology and; A high level of effectiveness in program practice.

Communicable Disease Control↗

PubMed1997

Role of molecular epidemiology in infection control.

Molecular typing methods have enabled infection control personnel to investigate outbreaks and endemic nosocomial infections more quickly and thoroughly than they could have with basic epidemiologic and microbiologic methods. This article reviews molecular typing methods that have been used successfully in the practice of hospital epidemiology. Included is an explanation of the basic principles of these methods and a description of their strengths and weaknesses.

Cross Infection↗

PubMed1996

Creative infection control.

In spite of the widespread use of educational programmes, there still remains a low staff knowledge and non-compliance of infection control policies. In order to overcome these problems we have attempted to increase interest and raise awareness of infection control by introducing a motivational programme termed Creative Infection Control. Some of the activities are illustrated and are loosely structured, and rely largely on humour and intergroup competition. These methods are based on sound psychological principles with an emphasis on adult-learning theory. Objective measures indicate that such programmes can significantly influence infection control outcomes.

Adult↗

PubMed1993

Spearheading the fight against infection. The role of the infection control nurse.

Prevention of nosocomial and cross-infection is essential, as it has physical and psychosocial implications for patients. The infection control nurse role has evolved over time, with different emphases being placed on the various role components. Specialist roles have been much debated, and it is important that specialist nurses reflect on and evaluate their practice. Further education must be undertaken to prepare ICNs for the diversity of their role.

Clinical Competence↗

PubMed1995

Infection control in a country with annual inflation of 3,600%.

The economic crisis that has been seen worldwide affects developing countries such as Brazil even more severely. Worsening budget shortfalls for the healthcare system progressively threaten patients care. Infection control programs also are affected, and basic preventive policies are not implemented. Infection control practitioners face lack of equipment and poor microbiological support. In contrast, the motivation of the infection control people can be maintained through training courses, conferences, and meetings. Administrative support may be the most important single factor determining success in decreasing the infection control rate and should be (but is not always) provided, given that several infection control measures are cost effective.

Brazil↗

PubMed1999

The role of age- and population-based differences in the attitudes, knowledge and infection control practices of Canadian dentists.

OBJECTIVES: To investigate age- and population-based differences in dentists' infection control practices and willingness and refusal to treat patients with HIV. METHODS: A national mailed survey of a stratified random sample of dentists in Canada (n = 6444) with three follow-up attempts. Pearson's chi-square test and multiple logistic regression were used for data analysis. Predictor variables included population, age, gender, marital status, specialty, number of patients treated per day and continuing education on HIV/AIDS. RESULTS: The adjusted response rate was 66.4%. The best predictors of willingness to treat patients with HIV were younger age (compared with dentists > or = 60 years of age: < 30 years, OR = 8.6, 30-39, OR = 3.4; 40-49, OR = 2.7; 50-59, OR = 1.6), attending continuing education on HIV/AIDS in the past 2 years (> 10 hours, OR = 1.6 compared with zero hours), practicing in small population centres < 10,000 (OR = 1.6 compared with > 500,000) and gender (male OR = 1.3). The best predictors of refusal to treat patients with HIV were older age (compared with dentists < 30 years of age: > or = 60, OR = 6.1; 50-59, OR = 4.1; 40-49, OR = 3.0; 30-39, OR = 2.6); and practicing in population centres > 500,000 (OR = 1.5 compared with < 10,000). However, the latter group also reported treating more HIV patients than respondents in smaller communities. Infection control practices varied significantly with age and population centre. Dentists in communities of < 10,000 were more compliant with HBV vaccination, but less compliant with handwashing after degloving and the use of infection control manuals. Similarly, dentists > 60 years of age were the least compliant with HBV immunization, routine use of barriers and sterilization of handpieces, but reported the highest compliance with handwashing. CONCLUSIONS: Age- and population-based differences need to be considered in planning educational interventions to improve both access to care for patients with HIV and dentists' compliance with recommended infection control procedures.

Adult↗

PubMedDate not supplied

Infection control practices in Minnesota nursing homes.

Because infection is a major cause of hospitalization among nursing home residents, we assessed infection control activities and related employee health policies in Minnesota nursing homes, using a questionnaire. The majority of institutions (378/440, 85.9%) responded. We found traditional isolation techniques were widely used, but blood and urine precautions were employed in less than half of the homes. Infection surveillance tended to focus on chart review. Antibiotic utilization studies were done in 76% of homes. Procedures for urinary catheter care were often at variance with current recommendations. Employee health policies required a physical examination of a new employee in a minority of institutions. Policies required by Minnesota statute (eg, skin testing for tuberculosis and documentation of employee illness) were carried out by most institutions. Infection control policies and procedures in nursing homes should be redefined so that, where appropriate, they are more consistent with practices in acute-care hospitals.

Aged↗

PubMed1991

Power and motivation: important concepts for infection control practitioners.

Organizations are composed of people vying with one another for power. Failure to acquire it may result in a limited ability to have an impact on organizational politics, and ultimately can lessen the success of motivating personnel. Therefore, using the power sources described to acquire power and developing strategies to motivate others are essential in attaining the goals of an infection control program. In summary, infection control practitioners have tended to focus on the technical aspects of their roles and may have neglected the development of influencing and motivational strategies that well could have an impact on improving compliance to infection control. Knowledge of key concepts, such as power and motivation, should be as important as any component of an infection control practitioner's training.

Behavior↗

PubMed2004

Infection control practices for SARS in Lao People's Democratic Republic, Taiwan, and Thailand: experience from mobile SARS containment teams, 2003.

BACKGROUND: Despite available recommendations on infection control for severe acute respiratory syndrome (SARS), information is limited on actual practices in Asian hospitals during the epidemic. We describe practices observed by mobile SARS containment teams (mobile teams) during outbreak investigations. METHODS: We retrospectively summarized infection control practices observed in hospitals visited by mobile teams in the Lao People's Democratic Republic (PDR), Taiwan, and Thailand, during March and April 2003. RESULTS: Mobile teams investigated 22 reports of SARS in 20 hospitals (1, 5, and 14 hospitals in Lao PDR, Taiwan, and Thailand, respectively). Facilities ranged from urban hospitals with negative-pressure isolation rooms and high-efficiency particulate air filtration to rural hospitals with patient rooms open to outside air circulation and intermittent running water. At the time of mobile team visits, 5 (25%) hospitals implemented infection control practices consistent with World Health Organization recommendations on visitor policies, private negative-pressure rooms, and personal protective equipment. CONCLUSIONS: Early in the SARS epidemic, mobile teams found wide variations in infection control practices and resources among Asian hospitals evaluating patients for SARS, indicating the importance of ongoing assessment during SARS preparedness. Mobile teams are one mechanism to assess practices and promote implementation of recommended infection control measures.

Communicable Disease Control↗

PubMed1997

Cross-national HIV infection control practices and fear of AIDS: a comparison between Nigeria and the USA.

Fears about occupational transmission of HIV may have a significant impact on the behaviour of health care workers and on infection control practices. We investigated the relationships between fear of AIDS and infection control practices in health care workers in major university teaching hospitals in Nigeria and the USA. Data from the fear of AIDS scale and on a measure of infection control practices and beliefs showed that knowledge of whether the patient was HIV-infected determined infection control practices in Calabar but not Texas. Where the patient was known to be infected, there were no differences between the 2 countries. Fears of AIDS were related to infection control practices significantly more in the USA than in Nigeria where there was almost no relationship. These data may be influenced by the greater availability of disposable equipment in the USA compared with Nigeria.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Attitudes of dental practitioners and dental students towards AIDS patients and infection control.

Members of a large urban dental society and students of three Texas dental schools were surveyed concerning their attitude and actions regarding infectious disease (AIDS and hepatitis) and infection control measures. In general, the responses of clinicians in practice less than 10 years more nearly paralleled that of students. Although the majority of both groups felt they were well informed regarding appropriate infection control, the percentage was significantly greater for the practitioners. While infection control is imposed in all clinical situations in the dental schools, compliance for practitioners was not consistent with their reported level of awareness. A majority of both groups reported decreased apprehension because of their knowledge of infection control techniques in the treatment of HIV positive individuals. A significantly higher percentage of students had received hepatitis B vaccine. Similar percentages of both groups reported they would willingly treat HIV positive patients, although a higher percentage of students were undecided. Practitioners reported having treated a significantly higher percentage of HIV positive individuals than did students in their clinical years. The percentage of clinical students who felt it was their professional obligation to treat HIV+ patients was significantly higher than in practitioners. There was an increase in student perception of their knowledge across years in school and a significant reduction in fear associated with education. Education appeared to have no effect on opinions as to whether the HIV positive patient could be safely treated using appropriate infection control measures.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Infection control: its evolution to the current standard precautions.

BACKGROUND: The use of appropriate infection control precautions to protect against transmission of bloodborne and other occupational microbial pathogens has become a routine component of health care provision. Evolution and revision of recommendations continues to be based on updated scientific information, as well as documented and inferred clinical applications of new knowledge. In addition, surveillance of occupational risks in medical treatment settings often has served as a basis for subsequent disease prevention recommendations for dental care. TYPES OF STUDIES REVIEWED: Guidelines designed to protect dental professionals and their patients have focused on bloodborne pathogens since the first published American Dental Association recommendations in the 1970s. Subsequent statements developed by the Centers for Disease Control and Prevention, the ADA and other organizations during the past 30 years also have addressed prevention of other infections, transmitted by either direct or indirect contact with a variety of potentially infectious body fluids. RESULTS: Review of the major features of these recommendations provides an appropriate framework to consider current guideline revisions. The success of long-standing universal precautions, or UP, against bloodborne infection has been augmented with the incorporation of body substance isolation, or BSI, practices into the infection control protocol designated "standard precautions." Combination of the major tenets of UP with the BSI systems routinely employed in acute care facilities affords all health care professionals the means of preventing a spectrum of bloodborne, respiratory, contact and other potential exposures during provision of patient care. CLINICAL IMPLICATIONS: As infection control recommendations for dentistry are updated this year, they undoubtedly will include guidelines expanding previous UP to provide expanded protection for dental professionals in the multiple types of nonacute treatment settings in which routine treatment is provided.

American Dental Association↗

PubMed1997

Infection control.

The Joint Commission promulgates six standards related to infection control--and it expects all employees to be involved in preventing nosocomical infections. Both the JCAHO and Nursing Management's editors urge you, the readers, to submit your questions for response in this column.

Humans↗