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PubMed1999

Requirements for infrastructure and essential activities of infection control and epidemiology in out-of-hospital settings: a Consensus Panel report.

In 1997 the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America established a consensus panel to develop recommendations for optimal infrastructure and essential activities of infection control and epidemiology programs in out-of-hospital settings. The following report represents the Consensus Panel's best assessment of requirements for a healthy and effective out-of-hospital-based infection control and epidemiology program. The recommendations fall into 5 categories: managing critical data and information; developing and recommending policies and procedures; intervening directly to prevent infections; educating and training of health care workers, patients, and nonmedical caregivers; and resources. The Consensus Panel used an evidence-based approach and categorized recommendations according to modifications of the scheme developed by the Clinical Affairs Committee of the Infectious Diseases Society of America and the Centers for Disease Control and Prevention's Healthcare Infection Control Practices Advisory Committee.

Allied Health Personnel↗

PubMed2006

A Web-based course on infection control for physicians in training: an educational intervention.

OBJECTIVE: To evaluate the effectiveness of a Web-based course on infection control accessed by physicians in training. DESIGN: Educational intervention. SETTING: A 607-bed urban teaching hospital. PARTICIPANTS: A total of 55 physicians in training beginning their first postgraduate year (the iPGY1 group) and 59 physicians completing their first, second, or third postgraduate year (the oPGY group). INTERVENTION: Individuals in the iPGY1 group took a Web-based course on infection control practices. MEASUREMENTS: Persons in the iPGY1 group who took the Web-based course completed an evaluation test consisting of 15 multiple-choice questions (total possible score, 15 points). The same test was given to persons in the oPGY group, who did not take the Web-based course. We compared scores of the Web-based test taken by subjects in the iPGY1 group immediately after the course with scores of the test they took 3 months after the course and with test scores of subjects in the oPGY group. RESULTS: The mean score (+/-SD) for subjects in the iPGY1 group who took the Web-based course was 10.6+/-2.2, compared with 8.0+/-2.5 for subjects in the oPGY group (P<.001). The mean score (+/-SD) for subjects in the iPGY1 group 3 months after completing the course decreased to 8.0+/-2.4 (P<.001 by the paired t test). For the oPGY group, significant differences were found between the scores (+/-SD) for subjects in the internal medicine (9.9+/-2.3), emergency medicine (8.4+/-1.7), pediatrics (7.0+/-1.7), and family medicine (5.8+/-1.6) residency programs (P<.001); there were no significant differences in scores according to the year of residency. CONCLUSIONS: Web-based infection control courses are an attractive teaching tool for physicians in training and need to be considered for teaching infection control. The evaluation of information retention will help identify physicians in training who require further training.

Education, Distance↗

PubMedDate not supplied

Infection control: do we all have a role to play?

Infection control became a recognised discipline in 1970. Its principles, however, had been in existence for some time. In the middle of the nineteenth century, Semelweiss showed the importance of hand washing in coping with the transmission of infections. Better acceptance of Semelweiss's idea came after Pasteur, Lister and Koch related asepsis to the prevention of the spread of infection. Florence Nightingale, on the other hand, at about the same time, made a remarkable contribution to sanitation and isolation practices.

Cross Infection↗

PubMed2000

Multicenter surveillance study for nosocomial infections in major hospitals in Korea. Nosocomial Infection Surveillance Committee of the Korean Society for Nosocomial Infection Control.

BACKGROUND: The goals of a surveillance for nosocomial infections (NIs) are to observe the magnitude and characteristics of NIs and to plan and evaluate policies and guidelines of infection control. This study was designed to determine the rate and distribution of NIs and their causative pathogens in Korean hospitals. METHODS: Prospective surveillance was performed at 15 acute care hospitals with more than 500 beds during a 3-month period from June to August 1996. The case-finding methods were laboratory-based surveillance for patients in the general wards and a direct review of medical charts done regularly for all the patients in the intensive care units. RESULTS: A total of 3162 NIs were found among 85,547 discharged patients, with an overall nosocomial infection rate of 3.70 per 100 patients discharged. Urinary tract infections constituted 30.3% of all NIs. Other infections were pneumonias, 17.2%, surgical site infections, 15.5%, and primary bloodstream infections, 14.5%. The infection rate was the highest in neurosurgery (14.21), followed by neurology (8. 62) and ontology services (6.70). The infection rate in intensive care units was higher than it was in the general wards (10.74 vs 2. 57, P =.001). The commonly isolated organisms were Staphylococcus aureus (17.2%), Pseudomonas aeruginosa (13.8%), and Escherichia coli (12.3%). CONCLUSIONS: This first multicenter surveillance study provided extensive information on the current status and trends of NIs in major hospitals in Korea. The results may contribute to the evaluation of infection control programs and the development of effective strategies in these hospitals.

Contact Tracing↗

PubMed1994

Infection control for general practice.

This paper, which is part of a course on infection control, includes basic guidelines for infection control i the offices of general practitioners.

Disinfection↗

PubMed1993

Assessment of the effectiveness of body substance precautions as the infection control system of a large teaching hospital.

BACKGROUND: Body substance precautions was the name given to the body substance isolation-based infection control system that was introduced in January 1990 at a Canadian university hospital with 650 acute care beds and 570 long-term care beds. When the body substance precautions system was begun, traditional category-specific isolation was discontinued. METHODS: After 2 years, we reviewed the incidence of several types of nosocomial infections and the frequency of isolation of hospital strains of bacteria before and after the introduction of body substance precautions to find out whether this system was as effective as the previous system of infection control. RESULTS: Most nosocomial infections did not increase. There was another likely cause for the only one that did. For many years, we had isolated patients infected or colonized by hospital bacteria, limiting their spread throughout the institution. Body substance precautions proved equally effective in doing this. CONCLUSION: Our results to date therefore indicate that the body substance precautions system was as successful as category-specific isolation used with other standard infection control techniques in maintaining low rates of nosocomial infections and in controlling the dissemination of hospital strains of bacteria in our institution. Body substance precautions provided a satisfactory alternative to universal precautions and traditional isolation categories for the protection of health care workers against the risk of infection by blood-borne viruses.

Body Fluids↗

PubMed2001

[Laboratory system for networks in infection control].

The goals of a surveillance for nosocomial infections are to observe the magnitude and characteristics of the infections, and to plan and evaluate policies and guidelines of infection control. In clinical laboratory, although it is most important to detect their causative pathogens, further to provide the surveillance study as a multicenter. Actually, we have just started an infection control room in our hospital. Thus this room may present various informations about infection and contribute to the networks with the area community.

Cross Infection↗

PubMed1992

Results of CHICA-Canada survey of long term care infection control practitioners.

Recognizing the unique and varied needs of infection control practitioners (ICPs) in long term care (LTC) facilities across Canada, CHICA-Canada established a task group to explore this area of practice and to determine the needs that could be met by CHICA-Canada. In March 1992 surveys were sent to CHICA-Canada members practicing in LTC facilities. Surveys were also sent to LTC associations in each province for distribution to their member agencies. A copy of the survey was published in The Canadian Journal of Infection Control in Summer 1992. As of August 31, 1992, 271 surveys have been returned from both members and nonmembers. The findings of the survey depict the special needs, unique practice settings and varied roles of ICPs in LTC facilities.

Canada↗

PubMed1998

The role of "colonization pressure" in the spread of vancomycin-resistant enterococci: an important infection control variable.

OBJECTIVE: The spread of nosocomial multiresistant microorganisms is affected by compliance with infection control measures and antibiotic use. We hypothesized that "colonization pressure" (ie, the proportion of other patients colonized) also is an important variable. We studied the effect of colonization pressure, compliance with infection control measures, antibiotic use, and other previously identified risk factors on acquisition of colonization with vancomycin-resistant enterococci (VRE). METHODS: Rectal colonization was studied daily for 19 weeks in 181 consecutive patients who were admitted to a single medical intensive care unit. A statistical model was created using a Cox proportional hazards regression model including length of stay in the medical intensive care unit until acquisition of VRE, colonization pressure, personnel compliance with infection control measures (hand washing and glove use), APACHE (Acute Physiology and Chronic Health Evaluation) 11 scores, and the proportion of days that a patient received vancomycin or third-generation cephalosporins, sucralfate, and enteral feeding. RESULTS: With survival until colonization with VRE as the end point, colonization pressure was the most important variable affecting acquisition of VRE (hazard ratio [HR], 1.032; 95% confidence interval [C1], 1.012-1.052; P=.002). In addition, enteral feeding was associated with acquisition of VRE (HR, 1.009; 95% CI, 1.000-1.017; P=.05), and there was a trend toward association of third-generation cephalosporin use with acquisition (HR, 1.007; 95% CI, 0.999-1.015; P=.11). The effects of enteral feeding and third-generation cephalosporin use were more important when colonization pressure was less than 50%. Once colonization pressure was 50% or higher, these other variables hardly affected acquisition of VRE. CONCLUSIONS: Acquisition of VRE was affected by colonization pressure, the use of antibiotics, and the use of enteral feeding. However, once colonization pressure was high, it became the major variable affecting acquisition of VRE.

APACHE↗

PubMed1990

Preventing septic shock. Infection control in the intensive care unit.

Preventing nosocomial infection in the critically ill patient is a challenge for the critical care nurse. The prevention of nosocomial infection may be impossible in the critically ill patient as long as invasive therapeutic interventions are key to patient care. Therefore, nursing practice must be guided by a clear understanding of the patient's host defense mechanisms and how they are jeopardized by the underlying medical condition and therapeutic interventions. Classic recommendations of infection control practices, such as hand washing and meticulous aseptic technique, plus an awareness of the many ways that microorganisms can contaminate and inoculate the patient are essential for preventative nursing care. The most effective infection control measures may be continual patient assessment, observing for subtle changes that indicate an infection is incubating. It is the early distinction of infection as the underlying mechanism for fever, inflammatory response, and clinical deterioration that can best facilitate an expedient and appropriate course of therapy and minimize the consequences of disease.

Cross Infection↗

PubMed2001

Reduced rates of hospital-acquired UTI in medical patients. Prevalence surveys indicate effect of active infection control programmes.

Prevalence surveys have been part of the Danish infection control programme since 1974. Nationwide surveys were carried out in 1978, 1979, 1980, 1991 and 1999. The results indicate a net reduction of approximately 25%, mainly due to a reduction of urinary tract infections (UTIs) in medical patients. Results from the nationwide surveys are validated by results of occasional independent surveys performed in regions or single hospitals. The reduction coincides with preventive programmes focused on catheter policy and UTI. We conclude that the prevalence survey is an important part of our strategic programme for infection control in hospitals.

Cross Infection↗

PubMedDate not supplied

Effect of various infection-control methods for light-cure units on the cure of composite resins.

This study (1) compared the curing-light intensity with various barrier infection-control methods used to prevent cross contamination, (2) compared the Knoop hardness value of cured composite resin when various barrier control methods were used, and (3) correlated the hardness of the composite resin with the light-intensity output when different infection-control methods were used. The light-cure unit tips were covered with barriers, such as cellophane wrap, plastic gloves, Steri-shields, and finger cots. The control group had no barrier. Composite resins were then cured for each of the five groups, and their Knoop hardness values recorded. The results showed that there was significant statistical difference in the light-intensity output among the five groups. However, there was no significant statistical difference in the Knoop hardness values among any of the groups. There was also no correlation between the Knoop hardness value of the composite resin with the light-intensity output and the different infection-control methods. Therefore, any of the five infection-control methods could be used as barriers for preventing cross-contamination of the light-cure unit tip, for the light-intensity output for all five groups exceeded the recommended value of 300 W/m2. However, to allow a greater margin of error in clinical situations, the authors recommend that the plastic glove or the cellophane wrap be used to wrap the light-cure tip, since these barriers allowed the highest light-intensity output.

Composite Resins↗

PubMed1997

Knowledge of and attitudes to infection control of tattooists at registered premises in Victoria, 1994.

Historically, the relationship between health authorities and tattooists has been marked by suspicion and mutual distrust, with tattooists being stereotyped as having little concern for hygiene, and considered largely ineducable about infection control. In this study, a random sample of tattooists working at one-third of the 65 registered tattooing premises in Victoria completed a questionnaire that recorded demographic information and knowledge and attitudes to Standards of practice for tattooing 1990, which specifies guidelines for infection control in Victorian tattooing premises. Of these premises, 89 per cent participated and 36 of 37 tattooists working therein (22 metropolitan, 14 country) completed the questionnaire; 81 per cent were male. Reports by the tattooists indicated that: 50 per cent had not commenced immunisation for hepatitis B; that 78, 42 and 34 per cent either had not been tested or were unsure whether they had been tested for hepatitis C, hepatitis B and human immunodeficiency virus (HIV); and that no tattooist was a hepatitis B carrier or was positive for hepatitis C or HIV. Respondents acknowledged the potential for transmission of infectious diseases through tattooing, endorsed formal training in tattooing and infection control for new tattooists, and supported continuing education in infection control for existing tattooists. Most were critical of environmental health officers, particularly for inaction in not closing and prosecuting unregistered tattooists. Despite deficiencies in the knowledge and training of tattooists in infection control, they recognise its importance and are willing to attend appropriate training.

Adult↗

PubMed1992

A survey of hospital infection control policies and employee measles cases during Los Angeles County's measles epidemic, 1987 to 1989.

BACKGROUND: Between December 1987 and December 1989, 74 adults employed in Los Angeles County acute care hospitals were found to have measles. To investigate measles infection control policies in Los Angeles County and to gain information on employee measles cases, two surveys were performed. METHODS: A survey of all infection control practitioners (N = 102) of acute care hospitals was conducted in July 1989. Reported employee measles cases were surveyed after initial case reports were reviewed. RESULTS: The survey of acute care hospitals revealed that only 17% had mandatory measles infection control policies requiring written proof of past measles vaccination, disease, or seropositivity. Only 4% of hospitals had policies affecting students or volunteers. A second survey of hospital employees with confirmed measles revealed that 46% (34/74) were working in hospitals without measles infection control policies, 43% (32/74) were born before 1957, and 31% (21/67) were working in jobs not traditionally considered to provide a high risk of measles exposure. One third of the sick employees were hospitalized. The standard of either birth date before 1957 or oral history of measles illness or vaccination would have classified 93% (39/42) of the employees with measles as immune. CONCLUSIONS: Effective infection control policies against measles and rubella should be adopted and enforced. Those policies should only allow written documentation as proof of measles immunity and should address all employees, regardless of age or job description.

Adult↗

PubMed1999

Medical and economic benefit of a comprehensive infection control program that includes routine determination of microbial clonality.

Nosocomial infections are a major part of the problem of reemerging pathogens causing infectious diseases, affecting 5% of patients hospitalized in the United States during 1995. We assessed the medical and economic effects on the overall nosocomial infection rate of an intervention that provided an enhanced, integrated infection control program, including an in-house molecular typing laboratory capability to rapidly assess microbial clonality. Data on nosocomial infections for 24 months prior to the change in approach to infection control were compared with data from the 24 months immediately following implementation of the new program. Infections per 1,000 patient-days and percentage of hospitalized patients in whom nosocomial infection developed were assessed. Overall, nosocomial infections per 1,000 patient-days decreased more than 10% (P = .027), and percentage of patients with nosocomial infection decreased 23% during the post-intervention period compared with the previous control 24 months. This translated to a mean reduction of some 270 patients per year with nosocomial infection, and lowering of actual health care costs for our institution by $4,368,100 over the 2 years of the intervention.

Cross Infection↗

PubMed2006

Assessment of knowledge and practice of cross--Infection control among Nigerian dental technologists.

OBJECTIVE: to determine the knowledge and current infection control practices among dental laboratory technologists in Nigeria. METHOD: a cross-sectional descriptive study using self-administered questionnaires distributed through the Dental Technologist Board. RESULT: 86 questionnaires were returned out of the 200 distributed (response rate=43%). Knowledge of risk of transmission of infections was poor with a remarkable percentage of non-responders. More than half (61.9%) considered HIV infection as the greatest infectious occupational hazard for them while only 25.5% correctly responded that Hepatitis B(HBV) was the greatest risk. Infection control practices were inadequate with 53.5% of them never sterilising their hand instruments and 74.4% treat impressions by rinsing in water while as high as 39.5% never wear gloves while working in the laboratory. Only 21(24.4%) had received HBV vaccination and 38.4% were not aware of the need to be vaccinated. CONCLUSION: the knowledge and practice of infection control was poor and below acceptable standards. The paper recommended ways by which improvements can be made.

Adult↗

PubMed2000

Infection control in physicians' offices. Academy of Pediatrics. The American Occupational Safety and Health Administration (OSHA).

Infection control is an integral part of pediatric practice in outpatient settings as well as in hospitals. All employees should be educated regarding the routes of transmission and techniques used to prevent transmission of infectious agents. Policies for infection control and prevention should be written, readily available, updated annually, and enforced. The Centers for Disease Control and Prevention standard precautions for hospitalized patients with modifications from the American Academy of Pediatrics are appropriate for most patient encounters. As employers, pediatricians are required by the Occupational Safety and Health Administration (OSHA) to take precautions to protect staff likely to be exposed to blood or other potentially infectious materials while on the job. Key principles of infection control include the following: hand-washing before and after every patient contact, separation of infected, contagious children from uninfected children, safe handling and disposal of needles and other sharp medical devices, appropriate use of personal protection equipment such as gloves, appropriate sterilization, disinfection and antisepsis, and judicious use of antibiotics.

Facility Design and Construction↗

PubMed1995

Practical application of infection control in endodontics.

The transmission of infections in an endodontic practice is a significant concern for both patients and dental health care providers. This article offers a review and practical application of infection control methods in the practice of endodontics.

Disinfectants↗