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PubMed1984

A national task analysis of infection control practitioners, 1982. Part Two: Tasks, knowledge, and abilities for practice.

Respondents (N = 473) from a randomized stratified sample (N = 600) of U.S. hospital ICPs in a national survey sponsored by the Certification Board of Infection Control were asked to rate specific task, knowledge, and ability statements related to infection control for frequency and importance. The questions included 175 items, of which 99 were for specific tasks and 76 were for knowledge and abilities for practice. Areas covered included patient care practices, infectious diseases, epidemiology and statistics, microbiologic practices, sterilization and disinfection, education, employee health services, and management and communications. A "profile respondent" group (N = 317) was defined as persons most likely to be practicing the full scope of infection control practice and was used to identify key tasks, knowledge, and abilities for practice. Results showed that patient care practices (i.e., suctioning, dressing changes, and catheterization) were rarely performed. The development of infection control policies and procedures were key tasks. Knowledge of microbiology and infectious diseases in order to interpret laboratory reports and other patient data was rated as essential; however, few respondents actually performed laboratory procedures. Epidemiologic principles were frequently used for surveillance and problem investigation. Although presentation of epidemiologic data was rated as important, analytic statistics were rarely used. Assessment of educational needs and teaching were large components of ICPs' activities.

Certification↗
PubMed1989

Recognition of endemic and epidemic prosthetic device infections: the role of surveillance, the hospital infection control practitioner, and the hospital epidemiologist.

Surveillance as a means of identifying endemic and epidemic problems is an established and useful public health practice, which increasingly has been applied to the hospital population. The current practice of hospital infection control surveillance tends to concentrate on acute, in-hospital events. It will miss most longer-term prosthetic device infections, since they will often appear at a distance both in time and place. Currently, case report information is not reliably returned to the hospital or physician responsible for the implantation of the device. Since ongoing analysis of the epidemiologic patterns involved in these cases would seem useful, it is proposed that existing infection control units create, define, and maintain a system of net-working communication to return case data to the hospital of origin. This hospital could then combine these data with its own population data, in the hopes of generating useful epidemiologic information for the future.

Cross Infection↗
PubMed1996

Should infection control practitioners do follow-up of staff exposures to patient blood and body fluids?

BACKGROUND: The purpose of this study was to determine the efficiency of a joint infection control/occupational health program for the follow-up of accidental blood or bloody body fluid exposures in health care workers. METHODS: A comprehensive staff follow-up program for all blood exposures with known patient sources was initiated in 1989, consisting of patient follow-up by the Infection Control Department (risk assessment for hepatitis B virus [HBV] and [HIV] infection and obtaining of consent for HIV testing) and staff follow-up by the Occupational Health Department. In 1992 a mailed survey was conducted to examine exposure follow-up policies and responsibilities in large teaching hospitals across Canada. RESULTS: A total of 924 blood exposures with known patient sources were reported between January 1989 and December 1993. HIV and HBV screening was obtained for 67.9% and 87.6% of patients assessed as at low risk and 82.3% and 92.2% of those assessed as at high risk for infection, respectively. Two previously unknown HIV-seropositive patients were identified, one of whom had been classified as at low risk (one of 530 [0.19%] patients at low risk who underwent screening). Primary reasons for screening being missed were patient discharge (46.3%) or communication problems (18.0%). The requirement for informed written consent before HIV screening accounted for the difference in completed HIV and HBV screens. Results of the hospital survey indicated that 40.8% of Canadian hospitals follow up all patients who are involved in blood exposures; however, most hospitals still rely on the physician to obtain consent (87.6%). CONCLUSIONS: Use of ICPs to screen patients involved in staff blood exposures during regular hours may be the most efficient method of follow-up, particularly if supplemented by a backup team of health professionals on nights and weekends. Although screening all patients for HBV/HIV may detect patients with undisclosed high-risk behaviors, institutions must decide whether the practice is cost-effective in areas of low prevalence.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Varicella in hospital personnel: a challenge for the infection control practitioner.

Five unrelated cases of chickenpox (varicella) occurred in a 1-month period involving one physician, two house staff members, one medical student, and a nursing assistant at a large Veterans Administration medical center. This required immediate identification of susceptible employees and patients to prevent transmission to other personnel and patients. Negative history is not a reliable predictor of susceptibility. Of the fifty contacts reporting negative histories, only five persons (10%) were actually negative by antibody testing. No secondary cases of varicella occurred. These incidents suggested that more rapid prescreening of key hospital personnel with negative histories who have direct patient contact might be helpful in identifying susceptible employees in the future.

Adult↗