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PubMed1992

Infection control. Nursing management of a patient with hepatitis A and B.

The Infection Control precautions for hepatitis B are those of "Blood and Body Fluid Precautions" and those of "Universal Precautions". Gloves, preferably latex, are worn when there is to be contact with blood and body fluid. Goggles/masks are worn when there is a danger of splashing or aerosol of blood-contaminated secretions. A plastic apron, or water repellant gown, may be indicated if there is a danger of splashing. Hand washing before and after contact with blood and body fluid, even if gloves are worn. Specimens are treated as biohazard. Refuse and linen are treated as infectious. It is important to establish if the patient is in the acute phase, a carrier, or not. Education of the patient about the disease, is very important, especially in the carrier. This poses a problem when there is a language barrier. This is a sensitive subject and must be handled tactfully, especially if the mode of transmission was sexual. Safe sex must be discussed. The partner, and the newborn baby must be assessed and immunised. The transmission of hepatitis A is mainly faeco-oral, and the infection control measures those called "Enteric Precautions", or blood and body fluid precautions. These include the wearing of latex gloves when handling faeces, urine, saliva, and blood. Handwashing is essential. The patient has his own bedpan, urinal, crockery and cutlery. Isolation is continued for the first two weeks of the illness, and one week after the onset of jaundice. The Infection Control management for hepatitis A is slightly different to that of hepatitis B, C, and Non-A Non-B.

Cross Infection↗
PubMed1997

Prevalence of use of infection control rituals and outdated practices: Education Committee survey results.

BACKGROUND: To better serve APIC membership, the National APIC Education Committee periodically conducts educational needs assessments. METHODS: In the July/August 1995 issue of APIC News, the committee published a survey on the prevalence of infection control "sacred cows," practices considered to be outdated and ritualistic. A response was requested only from ICPs working in inpatient facilities. We asked ICPs which of the listed practices were part of their facility's infection control program, and whether they were interested in changing those that were. We also asked about the certification status of the program's manager (CIC vs non-CIC). RESULTS: A total of 506 survey forms were completed and returned, with 74% from acute care only, 7% from long-term care only, 10% from acute and long-term care, and 8% from other types of facilities. Mean number of beds was 226. Infection control programs had existed for a mean of 15 years. Most respondents' facilities still engaged in infection control rituals. Fifty-eight percent of respondents were still doing total surveillance, 43% were still using reverse or protective isolation, and 11% were still subjecting employees with positive reactions to purified protein derivative of tuberculin testing to annual chest radiographs, to name a few. Certified respondents were significantly less likely to include outdated practices than were non-CICs for 11 of 15 practices (73%). CICs were no more likely than non-CICs, however, to be interested in changing any current rituals. CONCLUSION: The Education Committee will use this information to plan future educational offerings.

Chi-Square Distribution↗
PubMed1998

Infection control and HIV-related discrimination and anxiety. Glove use during venipuncture.

OBJECTIVE: Reports into HIV-related discrimination reveal continuing concerns about the behaviour of health care workers, particularly with reference to practices such as excessive or selective infection control. This study examines whether the selective adoption of an infection control procedure (using gloves during venipuncture) is related to discriminatory attitudes, anxiety about HIV/AIDS and the degree of contact with HIV-infected patients. METHOD: In 1993 and 1994, 451 general practitioners (GPs) were surveyed in six of the 12 New South Wales Health Areas and Regions. The sample included 49 anti-retroviral prescribers. GPs were presented with six patient scenarios and asked with whom they would use gloves during venipuncture. RESULTS: 41.9% of GPs reported that they would selectively use gloves, and generally targeted the homosexual patient only, or combinations of patients that included the homosexual man. GPs revealed poor compliance with universal precautions, as only 37.5% reported that they would use gloves with all of the six patients. Intended glove use was significantly related to HIV-related discrimination (p < 0.0001) and anxiety about HIV/AIDS (p < 0.0001). GPs who selectively chose to use gloves had the highest discrimination and anxiety scores; GPs who chose not to use gloves with any of the patients had the lowest discrimination and anxiety scores, and were more likely to work in HIV medicine. Except for differences in Health Area, this study did not identify any factors that helped to explain which GPs consistently followed universal precautions. CONCLUSION: This study demonstrates that selective infection control is related to discriminatory attitudes and anxiety about HIV/AIDS. GPs can avoid a discriminatory practice by consistently following universal precautions. More research is needed to identify the factors that promote good infection control practices.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Proven and unproven methods in hospital infection control in intensive care units.

Most common nosocomial infections in Intensive Care Units are: respiratory tract infections, urinary tract infections, bacteremias, and wound infections. Proven methods in hospital infection control are: hand washing, discipline of all personnel, appropriate nursing techniques, specially trained hygiene staff, isolation, appropriate number of nursing personnel per patient, appropriate use of antibiotics, few and brief usage of foreign bodies such as intravenous lines. Useless and unproven methods in hospital infection control are: environmental cultures, routine cultures of personnel, routine air sampling, fogging and spraying of disinfectants, UV lights, plastic shoe covers, routine floor disinfection, disinfection or sticky mats, change of humidifiers and tubings every eight hours, and systematic antibiotic prophylaxis against pneumonia.

Critical Care↗
PubMed2005

A national survey of dental hygienists' infection control attitudes and practices.

PURPOSE: The objectives of this study were to: 1) investigate the infection control practices of practicing dental hygienists, 2) document the attitudes and practices of dental hygienists toward patients with infectious diseases, and 3) determine if professional affiliation affected the attitudes and/or practices of the respondents. METHODS: A 49-item survey consisting of eight demographic, nine attitudinal, and 32 practice questions was used for this study. A stratified sampling method was used, in which the United States was divided into four regions. Three states were selected from each region according to geographic location and population. Five percent of registered dental hygienists within each selected state were randomly selected for inclusion in the study. All analyses were conducted using the Statistical Package for Social Scientists (SPSS v.10, Chicago, IL). RESULTS: Of the 2,009 surveys mailed, 104 were undeliverable. A total of 856 completed surveys were returned from practicing dental hygienists for a response rate of 44.9%. Overall, this study found an increased use of barriers and personal protective equipment in comparison to previous studies. A majority of respondents (53.9%) felt that treating patients with HIV or AIDS increased their personal risk for contracting the disease. The majority of respondents also reported always using extra precautions with HIV/AIDS patients (63.5%) and hepatitis patients (60.1%). In addition, most respondents reported they would not use an ultrasonic scaler when treating HIV/AIDS (65.8%) or hepatitis (58.9%) patients, indicating an alteration in clinical practice habits. CONCLUSION: The majority of dental hygienists surveyed reported altering infection control practices and treatment techniques when treating HIV/AIDS or hepatitis patients. While there has been an improvement in compliance with recommended infection control guidelines, practitioners still have misconceptions, and possibly fear, regarding infectious diseases and disease transmission.

Air Pollution, Indoor↗
PubMed1995

Nursing in nosocomial infection control in Spain.

This is a descriptive study of nursing practices in nosocomial infection control (NIC) in Spain. During the period 1990-1991, a questionnaire, adapted from that used in the Study on the Efficacy of Nosocomial Infection Control (SENIC), was mailed to all Spanish general hospitals, public and private, having more than 400 beds, and to all those in the public health sector having more than 100 beds. Nursing-related information was selected for analysis from each of three sections: staff, surveillance systems and programmes. The response rate was 70%. While nursing resources allocated to NIC in Spain registered an overall ratio of nosocomial infection control nurses (ICNs) of mean 0.45, SD 0.71 ICN per 250 hospital beds, ICN/beds ratios were below 0.34 and 0.30 in medium-sized and large hospitals respectively. Nurses who were active in NIC were either lacking or worked only a few hours per week in a considerable proportion of hospitals, with this trend being more pronounced in smaller facilities. The intervening period since 1965, and the last decade in particular, has been marked by the progressive adoption of a range of NIC policies. Most procedures proving NIC-efficient had been implemented in approximately 70-80% of responding hospitals. Teaching was most qualified and intensive in medium-sized hospitals. Nursing in NIC has only recently been developed in Spain, is increasingly accepted, exhibits diffusion levels comparable to those reported internationally, lacks monitoring and quality assessment systems and, in general, could be substantially improved.

Cross Infection↗
PubMed1994

Developing an effective infection control program for home care.

Home care agencies can develop comprehensive, effective infection control and prevention programs by including six critical elements: surveillance for infections, infection control education, consultation, epidemiological investigation, quality improvement activities, and policy and procedure development.

Centers for Disease Control and Prevention, U.S.↗
PubMed2005

[Infection control measures in intensive care units. Results of the German Nosocomial Infection Surveillance System (KISS)].

BACKGROUND: Aim of this study was to determine to what extent evidence-based infection control recommendations are applied in German intensive care units (ICUs). METHODS: A questionnaire concerning handling of tubes, central vascular catheters (CVC), urinary tract catheters and methicillin-resistant Staphylococcus aureus (MRSA) positive patients was sent to 230 participants of the German Nosocomial Infection Surveillance System (KISS). RESULTS: Nasal intubation is routinely performed in 9% of ICUs, all recommended measures for CVC insertion were obeyed by 43% of ICUs and one-third of ICUs conduct regular screening of urine in catheterized patients. Urinary tract catheters are replaced at defined time intervals in 37% of ICUs. MRSA positive patients are not isolated in 5% of ICUs. MRSA screening on admission is not performed for high risk patients in 16% of ICUs. CONCLUSIONS: There are still many German ICUs in which evidence-based recommendations are not implemented. Training of staff is necessary to improve quality of patient care.

Catheterization, Central Venous↗
PubMed1999

Infection control practices and compliance to national recommendations among dentists in Romania.

The aim of this study was to measure dental office compliance with current Romanian infection control regulations. A questionnaire was completed and returned from 61 randomly selected offices (32 private and 29 public with 94 dentists), where the sterilizers were also biologically monitored. Results indicated that with few exceptions, infection control practices in public and private offices were the same, with compliance on sterilising reusable instruments. Private offices monitored their sterilizers more frequently and had much newer equipment. Gowns were universally worn, but use of gloves, masks and protective eye-wear showed non-compliance with less than 10 per cent of the offices using personal protective equipment for all patients. Cost was the deciding factor. Predominant environmental disinfectants were alcohol and bleach. Offices were in compliance as to the use of disposable anaesthetic needles and carpules. Dentists reported reluctance to be vaccinated against hepatitis B even when offered free immunizations (6.4 per cent) and only 18.1 per cent of dentists had received any infection control training in the last three years. Results indicate that offices were in compliance for most national regulations. However, there are no recently published standards for dentistry in Romania concerning disinfectants or continuing education. Comparison with the literature indicates comparable compliance with recommended national infection control procedures for Romanian dentists as for dentists in other countries.

Attitude of Health Personnel↗
PubMed1998

The impact of infection control on intensive care unit microbial isolates.

In todays world, good infection control practices in high pressure intensive care units is of vital importance. Endogenous infections from the patients own microbial flora now cause the majority of nosocomial infections as the exogenous infections are curtailed to a large extent with aggressive surveillance and prevention of infection. We analysed absolute numbers of microbial isolates as an indirect reflection of infection rate in the intensive care unit (ICU) for 6 months in 1992, 1994 and 1996. We demonstrated that inspite of the total admission to the ICU increasing, the impact of infection control is certainly felt with strict inforcement of protocols.

Cross Infection↗
PubMed1986

Infection control and the pregnant health care worker.

Health care workers may be exposed to a variety of infectious agents in the workplace. The pregnant health care worker presents additional concerns because of the potential risk of infection to the developing fetus. Health care workers often misunderstand the basic elements of infection transmission. The result of this misinformation is that personnel are most often concerned about the agents that are least transmissible. To develop an infection control program that is rational and workable, the infection control practitioner must have a thorough understanding of the mechanisms of disease transmission. With this foundation, an infection control program for the pregnant health care worker will rarely involve transfer to alternative assignments or work restriction based on pregnancy alone. The approach outlined in this article stresses a more generic approach to infection control by isolating the disease and not the employee.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Infection control is more than just extra inventory.

Communication of infection-control practices is an overlooked area of practice management. Often, people forget to consider the training, time, and expense associated with the wide variety of protocols, techniques, and regimens. Explore and develop approaches aimed at conveying the infection-control practices you use to other care providers and your patient family. When these are used appropriately, you serve both patients and the community in the capacity for which you were trained--as a health-care professional. It does not get any better than that!

Humans↗
PubMed1991

Infection control of field dental units.

The need for infection control procedures exists for dental care provided outside of dental treatment facilities. In a wartime scenario or during military training exercises, traditional dental clinic settings may not be available and the dental officer will be required to treat patients using equipment provided by the Army's Table of Organization and Equipment. This article reviews the dental literature and makes recommendations to aid the dental officer in developing an infection-control protocol for field dental equipment.

Communicable Disease Control↗
PubMed2003

Assessment of the compliance of Nigerian dentists with infection control: a preliminary study.

OBJECTIVE: To assess the compliance of a group of Nigerian dentists with standard infection control practices. METHOD: A confidential self-administered questionnaire survey was conducted among dentists engaged in active clinical practices in public hospitals in Lagos, Nigeria (n = 185). RESULTS: One hundred forty-six questionnaires were returned (response rate, 78.9%). Most (70.6%) of the dentists always wore gloves when treating patients, whereas 29.4% sometimes did. Regarding facemasks, 45.9% always wore them, 52.7% sometimes wore them, and 1.4% never wore them. Protective eye wear was always worn by 4.8% of the dentists, sometimes worn by 52.7%, and never worn by 42.5%. Approximately half (50.7%) of the respondents had received hepatitis B vaccination. Sterilization was performed using a combination of methods, including autoclaving (84.1%), boiling (19.3%), dry heat (17.5%), and chemicals (29.7%). Nonavailability of materials was the major reason for noncompliance with infection control practices. CONCLUSIONS: Nigerian dentists need continuous education regarding infection control. Also, Nigerian hospitals urgently need adequate funding for up-to-date and functional equipment and materials.

Dental Service, Hospital↗
PubMed2004

An overview of infection control strategies for equine facilities, with an emphasis on veterinary hospitals.

Infection control entails preventing or minimizing exposure to infectious agents or optimizing resistance to infection at the individual and population levels should exposure occur. The degree to which each of these strategies is applied varies according to the attributes of the disease agent and the population at risk. In developing an infection control, biosecurity, or biocontainment plan, it is important to decide which agent or agents are to be controlled, the method by which they might be introduced to the individual or population, and methods by which they might spread once at a farm or veterinary clinic.

Animal Husbandry↗
PubMed2006

Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP).

This report summarizes recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP) concerning influenza vaccination of health-care personnel (HCP) in the United States. These recommendations apply to HCP in acute care hospitals, nursing homes, skilled nursing facilities, physician's offices, urgent care centers, and outpatient clinics, and to persons who provide home health care and emergency medical services. The recommendations are targeted at health-care facility administrators, infection-control professionals, and occupational health professionals responsible for influenza vaccination programs and influenza infection-control programs in their institutions. HICPAC and ACIP recommend that all HCP be vaccinated annually against influenza. Facilities that employ HCP are strongly encouraged to provide vaccine to their staff by using evidence-based approaches that maximize vaccination rates.

Cross Infection↗
PubMedDate not supplied

Nurses' knowledge of infection control.

The article is based on a research study examining infection control in nurse education and practice. A survey of a large population was carried out to establish the perceived importance of microbiological knowledge to nurses and to ascertain whether this knowledge was present. The results suggest that although microbiological knowledge is considered necessary for safe infection control practice, nurses' actual knowledge falls far short of the level required for 'informed' practice. What this implies in relation to patient care, and recommendations regarding education and practice, are discussed.

Aged↗