Changes don't diminish importance of infection control.
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Results for “Infection Control”
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Simply: a code number for infection control.
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Humans↗
New York State set to impose infection-control mandate.
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Infection Control↗
Disinfection procedures and infection control in the outpatient oral surgery practice.
The infection control and disinfection procedures employed by 434 oral surgeons were surveyed. Gloving practices varied substantially, with 55% of respondents wearing gloves during less than or equal to 10% of patient contacts and only 24% wearing gloves routinely. Gloving practices correlated strongly with having been taught in dental school or during residency training to wear gloves. While 100% of participants had received instruction in the use of intravenous fluids in dental school or residency training, usage patterns differed substantially from those currently recommended in hospitals and in outpatient, nondental surgical settings. Of the respondents who used intravenous fluids in an office setting, 68% used a single bag or bottle for more than one patient. The median number of patients receiving intravenous fluid from a single bag or bottle was 12, and the median duration of use of a single unit was three days. It was noted that infection control and disinfection procedures varied significantly by type of practice (private vs. other nonmilitary vs. military practices).
Adult↗
Cross-infection control in general dental practice: dentists' behaviour compared with their knowledge and opinions.
This study aimed to establish how dentists' knowledge, opinion and behaviour about cross-infection control were related and how they were affected by their ages, gender and the sizes of the practices in which they worked. In 1990/91 all general dental practitioners in the North Western Health Region of England were asked to complete a questionnaire about cross-infection control; 917 (75%) did so. Responses from all single-handed and one dentist selected randomly from each group practice were analysed (n = 546). The score to measure behaviour was based on guidelines on cross-infection control issued by the British Dental Association and this was correlated with scores for knowledge and opinion. The more knowledgeable not only tended to hold favourable opinions about the guidelines but also to practise them. Younger dentists were more knowledgeable about cross-infection control measures than older and more likely to wear gloves. Irrespective of age, all female dentists were more likely to wear gloves than their male colleagues. Single-handed dentists were less willing to treat carriers of HIV and HBV. Although 65% thought that recommended control procedures are feasible, 43% considered them prohibitively expensive.
Adult↗
Estimation of the impact of providing outpatients with information about SARS infection control on their intention of outpatient visit.
To examine the effect of provision of information about the infection control in the specific infection disease treatment unit in a city hospital on the outpatient's intention of outpatient service use, respondents who underwent outpatient medical care at the hospital (N = 821) were asked whether or not they intended to continue the outpatient visit at the hospital if a severe acute respiratory syndrome (SARS) patient was admitted to the unit. Although 56% of respondents replied that they could continue to visit the department if a SARS patient was admitted to the unit in the hospital before they read the information, the proportion of those who intended to continue outpatient care significantly increased by 15% after they read it. The logistic regression analyses revealed that respondents who had frequently visited the outpatient department (P < 0.001), those who felt relieved by reading the information about the unit (P < 0.001), and those who did not worry about nosocomial SARS infection inside the hospital (P < 0.001) were significantly more likely to reply that they would continue outpatient visits. We estimated that admission of a SARS patient to the unit would result in a 20% decrease in the cumulative total number of outpatients in the hospital during a 180-day interval after admission of a SARS patient to the unit, and the cumulative total number of outpatients increased by 7% after they read the information. This study suggests that providing outpatients with appropriate information about SARS infection control in the hospital had a statistically significant and substantial impact on the outpatients' intention to continue outpatient visits at the hospital.
Cross Infection↗
Assessing the status of infection control programs in small rural hospitals in the western United States.
BACKGROUND: Organized infection control (IC) interventions have been successful in reducing the acquisition of hospital-associated infections. Rural community hospitals, although contributing significantly to the US health care system, have rarely been assessed regarding the nature and quality of their IC programs. METHODS: A sample of 77 small rural hospitals in Idaho, Nevada, Utah, and eastern Washington completed a written survey in 2000 regarding IC staffing, infrastructure support, surveillance of nosocomial infections, and IC policies and practices. RESULTS: Almost all hospitals (65 of 67, 97%) had one infection control practitioner (ICP), and 29 of 61 hospitals (47.5%) reported a designated physician with IC oversight. Most ICPs (62 of 64, 96.9%) were also employed for other activities outside of IC. The median number of ICP hours per week for IC activities was 10 (1-40), equating to a median of 1.56 (0.30-21.9) full-time ICPs per 250 hospital beds. Most hospitals performed total house surveillance for nosocomial infections (66 of 73, 90.4%) utilizing Centers for Disease Control and Prevention (CDC) definitions (69 of 74, 93.2%). Most also monitored employee bloodborne exposures (69 of 73, 94.5%). All hospitals had a written bloodborne pathogen exposure plan and isolation policies. CDC guidelines were typically followed when developing IC policies. Access to medical literature and online resources appeared to be limited for many ICPs. CONCLUSIONS: Most rural hospitals surveyed have expended reasonable resources to develop IC programs that are patterned after those seen in larger hospitals and conform to recommendations of consensus expert panels. Given these hospitals' small patient census, short length of stay, and low infection rates, further studies are needed to evaluate necessary components of effective IC programs in these settings that efficiently utilize limited resources without compromising patient care.
Centers for Disease Control and Prevention, U.S.↗
Impact of an infection control program on rates of ventilator-associated pneumonia in intensive care units in 2 Argentinean hospitals.
BACKGROUND: Hospitalized, critically ill patients have a significant risk of developing nosocomial infection. Most episodes of nosocomial pneumonia occur in patients undergoing mechanical ventilation (MV). OBJECTIVE: To ascertain the effect of an infection control program on rates of ventilator-associated pneumonia (VAP) in intensive care units (ICUs) in Argentina. METHODS: All adult patients who received MV for at least 24 hours in 4, level III adult ICUs in 2 Argentinean hospitals were included in the study. A before-after study in which rates of VAP were determined during a period of active surveillance without an infection control program (phase 1) were compared with rates of VAP after implementation of an infection control program that included educational and surveillance feedback components (phase 2). RESULTS: One thousand six hundred thirty-eight MV-days were accumulated in phase 1, and 1520 MV-days were accumulated during phase 2. Rates of VAP were significantly lower in phase 2 than in phase 1 (51.28 vs 35.50 episodes of VAP per 1000 MV-days, respectively, RR = 0.69, 95% CI: 0.49-0.98, P <or= .003). CONCLUSION: Implementation of a multicomponent infection control program in Argentinean ICUs was associated with significant reductions in rates of VAP.
Aged↗
The infection control committee.
Hospital epidemiologists translate their expertise into institutional policy and gain the support of administrators through the infection control committee. Committee members have the important task of helping to disseminate information to all important hospital constituencies. The infection control team can facilitate its goals by properly preparing committee members for the meeting. A well-educated committee will approve policies efficiently. The committee periodically should reassess its accomplishments and goals. This article will explore the workings of the infection control committee and will suggest strategies that the hospital epidemiologist can use to make the committee an asset rather than a hindrance. an asset rather than a hindrance.
Efficiency, Organizational↗
Infection control and anesthesia: lessons learned from the Toronto SARS outbreak.
PURPOSE: To describe the outbreak of severe acute respiratory syndrome (SARS) in Toronto, its impact on anesthesia practice and the infection control guidelines adopted to manage patients in the operating room (OR) and to provide emergency intubation outside the OR. CLINICAL FEATURES: The SARS outbreak in Toronto was the result of a single index patient. The causative virus, SARS-CoV, is moderately contagious, and is spread by droplets and contact. The virus gains access to host through the mucosa of the respiratory tract and the eyes. It can affect both healthy and compromised patients. The use of several precautionary measures such as goggles, gloves, gowns and facemasks and the application of various infection control strategies designed to minimize the spread of the virus are discussed. CONCLUSION: In containing the spread of SARS, vigilance and strict infection control are important. This results in the rediscovery of standards of infection control measures in daily anesthesia practice.
Aged↗
Intervention for medical students: effective infection control.
Needlestick injuries, which lead to the transmission of hepatitis B, hepatitis C, and the AIDS virus, are a potentially serious threat to students during their clinical experiences. Exposure to infectious diseases, blood, and hazardous body fluids is one of the most frequently reported injury events by medical students at a health science center in the southwestern region of the United States. This study was conducted to determine the effectiveness of a customized intervention about infection control for second-year medical students (N = 200). Preparation for the intervention included a needs assessment, which included both qualitative and quantitative research methods that incorporated input from fourth-year medical students, medical staff members, and local hospital infection control specialists. The intervention included a pretest, a lecture, a demonstration of standard precautions and infection control procedure with 2 clinical scenarios, an exercise on proper handwashing, and a posttest. The evaluation of the intervention demonstrated a significant increase in posttest knowledge scores about infection control (from 12.6 +/- 2.1 pretest to 16.5 +/- 1.8 posttest, P < .001). Medical students showed a significant knowledge increase about infection control after participating in the intervention . Thus we recommend that all medical colleges and universities develop and evaluate a similar customized intervention for their medical students.
Adult↗
An evaluation of autopsy review as a technique for infection control: a procedure of questionable value.
Review of necropsy reports for evidence of undiagnosed antemortem infection is included by the Joint Commission on Accreditation of Hospitals as an element of an effective hospital infection control program. We reviewed records of 155 patients autopsied at St. Paul-Ramsey Medical Center between January 1, 1980 and March 31, 1981. In 13 patients (8%), there was a discrepancy between documentation of infection during the patient's hospitalization and at autopsy. However, in none of these cases was this information useful in our infection control program. We doubt the effectiveness of necropsy review as a tool for nosocomial infection control.
Aspergillosis↗
Credentialing, diversity, and professional recognition-foundations for an Australian infection control career path.
BACKGROUND: There are no regulatory, legislative, or professional criteria stipulating minimum qualifications or experience that a health care worker must meet to be capable of coordinating an Australian infection control (IC) program. Measurement of IC competence is important to protect the public and for the ongoing credibility and growth of the profession. METHOD: Our study group was all 1078 nonmedical and nonindustry members of the Australian Infection Control Association in 1996. The survey examined perceived level of proficiency, level of education, and experience in health care and infection control. Almost three quarters (65%) of the members responded, and almost all (85%) of these respondents fulfilled the inclusion criterion of coordinating an IC program. RESULTS: Experience in IC ranged from less than 2 years (33.6%) to more than 20 years (10.0%). The majority (65.0%) of infection control professionals (ICPs) had between 8 years and 12 years IC experience. The respective proportions of respondents' self-ranked levels of proficiency on a 5-point scale were novice (3.6%), advanced beginner (21.2%), competent (33.8%), proficient (34.7%), and expert (6.8%). Almost half (47%) of the novices agreed that a registered nursing (RN) qualification was required, whereas a majority (41%) of advanced beginners considered both an RN and a basic IC course (BASIC) were required. Competent ICPs agreed less often than the other levels about their requirements. However, 27% of competents identified a BASIC and an undergraduate degree (UG) as the minimum requirements for a competent ICP. Proficient ICPs agreed that they required an RN, UG, BASIC, and a postbasic course in IC. Nearly all experts (80.0%) agreed that they required an RN, UG, BASIC, postbasic course, and a course in hospital epidemiology (EP). Two thirds of experts expected a master's degree as a requirement. CONCLUSION: The Australian IC profession is in an exciting period of development; however, the variation in ICP perception of the most appropriate qualifications and experience threatens the credibility and viability of the profession. This variation indicates the need for a clear-cut pathway that includes a system of credentialing, recognition of expertise, adoption of divergent roles, and improved networking. This pathway will lead to an increasingly credible and viable IC profession in Australia. Developing IC communities globally can benefit from the Australian experience.
Australia↗
Infection control for the burn patient.
Infection control in the burn patient is dependent on the aseptic management of the wound and the environment of the patient, knowledgeable use of topical antibacterial agents, aggressive wound management, judicious use of systemic antibiotics, support of the deficient host defense system, maintenance of adequate nutrition, and close monitoring of laboratory and clinical signs of impending sepsis. With these key factors in mind, the nurses and physicians who care for burn patients can reduce the number of septic episodes as well as the morbidity and mortality associated with sepsis in the burn patient.
Anti-Bacterial Agents↗
Draft guideline for infection control in health care personnel, 1997--CDC. Notice.
This notice is a request for review of and comment on the Draft Guideline for Infection Control in Health Care Personnel, 1997. The guideline consists of two parts: Part 1. "Infection Control Issues for Health Care Personnel, an Overview" and Part 2. "Recommendations for Prevention of Infections in Health Care Personnel", and was prepared by the Hospital Infection Control Practices Advisory Committee (HICPAC), the National Center for Infectious Diseases (NCID), the National Immunizations Program, and the National Institute of Occupational Safety and Health (NIOSH), CDC.
Centers for Disease Control and Prevention, U.S.↗
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↗
Infection control procedures in intraoral radiology: a survey of Michigan dental offices.
A questionnaire was mailed to members of the Michigan Dental Association to determine the extent and adequacy of infection control procedures utilized during intraoral radiography. These measures were then compared with the infection control guidelines recommended by the American Dental Association for exposing and processing radiographs. During exposure procedures, it was found that an overwhelming majority of practitioners wore disposable gloves and placed saliva-contaminated film packets in a receptacle after removing them from the mouth. Very few clinicians complied with the ADA recommendations for wrapping surfaces in the X-ray operatory, but many used disinfectants to decontaminate surfaces touched by the operator. Most respondents washed or removed their gloves before leaving the operatory to process films, thereby stopping the spread of saliva. ADA recommendations for infection control during processing were generally not followed although alternate methods were frequently used. It is emphasized that infection control regimens be employed for all patients, and not only for those who are thought to be infectious. Auxiliaries should be educated in these protocols because they expose radiographs in many dental offices.
Communicable Disease Control↗
The use of a ward-based educational teaching package to enhance nurses' compliance with infection control procedures.
Obtaining study leave is becoming difficult for clinical nurses in the current economic climate, but the need to develop new clinical skills and to maintain existing good practice remains of prime importance to patient care and will become mandatory with the advent of post-registration education and practice (PREP) in the UK. The ward is widely acknowledged as the best venue for learning clinical skills by nurse educationalists and for many nurses is the preferred learning environment. The feasibility of using a ward-based teaching package to enhance nurses' compliance with key infection control precautions (hand decontamination, the use of gloves and the safe handling and disposal of sharp instruments) was tested in a quasi-experimental research study conducted on matched surgical wards in a teaching hospital, controlling for variables likely to influence performance (knowledge, availability of resources to perform infection control, previous opportunity to develop infection control expertise and nursing workload). Nurses on two wards received the intervention (experimental group). The remaining wards, which received no intervention, operated as controls. The ward-based sessions consisted of a carefully planned sequence of theory and practical demonstration delivered to qualified nurses in the clinical environment at convenient times selected by the ward managers. Performance of infection control precautions was audited before the intervention and 3 months afterwards. The sessions were well evaluated and the clinical environment was considered suitable for teaching by the nurses, but heavy and unpredictable workload prevented the teaching programme from being implemented as planned. The analysis of covariance failed to detect any changes in performance between nurses in the control and experimental groups. The implications of the study findings are discussed to help develop creative new ways of strengthening ward-based educational programmes.
Education, Nursing, Continuing↗