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PubMed1990

Neonatal sepsis and infection control policies in Australia.

The pattern of neonatal bacterial infection, its management and the types of infection control policy were ascertained in 20 neonatal intensive care units (NICU) in Australia by questionnaire survey. Group B Streptococcus and Escherichia coli were the predominant organisms responsible for perinatally acquired infection for which the most common antibiotic combination used was Penicillin and Gentamicin. Staphylococcus epidermidis and aureus (majority Methicillin resistant) were the predominant organisms responsible for nosocomial infection for which the most common antibiotic combination used was Vancomycin and Cefotaxime. A Serratia epidemic was experienced in four NICU. Lumbar and suprapubic punctures were frequently done as part of the diagnostic workup in nosocomial infections but not with perinatally acquired infections. Haematological indices considered useful as a diagnosis aid varied between NICU and acute phase reactants were rarely relied upon for diagnosis or for monitoring treatment response. Granulocyte transfusion and intravenous immunoglobulins were infrequently used in therapy. No consensus was found on infection control policies. Eight NICU required routine gowning on entry, two restricted sibling visiting and four restricted visiting by relatives and friends. Although routine bacteriological surveillance on staff or equipment was uncommon, serial cultures were carried out in infants from the body surface in six NICU and from the endotracheal aspirate in 17 NICU. Antiseptics used with technical procedures included iodine, chlorhexidine and alcohol used singly or in combination. Skin and umbilical cord care also varied between NICU. The literature was reviewed to determine the effectiveness or otherwise of some of the existing policies in the prevention or management of neonatal infection to encourage consensus towards a more rational approach to neonatal infection in Australia.

Anti-Bacterial Agents↗

PubMed2003

A survey of doctors' and nurses' knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals.

This study investigated knowledge about infection control amongst doctors and nurses through a cross-sectional survey conducted between March and May 2001 in three Birmingham, UK teaching hospitals. Seventy-five doctors and 143 nurses, representing 7% and 4%, respectively, of potential respondents, participated in the study measuring knowledge of, attitudes towards, and compliance with universal precautions. Overall knowledge of risks of blood-borne virus (BBV) transmission from an infected patient after needlestick injury was low [44.0% for hepatitis B virus (HBV), 38.1% for hepatitis C virus (HCV), 54.6% for human immunodeficiency virus (HIV)]. There were significant differences between doctors and nurses concerning the estimations of HBV (e-antigen +) (P=0.006) and HIV (P<0.001) transmission risks. Eighty-six percent of nurses stated that they treat each patient as if they are carrying a BBV compared with 41% of doctors. Doctors and nurses differed significantly in their attitudes about and reported compliance with washing hands before and after patient contact and with wearing gloves when taking blood (P<0.001 for all). Doctors consistently de-emphasized the importance of, and reported poor compliance with, these procedures. Doctors were also more likely to state that they re-sheath used needles manually than were nurses (P<0.001). Thirty-seven percent of respondents reported that they had suffered a needlestick injury with a used needle, with doctors more likely to be injured than nurses (P=0.005). Twenty-eight percent of these doctors and 2% of the nurses did not report their needlestick injuries (P=0.004). Education, monitoring, improved availability of resources, and disciplinary measures for poor compliance are necessary to improve infection control in hospitals, especially amongst doctors.

Adult↗

PubMed2001

Cross-infection control in dental practice in the Republic of Ireland.

OBJECTIVE: The purpose of this study was to examine the infection control procedures used in general dental practices in the Republic of Ireland. DESIGN: Postal survey. SETTING: The Republic of Ireland. PARTICIPANTS: 250 general dental practices. METHODS: Postal questionnaire. MAIN OUTCOME MEASURES: Use of infection control procedures; gloves, masks, sterilisation of instruments, staff training. RESULTS: A 74% response rate (n = 177), with 162 wearing gloves for all patients, 97% of whom used latex gloves. Routine glove use by 69% of dental nurses. Approximately one third of respondents complained of hand skin irritation attributed to the wearing of latex gloves. Routine mask wearing during treatment was reported by 68% of respondents. The method of choice for sterilising instruments was the steam autoclave for 97%. Time spent on surgery cleaning between patients was less than one minute in 12 per cent of practices. CONCLUSIONS: Cross-infection control procedures practiced by a high proportion of the respondents to the survey conform to guidelines suggested by various authorities. Further education may be appropriate in a number of areas such as mask wearing and the need to change gloves between patients.

Cross Infection↗

PubMed2006

Infection control and pandemic influenza.

If an influenza pandemic occurs, the spread of the virus should be reduced for as long as possible while an effective vaccine is produced. Influenza spreads mainly by large respiratory droplets (> 5 microm) depositing onto the mucosal surfaces of the eye, mouth or respiratory tract. Hands are another major means for spread, and are frequently contaminated by droplets. The most effective way to reduce the spread of the virus is with good infection control practices and social distancing. Infection control practices include the use of personal protective equipment (PPE), hand hygiene, and respiratory hygiene and cough etiquette. Infected people should be isolated and spatial separation observed in common areas where infected people may be present. Any practices that create aerosols (eg, nebulisation) should be avoided, unless performed with appropriate precautions, especially with all people in the room wearing appropriate PPE. Now is the time to re-examine all our current practices so that we are better prepared, well practised and have good infection control practices in place for all transmissible respiratory infections.

Australia↗

PubMed2006

How much do medical students know about infection control?

Changes in undergraduate medical training mean that students have direct patient contact from an early stage of their training. This study aimed to assess the knowledge of third-year medical students at the University of Birmingham Medical School, UK on infection control policy and procedures. A semi-structured questionnaire was distributed to medical students. Out of 322 students, 156 returned completed questionnaires (48%). Results showed that 58% of medical students did not know the correct indications for using alcoholic hand gel, 35% did not know the correct use of gloves, and 50% did not know the exclusion period after an episode of diarrhoea and vomiting. Sixty-four percent of medical students reported formal teaching on hand hygiene, 12% reported informal teaching, 19% reported both types of teaching and 5% reported no hand hygiene teaching at all. Forty-nine percent of medical students thought that there was insufficient emphasis on infection control in their course. These results raised concerns about medical students' knowledge about infection control. The University is currently reviewing the need for a more structured model for the teaching and assessment of infection control.

Clinical Competence↗

PubMedDate not supplied

[Infection control in dentistry. Educational requirements].

The need for an effective infection control program has always been an essential and integral part of the dental practice. Despite human and material efforts, occupational diseases continue to consume significant health care worldwide and the risk of "cross-infection" remains high. The European dental education requires the specialists in this field to have a high level of medical training, the standards for clinical skills and abilities including knowledge on the control of "cross infection" and the prevention of physical, chemical, and microbial contamination. The results of a questionnaire-based assessment of the knowledge gained by the last year students (VI) of the Iaşi School of Dentistry revealed the need for improving their knowledge in this field by inducing firm clinical behavioral abilities, organization of practical "exercises" in ideal circumstances and conditions for applying the infection control protocols.

Education, Dental↗

PubMed2005

Roles of infection control nurses in Royal Thai Army hospitals.

OBJECTIVE: To study the performance according to the assigned roles of infection control nurses (ICNs) in Royal Thai Army hospitals. MATERIAL AND METHOD: Interviewing ICNs in 6 hospitals. RESULTS: During April and May 2002, 11 ICNs in 6 hospitals were interviewed. Two hospitals had been accredited and 4 were applying for hospital accreditation. Full-time ICNs were identified in 5 and part-time in 6. The ICNs were graduated with bachelor and master degrees in 5 and 6 respectively. Two ICNs graduated with master degree in IC. All could perform their roles in administration, education, surveillance, personnel health, consultation and quality improvement. Only 7 ICNs had experience in outbreak investigation. None were principle investigators in research except for their master degrees. The main problem was the absence of ICNs posts in all except 1 hospital. CONCLUSION: Infection control nurses in Royal Thai Army hospitals in the present study could perform their roles according to assignment except involvement in outbreak investigation in some and in research as the principle investigators in all.

Adult↗

PubMed2003

Infection control practices among tattooists and body piercers in Sydney, Australia.

BACKGROUND: Tattooing and body piercing have a long history, and both have become increasingly fashionable worldwide. There is an association between tattooing/body piercing and hepatitis B and C infections. METHOD: We undertook an observational study to examine the prevalence and predictors of infection control practices among tattooists and body piercers in Sydney, Australia. Within each premise, data were obtained from owners/mangers and nominated staff completion of a knowledge and attitudes questionnaire, owner/manager demonstration of key infection control procedures, and an inspection of the premises. RESULTS: Consent to participate was obtained in 41 of 44 premises (93.2%). A low proportion of owners/managers and staff gave the correct answer for the purpose of disinfection (52.8%/26.9%) and sterilization (50%/53.8%). About one third of owners/managers (38.8%) and 56% of staff reported that their infection control compliance could be improved. Approximately one quarter of owners/managers reported that the frequency of inspections was inadequate. Even though the majority of demonstration and inspection items were complied with, deficiencies were observed concerning washing of hands, wearing of gloves, and sterilization procedures. CONCLUSION: There is a continuing need to improve infection control performance among tattooists and body piercers. The effectiveness of intervention approaches designed to achieve this should be explored.

Adult↗

PubMed1992

Implementing an infection control program for the community-based healthcare facility.

With the rampant increase in patients with communicable diseases, including AIDS and Hepatitis B, a sound infection control program is vital. Focusing on the needs of administrators in community healthcare agencies such as home health agencies, long-term care facilities, and public health departments, the authors discuss infection control concepts and the primary components of an infection control program.

Community Health Centers↗

PubMed1986

Structure and research activities of pediatric infection control programs in the United States and Canada.

Although this survey was not intended to evaluate all aspects of pediatric infection control programs, we hoped to learn about such programs as reflected by the placement and classification of the practitioner and the infection control program in the hospital administrative hierarchy, by salary, and by research priorities and activities. Perhaps our informal survey may prompt pediatric institutions to evaluate the goals of their infection control programs and to explore possibilities for growth and development of the program as well as the practitioner.

Adolescent↗

PubMed1995

Cross-infection control in Malaysian dental practice.

A questionnaire survey on cross-infection control was conducted among 1371 professionally trained dentists whose names appeared in the Malaysian Government Gazette of 1990. A 73.1 percent response rate was obtained. About 13 percent of the dentists routinely did not wear gloves during treatment of patients as opposed to 54 percent who routinely did. About 83 percent and 52 percent of dentists wore a mask and eyewear or glasses respectively when carrying out dental procedures. About 93 percent of dentists would use a new sterile needle for each patient and about 40 percent would wipe working surfaces with disinfectant after each patient. The practice of sterilizing handpieces was found to be uncommon as opposed to the sterilization of hand instruments. Variations were observed in some of the infection control measures by gender, seniority in service and employment status. More than one-third of the respondents had experienced puncture wounds during the last month prior to the survey.

Cross Infection↗

PubMed1991

Infection control policies and guidelines--Scandinavian experience.

In the Scandinavian countries few regulations govern hospital infection control. In Sweden a common procedure manual is used nationwide, consisting of guidelines covering a wide range of nursing and medical procedures performed by the nursing staff. It is revised every fifth year. A recent enquiry to over 150 wards in some 100 hospitals demonstrated that the manual is widely accepted and used. In the other Scandinavian countries, guidelines and policies on a variety of infection control topics have been published.

Clinical Protocols↗

PubMed1999

National guidelines for infection control in The Netherlands.

National guidelines for the prevention of hospital infections in The Netherlands were established by the Working Group on Infection Prevention (WIP) in 1981. Since 1992 these guidelines have functioned as national standards for infection control applicable in all hospitals. The organization of the WIP, the process of developing guidelines and the current guidelines are described. The working group has also produced guidelines for nursing homes, institutions for the mentally handicapped and dentists.

Cross Infection↗

PubMed2003

Infection control for SARS in a tertiary neonatal centre.

The Severe Acute Respiratory Syndrome (SARS) is a newly discovered infectious disease caused by a novel coronavirus, which can readily spread in the healthcare setting. A recent community outbreak in Hong Kong infected a significant number of pregnant women who subsequently required emergency caesarean section for deteriorating maternal condition and respiratory failure. As no neonatal clinician has any experience in looking after these high risk infants, stringent infection control measures for prevention of cross infection between patients and staff are important to safeguard the wellbeing of the work force and to avoid nosocomial spread of SARS within the neonatal unit. This article describes the infection control and patient triage policy of the neonatal unit at the Prince of Wales Hospital, Hong Kong. We hope this information is useful in helping other units to formulate their own infection control plans according to their own unit configuration and clinical needs.

Cross Infection↗

PubMed2005

Problems and obstacles in implementation of nosocomial infection control in Thailand.

OBJECTIVES: To study the problems in implementation of nosocomial infection (NI) control in Thailand and strategies to overcome the obstacles. MATERIAL AND METHOD: Interviewing administrators, chair-persons of infection control committee and doctors. RESULTS: During June 2002 and August 2003, 255 persons were interviewed by infection control nurses using a set of questionnaires. Administrators, chair-persons of infection control committee, doctors in 32 hospitals across the country were enrolled by stratified random sampling. Policy on NI control was known to 95.3% and implementation to 81.2% of subjects. The main obstacles of NI control was the lack of incentive (66.7%) and support from administrators (30.2%). Hospital administrators set NI control at high priority, in only 40.9%, they could be motivated by regular presentation of NI data. Infection control nurses (ICN) should ideally work full-time (88.6%) but in reality, only 20.8% did so. The main problem for NI control was the shortage of ICN posts in most hospitals. This resulted in no career ladder and incentive for ICN. To overcome these problems, support from administrators, more education programs in NI control and provision of posts for ICN, are needed. CONCLUSION: The main problems and obstacles an implementation of NI control were the lack of support from administrators and the lack of the ICN post.

Cross Infection↗

PubMed1988

Postdoctoral nursing education in infection control: program description.

The need to identify and evaluate those clinical practices that are efficacious in reducing risk of nosocomial infection is clear. A model of large-scale programmatic evaluation is the Study of the Efficacy of Nosocomial Infection Control. Other important clinical studies have demonstrated the effectiveness of practices such as closed urinary drainage and management of intravascular lines and the ineffectiveness of such practices as double bagging and routine gowning in the newborn nursery. Clearly, research is one essential way to direct practice in infection control. It is our goal that the Johnson & Johnson/SURGIKOS Postdoctoral Nursing Fellows in Infection Control will make a significant contribution to the knowledge base in the specialty. The need for collaboration by government, industry, and academia in addressing health care research needs has been recently emphasized. We also believe that this Program can serve as one model for such a collaborative effort.

Baltimore↗

PubMed2005

[The design and content validity of an infection control health education program for adolescents with cancer].

The purpose of this article is to describe the process of designing an Infection Control Health Education Program (ICP) for adolescents with cancer, to describe the content of that program, and to evaluate its validity. The program consisted of an audiovisual "Infection Control Health Education Program in Video Compact Disc (VCD)" and "Self-Care Daily Checklist (SCDC)". The VCD was developed from systematic literature reviews and consultations with experts in pediatric oncology care. It addresses the main issues of infection control among adolescents. The content of the SCDC was designed to enhance adolescents' self-care capabilities by means of twice daily self-recording. The response format for content validity of the VCD and SCDC was a 5-point Likert scale. The mean score for content validity was 4.72 for the VCD and 4.82 for the SCDC. The percentage of expert agreement was 99% for the VCD and 98% for the SCDC. In summary, the VCD was effective in improving adolescents' capacity for self-care and the extensive reinforcement SCDC was also shown to be useful. In a subsequent pilot study, the authors used this program to increase adolescent cancer patients' self-care knowledge and behavior for, and decrease their levels of secondary infection.

Adolescent↗

PubMedDate not supplied

Observations relating to an inter-hospital outbreak of methicillin-resistant Staphylococcus aureus: role of antimicrobial therapy in infection control.

Clinical, bacteriologic, epidemiologic and hospital infection-control observations related to an inter-hospital outbreak of methicillin-resistant Staphylococcus aureus are described. The outbreak involved 66 patients at the University of Oregon Health Sciences Center (UOHSC) and its closely affiliated VA hospital, the Portland VA Medical Center (PVAMC). No environmental source of infection was identified; person-to-person transmission was most likely responsible for its spread. Surveillance cultures demonstrated nasal colonization in house staff and nursing personnel at both hospitals. Inter-hospital transfer of infection was, in all likelihood, achieved via nasal carriage by a single physician. Case-control analysis indicated a significantly increased risk (p less than 0.05) of acquisition of infection related to age, number of days hospitalized, severity of underlying disease and number of invasive procedures. Prior antibiotic receipt was a significant risk factor when analyzed by univariate analysis (p less than 0.01), but, in contrast to previous studies, this was not a significant risk factor (p greater than 0.05) when related variables were controlled by multivariate analysis. Prevention of spread of infection by routine infection control measures was less effective at PVAMC than at UOHSC. Patients at PVAMC were significantly older and had longer durations of hospitalization (p less than 0.05). Antimicrobial therapy of colonized patients and personnel appeared to assist in the control of the outbreak at PVAMC. Antimicrobial therapy with topical bacitracin and oral rifampin, alone or in combination with oral trimethoprim-sulfamethoxazole, was effective in eliminating colonization with methicillin-resistant S. aureus.

Administration, Oral↗