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At least 667 records · Page 37Linked to original sources
PubMed1991

Simplified cross-infection control: a study of cost, time and patient flow in Antigua.

This study was designed to assess the factors, such as cost of imported dental materials, time spent on cross-infection control procedures and the limited number of dental instruments, that determine the suitability of cross-infection control methods in a government dental clinic in a developing country. During the 6-month study period, 510 adult patients received extraction treatment, the mean treatment time for each patient being 8-9 min. In each session, it was found that every 1-1 1/2 hours, instruments had to be autoclaved again for the treatment of further patients, but patient-flow was maintained. Between patients, a hand washing time of 20-25 s with chlorhexidine was recorded. Every 1 1/2-2 hours a new pair of gloves had to be used. Work surfaces were disinfected with either 1 per cent chlorine or 2 per cent glutaraldehyde. Extraction of 22 teeth per session was completed within the available working time of 3-3 1/2 hours at a cost for materials of US 50 cents per patient. These cross-infection control procedures were deemed suitable for use in the Government Dental Clinic.

Adult↗
PubMedDate not supplied

A model for a comprehensive infection control program in home healthcare.

A comprehensive infection control program in home healthcare consists of activities related to direct patient care as well as activities that support the provision of such care. All these activities are designed so as to reduce the transmission of infections among a facility's patients and staff members. This article relates how the cause-and-effect diagram becomes an effective tool to systematically delineate the key elements required to accomplish this goal.

Forms and Records Control↗
PubMedDate not supplied

Survey of infection control procedures at manicure and pedicure establishments in North York.

OBJECTIVE: To describe infection control practices used by technicians doing manicures and pedicures in an urban setting in Ontario. METHODS: A random sample of 120 establishments was selected from a sampling frame. A survey was designed and administered to technicians through face-to-face interviews. RESULTS: Technicians in 72 establishments were interviewed, representing a 60% response rate. Twenty-nine (40%) of these technicians indicated that they had been immunized against hepatitis B. Technicians re-used almost all instruments even if this was not the intent of the manufacturer. Isopropyl alcohol was the most commonly used disinfectant. Many technicians did not wear gloves while performing procedures. Most did not follow universal precautions when asked how they would react to incidental cuts on either the client or themselves. CONCLUSION: There is a need for the development of infection control protocols for manicure and pedicure establishments since the potential for transmission of infectious diseases does exist.

Beauty Culture↗
PubMed2002

Effectiveness of a multifaceted infection control policy in reducing vancomycin usage and vancomycin-resistant enterococci at a tertiary care cancer centre.

We undertook a prospective cohort study to evaluate the role of a multifaceted infection control policy including the use of a "vancomycin order form," in decreasing the transmission of vancomycin-resistant enterococci (VRE). In January 1997, a multifaceted infection-control policy was implemented amongst patients admitted to the M. D. Anderson Cancer Center in whom neutropenic fever developed or who were found to be colonized or infected with VRE. As part of this programme, we initiated the use of a vancomycin order form to reduce the use of empirical vancomycin. The total incidence of VRE infections declined from 0.437/1000 patient days in 1996-97 to 0.229/1000 patient days in 1998-99 (P=0.008). The VRE bloodstream infections declined from 0.338/1000 patient days in 1996-97 to 0.181/1000 patient days in 1998-99 (P=0.027). Empiric vancomycin use decreased from 416 g/1000 patient days in 1996-97 to 208 g/1000 patient days in 1998-99 (P<0.001), resulting in a decreased vancomycin cost from $2561 US dollars/1000 patient days in 1996-97 to $1195 US dollars/1000 patient days in 1997-98 (P<0.001). We conclude that a multifaceted infection control policy incorporating the use of a vancomycin order form can effectively decrease the use of empirical vancomycin and can play a role in limiting the spread of VRE in an endemic setting.

Anti-Bacterial Agents↗
PubMed1987

Effectiveness of an infection control programmed unit of instruction in nursing education.

To determine whether programmed instruction is an acceptable, cost-effective alternative to classroom lectures for teaching the basic principles of infection control to nursing students, a 46-frame programmed unit of instruction (PUI), with a pretest and posttest, was developed, piloted, and tested for reliability and validity. The instruments were developed on the basis of current knowledge of the epidemiology of infectious diseases and the 1983 revised Centers for Disease Control guideline for category-specific isolation precautions. A study was undertaken to test the hypothesis: Student nurses who take a PUI in the basic principles of infection control will score higher on posttests than those who do not take the PUI. A sample of 40 subjects was selected from the senior class in a baccalaureate nursing program at a public university. The subjects were randomly assigned to four groups of 10. A Solomon four-group design was used for data analysis, and a two-way analysis of variance was performed on the posttest means. Results indicated that the treatment (PUI) effect was significant (p less than 0.001). Therefore, it was concluded that the PUI in the basic principles of infection control is an effective instrument for nursing education.

Analysis of Variance↗
PubMed2006

[Inspection by infection control team of the University Hospital, Faculty of Dentistry, Tokyo Medical and Dental University].

Factors affecting infection are the existence of infectious microorganisms, sensitivity of hosts, number of microorganisms, and infectious routes. Efforts to prevent infection focus on not allowing these factors to reach the threshold level. Inspection by an infection control team (ICT) of a hospital is one countermeasure for preventing nosocomial infection. We summarize here the problems for complete prevention of nosocomial infection based on the results of inspection by our ICT, so that staff working in the hospital can recognize the importance of preventing nosocomial infection. The following were commonly observed problems in our clinics found by the ICT : (1) incomplete practice of standard precautions and/or isolation precautions, (2) noncompliance with guidelines for the prevention of cross-infection, and (3) inappropriate management of medical rejectamenta. Infection control can be accomplished by strictly observing the standard precautions and isolation precautions. The ICT inspection round in the hospital could be an effective metaff working in the hod to clarify and overcome the problems involved in infection.

Cross Infection↗
PubMed1998

Correlates of infection control practices in dentistry.

BACKGROUND: Studies conducted in the first decade of the AIDS epidemic indicated that, in general, dentists had suboptimal levels of compliance with standard infection control practices, including work practices designed to reduce exposure to bloodborne pathogens. This study was designed to assess current rates of compliance with these practices in a population of Maryland dentists and to identify correlates of safe work practices. METHODS: We surveyed 648 Maryland dentists using a confidential, self-administered questionnaire. RESULTS: Three hundred and ninety-two questionnaires were returned (60% response rate). We found that infection control practices were variable as reported by responding dentists. In addition, several potentially modifiable factors were found to be significantly correlated with these practices, including (1) attitudes toward patients infected with HIV and (2) safety program management within the practice. CONCLUSION: These data are encouraging in that recommended infection control practices are being adopted, at least among a sample of Maryland dentists. Strategies for further improvement are identified.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Protecting health care workers from SARS and other respiratory pathogens: a review of the infection control literature.

BACKGROUND: Severe Acute Respiratory Syndrome (SARS) was responsible for outbreaks in Canada, China, Hong Kong, Vietnam, and Singapore. SARS focused attention on the adequacy of and compliance with infection control practices in preventing airborne and droplet-spread transmission of infectious agents. METHODS: This paper presents a review of the current scientific knowledge with respect to the efficacy of personal protective equipment in preventing the transmission of respiratory infections. The effectiveness of infection control policies and procedures used in clinical practice is examined. RESULTS: Literature searches were conducted in several databases for articles published in the last 15 years that related to infection control practices, occupational health and safety issues, environmental factors, and other issues of importance in protecting workers against respiratory infections in health care settings. CONCLUSION: Failure to implement appropriate barrier precautions is responsible for most nosocomial transmissions. However, the possibility of a gradation of infectious particles generated by aerosolizing procedures suggests that traditional droplet transmission prevention measures may be inadequate in some settings. Further research is needed in this area.

Humans↗
PubMed1992

The final word. OSHA's final ruling offers firm deadlines for infection control.

Departments that have put off program development while waiting for the final ruling to be published have a lot of work to do. Many departments have been cited and fined by OSHA in the past year for failure to begin infection-control programs or provide hepatitis-B vaccines to personnel. Under the new budget, OSHA was granted permission to up its fine structure sevenfold--thus, a small fine is $7,000, and the highest fine for a single violation is $70,000. Fines can have a greater impact on a department's budget than implementation of the program over time. A key point to remember is that a strong infection-control program will reduce exposure follow-up costs and worker-compensation claims. Infection control is a win-win situation.

Blood↗
PubMedDate not supplied

Resources to aid further learning about infection control.

Last year, the National Audit Office published a report outlining progress since its initial analysis of hospital-acquired infection in 2000 (National Audit Office, 2004). It identified that up to 300,000 patients picked up a hospital-acquired infection every year. Contributing factors included: patchy implementation of good infection control practice; a lack of resources for infection control teams; increasing antibiotic resistance; poor isolation facilities; and a lack of data on the extent and cost of hospital-acquired infections. It also identified that a range of approaches was needed to change staff behaviour to reduce the risk of a hospital-acquired infection

Education, Continuing↗
PubMed2001

Infection control considerations in critical care unit design and construction: a systematic risk assessment.

When contemplating major renovation or new construction of a critical care unit (CCU), the use of systematic infection control risk assessment (ICRA) provides guidance to limit infectious perils for patients and to reduce occupational hazards for employees in this environment. The nursing representative and other members of the multidisciplinary planning and design team must routinely address infection control factors throughout the project and assist administration in understanding the rationale for the floor plan, equipment, and furnishings required to support sound infection control practices. Collaborative team skills, articulate communication techniques, and frequent rounds are integral throughout the construction.

Hospital Design and Construction↗
PubMed1984

National survey of hospital infection control organization in Italian public hospitals.

A questionnaire was mailed to 1073 Italian public hospitals in an attempt to find out if infection control programmes existed, the type of programme used and available resources. After two attempts a total of 54.9 per cent of the hospitals responded to the request and of these 16.1 per cent claimed to have an infection control programme. Sixty-six per cent of the hospitals who have a control programme also have a system of continuous surveillance whilst the remainder investigated epidemics only. Infection control programmes were encountered most frequently in paediatrics, obstetrics and surgical departments. The organisms most often surveyed were the salmonellas, other types of enterobacteria, staphylococci and streptococci.

Cross Infection↗
PubMed1993

Infection control in a prosthodontic residency program.

Awareness of the need to incorporate an effective infection control program within a prosthodontic practice requires the faculty of a prosthodontic residency program to present a clear and workable model that will allow the flexibility necessary to accommodate the changes in infection control procedures and materials. The use of the barrier system to insulate the operatory, resident, faculty, and dental laboratory is discussed. Current disinfection and sterilization methods used to maintain the barriers are recommended.

Dental Service, Hospital↗
PubMed1995

Attitudes and beliefs of Canadian infection control decision-makers towards 'borderline' methicillin-resistant Staphylococcus aureus.

'Borderline' methicillin-resistant Staphylococcus aureus (MRSA) strains are inhibited by drug concentrations of 2 to 8 micrograms/mL. This type of resistance is usually mediated by 'hyper beta-lactamase' production which is detectable in vitro by susceptibility to combinations of a beta-lactam and a beta-lactamase inhibitor (ie, amoxicillin and clavulanic acid). A survey of Canadian infection control experts was performed to assess the knowledge, attitudes and beliefs regarding the containment requirements for borderline MRSA strains in acute health care facilities. Twenty-three of 38 Canadian infection control experts (61%) (members of the Canadian Hospital Epidemiology Committee [CHEC] or the Society for Healthcare Epidemiology of American [SHEA]) returned a questionnaire about a fictional patient with a postoperative wound infection with such a strain. Eleven respondents (48%) considered the isolate as an MRSA, 11 did not and one was unsure. All who did not believe the strain to be MRSA would not have isolated or cohorted the patient. Four in the latter group would have isolated the patient if he or she were on a neurosurgery or cardiovascular surgery unit, indicating a desire to restrict spread of this isolate on those units. Seven of the 12 individuals who had managed at least one patient with a borderline MRSA did not advocate patient isolation or cohorting, and five did. This survey has supported the belief that there are discrepancies among infection control decision-makers in Canada regarding the approach, precautions and therapy of patients infected with borderline strains of MRSA. Further data on virulence of and effective therapy for these isolates are needed to assess whether the additional cost is warranted in controlling the nosocomial spread of these isolates.

Canada↗
PubMed1995

Recommendations for preventing the spread of vancomycin resistance. Recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC).

Since 1989, a rapid increase in the incidence of infection and colonization with vancomycin-resistant enterococci (VRE) has been reported by U.S. hospitals. This increase poses important problems, including a) the lack of available antimicrobial therapy for VRE infections, because most VRE are also resistant to drugs previously used to treat such infections (e.g., aminoglycosides and ampicillin), and b) the possibility that the vancomycin-resistant genes present in VRE can be transferred to other gram-positive microorganisms (e.g., Staphylococcus aureus). An increased risk for VRE infection and colonization has been associated with previous vancomycin and/or multiantimicrobial therapy, severe underlying disease or immunosuppression, and intraabdominal surgery. Because enterococci can be found in the normal gastrointestinal and female genital tracts, most enterococcal infections have been attributed to endogenous sources within the individual patient. However, recent reports of outbreaks and endemic infections caused by enterococci, including VRE, have indicated that patient-to-patient transmission of the microorganisms can occur either through direct contact or through indirect contact via a) the hands of personnel or b) contaminated patient-care equipment or environmental surfaces. This report presents recommendations of the Hospital Infection Control Practices Advisory Committee for preventing and controlling the spread of vancomycin resistance, with a special focus on VRE. Preventing and controlling the spread of vancomycin resistance will require coordinated, concerted efforts from all involved hospital departments and can be achieved only if each of the following elements is addressed: a) prudent vancomycin use by clinicians, b) education of hospital staff regarding the problem of vancomycin resistance, c) early detection and prompt reporting of vancomycin resistance in enterococci and other gram-positive microorganisms by the hospital microbiology laboratory, and d) immediate implementation of appropriate infection-control measures to prevent person-to-person transmission of VRE.

Anti-Bacterial Agents↗
PubMed2001

The role of economic evaluation in infection control.

Given the rise in health care-related expenditures, decision-makers are increasingly relying on both clinical effectiveness and economic efficiency when making health care decisions. The field of infection control is not immune to this rise in cost-consciousness among health care managers. This article clarifies the role of economic evaluation within infection control for both the user and producer of economic evaluations in this field. The strengths and drawbacks of the several different types of economic analysis--cost minimization, cost-effectiveness, cost-benefit, and cost utility analysis--will be discussed. Additionally, the important features of two specific methods used for economic evaluation-decision analytic modeling and economic analysis alongside a clinical trial-will be outlined. Finally, the criteria by which economic analyses should be judged will be provided. As economic evaluation and health services research continue to play an increasingly important role in health care, it will be vital for infection control advocates to partner with individuals from diverse fields to give decision-makers the type of information they need to make choices.

Clinical Trials as Topic↗
PubMed1988

Study on the efficacy of nosocomial infection control (SENIC Project): results and implications for the future.

The purpose of the Study on the Efficacy of Nosocomial Infection Control (SENIC Project) was to evaluate nosocomial infection prevention and control programs in hospitals in the United States. The overall plan was to assess the surveillance and control activities in hospitals in the United States in 1970 and 1976, to measure the change in the nosocomial infection rates from 1970 to 1976 as determined from a carefully conducted retrospective chart review, and to assess the influence of changes in these programs on infection rates after controlling for other important changes that occurred during the interval. The SENIC 'bottom line' was that 32% of infections that would have occurred in the absence of well-organized infection surveillance and control programs were potentially preventable. However, only 6% of infections were actually being prevented by programs that existed in 1976. The critical components of an effective program were a balance between surveillance and control efforts, one infection control nurse for every 250 beds, a trained hospital epidemiologist, and feedback of surgical wound infection rates to practicing surgeons. In the United States, priorities for nosocomial infection prevention and control efforts include infections caused by emerging pathogens such as coagulase-negative staphylococci, enterococci, and Candida species; infections of the blood stream and surgical wounds; and infections in critical-care units. In addition, there is a critical need for timely analysis and dissemination of surveillance data and for continued training of infection control practitioners and physicians to maximize the effectiveness of prevention and control efforts.

Cross Infection↗