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PubMed1993

APIC position paper: prevention of device-mediated blood-borne infections to health care workers. 1992 Governmental Affairs Committee of the Association for Practitioners in Infection Control, Inc.

The Association for Practitioners in Infection Control, Inc. (APIC) is a multidisciplinary organization of over 9000 health care professionals who practice institutional epidemiology in the form of infection control and quality improvement within a variety of settings. As a national leader in prevention and control of infections, APIC supports efforts to reduce and eliminate device-mediated blood-borne infections.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Surgical wound infections occurring in day surgery patients.

The occurrence of surgical wound infection in outpatient day surgery has not been extensively studied despite the increasing popularity of this mode of treatment. The present study was conducted to determine the frequency of surgical wound infections in a day surgery population. We randomly selected during a 6-month period 635 (25%) of 2540 patients undergoing a day surgery procedure in which a skin incision was made. The patients were telephoned 1 month after their procedure by an infection control practitioner. Infection was diagnosed if the patient reported that (1) their physician had made a diagnosis of a wound infection or (2) pus was or had been issuing from the wound. Of the 515 patients contacted, 72% had undergone a clean and 28% a clean-contaminated procedure. Patient risk factors for infection were almost completely absent in our day surgery patients. Twenty-six wound infections were diagnosed, 19 of which were identified by physicians' diagnosis and 7 by patient description, for a rate of 5.05%. Two patients required hospitalization for their infections, and 14 were treated with antibiotics. The clean wound infection rates were 4.62%, less than half the infection rate seen in our patients undergoing inpatient surgery at 1 month follow-up by the same surveillance technique. We conclude that day surgery infection rates are much lower than inpatient surgery infection rates at our facility, probably because of a relative absence of risk factors in the day surgery patients.

Ambulatory Surgical Procedures↗
PubMed1996

Prevention and control of nosocomial infections in Spain: current problems and future trends.

Spain is a state member of the European Union, with more than 180,000 hospital beds and 800 public and private institutions. Only 6.9% of our gross national product is devoted to health expenditures. All citizens receive free health care through the National Health System. This system has given increasing attention to the prevention and control of nosocomial infections since 1986. In this article, results of serial prevalence surveys of antibiotic use and resistance patterns of microorganisms isolated from nosocomial infections are discussed. The needs for future development of infection control and quality assurance training programs in Spain also are discussed. Overall, a clinically and epidemiologically oriented approach to infection control is preferred, with greater emphasis in the role of infection control practitioners and infection control committees.

Anti-Bacterial Agents↗
PubMed1991

The nonexistent problem.

Effective assessment of problems is essential for the infection control practitioner to function optimally. Today's infection control practitioner not only learns problem solving on the job but is trained in both individual and participatory problem solving techniques. Correct response to a potential problem requires careful investigation and identification of causal relationships. Most literature, however, is directed at solving problems that exist. The phenomenon of nonexistent problems exists when the presented problem is not real but exists only in the perception of the presenter. In some cases, the nonexistent problem may partially represent a real problem, but the relationship may not be readily apparent. Time spent by infection control practitioners responding to nonexistent problems is significant. Without the ability to distinguish between nonexistent and existent problems, needless and ineffective actions may be taken. It is essential that the infection control practitioner understand both the dynamics resulting from the presentation of nonexistent problems and their characteristics.

Hospitals↗
PubMed1991

Study of the definition of nosocomial infections (SDNI). Research Committee of the Association for Practitioners in Infection Control.

If nosocomial infections are to be used as clinical indicators of quality, their definitions must be accurate. To assess validity and reliability of definitions of nosocomial infection, a study was conducted in two groups of U.S. hospitals. Group A consisted of a stratified, random sample of 715 hospitals and excluded those that are part of the National Nosocomial Infections Surveillance System. The 112 NNIS hospitals were surveyed separately in group B. Both groups used the same instrument, consisting of 36 case studies simulating patients' charts. Content and construct validity were formally tested and demonstrated. Six case studies were presented for each of the four major NI sites and for community-acquired or no infection. The pooled hospital response was 48% (396/827). The pooled number of individual responders whose data were used in the analysis was 469. Their overall mean score was 84%, and the score for correctly identifying any NI was 83%. Both groups were best at identifying urinary nosocomial infections (Group A = 92%, Group B = 93%) and poorest for no infection (Group A = 62%, Group B = 75%). Group A responders had significantly higher scores if they were certified, had a baccalaureate or higher degree, had taken a formal infection control course, had worked in infection control for greater than or equal to 2 years, or had worked full time in infection control in a greater than or equal to 200-bed hospital that was affiliated with a medical school (all p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

A statewide characterization of hospital infection control practices and practitioners.

Selected features of infection control programs among the 163 general hospitals in Tennessee were surveyed in 1976 and 1979. Each hospital but one had a designated infection control practitioner. Three-fourths of the hospitals had fewer than 200 beds and most were in rural areas. The practitioners in these small hospitals worked in an isolated professional milieu: few (4%) had attended a basic training course or were members of a national (11%) or local (16%) infection control association. They also had significantly less access to standard infection control resource publications than did practitioners in large hospitals. Use of aqueous quaternary ammonium compounds for disinfection was reported by 37% of all hospitals in 1979; 68% of hospitals routinely performed bacteriologic cultures of personnel or the environment. In contrast, only 3% of hospitals did not have a policy specifying the use of sterile closed-system drainage of indwelling bladder catheters. Although these practices varied somewhat by hospital size, the differences were not statistically significant. Modest improvement in each parameter was noted since 1976. Pathology was the most common medical specialty (34%) among chairman of infection control committees; internal medicine and pediatrics accounted for only 13%. The practice of routine microbiologic monitoring was significantly more common among hospitals with chairmen who were pathologists. The implications of these findings for national priorities in hospital infection control are discussed.

Bacteria↗
PubMed1992

Impact on knowledge and practice of a multiregional long-term care facility infection control training program.

BACKGROUND: Few affordable training opportunities are specifically designed for the long-term care facility infection control practitioner. There is also little evidence of the success of training in improving infection control practices. The Nebraska Infection Control Network developed a 2-day basic skills training program for Midwestern long-term care facility infection control practitioners that was later disseminated to eastern and western training sites. In this study we examined the effectiveness of the training program in terms of trainee knowledge and practice. METHODS: From 1986 to 1990, a total of 17 courses conducted at the three sites were attended by a total of 266 infection control practitioners. Trainees completed a 40-item multiple choice test before and after training to evaluate their knowledge gain. Implementation of eight key infection control practices and time devoted to infection control duties were measured before training and at 3 and 12 months after training. Implementation of infection control practices was also evaluated in a second study, with infection control practitioners randomly assigned to trained and wait-control conditions. RESULTS: Significant increases after training were found at each site for both knowledge and implementation measures. These increases were maintained at 12 months follow-up. Time devoted to infection control duties increased significantly at the midwest and western sites but not at the eastern site. In the second study, significant differences were found between the trained and the wait-control group in use of infection control practices, providing evidence for a causal relationship between training and increased use of practices. CONCLUSIONS: The training program was effective in producing improvements in knowledge and implementation of recommended infection control practices in long-term care facilities. These improvements were consistent across three diverse geographic areas. There were some specific geographic differences.

California↗
PubMed1984

Training of personnel for infection control.

The overall objectives for implementing an infection control program are to make hospital personnel aware of nosocomial infections and to educate these persons in their role in decreasing the risk of these infections. The infection control practitioner (ICP) implements these objectives by performing surveillance to determine problem areas and by developing policies and procedures that prevent and control nosocomial infections. Appropriate qualities for an ICP include initiative, leadership, communication skills, commitment, and charisma. Expertise in patient care practices, aseptic principles, sterilization practices, education, research, epidemiology, microbiology, infectious diseases, and psychology are acquired skills. Local, state, and national organizations, as well as universities, are responsible for ICP training, In the US the Centers for Disease Control have established a training program for the beginning ICP and the Association of Practitioners in Infection Control (APIC) has developed a study guide for developing infection control skills. The ultimate responsibility for education is an individual obligation, however. Certification of the ICP would insure a minimum level of knowledge, thereby standardizing and upgrading the practice of infection control.

Asepsis↗
PubMed1986

Infection control in the Netherlands.

A survey was made by the Dutch association of infection control practitioners (VHIG) concerning the organization of infection control in Dutch hospitals and the activities of its members. The results are reported and compared with recent American studies. A comparison is made between a group of infection control technicians (ICTs) who were not nurses and a group of nurses (ICNs), working in infection control. Although the ICT has significantly more daily contacts with the hospital microbiologist and is more often secretary to the infection control committee and the ICN visits the outpatient department significantly more often, the other activities in their practice are essentially the same. From this study we conclude that either an ICT or an ICN can adequately function as an infection control practitioner in the Netherlands.

Adult↗
PubMed1994

Same problems, different system? A UK perspective of infection control in an American hospital.

1. Infection control practitioners are at the forefront of enforcement of infection control procedures in the US. 2. HIV infection is cited as the single most prominent cause of increases in cases of TB in most US health departments. 3. Attention to record keeping is an area in which infection control practitioners in the UK would be well advised to emulate their US colleagues.

HIV Infections↗
PubMed1995

Hospital epidemiology in smaller hospitals.

In hospitals with 200 to 300 beds, hospital epidemiologists serve primarily as medical and epidemiology consultants to the infection control practitioners, as advocates for the infection control programs, and as chairpersons of the infection control committees. Because smaller hospitals often have limited resources for infection control, surveillance and control activities must focus on issues that have caused problems for the facility and on compliance with mandates and recommendations made by healthcare agencies. The clinical microbiology laboratory plays an important role in ongoing surveillance activities and often is responsible for performing cultures obtained during point prevalence culture surveys or outbreak investigations. Because laboratory support often is limited, the indications for obtaining a culture from patients, personnel, or the inanimate environment for infection control purposes must be reviewed and discussed carefully with the clinical laboratory in advance.

Cross Infection↗