AIDS: problem solving in infection control. Infection control, human immunodeficiency virus, and home health care: I. Infection risk to the patient.
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Compelling data exist for the return on investment of infection control activities. Such information is important in the era of managed care where cost containment and accountability are mandated.
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To study the impact of the professional background of infection control personnel, we compared the characteristics and activities of 107 infection control nurses (ICNs) with those of 13 infection control laboratorians (ICLs), all in hospitals with 300 beds or more. Although the two groups performed similarly in many respects. ICNs spent more time teaching, whereas ICLs spent more time and appeared more proficient in investigating outbreaks. Staff nurses at hospitals with ICNs found the infection control person more visible on the wards and more available for discussing infection control matters. ICNs appeared less hesitant to speak up to personnel not following correct handwashing techniques. ICNs and ICLs appear to offer different skills that should be considered when filling different infection control positions.
Infection control programs were among the first organized efforts to improve the quality of healthcare delivered to patients and are an excellent model for the development of other healthcare performance improvement activities. Whether labeled as infection control, quality improvement, or patient safety, performance improvement initiatives share similar methods and principles. The quality of care in long-term-care facilities (LTCFs) has been scrutinized for years and has received renewed attention with the recent initiation of public reporting of quality measures by Medicare. This article reviews the principles of performance improvement, discusses the importance of employing evidence-based interventions, and emphasizes the value of local performance improvement in LTCFs. Residents of LTCFs remain at high risk for the development of nosocomial infections, and among performance improvement initiatives, infection control is recommended as a high priority for all LTCFs. Fortunately, infection control contains the essential elements for performance improvement, and a successful infection control program can provide the foundation for expanding performance improvement throughout the LTCF. There is still much that needs to be done to determine the best clinical practices for LTCFs, and this should remain a priority for future research. Furthermore, efforts should continue to apply these principles at the local level to ensure that all residents of LTCFs receive the best care possible.
Infection control is a dynamic and ever-changing subject and all dental staff should be kept aware of the most up-to-date procedures required to prevent the transmission of infection and should understand why these procedures are necessary. Regular monitoring and updating of all procedures in the light of new scientific evidence is necessary and all new staff must be trained in infection control procedures prior to working in the surgery. A practitioner who is routinely following an appropriate infection control policy, including the use of techniques and products of proven efficacy (perhaps through accreditation), is better placed to refute allegations arising in the course of civil litigation, health and safety at work prosecution, complaints and disciplinary procedures, or investigations by the GDC.
A frequently expressed concern regarding infection control guidelines is that they require too much time, effort and expense. This paper will address those concerns by examining the relationship between infection control and clinical efficiency. Infection control procedures can be minimized if proper attention is given to the concept of Limited Surface Contamination. Adherence to a clearly defined Zone of Contamination is essential. Emphasis should be on prevention rather than elimination of contamination. By following well-established principles of Dental Assistant Utilization (DAU), or 'four-handed dentistry', clinical efficiency is enhanced and infection control improved. Proper infection control in the dental surgery is virtually impossible without the cooperation and involvement of a well-trained, committed dental chairside assistant.
Infection control in developing countries differs markedly from that in the developed countries. It is important that both local and international authorities take these differences into account when formulating policies for use in developing countries. This review examines these issues and sets out some suggestions for improvements. The advantages of involving local experts in the development of such policies are emphasized.
Our ten-part infection control series concludes with a look at a skill fundamental to nurses everywhere--communication. Just how well do nurses communicate with patients, professionals and other nurses about infection control issues?
There is increasing public and government concern about the risks of transmission of diseases in dentistry. This can be addressed by implementing a voluntary self regulatory infection control assessment process. Such a system (AMADA Quality Management) has been developed and implemented in South Australia and has eased the pressure on the Government to legislate for the establishment of minimum infection control standards for the dental profession. Control of these issues has remained with the profession an the standards achieved have been high and sustainable.
Two new JCAHO requirements focus on engineering controls with infection control crossover.
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This study examined dentists' knowledge of infection control, what dentists say they do to control infection, and what procedures they actually take to prevent the transmission of disease. A professional actor, obviously in need of dental care and playing the part of a patient, was sent to three groups of randomly selected dentists in general practice. The dentists were uninformed subjects who were debriefed about the research immediately after their part in the experiment was completed. The study found that dentists apparently know what they should do to protect themselves from contamination. However, very few dentists discussed HIV or AIDS while taking a pretreatment history of a new patient even if that patient was perceived to belong to a high-risk group. The behavior of the dentists indicates a neglect of this important aspect of a thorough history, providing more evidence that emphasis on infection and infection control is necessary in the dental school curriculum and beyond. Unless dentists learn to fully understand what infections their patients may have, they take the chance of transmitting diseases to other patients as well as to themselves, their staff, and their families.
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Little information exists on the state of infection control (IC) practices in ambulatory sites. In preparation for a JCAHO survey, 62 ambulatory sites were visited to monitor and improve IC practices. A dedicated IC practitioner was instrumental in improving practices at ambulatory sites and in successfully completing a JCAHO survey.