Professional Documents
Culture Documents
Florence Nightingale
2
Nosocomial infection =
Any infection that is not present or
incubating at the time the patient is
admitted to the hospital
Surveillance of nosocomial
infections
Outbreak investigation
Develop written policies for
isolation of patients
Development of written policies to
reduce risk from patient care
practices
Cooperation with occupational
health
Cooperation with quality
improvement program
10
bloodstream infections
pneumonia
urinary tract infections
surgical wound infections
Patterns of transmission of
nosocomial infections
Outbreak investigation
Isolation precautions
Evaluation of exposures
Employee health
Disinfection and
sterilization
Hospital engineering and
environment
water supply
air filtration
Antibiotic use
Antibiotic resistant
pathogens
Microbiology support
National regulations
on infection control
Infection control
committee
Quantitative
methods in
epidemiology
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13
14
External organizations
establish rules and
regulations
Data collection for
comparison with outside
standards
Inspections for compliance
Penalties for noncompliance
TQM/QI approach
Internal organization of
hospital staff to develop goals
and methods
Data collection for internal
review
Continuous efforts to improve
Failure belongs to the entire
system, not an individual
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Personnel
Hospital Epidemiologist
MD with clinical training
Usually part time salaried by the hospital for infection control
duties and part time as infectious diseases clinician
Training in infection control
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Main elements
Develop an effective surveillance system
Establish policies and regulations to reduce risks
Develop with clinicians (physicians and nurses)
20
Occupational health
Provide resource to other departments for
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Advisory
Review ideas from infection control team
Review surveillance data
Expert resource
Help understand hospital systems and policies
Decision making
Review and approve policies and surveillance plans
Policies binding throughout hospital
Education
Help disseminate information and influence others
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Hospital Epidemiologist
Infection Control Practitioners
Administrator
Ward, ICU and Operating room Nurses
Medicine/Surgery/Obstetrics/Pediatrics
Central Sterilization; Hospital Engineer
Microbiologist; Pharmacist
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Training Courses
Society of Hospital Epidemiologists of America (SHEA)
Association of Professionals in Infection Control (APIC)
National courses and congresses
Books
Textbooks: Bennett and Brachman - Wenzel - Mayhall
APIC Curriculum and Guidelines; CDC Guidelines
Journals
Infection Control and Hospital Epidemiology
Journal of Hospital Infections
American Journal of Infection Control
Consulting services
National: CDC, Ministry of Health; Colleagues
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27
Age
Obesity
Malnutrition (low albumin)
Diabetes
Steroids/immunosuppression
Prolonged pre-op
hospitalization
Infection at another
site
Prolonged procedure
Drains
Urgency of surgery
Foreign body
Skill of surgeon
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29
Recommendation
31
Eliminate waste
Example: Unnecessary nursing techniques
32
Eliminate waste:
Unnecessary microbiologic monitoring
34
Environmental Culturing:
U. of Wisconsin Hospital Experience
35
InfectionSite ExcessD
ays
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36
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programexpenses
Hospitalsavings
$186,700
Each $1000 invested in infection control
will return $3000 in net direct cost savings
37
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