Outline of this topic contains hospital program, infection control (IC) responsibility, program components, nosocomial infection surveillance, an organization for surveillance, and Staff health promotion and education.
Prevention of nosocomial infection is the responsibility of all individuals and services provided by the healthcare setting. Prevention of nosocomial infection is the responsibility of all individuals and services provided by the healthcare setting. A comprehensive, effective and supported program is essential for reducing infection risk and increasing hospital safety. It should include surveillance, preventive activities, and staff training.
I. National program developed by Ministry of Health: to support hospital programs. It sets national objectives, develops and updates guidelines recommended for health care.
II. Hospital programs including:
1) major preventive efforts; keeping in mind patients and staff.
2) It must be supported by senior management and provided with sufficient resources.
3) It must develop a yearly work plan to assess and promote all good health care activities.
It contains the infection control team, IC committee, and IC manual.
The optimal structure varies with hospitals types, needs, and resources.
The hospital can appoint an epidemiologist or infectious disease specialist, microbiologist to work as an infection control physicians. Infection control nurse who is interested and has experience in infection control issues.
The team should have the authority to manage an effective control program.
The team should have direct reporting with senior administration. Infection control team members or are responsible for day-to-day functions of infection control (IC) and preparing the yearly work plan. They should be experts and creative in their job.
It is a multidisciplinary committee responsible for monitoring program policies implementation and recommends corrective actions. It includes representatives from different concerned hospital departments &management. They meet bimonthly. It establishes standards for patient care, reviews and assesses IC reports, and identifies areas of intervention.
Every Hospital should have a nosocomial infection prevention manual compiling recommended instructions and practices for patient care.
This manual should be developed and updated in a timely manner by the infection control team. It is to be reviewed and accepted by the IC committee.
The role of every hospital department and service unit must be identified, documented as manuals kept inaccessible place. Job description of every hospital staff; defining details of his duties must be discussed before employment. Infection control precautions should be part of the routine work and stressed for that.
It completes in the following steps-
Surveillance
Preventive activities and
Staff training
The nosocomial infection rate in a hospital is an indicator of quality and safety of care. Surveillance to monitor this rate is essential to identify problems and evaluate control activities. The ultimate aim is the reduction of infection rate and their costs. The term surveillance implies that observational data are regularly analyzed.
Active surveillance (Prevalence and incidence studies)
Targeted surveillance (site, unit, priority-oriented)
Appropriately trained investigators
Standardized methodology
Risk-adjusted rates for comparisons
Data collection and analysis
1. ward activity: devices or procedure, fever and infection sign, antibiotics and charts
2. Laboratory reports: Culture and sensitivity, resistance patterns, serological tests
3. Data elements and analysis: patient data and infection, population and risks, computerization of data
Feedback and dissemination
Prompt, relevant to the target group
Meetings and discussions
Dissemination by committee
1. Health care workers (HCWs) are at risk of acquiring infection, they can also transmit the infection to patients and other employees.
2. Employee health history must be reviewed, immunizations recommendations to be considered.
3. Release from work if sick, occupation injury must be notified.
4. Continuous education to improve practice, better performance of new techniques.
