Infection prevention data web

Health care is beset with directives from regulatory agencies to provide quality data to national databases, which make the data available to the public at large. The quality and validity of the data is crucial to the success of health care at large. Data collection methods are changing to keep pace with the changing environment, as are data dissemination strategies. The infection control department, in partnership with nurses of critical care units, is moving to electronic data mining of electronic medical records to ensure validity and relevancy of data.     

Infection prevention and control.

Nurses are clearly at risk for exposure to HIV through blood and body fluids, and they frequently use needles and sharp objects. In addition, critical care patients are at high risk for nosocomial infections due to other etiologic agents. This article addresses reducing the risk of infection for both nurses and patients using a variety of strategies.     

Infection control and prevention strategies in the ICU

Although only 5–10% of all hospitalized patients are treated in ICUs, they account for approximately 25% of all nosocomial infections, and the incidence of nosocomial infections in ICUs is 5–10 times higher than that observed in general hospital wards. Systemic and respiratory infections are far more common than in general wards, and most epidemics originate, in ICUs. Nosocomial infections are the primary focus of most infection control programmes because they are the cause of high mortality rates in ICUs. Effective programmes are usually based on the cooperation of the intensive care physician, the infectious disease specialist, the microbiologist and the clinical epidemiologist. The infectious disease specialist develops specific guidelines for the antimicrobial therapy of typical infections which minimize the selective pressure for microorganisms within the ICU. The microbiologist provides rapid and accurate diagnosis of the pathogens involved. The clinical epidemiologist identifies epidemics at early stages, using epidemiological tools and molecular typing methods, as well as summarizing trends of antimicrobial susceptibility patterns and setting standards for isolation practices. A simple and inexpensive way to reduce nosocomial infections in ICUs is to ensure that staff disinfect their hands after dealing with a patient. Intravascular devices, mechanical ventilation and urinary catheterization are major risk factors for nosocomial infections, and their use should be evaluated daily and discontinued as soon as clinically possible. Selective decontamination of the digestive tract and the use of standard immunoglobulin for prophylaxis are still controversial and need further investigation. The use of monoclonal antibodies, such as anti-endotoxin antibodies, has failed to improve the prognosis in the critically ill septic patient. Today, the major infectious threat to ICU patients is the increase in multiply-resistant microor-ganisms: methicillin-resistantStaphylococcus aureus, enterococci andCandida spp. in particular.     

Infection prevention and control for foodborne infections

Patients' care for foodborne infections is sometimes very critical, since these patients exerting high copy numbers of contagious pathogens. Recently, Norovirus infection became the most frequent pathogen for large outbreaks in the community and the hospital around the world. Norovirus is alcohol-resistant and highly contagious. For preventing outbreaks of foodborne infections, standard precaution(and contact precaution for diaper changing patients) is required by the CDC's isolation precaution guideline revised at 2007. We need to provide for infection prevention and control in the epidemic winter period not only in healthcare facilities but also for communities.     

Infection prevention and treatment in patients with major burn injuries

Infection is a significant challenge in burn care, particularly for those patients who have major burn injuries. This article aims to review the literature and establish best practice in prevention and treatment of infection in patients with major burns. The article considers the causes and clinical features of wound infection, and examines systemic and local methods of prevention and treatment.     

疫情时代的医院感染预防与控制:机遇与挑战

中国的感染预防与控制（以下简称“感控”）工作经过30多年的本土化发展,已经建立了符合我国国情的防控体系。新型冠状病毒肺炎疫情发生以来,随着各级卫生行政部门对医院感染的空前重视,各类人员的感控意识不断加强,促进了感控相关学科的交叉融合和发展。但是,在常态化疫情防控下,感控也面临着巨大的压力和挑战。该文总结了新时期感控工作面临的机遇,分析了目前感控领域面临的挑战,旨在为感控工作的未来发展提供一定思路。     

宫颈机能不全足月妊娠产妇的感染控制

目的探讨感染控制在宫颈机能不全足月妊娠产妇中的应用效果。方法对80例宫颈机能不全足月妊娠产妇做好感染控制,内容包括加强手卫生、保持病房环境卫生、做好外阴卫生、加强皮肤护理、减少肛査阴査和减少探视、预防并发症等。结果 1例发生感染,经过积极抗感染,补充能量,增加营养摄入后治愈,其他79例无发生感染。80例均母婴平安。结论感染控制可预防宫颈机能不全足月妊娠产妇感染的发生,提高其围产质量,有效保证母婴平安。     

Infection prevention in intensive care by selective decontamination of the digestive tract

Infection prevention in the ICU by SDD is based on new insights in the pathogenesis of infections. The recognition that the colonization defense of the oropharynx and gastrointestinal tract is severely impaired in critically ill patients plays a crucial role in this concept.Selective decontamination of the digestive tract is a technique aiming at the elimination of aerobic, potentially pathogenic microorganisms from the oropharynx and gastrointestinal tract with topical nonabsorbable antibiotics. It is based on the following observations: the indigenous flora is seldom involved in infections and has important physiologic functions; there are major differences in the intrinsic pathogenic potential of microorganisms; and colonization and infection of the respiratory and urinary tract and wounds are generally preceded by colonization of the oropharynx or gastrointestinal tract.Several studies have shown that SDD is very effective in preventing acquired infections in intensive care. Although in polytrauma patients the outcome seems to improve with SDD, in general surgical patients, the expected reduction of mortality with the prevention of nosocomial infections has not been found. However, none of the studies was designed for that purpose. The most important conclusion is that many patients are admitted in the ICU with potentially preventable infections and that SDD might be more useful in these patients if applied in an earlier stage. Unlike previous attempts with topical antibiotics, emergence of resistance has not been observed. On the contrary, the prevalence of multiresistant strains seems to decrease with the routine application of this regimen. It has been shown that outbreaks with multiresistant gram-negative bacilli can be controlled by SDD.More studies are required to investigate the potential indications and consequences of this technique.     

北京两所医院手术科室护士对手术部位感染预防知识掌握现状的调查分析

目的 了解手术科室护士对手术部位感染(SSI)预防知识的掌握现状,确定影响护士掌握SSI预防知识的相关因素.方法 采用横断面描述性研究,以自行设计的<手术科室护士SSI预防知识调查问卷>为资料收集工具,对北京市两所三甲医院手术科室护士进行问卷调查.结果 共发放问卷312份,回收率和有效率分别为91.0%和96.1%.手术科室护士知识得分平均为(6.63±2.20)分,及格52名(19.3%).经过岗前培训的护士,知识得分高于未经岗前培训的护士,差异有统计学意义(P＜0.05),不同科室护士之间的知识得分差异有统计学意叉(P＜0.01).结论 手术科室护士的SSI预防知识不足以提供有效的SSI预防措施,提示需进一步加强对手术科室护士进行SSI知识的岗前培训和继续教育.     

白色念珠菌医院感染调查及预防

目的凋查白色念珠菌引起医院感染的原因，制定预防和控制医院内白色念珠菌感染的措施。方法对2003年1～12月106例白色念珠菌引起医院感染的患者进行调查分析。结果免疫抑制剂、广谱抗生素的广泛应用，各种侵入性操作和临床严重疾病的不断上升，是引起医院内白色念珠菌感染的主要原因。结论严格按照药敏试验使用抗生素，防止菌群失调，严格无菌操作，做好消毒隔离工作，防止外源性感染；积极治疗原发病；及时补充营养，提高机体抵抗力是预防医院内感染白色念珠菌的重要措施。     

Infection prevention and control in the era of the AIDS/HIV epidemic

The chronology of important events in the AIDS/HIV epidemic is presented in Table 2. Nurses are the largest group of health care workers and persons who provide direct care and handle sharp objects regularly. As the number of persons infected with HIV increases and as more infected persons become ill enough to require care, the opportunity for an individual nurse to have contact with an infected person will increase. Because many persons with HIV infection also have Kaposi's sarcoma and other malignancies, some oncology nurses may have more contact with HIV-infected individuals than nurses in general. However, it is well established that the major risk for HIV infection is from puncture injuries, and a number of strategies are available and are being developed to make needle and sharps handling safer. Nurses must take personal responsibility for knowing how to reduce their own risks for exposure to HIV and other infectious agents while keeping in mind the need not to increase risks of nosocomial infections in patients. Thus, all nurses need a comprehensive understanding of the purposes of barriers (eg, gloves, gowns, masks, handwashing, room assignment) and when and how to use them correctly. In addition, all nurses who have contact with blood and body fluids should take responsibility for their own immunity to hepatitis B by obtaining hepatitis B vaccination. By using all of these strategies in combination, many infection risks to nurses and patients will be minimized.