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Infection Control in Primary Care

2. Hospital Epidemiology(Infection Control) . 3. Epidemiology is the scientific process applied to the control of infections in the healthcare setting. . 4. "It may seem a strange principle to enunciate as the very first requirement in a hospital that it should do the sick no harm" Florence Nightingale.

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Infection Control in Primary Care

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    6. 6 History of infection control and hospital epidemiology in the USA Pre 1800: Early efforts at wound prophylaxis 1800-1940: Nightingale, Semmelweis, Lister, Pasteur 1940-1960: Antibiotic era begins, Staph. aureus nursery outbreaks, hygiene focus 1960-1970’s: Documenting need for infection control programs, surveillance begins 1980’s: focus on patient care practices, intensive care units, resistant organisms, HIV 1990’s: Hospital Epidemiology = Infection control, quality improvement and economics 2000’s: ??Healthcare system epidemiology

    7. 7 Why do we need infection control?? Hospitals and clinics are complex institutions where patients go to have their health problems diagnosed and treated But, hospitals, clinics, and medical/surgical interventions introduce risks that may harm a patient’s health

    8. 8 Nosocomial infection Any infection that is not present or incubating at the time the patient is seen in the hospital or clinic.

    9. 9 Additional morbidity Prolonged hospitalization Long-term physical, developmental and neurological sequelae Increased cost of hospitalization Death

    10. 10 Challenges to the healthcare epidemiologist Make a healthcare setting safe Prevent harm to the patient and employees focus on infectious diseases

    11. 11 What is healthcare epidemiology? The fundamental roles of healthcare epidemiology are to: Identify risks Understand risks Eliminate or minimize risks

    12. 12 What is the role of healthcare epidemiology? Identify risks to patient’s health Find nosocomial infections surveillance Identify and study risk factors for nosocomial infections understand epidemiologic principles and methods understand nosocomial pathogens what is it about healthcare institutions that increases risk?

    13. 13 What is the role of healthcare epidemiology? Eliminate or minimize risks to a patient’s health organize care to minimize risk eliminate risk factors work around risk factors develop improved policies and procedures educate physicians and nurses regarding risks study risk factors to learn more about them and how to eliminate them

    14. 14 Responsibilities of the Infection Control Program Surveillance of nosocomial infections Outbreak investigation Develop written policies for isolation of patients Develop written policies to reduce risk from patient care practices Cooperation with occupational health Education of hospital staff on infection control Ongoing review of all aseptic, isolation and sanitation techniques Eliminate wasteful or unnecessary practices

    15. 15 Areas of interest to a healthcare epidemiologist Surveillance for nosocomial infection 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 Reviewing policies and procedures for patient care

    16. 16 Organizing for Infection Control Requires cooperation, understanding and support of hospital administration and medical/surgical/nursing leadership There is no simple formula: Every facility is different Every facility’s problems are different Every facility’s personnel are different The facility must develop its own unique program

    17. 17 Personnel Hospital Epidemiologist MD with clinical training Training in infection control Infection Control Practitioner Usually a nurse but can be a microbiologist Has clinical experience before entering infection control Training in infection control

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    19. 19 Organizing for Infection Control Main elements Establish policies and regulations to reduce risks Develop with clinicians (physicians and nurses) Develop and maintain a program of continuing education for hospital personnel Use scientific (epidemiologic) methods to study problems and test hypotheses

    20. 20 Resources: Where to get more information or help 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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