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The outbreak of corona virus disease (COVID-19) has raised concerns among dentists to develop strategies to prevent infection of dental equipment, materials, and patients during an epidemic period. Strategies following the National Laws and Standards of China and local standards of several provinces for controlling cross-infection and instituting protective measures for medical staff in dental clinics during an epidemic period are discussed. A proposal is put forth for dental clinics that will face similar situations in the future. Further research is warranted to address potential problems that will be encountered under such dire circumstances.
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The purpose of this study was to investigate the actual conditions of nosocomial infection control in Kathmandu City, Nepal as a basis for the possible contribution to its improvement. The survey was conducted at 17 hospitals and the methods included a questionnaire, site visits and interviews. Nine hospitals had manuals on nosocomial infection control, and seven had an infection control committee (ICC). The number of hospitals that met the required amount of personal protective equipment preparation was as follows: gowns (13), gloves (13), surgical masks (12). Six hospitals had carried out in-service training over the past one year, but seven hospitals responded that no staff had been trained. Eight hospitals were conducting surveillance based on the results of bacteriological testing. The major problems included inadequate management of ICC, insufficient training opportunities for hospital staff, and lack of essential equipment. Moreover, increasing bacterial resistance to antibiotics was recognized as a growing issue. In comparison with the results conducted in 2003 targeting five governmental hospitals, a steady improvement was observed, but further improvements are needed in terms of the provision of high quality medical care. Particularly, dissemination of appropriate manuals, enhancement of basic techniques, and strengthening of the infection control system should be given priority.
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Objective To investigate the application effect of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital. Methods The first-time qualification rate of cleaning,packaging and sterility test and incidence rate of nosocomial infection before and after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital.The application effect was comprehensively evaluated. Results The first-time qualification rate of cleaning,packaging and sterility test after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center were significantly increased.The incidence rate of nosocomial infection was 1.5％ before and 5.5％ after the application of cleaning packaging of surgical medical apparatus and instruments,the difference was significant. Conclusions Application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center can effectively control the cleaning and packaging quality,guarantee the thoroughness of subsequent disinfection and sterilization,decrease the incidence rate of nosocomial infection caused by poor quality of surgical medical apparatus and instruments.It creates reliable medical environment for patients and obtain good social and economic benefit,which is worthy of wide application.
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Objective To investigate the effect of total quality management of foreign surgical instruments in nosocomial infection control in the sterilization and supply center. Methods The effect before and after the application of total quality management for foreign surgical instruments in the control of nosocomial infection in the sterilization and supply center was comparatively analyzed. Results The results showed that after the application of total quality management for foreign surgical instruments,the onetime passing rate of sterilization and limits of microbial detection of surgical instruments increased significantly compared with that before application.The passing rate after application was significantly higher than before.The difference was significant.The implementation rate of planed surgery depending on foreign surgical instruments was 98.3％,the rate was 92.4％ before application.There was a significant difference before and after application,the nosocomial infection rate after surgery depending on foreign surgical instruments was 0.88％,before the application was 6.50％,there was a significant difference before and after application. Conclusions Application of total quality management of foreign surgical instruments can significantly improve the efficiency of the use of foreign equipment and working efficiency of the operation room,reduce costs and the incidence of nosocomial infection significantly.It should be applied in the management of foreign surgical instruments in the sterilization and supply center.
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Trata-se de um estudo quantitativo descritivo e transversal. Objetivou conhecer a atuação do enfermeiro no Controle de Infecção Hospitalar no Estado do Paraná. Foi aprovado pelo comitê de ética seguindo a Resolução 196/96 do Conselho de Saúde. A coleta de dados foi de julho a setembro de 2007, como instrumento, utilizou-se um questionário auto-aplicado enviado via web e correio a todos os enfermeiros do Serviço de Controle Infecção Hospitalar das instituições hospitalares do Paraná que se ajustaram aos critérios de inclusão: cem ou mais leitos. Participaram da pesquisa 56,5% da população alvo. Informaram sobre a caracterização das instituições quanto à forma de prestação de serviço, tempo de constituição da Comissão de Controle de Infecção Hospitalar e organização do serviço de controle de infecção hospitalar. Os dados apontaram que a prática desenvolvida na rotina do enfermeiro do Serviço de Controle de Infecção Hospitalar se concentra na implantação do sistema de vigilância epidemiológica (100%); em investimentos em educação continuada, (84,6%); na adequação, implementação e supervisão de normas e rotinas (100%) e no fornecimento de parecer técnico para a aquisição de materiais e equipamentos médico-hospitalares (73%). Constatou-se que somente 7,6% dos participantes divulgavam as taxas de infecção hospitalar e apenas 3,8% dos enfermeiros estavam envolvidos com programas de imunização do staff profissional. As principais dificuldades identificadas foram a sobrecarga de trabalho (51,7%), a falta de compromisso e despreparo dos profissionais (58,6%) e a desvalorização do serviço pelos enfermeiros assistenciais (10,3%). Os fatores que facilitaram a atuação do enfermeiro foram o apoio da administração nas tomadas de decisões (27,5%), adesão da equipe de enfermagem às orientações (20,6%), experiência e conhecimento técnico (20,6%), aceitação e respeito do corpo clínico (20,6%). Os dados mostraram que as atividades do enfermeiro são norteadas pela Portaria MS nº 2.616/98, porém existe falta de tempo hábil para executá-las de forma eficiente. Ressaltou a dificuldade da incorporação dos enfermeiros assistenciais na função primária de prevenção como hábito, bem como de outros profissionais. Evidenciou o papel vigilante do enfermeiro do SCIH, e a necessidade da incorporação de práticas que não centralizem a responsabilidade do controle de infecção hospitalar apenas num grupo específico de profissionais, e sim que a prevenção dessas infecções seja foco de todas e em todas as áreas estimulando o desenvolvimento dessa como uma cultura. O estudo trouxe à tona as interfaces da atuação do enfermeiro do Serviço de Controle Infecção Hospitalar, no Estado do Paraná e pode contribuir tanto para o desenvolvimento de novas linhas de ação no âmbito do controle de infecção em nível Estadual, como com a própria atuação do enfermeiro, pela socialização dos resultados, estimulando-os no aperfeiçoamento de seu trabalho.
This is a descriptive and quantitative cross-sectional study. The nurse role in the Hospital Infection Control in hospitals of the state of Paraná was the objective of the study. It was approved by the ethics committee, following the Resolution 196/96 of the Council of Health. The data collection occurred from July to September 2007, using a questionnaire self-applied sent via web and mail to nurses that work at Hospital Infection Control Service in all institutions of Paraná that adjusted to the inclusion criteria: one hundred or more beds. From the target population, 56.5% participated. They informed about the characterization of the institutions on how to provide service, time of formation of the Commission of Control of Hospital Infection and organization of the service of nosocomial infection control. The data showed that the practice developed in the routine of the nurse focuses on the development of the epidemiological surveillance (100%); continuing education, (84.6%), the adequacy, implementation and supervision of rules and routines (100%) and the provision of technical advice for the purchase of materials and equipments (73%). It was found that only 7.6% of the participants inform the rates of hospital infection and only 3.8% of the nurses were involved with programs of immunization of the staff. The main problems identified were the work overload (51.7%), lack of commitment and preparedness of the professionals (58.6%) and the underestimation of the importance of the service (10.3%). The factors that contribute to improve the performance of the nurses were: the support of the administration (27.5%), attachment of the nursing staff to the guidelines (20.6%), experience and technical knowledge (20.6%), acceptance and respect of the colleagues (20.6%). The data showed that the activities of the nurses are guided by Order No 2.616/98 MS, but there is lack of time to implement them efficiently. It was shown also the difficulty of introducing the primary prevention in the nursing care practice, as well as in other professionals practices. The role of surveillance of the SCIH nurse was emphasized, but it showed also the need for sharing the responsibility of the control of nosocomial infection with other groups of professionals, and prevention of these infections should be the focus of all and in all areas. The study brought to light the interfaces of the role of nurse of the Hospital Infection Control Service, in the State of Paraná, and the contribution to the development of new lines of action under the control of infection in the State level.
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Humans , Male , Female , Adult , Middle Aged , Professional Practice , Nurses , Infection Control , Cross Infection , Practice Patterns, Nurses' , Nurse's Role , Nursing , Epidemiological MonitoringABSTRACT
Since 2000, the authors have been conducting technical cooperation on nosocomial infection control at Bach Mai Hospital (BMH) in Vietnam, which is the first trial in the country. The main contents include: (1) Consolidation of the bases of nosocomial infection control at BMH, which include setting up the appropriate control system and providing training for hospital staff, (2) Cooperation in the SARS outbreak, (3) Fact-finding survey on nosocomial infection, and (4) Preparation against avian influenza at hospitals. As a result of these activities, nosocomial infection control at BMH has been enhanced and the staff is providing technical guidance to other hospitals in recent years with the aim to disseminate skills and knowledge widely in Vietnam. The questionnaire survey on preparedness against SARS, including awareness among staff, training situation, infection control system in hospital, etc., showed comparatively good results in Vietnamese hospitals. The present paper summarizes the collaboration on nosocomial infection control between Vietnam and Japan.<br>Nosocomial infection control is considered essential to upgrade the quality of medical care. Also, constant efforts to upgrade the skills and knowledge of medical staff and to set up an efficient infection control system will be useful in dealing with the potential risk of resurgence of SARS or human influenza pandemic. Nosocomial infection control is one of the most appropriate subjects for technical cooperation at hospitals in developing countries.
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OBJECTIVE To know the status of nosocomial infection control of epidemic measles in medical units at all levels of the epidemic area.METHODS The scene of the correlated medical units by cross-sectional study was investigated.RESULTS There were 7 children cases included 1 case of measles,4 cases with fever and 2 ordinary childrens cases in a local city general hospital.At the rural health clinic,a total of 19 cases were studied,including 3 cases with measles infection,2 cases of suspected measles cases,10 cases of children with fever and other children 4 cases.CONCLUSIONS The infected sources concentrate in grass roots medical unit relatively,The problem of isolating infected sources,protecting high risk crowd and measures for medical staff in grass roots medical unit should be improved.
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OBJECTIVE To investigate the management and sanitation status of the air circumstance in laminar flow operating rooms of grade two and above hospitals in Beijing.METHODS Air surveillance methods,cleaning methods of intakes,cleaning status of pipelines and frequency of renewing filter systems were investigated through interviewing charge nurse of 18 hospitals by questionnaires.RESULTS 50.0% of pipelines had never been cleaned,14.3% of intakes had never been cleaned.Air surveillance method of all hospitals was using sedimentation,with a low sensitivity.The monitoring systems were poor in 50.0% of hospitals.CONCLUSIONS Now there is only requirements of construction standard of clean surgery region,lacking routine regulations and technologies of contamination controlling standard,nor available dynamic contamination controlling system.Potential hazard exists in routine regulations of laminar flow operating room and it demands for making contamination controlling standard urgently in hospitals.
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OBJECTIVE To evaluate the capabilities of nosocomial infection control in local general hospitals in handling public health emergencies,and to provide reliable data for future work.METHODS A random sampling questionnaire method was adopted to investigate how nosocomial infection control in local hospitals performed their functions and handled public health emergencies.RESULTS The 15 hospitals which were surveyed had all been equipped with computer network of directly reporting epidemic situations of infectious diseases.Four from 15 hospitals had full-time employees reporting epidemic situations,and 11 had part-time employees.Twelve hospitals established,according to standards,a department of infectious diseases or a department of pre-examination and sorting diagnosis.Seven hospitals did not have full-time staff of infection control till 2003.The rate of the staff's knowledge of nosocomial infection control was 73.7%.The medical wastes of the 15 hospitals were all disposed at the local medical waste disposal center.CONCLUSIONS Our city,in terms of nosocomial infection control,has acquired certain capabilities of handling public health emergencies.But the capabilities vary from hospital to hospital.Further improvement in some work is still needed.
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Severe Acute Respiratory Syndrome (SARS) has rapidly spread and caused epidemics in many countries. During these epidemics, the Japanese government contributed to SARS control by dispatching medical teams. In the present article, the author reviews and discusses the process of control of the SARS outbreak based on experiences in activities to support SARS control in Vietnam and China.<BR>Vietnam succeeded in the effective control of SARS for the first time in the world. This was accomplished by complete isolation of patients and implementation of nosocomial infection control from an early stage of epidemic, etc. In China, due to inadequate response in the early stage, nosocomial infection occurred frequently and the disease quickly spread. However, later, effective actions were taken under the strong direction of the government, and the disease was finally put under control. The Japan Medical Team for Disaster Relief dispatched by the government of Japan to Hanoi, Vietnam and Beijing, China offered cooperative activities for the prevention of nosocomial infection and respiratory management. In addition, the Medical Aid Team sent to Guangdong Province in China provided guidance to the local Japanese residents to prevent the infection of SARS and to alleviate anxiety about the disease.<BR> In the control of SARS, it is essential to take adequate actions from an early stage in the development of the disease. For this purpose, rather than starting measures for the control of nosocomial infection after the eruption of the disease, it is important to train medical staff on a routine basis, to establish a nosocomial infection control system, and to consolidate basic preventive practices.
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This study was designed to compare the nurse and nurses aids on their perception and performance levels for nosocomial infection control and to evaluate the relevant variables. The study data were obtained from 246 nurses and 219 nurse aids working at two university hospitals in Seoul, by using a constructed questionnaire. The data was collected from March to April of 1998, and analyzed using the SAS program for t-test, two way ANOVA, Pearson's Correlation Coefficients. The results were as follows; 1. The mean score of the perception level for nosocomial infection control of the nurse(M= 4.72) was higher than that of the nurses aids(M= 4.56). 2. No significant association was found between the nurse and nurses aids on their performance level for nosocomial infection control. 3. The score of perception level showed significant interaction by age in all domains, by career in contaminated material and environmental management, and by department in sterile and environmental management. Regarding the performance levels, the score showed significant association between hand washing and clothing management by age and career. However, there was no significant difference by department. 4. A positive correlation was found in the perception and performance levels for nosocomial infection control between the nurse and nurse aids. In conclusion: the mean score of the perception level for nosocomial infection control in nurses was higher than that of their performance level. In the case of nurses aids, the mean scores of the perception and performance level for the nosocomial infection control were the same but lower than those of the nurses. It is suggested that appropriate hospital infection control programs should be developed by continuous systemic education and practice to improve the nurse and nurses aids' level of perception and performance for nosocomial infection control.
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Clothing , Cross Infection , Education , Hand Disinfection , Hospitals, University , Seoul , Surveys and QuestionnairesABSTRACT
BACKGROUND: It is well known that Methicillin-resistant Staphylococcus aureus (MRSA) is hardly controllable organism among pathogens of nosocomial infection. The MRSA infection control measures have been initiated at a brand new tertiary care teaching hospital which was opened in June, 1994. However, the control measures did bring out little effect. In 1997, reenforcement of all control measures were practiced in intensive care units. The measures brought out a significant improvement in reducing the incidence of MRSA infection, subsequently the same control measures were implemented through-out the entire inpatient area. METHODS: The following control measures have been reenforced since March 1997: first, application of thorough surveillance of confirmed MRSA infected patients: second, providing cohort care: third, enforcing handwashing practices after patient contact; fourth, establishing infected patients isolation zone: fifth, tagging infected patient's bed and medical record, providing disinfectant spray for washing hands, identifying and treating carriers among patient contact staffs, separate disposal of contaminated wastes, and finally repeating education of nursing staff and family members of the patients. Each month the number of incidence in MRSA nosocomial infection were followed and the leu supervisors were notified the outcome. RESULTS: The incidence of MRSA infection started to decline soon after the initiation of the control measures, from 132% in March 1997 to 5.8% in July 1997. In 1998, the infection rate maintained close to 2-3%. There had been 467 MRSA infected cases (5.7%) out of 8,253 discharges during the study period; among them 319 cases were infected once; 40 cases twice; 15 cases three times: four cases four times and 1 case seven times. The order of preference of organs infected are lungs (56.3%), wounds(11.8%), blood (7.9%), and urinary tract (1.9%). The highest incidence of this infection was found in Medicine (34.8%) and Neurosurgery (22.8%) CONCLUSION: The implementation and reenforcement of infection control measures are key to successful control of nosocomial infection, in particular, hand washing of patient contact staffs and eradication of carriers could be the most effective measures.
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Humans , Cohort Studies , Cross Infection , Education , Hand , Hand Disinfection , Hospitals, Teaching , Incidence , Infection Control , Inpatients , Intensive Care Units , Critical Care , Lung , Medical Records , Methicillin-Resistant Staphylococcus aureus , Neurosurgery , Nursing Staff , Tertiary Healthcare , Urinary TractABSTRACT
BACKGROUND: Nosocomial urinary tract infection (UTI) is the most frequent nosocomial infection and could be prevented through the intensive nosocomial infection control (NIC) or restricting the use of indwelling urinary catheter. The efficiency of the intensive NIC to prevent UTI for the patients with indwelling urinary catheter was investigated. METHODS: Study population consisted of 296 patients with indwelling urinary catheter in the intensive care unit (lCU) who didn't have UTI on admission. The incidence rates of nosocomial UTI were compared between 146 patients being provided with ordinary NIC from March 15 to July 31, 1995 (control group) and 150 patients being provided with intensive NIC from January 16 to October 31, 1996 (NIC group). RESULTS: There was significant decrease in the incidence of nosocomial UTI in the NIC group (35 UTI among 150 patients, 23.8%) than in me control group (68 UTI among 146 patients, 46.6%) (P<0.01). But there were no differences in age distribution, sex, admission route to the ICU and underlying diagnoses between two groups. Interval between insertion of urinary catheter and development of UTI was significantly prolonged in the NIC group (10.0 +/- 3.5 days) than in the control group(7.6 +/- 3.9 days) (p < 0.01) despite there were no differences in the duration of urinary catheterization in two groups. The most common organism isolated from the urine of the patients was Candida tropicalis in both groups and the other organisms were in the order of Enterococcus faecium, Pseudomonas putida, Staphylococcus epidermidis in the control group and in the order of Staphylococcus aureus, Acinetobacter baumannii, Enterococcus faecalis in the NIC group. Four of five Staphylococcus aureus isolated in NIC group were MRSA. CONCLUSION: This study result confirms the efficiency of intensive NIC fur decrease in the incidence of nosocomial UTI in patients with indwelling urinary catheter. But the incidence of nosocomial UTI should be decreased further through the continuous emphasis on NIC and it seems to be necessary to study the effect of each component of NIC with proper control of the risk factors for the development of nosocomial UTI in the future.
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Humans , Acinetobacter baumannii , Age Distribution , Candida tropicalis , Cross Infection , Diagnosis , Enterococcus faecalis , Enterococcus faecium , Incidence , Intensive Care Units , Critical Care , Methicillin-Resistant Staphylococcus aureus , Pseudomonas putida , Risk Factors , Staphylococcus aureus , Staphylococcus epidermidis , Urinary Catheterization , Urinary Catheters , Urinary Tract Infections , Urinary TractABSTRACT
OBJECTIVE To ascertain the current situations of nosocomial infection control in local general hospitals,and to provide reliable data for future work.METHODS A random sampling questionnaire(method) was adopted to investigate the current situations of nosocomial infection control in 15 local hospitals in eight counties and cities.RESULTS Altogether 15 hospitals at the county and urban levels have been surveyed,(among) which 14 hospitals have fewer than 300 sickbeds and only 1 hospital has over 500 sickbeds.Seven hospitals did not have full-time staff of infection control till 2003.In the 15 hospitals,each full-time staff was(responsible) for an average of 143.9(sickbeds);in terms of the constitution of the full-time staff,nurses accounted for 73.7%,doctors,21.9%,and technicians,5.2%;of the full-time staff,63.2% held an intermediate(professional) position,and 36.8% held a junior professional position;with regard to the chances of further professional training in other places,19 full-time staff had 56 chances.The applications of sterilized agents and protective equipments were increasing each year.CONCLUSIONS The(infection) control in local general hospitals is gradually on the right track,but in some aspects,improvements are still needed.The prerequisites for improving infection control work in local general hospitals are that leaders should pay more attention to nosocomial infection control,and that more human and(material) resources should be pooled in it.