Pub Date : 2006-12-01DOI: 10.1177/14690446060070060301
S. Newsom
Introduction The plot thickens. I mentioned multiple-drug-resistant (MDR) strains of Mycobacterium tuberculosis in part one published in the last issue of this journal. The drastic control measures taken in the US were followed by a reduction in cases, and are recommended in the National Institute for Health and Clinical Excellence (NICE) guidelines on tuberculosis recently published by the Royal College of Physicians (2006). However, we now have extensively drug resistant (XDR) strains, which are also resistant to some of the ‘third line’ drugs used to treat MDR infections. Of 17 690 isolates from reference laboratories throughout the world in 2000 to 2005, 20% were MDR and 2% were XDR. XDR strains were found as far apart as the US, South Korea and Latvia (Morbidity and Mortality Weekly Report, 2006). The potential danger of XDR strains is shown in an outbreak in South Africa, 52 of 53 patients (all with HIV) died within a median of 25 days. All had been in hospital previously, raising the likelihood of nosocomial infection – this was a real ‘wake-up call’ (Lawn and Wilkinson, 2006). However, back to history. Was the disease familial or contagious? Hippocrates mentioned the phthisic diathesis. The occurrence of the disease in families (the Keats’ for example) and the high death rate in small children (grandfather coughing over the baby) suggested a genetic element. Galen thought phthisis was contagious and later Benjamin Marten (1722) wrote in A new theory of consumptions: ‘The original and essential cause may possibly be certain species of animalculi or wonderfully minute living creatures that by their peculiar shape or disagreeable parts are inimical to our nature... Worms and animalculi fretting and gnawing.’
{"title":"The history of infection control: Tuberculosis: part two — Finding the cause and trying to eliminate it","authors":"S. Newsom","doi":"10.1177/14690446060070060301","DOIUrl":"https://doi.org/10.1177/14690446060070060301","url":null,"abstract":"Introduction The plot thickens. I mentioned multiple-drug-resistant (MDR) strains of Mycobacterium tuberculosis in part one published in the last issue of this journal. The drastic control measures taken in the US were followed by a reduction in cases, and are recommended in the National Institute for Health and Clinical Excellence (NICE) guidelines on tuberculosis recently published by the Royal College of Physicians (2006). However, we now have extensively drug resistant (XDR) strains, which are also resistant to some of the ‘third line’ drugs used to treat MDR infections. Of 17 690 isolates from reference laboratories throughout the world in 2000 to 2005, 20% were MDR and 2% were XDR. XDR strains were found as far apart as the US, South Korea and Latvia (Morbidity and Mortality Weekly Report, 2006). The potential danger of XDR strains is shown in an outbreak in South Africa, 52 of 53 patients (all with HIV) died within a median of 25 days. All had been in hospital previously, raising the likelihood of nosocomial infection – this was a real ‘wake-up call’ (Lawn and Wilkinson, 2006). However, back to history. Was the disease familial or contagious? Hippocrates mentioned the phthisic diathesis. The occurrence of the disease in families (the Keats’ for example) and the high death rate in small children (grandfather coughing over the baby) suggested a genetic element. Galen thought phthisis was contagious and later Benjamin Marten (1722) wrote in A new theory of consumptions: ‘The original and essential cause may possibly be certain species of animalculi or wonderfully minute living creatures that by their peculiar shape or disagreeable parts are inimical to our nature... Worms and animalculi fretting and gnawing.’","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116246720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-12-01DOI: 10.1177/14690446060070060401
S. Millership, M. Edoo
ntense international interest following serious human infections with avian influenza and the possibility of the virus becoming a pandemic strain has resulted in a huge range of literature on the subject. There is a confusing mixture of evidence-based information and expert, sometimes conflicting, opinion. The following is an attempt to distill essential points and highlight where advice differs. Guidance is frequently revised; as the Health Protection Agency points out this is `an ongoing activity' (HPA, 2006b). There is a clear need to simply the numerous publications into a few readable documents to assist busy professionals who do not have time to search the multitude of publications currently available.
{"title":"Review of guidance for pandemic influenza","authors":"S. Millership, M. Edoo","doi":"10.1177/14690446060070060401","DOIUrl":"https://doi.org/10.1177/14690446060070060401","url":null,"abstract":"ntense international interest following serious human infections with avian influenza and the possibility of the virus becoming a pandemic strain has resulted in a huge range of literature on the subject. There is a confusing mixture of evidence-based information and expert, sometimes conflicting, opinion. The following is an attempt to distill essential points and highlight where advice differs. Guidance is frequently revised; as the Health Protection Agency points out this is `an ongoing activity' (HPA, 2006b). There is a clear need to simply the numerous publications into a few readable documents to assist busy professionals who do not have time to search the multitude of publications currently available.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116202325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-12-01DOI: 10.1177/14690446060070060201
{"title":"HAI rates decrease over last decade","authors":"","doi":"10.1177/14690446060070060201","DOIUrl":"https://doi.org/10.1177/14690446060070060201","url":null,"abstract":"","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121697297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-12-01DOI: 10.1177/14690446060070060701
M. Cole
he importance of high-quality research to address our knowledge deficits in relation to the causes of hospital-acquired infection has been acknowledged by the Department of Health. However, the contribution of nursing research may be restricted by confusion over the use of different paradigms and the discipline's lack of research pedigree. This paper discusses how nursing and infection control has historically favoured quantitative methods as they are associated with rigour, objectivity, generalisation and increased credibility. However, increasingly nurse researchers are turning to qualitative methods as they better explain the complex behavioural issues that affect practice. The paper describes a number of qualitative methods and infection control studies that have adopted these approaches. It concludes by suggesting that infection control nurses, because of their close relationship with practice are well placed to consider the merits of qualitative research as a way of contributing towards the discipline's research agenda.
{"title":"Qualitative research: a challenging paradigm for infection control","authors":"M. Cole","doi":"10.1177/14690446060070060701","DOIUrl":"https://doi.org/10.1177/14690446060070060701","url":null,"abstract":"he importance of high-quality research to address our knowledge deficits in relation to the causes of hospital-acquired infection has been acknowledged by the Department of Health. However, the contribution of nursing research may be restricted by confusion over the use of different paradigms and the discipline's lack of research pedigree. This paper discusses how nursing and infection control has historically favoured quantitative methods as they are associated with rigour, objectivity, generalisation and increased credibility. However, increasingly nurse researchers are turning to qualitative methods as they better explain the complex behavioural issues that affect practice. The paper describes a number of qualitative methods and infection control studies that have adopted these approaches. It concludes by suggesting that infection control nurses, because of their close relationship with practice are well placed to consider the merits of qualitative research as a way of contributing towards the discipline's research agenda.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123273788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-12-01DOI: 10.1177/14690446060070060601
M. Tunney, C. Hughes, J. Magee
ackground: Limited information is available regarding the role of infection control in the prevention of infection in nursing and residential care homes. Objectives: To determine what infection control policies and procedures are in place in care homes for older people in Northern Ireland. Methods: Anonymous postal questionnaire survey of all 410 nursing and residential homes in Northern Ireland that provide care to residents over the age of 65. Results: A total of 318 (78%) questionnaires were returned. Visits from infection control nurses from health boards or community trusts were infrequent, with only 23% of homes receiving such a visit. Nearly all homes (99.7%) had a policy on infection control, with 72.4% and 84.3% of homes having a policy on the admission and care of residents with meticillin-resistant Staphylococcus aureus (MRSA) respectively. Of those respondents that had a policy on admission of persons with MRSA, only a small percentage (9.2%) would not admit residents with MRSA. Only 11% of respondents believed that MRSA was a problem in their particular home, but at least 30% agreed that there was a problem with MRSA in care homes. A desire was expressed for more information and support, with 75% of respondents agreeing that more information should be provided to homes on MRSA. Conclusions: There is a clear need for additional infection control advice to be available to care homes and for the development of uniform policies and an infection control audit tool. The audit tool could then be used to ensure that the appropriate policies and standards are in place within care homes and that these standards are met on an ongoing basis.
{"title":"Infection control policies and procedures for meticillin-resistant Staphylococcus aureus in care homes for older people in Northern Ireland: a questionnaire study","authors":"M. Tunney, C. Hughes, J. Magee","doi":"10.1177/14690446060070060601","DOIUrl":"https://doi.org/10.1177/14690446060070060601","url":null,"abstract":"ackground: Limited information is available regarding the role of infection control in the prevention of infection in nursing and residential care homes. Objectives: To determine what infection control policies and procedures are in place in care homes for older people in Northern Ireland. Methods: Anonymous postal questionnaire survey of all 410 nursing and residential homes in Northern Ireland that provide care to residents over the age of 65. Results: A total of 318 (78%) questionnaires were returned. Visits from infection control nurses from health boards or community trusts were infrequent, with only 23% of homes receiving such a visit. Nearly all homes (99.7%) had a policy on infection control, with 72.4% and 84.3% of homes having a policy on the admission and care of residents with meticillin-resistant Staphylococcus aureus (MRSA) respectively. Of those respondents that had a policy on admission of persons with MRSA, only a small percentage (9.2%) would not admit residents with MRSA. Only 11% of respondents believed that MRSA was a problem in their particular home, but at least 30% agreed that there was a problem with MRSA in care homes. A desire was expressed for more information and support, with 75% of respondents agreeing that more information should be provided to homes on MRSA. Conclusions: There is a clear need for additional infection control advice to be available to care homes and for the development of uniform policies and an infection control audit tool. The audit tool could then be used to ensure that the appropriate policies and standards are in place within care homes and that these standards are met on an ongoing basis.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128683695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-12-01DOI: 10.1177/14690446060070060501
A. Flores, D. Pevalin
espite considerable evidence that appropriate hand hygiene is the leading measure to prevent healthcare-associated infection, compliance with infection control recommendations remains low among healthcare workers. Literature regarding the role that concomitant glove use has on compliance with hand hygiene is limited and conflicting. The aims of this study were to examine healthcare workers' glove use by observation and to evaluate the effect that glove use has on compliance with hand hygiene. Non-participant observation was carried out on 12 randomly-selected wards in two district general hospitals. Although the overall compliance rate for glove use was high at 92%, gloves were also overused. The proportion of glove overuse was 42%. Overall hand hygiene compliance was 64%. However, hand hygiene compliance was significantly worse following glove overuse, demonstrating that inappropriate glove use may be a component of poor hand hygiene compliance. Recommendations arising from these results are that, in order to improve adherence to hand hygiene recommendations, multi-faceted interventions should be aimed at changing healthcare workers' glove use behaviour.
{"title":"Healthcare workers' compliance with glove use and the effect of glove use on hand hygiene compliance","authors":"A. Flores, D. Pevalin","doi":"10.1177/14690446060070060501","DOIUrl":"https://doi.org/10.1177/14690446060070060501","url":null,"abstract":"espite considerable evidence that appropriate hand hygiene is the leading measure to prevent healthcare-associated infection, compliance with infection control recommendations remains low among healthcare workers. Literature regarding the role that concomitant glove use has on compliance with hand hygiene is limited and conflicting. The aims of this study were to examine healthcare workers' glove use by observation and to evaluate the effect that glove use has on compliance with hand hygiene. Non-participant observation was carried out on 12 randomly-selected wards in two district general hospitals. Although the overall compliance rate for glove use was high at 92%, gloves were also overused. The proportion of glove overuse was 42%. Overall hand hygiene compliance was 64%. However, hand hygiene compliance was significantly worse following glove overuse, demonstrating that inappropriate glove use may be a component of poor hand hygiene compliance. Recommendations arising from these results are that, in order to improve adherence to hand hygiene recommendations, multi-faceted interventions should be aimed at changing healthcare workers' glove use behaviour.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124451072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-12-01DOI: 10.1177/14690446060070060204
{"title":"Scotland launches new hand hygiene campaign","authors":"","doi":"10.1177/14690446060070060204","DOIUrl":"https://doi.org/10.1177/14690446060070060204","url":null,"abstract":"","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114903846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-10-01DOI: 10.1177/14690446060070050201
Vascular access device toolkit launched at 2006 ICNA conference A unique resource pack for all healthcare professionals aimed at reducing infection rates in patients using vascular access devices was launched at the ICNA conference last month. The toolkit, entitled Preventing Infections in Vascular Access (PIVA), offers both hospital and community healthcare practitioners easily accessible information and guidelines to implement a direct management approach involving practical measures for introducing, managing or removing intravascular devices. The audit tools will inform staff of the actual outcome of these interventions, thus enabling action plans to be developed for targeted education and review of practice. ICNA president professor Dame Jill Macleod Clark said: ‘The PIVA toolkit combines innovation and excellence and provides a gold standard for practice. It is an outstanding example of a resource which will directly reduce the incidence of infections and improve quality of care of patients and their health outcomes.’ The toolkit has been developed by senior representatives of the ICNA in collaboration with 3M Health Care, and its contents can be dowloaded from the websites www.icna.co.uk and www.3mhealthcare.co.uk.
在上个月的ICNA会议上，为所有医疗保健专业人员推出了一个独特的资源包，旨在降低使用血管通路设备的患者的感染率。该工具包名为“预防血管通路感染”(PIVA)，为医院和社区保健从业人员提供了易于获取的信息和指南，以实施直接管理方法，包括引入、管理或移除血管内装置的实际措施。审计工具将使工作人员了解这些干预措施的实际结果，从而能够制定有针对性的教育和审查实践的行动计划。ICNA主席吉尔·麦克劳德·克拉克教授说:“PIVA工具包结合了创新和卓越，为实践提供了黄金标准。”这是一种资源的杰出例子，它将直接减少感染的发生率，改善对病人的护理质量及其健康结果。该工具包是由ICNA的高级代表与3M Health Care合作开发的，其内容可从www.icna.co.uk和www.3mhealthcare.co.uk网站下载。
{"title":"NICE abandons its SSI guidance","authors":"","doi":"10.1177/14690446060070050201","DOIUrl":"https://doi.org/10.1177/14690446060070050201","url":null,"abstract":"Vascular access device toolkit launched at 2006 ICNA conference A unique resource pack for all healthcare professionals aimed at reducing infection rates in patients using vascular access devices was launched at the ICNA conference last month. The toolkit, entitled Preventing Infections in Vascular Access (PIVA), offers both hospital and community healthcare practitioners easily accessible information and guidelines to implement a direct management approach involving practical measures for introducing, managing or removing intravascular devices. The audit tools will inform staff of the actual outcome of these interventions, thus enabling action plans to be developed for targeted education and review of practice. ICNA president professor Dame Jill Macleod Clark said: ‘The PIVA toolkit combines innovation and excellence and provides a gold standard for practice. It is an outstanding example of a resource which will directly reduce the incidence of infections and improve quality of care of patients and their health outcomes.’ The toolkit has been developed by senior representatives of the ICNA in collaboration with 3M Health Care, and its contents can be dowloaded from the websites www.icna.co.uk and www.3mhealthcare.co.uk.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121970883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-10-01DOI: 10.1177/14690446060070050801
N. Vaughan, J. Randle, G. Adams
lostridium difficile is a common cause of diarrhoea in hospitalised patients. It can result in longer hospital stays and due to the need for strict isolation procedures can add significantly to nursing workload. Additionally, it can be very distressing for the patient and if patients are vulnerable to infection it can have serious health consequences. Cross-transmission can be limited by good infection prevention and control practices, however this relies on a sound knowledge base and support from the infection control team. This small-scale study reports on infection control link professionals' knowledge and assesses how they would utilise this knowledge in practice situations. Findings imply that the knowledge base concerning the microorganism was poor, but knowledge relating to general infection procedures was good.
{"title":"Infection control link professionals' knowledge of Clostridium difficile","authors":"N. Vaughan, J. Randle, G. Adams","doi":"10.1177/14690446060070050801","DOIUrl":"https://doi.org/10.1177/14690446060070050801","url":null,"abstract":"lostridium difficile is a common cause of diarrhoea in hospitalised patients. It can result in longer hospital stays and due to the need for strict isolation procedures can add significantly to nursing workload. Additionally, it can be very distressing for the patient and if patients are vulnerable to infection it can have serious health consequences. Cross-transmission can be limited by good infection prevention and control practices, however this relies on a sound knowledge base and support from the infection control team. This small-scale study reports on infection control link professionals' knowledge and assesses how they would utilise this knowledge in practice situations. Findings imply that the knowledge base concerning the microorganism was poor, but knowledge relating to general infection procedures was good.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133641993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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