The Journal of hospital infection
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Tuberculosis infection control in hospitals has received renewed interest after decades of low prominence following the occurrence of multiply drug-resistant strains in populations of patients with immune systems affected by HIV. This paper examines the history of tuberculosis infection control in hospitals and how recent outbreaks have influenced contemporary measures. ⋯ Procedures which may generate infectious aerosols should be carried out in similarly ventilated rooms. The quality assurance in such infection control is through the administrative systems put in place, staff training and the engineering controls of isolation room ventilation.
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Comparative Study
Risk-adjusted infection rates in surgery: a model for outcome measurement in hospitals developing new quality improvement programmes.
Assessment of healthcare quality is a major challenge in countries such as Hungary where there is limited experience with measurement of patient outcomes. We sought to develop the capacity for valid outcome measurement in Hungarian hospitals using surgical site infection (SSI) surveillance as a model and to identify areas for improvement by comparing SSI rates in Hungarian hospitals to benchmarks published by the United States Centers for Disease Control and Prevention's National Nosocomial Infection Surveillance (NNIS) System. We surveyed the incidence of SSI among 5126 patients undergoing 6006 procedures in 20 public hospitals in Hungary during 1996 using the Hospitals in Europe Link for Infection Control through Surveillance (HELICS) protocol, a protocol consistent with the methods used by the NNIS System. ⋯ Future work should focus on optimizing prevention strategies for patients undergoing cholecystectomy, open reduction of fracture, and mastectomy. The effect of the utilization of open vs. laparoscopic cholecystectomy, short procedure duration, and procedure volume on SSI rates should be evaluated further. This programme expanded the capacity of Hungarian hospitals to perform surgical site infection surveillance and can serve as a model for hospitals in other countries with limited experience with outcome measurement.
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Long term care facilities (LTCFs) include a variety of different types of healthcare settings, each with their own unique infectious disease problems. This report focuses on the epidemiological considerations, risk factors and types of infections that occur in elderly patients institutionalized in nursing home settings. In the US, the number of patients in nursing homes continues to grow as the population ages. ⋯ The potential for epidemic infections with antibiotic-resistant organisms is real. In the nursing home setting, attention must be given to develop and support strong infection control programmes that can monitor the occurrence of institutionally-acquired infections and initiate control strategies to prevent the spread of epidemic infections. Education in infection control issues and attention to employee health is essential to enable staff to care appropriately for today's nursing home population and to prepare them for the even more complicated patients who will be cared for in this type of setting in future.
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Nosocomial infections (NI) are a major problem, and numerous measures are being recommended for preventing NIs in Germany. However, the evidence for the efficacy of many currently recommended measures is incomplete or has been established for certain sub-groups of patients or specific conditions only. In view of this situation, it is necessary to improve the established measures for preventing NIs. Since many procedures and components of infection control involve additional expenditure, their deployment can only be justified if their efficiency has been demonstrated or is highly likely on the basis of rational considerations.