Das Gesundheitswesen
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With the increase of treatable chronic diseases and of the number of elderly persons in society, rehabilitation and social services to compensate disabilities are getting increasingly important. At the same time, social security systems today are hard pressed to control health care costs and to justify their services. ⋯ For this reason knowledge and use of this Classification are now being taught to experts of the MDK (German medical service of health insurances). The way how this is done in the MDK Berlin-Brandenburg and first results are reported.
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Although microorganisms are the main cause of nosocomial infections, they are by no means their only determinants. Patient-associated factors play a major role (especially immune status), the therapeutic conditions (personnel behaviour, 'devices') and the patient's environment. The hospital infection control team is responsible for implementing and operating an efficient and cost-effective infection control and prevention system. ⋯ The increase in methicillin (oxacillin) resistant S. aureus (MRSA) is particularly worrying. Building up an effective surveillance system for nosocomial infections, as demanded by the new German infection control act has far-reaching implications and entails recording risk-adjusted infection rates (KISS project = Hospital Infection Surveillance System of the National Reference Center for Hospital Hygiene in cooperation with the Robert Koch-institute). Proper collaboration between hospital staff in implementing infection control measures, and especially hand hygiene is of paramount importance.