Hospital-acquired infections / Julia B. Wilcox, editor.

Format:

Book

Contributor:

Wilcox, Julia B.

Language:

English

Subjects (All):

Nosocomial infections.

Physical Description:

1 online resource (391 p.)

Edition:

1st ed.

Place of Publication:

New York : Nova Science Publishers, 2009.

Summary:

Hospital-acquired infections (HAIs), also known as health-care-associated infections, encompass almost all clinically evident infections that do not originate from a patient's original admitting diagnosis. Within hours after admission, a patient's flora begins to acquire characteristics of the surrounding bacterial pool. Most infections that become clinically evident after 48 hours of hospitalization are considered hospital-acquired. Infections that occur after the patient's discharge from the hospital can be considered to have a nosocomial origin if the organisms were acquired during the hospital stay. This new book present a set of reports detailing the depth of the problems as well as suggesting remedies.

Contents:

Intro

HOSPITAL-ACQUIRED INFECTIONS

CONTENTS

PREFACE

GUIDELINE FOR ISOLATION PRECAUTIONS: PREVENTING TRANSMISSION OF INFECTIOUS AGENTS IN HEALTHCARE SETTINGS 2007*

EXECUTIVE SUMMARY

Tables, Appendices, and other Information

Appendix A: Type and Duration of Precautions Recommended for Selected Infections and Conditions

Pre- Publication of the Guideline on Preventing Transmission of MDROs

Summary

Abbreviations Used in the Guideline

PART I: REVIEW OF SCIENTIFIC DATA REGARDING TRANSMISSION OF INFECTIOUS AGENTS IN HEALTHCARE SETTINGS

I.A. Evolution of the 2007 Document

Objectives and Methods

Changes or Clarifications in Terminology

Scope

I.B. Rationale for Standard and Transmission-Based Precautions in Healthcare Settings

I.B.1. Sources of Infectious Agents

I.B.2. Susceptible Hosts

I.B.3. Modes of Transmission

I.B.3.A. Contact Transmission

I.B.3.A.I. Direct Contact Transmission

I.B.3.A.II. Indirect Contact Transmission

I.B.3.B. Droplet Transmission

I.B.3.C. Airborne Transmission

I.B.3.D. Emerging Issues Concerning Airborne Transmission of Infectious Agents

I.B.3.D.I. Transmission from Patients

I.B.3.D.II. Transmission from the Environment

I.B.3.E. Other Sources of Infection

I.C. Infectious Agents of Special Infection Control Interest for Healthcare Settings

I.C.1. Epidemiologically Important Organisms

I.C.1.A. C.Difficile

I.C.1.B. Multidrug-Resistant Organisms (MDROs)

I.C.2. Agents of Bioterrorism

I.C.2.A. Pre-Event Administration of Smallpox (Vaccinia) Vaccine to Healthcare Personnel

I.C.3. Prions

I.C.4. Severe Acute Respiratory Syndrome (SARS)

I.C.5. Monkeypox

I.C.6. Noroviruses

I.C.7. Hemorrhagic Fever Viruses (HFV)

I.D. Transmission Risks Associated with Specific Types of Healthcare Settings.

I.D.1. Hospitals

I.D.1 .A. Intensive Care Units

I.D.1.B. Burn Units

I.D.1.C. Pediatrics

I.D.2. Non-Acute Healthcare Settings

I.D.2.A. Long-Term Care

I.D.2.B. Ambulatory Care

I.D.2.C. Home Care

I.D.2.D. Other Sites of Healthcare Delivery

I.E. Transmission Risks Associated with Special Patient Populations

I.E.1. Immunocompromised Patients

I.E.2. Cystic Fibrosis Patients

I.F. New Therapies Associated with Potentially Transmissible Infectious Agents

I.F.1. Gene Therapy

I.F.2. Infections Transmitted through Blood, Organs and Other Tissues

I.F.3. Xenotransplantation

PART II: FUNDAMENTAL ELEMENTS NEEDED TO PREVENT TRANSMISSION OF INFECTIOUS AGENTS IN HEALTHCARE SETTINGS

II.A. Healthcare System Components that Influence the Effectiveness of Precautions to Prevent Transmission

II.A.1. Administrative Measures

II.A.1.A. Scope of Work and Staffing Needs for Infection Control Professionals

II.A.1.A.I. Infection Control Nurse Liaison

II.A.1.B. Bedside Nurse Staffing

II.A.1.C. Clinical Microbiology Laboratory Support

II.A.2. Institutional Safety Culture and Organizational Characteristics

II.A.3. Adherence of Healthcare Personnel to Recommended Guidelines

II.B. Surveillance for Healthcare-Associated Infections (HAIs)

II.C. Education of HCWs, Patients, and Families

II.D. Hand Hygiene

II.E. Personal Protective Equipment (PPE) for Healthcare Personnel

II.E.1. Gloves

II.E.2. Isolation Gowns

II.E.3. Face Protection: Masks, Goggles, Face Shields

II.E.3.A. Masks

II.E.3.B. Goggles, Face Shields

II.E.4. Respiratory Protection

II.F. Safe Work Practices to Prevent HCW Exposure to Bloodborne Pathogens

II.F.1. Prevention of Needlesticks and Other Sharps-Related Injuries

II.F.2. Prevention of Mucous Membrane Contact.

II.F.2.A. Precautions During Aerosol-Generating Procedures

II.G. Patient Placement

II.G.1. Hospitals and Long-Term Care Settings

II.G.2. Ambulatory Settings

II.G.3. Home Care

II.H. Transport of Patients

II.I. Environmental Measures

II.J. Patient Care Equipment and Instruments/Devices

II.K. Textiles and Laundry

II.L. Solid Waste

II.M. Dishware and Eating Utensils

II.N. Adjunctive Measures

II.N.1. Chemoprophylaxis

II.N.2. Immunoprophylaxis

II.N. 3. Management of Visitors

II.N.3.A. Visitors as Sources of Infection

II.N.3.B. Use of Barrier Precautions by Visitors

PART III: PRECAUTIONS TO PREVENT TRANSMISSION OF INFECTIOUS AGENTS

III.A. Standard Precautions

III.A.1. New Elements of Standard Precautions

III.A.1.A. Respiratory Hygiene/Cough Etiquette

III.A.1.B. Safe Injection Practices

III.A.1.C. Infection Control Practices for Special Lumbar Puncture Procedues

III.B. Transmission-Based Precautions

III.B.1. Contact Precautions

III.B.2. Droplet Precautions

III.B.3. Airborne Precautions

III.C. Syndromic and Empiric Applications of Transmission-Based Precautions

III.D. Discontinuation of Transmission-Based Precautions

III.E. Application of Transmission-Based Precautions in Ambulatory and Home Care Settings

III.F. Protective Environment

PART IV: RECOMMENDATIONS

I. Administrative Responsibilities

II. Education and Training

III. Surveillance

IV. Standard Precautions

V. Transmission-Based Precautions

VI. Protective Environment (Table 4)

APPENDIX A

APPENDIX A1 TYPE AND DURATION OF PRECAUTIONS RECOMMENDED FOR SELECTED INFECTIONS AND CONDITIONS

GLOSSARY

REFERENCES

HEALTH-CARE-ASSOCIATED INFECTIONS IN HOSPITALS: LEADERSHIP NEEDED FROM HHS TO PRIORITIZE PREVENTION PRACTICES AND IMPROVE DATA ON THESE INFECTIONS

WHAT GAO FOUND.

WHY GAO DID THIS STUDY

WHAT GAO RECOMMENDS

ABBREVIATIONS

RESULTS IN BRIEF

BACKGROUND

CDC's Infection Control and Prevention Guidelines

CMS's and the Accrediting Organizations' Standards for Hospitals

CDC HAS 13 INFECTION CONTROL AND PREVENTION GUIDELINES CONTAINING ALMOST 1,200 RECOMMENDED PRACTICES, BUT ACTIVITIES ACROSS HHS TO PROMOTE IMPLEMENTATION ARE NOT GUIDED BY PRIORITIZATION OF PRACTICES

CDC Has 13 Infection Control and Prevention Guidelines, Which Contain Almost 1,200 Recommended Practices, and over 500 of Them Are Strongly Recommended

CDC and AHRQ Have Taken Steps to Promote Implementation of Practices to Reduce HAIs but Lack Prioritization of These Practices to Guide Their Actions

CMS'S AND ACCREDITING ORGANIZATIONS' REQUIRED HOSPITAL STANDARDS DESCRIBE COMPONENTS OF INFECTION CONTROL PROGRAMS, AND COMPLIANCE WITH THESE STANDARDS IS ASSESSED THROUGH ON-SITE SURVEYS

Standards for Hospitals on Infection Control Required by CMS and Accrediting Organizations Describe Components of Infection Control Programs

Compliance with Required Infection Control Standards Is Assessed through Observation and Document Review during on-Site Surveys of Hospitals

MULTIPLE HHS PROGRAMS COLLECT DATA ON HAIS, BUT LACK OF INTEGRATION OF AVAILABLE DATA AND OTHER PROBLEMS LIMIT UTILITY OF THE DATA

MULTIPLE HHS AGENCIES COLLECT DIFFERENT DATA ON HAIS, BUT THESE DATA PRESENT ONLY A PARTIAL VIEW OF THE EXTENT OF THE PROBLEM

Available Data Are Not Integrated across Programs to Use Them to Their Full Potential

Data Limitations Preclude Development of Reliable National Estimates

CONCLUSIONS

RECOMMENDATIONS FOR EXECUTIVE ACTION

COMMENTS FROM HHS AND ACCREDITING ORGANIZATIONS AND OUR EVALUATION

APPENDIX I: OTHER CDC ACTIVITIES DESIGNED TO REDUCE OR PREVENT HEALTH-CARE-ASSOCIATED INFECTIONS.

APPENDIX II: CENTERS FOR MEDICARE &amp

MEDICAID SERVICES' (CMS) CONDITION OF PARTICIPATION: INFECTION CONTROL

APPENDIX III: COMMENTS FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES

HEALTH-CARE-ASSOCIATED INFECTIONS IN HOSPITALS: AN OVERVIEW OF STATE REPORTING PROGRAMS AND INDIVIDUAL HOSPITAL INITIATIVES TO REDUCE CERTAIN INFECTIONS*

WHAT GAO FOUND

WHY GAO DID THIS STUDY

Hospital Practices to Reduce HAIs

MRSA

Federal Activities

STATES HAVE DESIGNED BROADLY SIMILAR MANDATORY HAI PUBLIC REPORTING SYSTEMS, WITH RESOURCE AND TECHNOLOGICAL CHALLENGES AFFECTING IMPLEMENTATION

States Have Designed HAT Public Reporting Systems with Most Using Similar Approaches

Use of Advisory Committees

Selection of HAI Measures

Data Collection Systems

Data Validation

Most States Do Not Require Hospitals to Track MRSA HAIs, though Some States Collect Limited MRSA Data through Public Reporting or Other Systems

Resource and Technological Challenges Influence How States Implement HAI Reporting Systems

HOSPITAL MRSA- REDUCTION INITIATIVES SHARE MULTIPLE COMPONENTS, BUT VARY IN SCOPE AND RESOURCE REQUIREMENTS

All Initiatives Use Routine Testing for MRSA but Vary in How Testing Is Targeted and Conducted

Hospitals Expanded Infection Control Activities and Information Systems to Reduce MRSA

All 14 Hospitals Included Decolonization in Their MRSA-Reduction Initiatives

Hospital MRSA Initiatives Reported Needing Varying Levels of Funding and Staff Resources

Hospitals with MRSA Initiatives Consistently Reported Reductions in MRSA Infection Rates

TWO HOSPITAL SYSTEMS ADDRESSED SIMILAR CHALLENGES IN IMPLEMENTING MRSA- REDUCTION INITIATIVES.

The Two Systems Faced Process, Compliance, and Resource Challenges in Implementing Their MRSA Reduction Initiatives.

Notes:

Description based upon print version of record.

Includes bibliographical references and index.

Description based on print version record and CIP data provided by publisher.

ISBN:

1-61470-054-0

OCLC:

758384439