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At least 433 records · Page 24Linked to original sources
PubMed2003

Policymakers' views on dengue fever/dengue haemorrhagic fever and the need for dengue vaccines in four southeast Asian countries.

A survey of policymakers and other influential professionals in four southeast Asian countries (Cambodia, Indonesia, Philippines and Vietnam) was conducted to determine policymakers' views on the public health importance of dengue fever and dengue haemorrhagic fever (DHF), the need for a vaccine and the determinants influencing its potential introduction. The survey, which involved face-to-face interviews with policymakers, health programme managers, researchers, opinion leaders and other key informants, revealed an almost uniformly high level of concern about dengue fever/DHF and a high perceived need for a dengue vaccine. Several characteristics of the disease contribute to this high sense of priority, including its geographic spread, occurrence in outbreaks, the recurrent risk of infection each dengue season, its severity and the difficulty in diagnosis and management, its urban predominance, its burden on hospitals, and its economic toll on governments and families. Research felt to be key to future decision-making regarding dengue vaccine introduction include: disease surveillance studies, in-country vaccine trials or pilot projects, and studies on the economic burden of dengue and the cost-effectiveness of dengue vaccines. The results suggest favourable conditions for public and private sector markets for dengue vaccines and the need for creative financing strategies to ensure their accessibility to poor children in dengue-endemic countries.

Asia, Southeastern↗
PubMed2000

Maximising handwashing rates in the critical care unit through yearly performance feedback.

Handwashing following patient contact reduces the incidence of nosocomial infections. Despite this, handwashing rates by health care workers (HCWs) are often poor. Feedback on handwashing has been shown to significantly improve its rates. This study determined the optimum time to repeat performance feedback on handwashing rates of hospital staff in order to maximise its incidence. The baseline incidence of handwashing by staff following patient contact was determined by covert observation. This was followed by a period of feedback on handwashing performance by means of histograms displayed in the unit. Handwashing incidence was reassessed 6 and 12 months after the feedback ended. Performance feedback induced significant increases in handwashing incidence amongst nurses (p = 0.0433), resident medical officers (p = 0.0134), specialists (p = 0.0021) and radiographers (p = 0.0001). Non-significant increases were noted in handwashing rates amongst wardsmen/women and physiotherapists. Overall, handwashing incidence declined significantly (p = 0.0001) 12 months post feedback. This study demonstrated that feedback should be repeated within 12 months in order to maximise handwashing rates with the minimum intervention.

Critical Care↗
PubMed2006

Monitoring patient safety in health care: building the case for surrogate measures.

BACKGROUND: Objective measurements are notably lacking for many adverse events in health care. A new approach to monitoring such events is based on the experience in measuring hospital-associated infections. DEVELOPING OBJECTIVE AND UNIVERSAL MEASURES: An essential tenet of the current goal of surveillance-focusing only on rigorously confirmed adverse events-is neither necessary nor achievable across the entire health care system. Efforts should be directed instead to creating objective measures of quality of care and of outcomes that can be used by all health care facilities. Adopting objective measures would be easier if health care was open to surrogate measures of important outcomes. Surrogate measures of interest for infection surveillance are used to identify objective, readily ascertained events that are sufficiently correlated with infections to provide useful information about organizations' infection rates. For example, the surgical site infection rate following coronary artery bypass appears to correlate closely enough with the proportion of patients who receive extended courses of inpatient antibiotics to be a useful indicator of a hospital's outcomes for the procedure. CONCLUSION: Developing clinically relevant process or surrogate measures that clinicians would use to improve patient outcomes is essential. These measures could be relevant not only to hospital-acquired infections but other health care-related adverse events that are relatively common yet require substantial resources to identify.

Centers for Disease Control and Prevention, U.S.↗
PubMed2006

Eliminating nosocomial infections at Ascension Health.

BACKGROUND: Eliminating nosocomial infections was identified as one of eight priorities for action for Ascension Health. St. John Hospital and Medical Center (SJHMC), and St. Vincent's Hospital (STV), designated alpha sites, developed best practices for the prevention of catheter-related blood stream infections (CR-BSIs) and ventilator-associated pneumonia (VAP), respectively. METHODS: Both hospitals used the Institute for Healthcare Improvement model of "bundles" to achieve the goal of reducing nosocomial infections and also implemented multidisciplinary rounds and the use of daily goal sheets in the intensive care unit (ICU). RESULTS: Through the use of ventilator bundle, central line (CL) bundle, MDRs, and daily goal sheets, both facilities reduced CR-BSIs and VAPs by more than 50%. DISCUSSION: SJHMC saw the benefit of having the physical presence of the ICPs in the ICUs, providing the staff with on-the-spot reinforcement of the initiative. STV found by starting the change process through the use of a flexible MDR team, the hospital was able to successfully implement positive changes in its ICU culture. On the basis of the success in the ICU, the concept of MDR teams eventually was adapted and spread to all units. Open communication among all patient caregivers was extended and served to provide improved patient care throughout the hospital.

Alabama↗
PubMed2005

Twenty-first-century medical microbiology services in the UK.

With infection once again a high priority for the UK National Health Service (NHS), the medical microbiology and infection-control services require increased technology resources and more multidisciplinary staff. Clinical care and health protection need a coordinated network of microbiology services working to consistent standards, provided locally by NHS Trusts and supported by the regional expertise and national reference laboratories of the new Health Protection Agency. Here, I outline my thoughts on the need for these new resources and the ways in which clinical microbiology services in the UK can best meet the demands of the twenty-first century.

Communicable Disease Control↗
PubMed1999

Credentialing, diversity, and professional recognition-foundations for an Australian infection control career path.

BACKGROUND: There are no regulatory, legislative, or professional criteria stipulating minimum qualifications or experience that a health care worker must meet to be capable of coordinating an Australian infection control (IC) program. Measurement of IC competence is important to protect the public and for the ongoing credibility and growth of the profession. METHOD: Our study group was all 1078 nonmedical and nonindustry members of the Australian Infection Control Association in 1996. The survey examined perceived level of proficiency, level of education, and experience in health care and infection control. Almost three quarters (65%) of the members responded, and almost all (85%) of these respondents fulfilled the inclusion criterion of coordinating an IC program. RESULTS: Experience in IC ranged from less than 2 years (33.6%) to more than 20 years (10.0%). The majority (65.0%) of infection control professionals (ICPs) had between 8 years and 12 years IC experience. The respective proportions of respondents' self-ranked levels of proficiency on a 5-point scale were novice (3.6%), advanced beginner (21.2%), competent (33.8%), proficient (34.7%), and expert (6.8%). Almost half (47%) of the novices agreed that a registered nursing (RN) qualification was required, whereas a majority (41%) of advanced beginners considered both an RN and a basic IC course (BASIC) were required. Competent ICPs agreed less often than the other levels about their requirements. However, 27% of competents identified a BASIC and an undergraduate degree (UG) as the minimum requirements for a competent ICP. Proficient ICPs agreed that they required an RN, UG, BASIC, and a postbasic course in IC. Nearly all experts (80.0%) agreed that they required an RN, UG, BASIC, postbasic course, and a course in hospital epidemiology (EP). Two thirds of experts expected a master's degree as a requirement. CONCLUSION: The Australian IC profession is in an exciting period of development; however, the variation in ICP perception of the most appropriate qualifications and experience threatens the credibility and viability of the profession. This variation indicates the need for a clear-cut pathway that includes a system of credentialing, recognition of expertise, adoption of divergent roles, and improved networking. This pathway will lead to an increasingly credible and viable IC profession in Australia. Developing IC communities globally can benefit from the Australian experience.

Australia↗
PubMed2000

Infection control training: evaluation of a computer-assisted learning package.

An evaluation of the training module of an interactive infection control computer-assisted learning (CAL) software program was carried out with ward-based nurses, third-year medical students and infection control personnel. All nursing staff, 87% of the medical students and all infection control staff found the programme easy and enjoyable to use. The module was accessed 3101 times on the hospital network in 18 months with usage settling to between 100-150 times per month. There was a higher level of use by night-duty and weekend staff. Medical students gained as much infection control knowledge from using the CAL package (increase in correct responses from 63.5% to 83.4%;P<0.0001) as they did from a formal lecture (increase in correct responses from 62.1% to 79.5%;P<0.0001). We conclude the training module which is accessible on the hospital wards and across the academic network, is a convenient and effective way for staff and students to gain a basic understanding in evidence-based infection control practices, at locations and times suitable for them.

Attitude of Health Personnel↗
PubMed2000

The hospital management/microbiology interface--a British viewpoint.

The interface between managers and clinicians is where the success or otherwise of a hospital is decided. Understandable organizational structures, explicit lines of accountability and, above all, clear communications are essential. Clinicians need to understand the background against which the hospital's Executive Team operates. The Executive Team needs to be open and honest with clinicians about expectations and their deliverability. It is incumbent upon every senior staff member to have some understanding of the wider issues and to listen to the arguments presented, in every case, if the best is to be achieved within limited resources.

Hospital-Physician Relations↗
PubMed2000

Educating the infection control team - past, present and future. A British prespective.

This review sets out to explore how education and training provisions for members of the Infection Control Team (ICT) have developed alongside their roles and in response to changes in the British National Health Service. It focuses on the Consultant in Communicable Disease Control, the Infection Control Doctor and the Infection Control Nurse in the United Kingdom, but also briefly considers approaches adopted by other countries. Future developments should include maximizing information technology for delivering teaching materials, shared learning and improvements to pre-registration curricula for both doctors and nurses.

Certification↗
PubMed2001

The organization of infection control in Belgium.

The authors describe the organization of infection control in Belgium with respect to official regulations, the tasks and the training of the infection control doctor and of the infection control nurse, functioning of the infection control committee, the financing and the availability of guidelines.

Belgium↗