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PubMedDate not supplied

Prevention of infective endocarditis in the pediatric congenital heart population.

In 1997, the American Heart Association updated recommendations for the prevention of sub-acute bacterial endocarditis (SBE) or infective endocarditis (IE) occurring in the pediatric population with congenital heart disease (Dajani, et al., 1997). Although uncommon, endocarditis remains an important cause of morbidity and mortality in children with cardiovascular disease, which constitutes the primary population at risk. Through comprehensive discharge planning and teaching, the advanced practice nurse (APN) and the pediatric cardiovascular nurse may contribute significantly toward preventing IE in this population. Nursing's role and responsibility is to convey the appropriate information to patients, families, and the staff who care for children with heart disease.

Antibiotic Prophylaxis↗
PubMedDate not supplied

Strategies for dental clinic infection control.

The application of proper infection control procedures helps to protect practitioners, patients and the community. The goal is to minimize the spread of potentially pathogenic micro-organisms and to remove and/or kill organisms that have contaminated objects and surfaces. Dental practitioners are aided in this process by the generation of rules, guidelines and recommendations by regulatory agencies and professional organizations. Ideally, each office/clinic would generate and maintain a written set of infection control procedures.

Cross Infection↗
PubMed1992

Design and dissemination of a multiregional long-term care infection control training program.

Long-term care facilities have only recently begun to receive attention in the area of infection control. A training program was developed in Nebraska to help supply practitioners with knowledge and techniques designed specifically for the long-term care environment. This program's success led to its implementation in other regions. The regional extensions of the program were designed to operate with independent faculty but standardized course materials.

Cross Infection↗
PubMed2000

Competency standards in the context of infection control.

BACKGROUND: To ensure quality patient care and enhance career development, competency levels of infection control professionals (ICPs) need to be identified and strengthened so that high standards of practice are established and maintained. OBJECTIVE: The purpose of this study was to apply a modified version of Benner's (1984) "Novice to Expert" model of skill acquisition to levels of competency and to seek to measure practices of the specialist practitioner in the context of infection control. METHOD: A self-administered questionnaire was developed and mailed to 464 members of the Infection Control Association, New South Wales (NSW) Inc, Australia. RESULTS: Seventeen percent of respondents reported full-time infection control responsibilities, 78% part time, and 5% unknown. The sample comprised 4 groups of ICPs. The largest groups were registered nurses, representing 37% of total respondents and "Other health care professionals" representing 35%. Forty-nine percent of the sample had completed a basic or advanced infection control certificate course, 21% had completed a bachelor of nursing or health science degree, and 21% had completed other studies not related to the specialty. Key findings of this study indicated that the clinical nurse consultant group rated their individual levels of skills and knowledge as proficient (competent). Although a small percentage from this group had completed higher level education, years of service within the specialty contributed to an increase in competent performance. This was also applicable to the other groups studied. CONCLUSION: The findings highlighted the need for a framework to be developed on which to build a model to measure and reflect progression of infection control competence at the beginner, advanced beginner, competent, and expert levels. Continuing education as a means of achieving competence needs to be further developed, maintained, and nurtured so that the ICP can acquire appropriate specialty knowledge and skills.

Education, Nursing, Continuing↗
PubMed2005

Compliance with infection control programs in private dental clinics in Jordan.

The aim of this study was to assess the compliance of general dental practitioners (GDPs) in the private sector in North Jordan with infection control measures. A pilot-tested questionnaire about infection control measures was distributed in March 2004 to 120 private practices. The response rate was 91.66 percent. About 77 percent of dentists usually ask their patients about medical history, 36 percent were vaccinated against hepatitis B, 81.8 percent wear and change gloves during treatment and between patients, and 54.5 percent wear and change masks during treatment and between patients. Most dental practitioners (95.4 percent) reported that they changed extraction instruments and burs between patients. All dental practitioners reported that they changed saliva ejectors between patients, but only 41.8 percent changed handpieces between patients. Approximately 63 percent (69/110) used autoclaves for sterilization, 47.3 percent (52/110) used plastic bags to wrap sterilized instruments, and only 18 percent (20/110) disinfected impressions before sending them to dental labs. Fourteen percent used rubber dams in their clinics, and only 31.8 percent had special containers for sharps disposal. Based on these responses, approximately 14 percent of general dentists in this sample were considered to be compliant with an inventory of recommended infection control measures. In Jordan, there is a great need to provide formal and obligatory infection control courses and guidelines for private dentists by the Ministry of Health and the dental association in addition to distribution of standard infection control manuals that incorporate current infection control recommendations.

Adult↗
PubMed2006

Superbugs and the dentist: an update.

UNLABELLED: This paper presents an overview of three of the most commonly encountered 'superbugs; with a comment on the implications of each for the dental practitioner. The origins of antibiotic resistant micro-organisms lie in the acquisition of resistance genes and selection pressures, with their spread facilitated by inappropriate prescribing and inadequate infection control. Dentists should attempt to rationalize their antibiotic prescribing and ensure that they and other dental staff adhere to standard infection control procedures. CLINICAL RELEVANCE: Many dental practitioners will treat a wide range of patients in a variety of healthcare settings ranging from general practices to hospital in-patients. It is increasingly likely that they will either knowingly or unknowingly come into contact with people colonized or infected with drug-resistant micro-organisms. This article explains the background to some commonly occurring antibiotic-resistant bacteria.

Enterococcus↗
PubMedDate not supplied

[Infection control procedures used in dental offices in Belo Horizonte].

Survey data from 300 randomly selected private dental practitioners working in Belo Horizonte, Minas Gerais, were used to evaluate the infection control procedures routinely practiced here. The function of this report might be to alert the teaching team from Dental Schools and the dentists to the problems that potentially contribute to the transmission of infectious disease as a first step for additional specific recommendations to an effective and safe infection controL program that we intend to discuss later.

Brazil↗
PubMed2002

Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention.

These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery anesthesiology interventional radiology pulmonary medicine, pediatric medicine, and nursing. The working group was led by the Society of Critical Care Medicine (SCCM), in collaboration with the Infectious Disease Society of America (IDSA), Society for Healthcare Epidemiology ofAmerica (SHEA), Surgical Infection Society (SIS), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), American Society of Critical Care Anesthesiologists (ASCCA), Association for Professionals in Infection Control and Epidemiology (APIC), Infusion Nurses Society (INS), Oncology Nursing Society (ONS), Society of Cardiovascular and Interventional Radiology (SCVIR), American Academy of Pediatrics (AAP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC) and is intended to replace the Guideline for Prevention of Intravascular Device-Related Infections published in 1996 These guidelines are intended to provide evidence-based recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

Adult↗
PubMed1952

The management of ureteral stone; a guide for physicians in general practice.

General practitioners are usually the first to observe a patient with ureteral stone, and often they practice in communities where consultation with a urologist is not immediately available. Study of the records of 423 patients with ureteral stone observed in private practice indicates that by following a definite system for diagnosis, relief of pain, determination of contralateral function, control of infection, and prophylaxis, general practitioners can manage the disease in the great majority of cases, and can determine when treatment by a specialist is imperative.

Calculi↗
PubMed1990

Preventive control of AIDS by the dental profession: a survey of practices in a large urban area.

The purpose of this study was threefold: (1) to report the proportion of dental practitioners adhering to the 1987 Centers for Disease Control (CDC) procedures for using infection control techniques (ICTs); (2) to identify attitudes toward infection control and disease; and (3) to establish whether certain practitioner characteristics or use of certain ICTs were related to willingness to treat HIV-positive patients, willingness to volunteer for an HIV specialty clinic outside of regular practice, vaccination against hepatitis B, and a felt need for a specialty clinic within the practice to treat HIV patients effectively. A survey of approximately 3,800 members of a major metropolitan dental society found that 89 percent of respondents regularly used at least one CDC ICT beyond routine medical histories. Ninety-one percent indicated a moderate to extreme change in attitude toward the risks of infectious diseases and the regular use of ICTs (80.2% identified AIDS as the major factor in this change). Twenty-seven percent indicated that they would knowingly treat HIV-positive patients. No differences were found among practitioners willing to treat HIV-infected patients and those unwilling to treat these patients in terms of adherence to the CDC ICT recommendations for dentists. Statistical association between ICT use and other practitioner response variables are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Nebraska dental professional's procedures and opinions related to infectious diseases.

Based on the findings of this study, the following specific strategic recommendations are offered: 1. Offer continuing education courses throughout the state at reasonable fees. The courses should emphasize recognition of AIDS related lesions and infectious diseases, aseptic techniques/infectious disease control, AIDS, Hepatitis B, and infections/antibiotics. In addition, continuing education courses in the area of medical history taking methods should be offered to teach methods of inquiring about sexual and drug-use histories. 2. Establish a state resource center for information regarding infectious diseases. This could, perhaps, be a cooperative venture with the Department of Health, the Nebraska Dental Association, and the College of Dentistry. There is a need to gather, interpret and disseminate periodic updates on infectious disease research. This venture should also focus on developing literature for practitioners with consistent information about infection control regulations and guidelines. 3. Either through continuing education courses or through the information resource center, provide instruction on realistic assessment of the risk of infectious disease transmission in dentistry. 4. Develop a public relations campaign to educate the public about infection control policies in dentistry, what is being done to protect the public. 5. A research effort should be undertaken to determine the discrepancy between self-reported infection control practices and observed infection control practices. This could be accomplished through patient and dentist surveys, interviews, and/or observations. 6. Establish a confidential HIV blood screening program for health care providers.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Maintaining women's oral health.

Women must adopt health-promoting strategies for both general health and the oral cavity, because the health of a woman's body and oral cavity are bidirectional. For general health-maintenance strategies, dental practitioners should actively advise women to minimize alcohol use, abstain from or cease smoking, stay physically active, and choose the right foods to nourish both the body and mind. For oral health-maintenance strategies, dental practitioners should advise women on how to prevent or control oral infections, particularly dental caries and periodontal diseases. Specifically, women need to know how to remove plaque from the teeth mechanically, use appropriate chemotherapeutic agents and dentifrices, use oral irrigation, and control halitosis. Dental practitioners also need to stress the importance of regular maintenance visits for disease prevention. Adolescent women are more prone to gingivitis and aphthous ulcers when they begin their menstrual cycles and need advice about cessation of tobacco use, mouth protection during athletic activities, cleaning orthodontic appliances, developing good dietary habits, and avoiding eating disorders. Women in early to middle adulthood may be pregnant or using oral contraceptives with concomitant changes in oral tissues. Dental practitioners need to advise them how to take care of the oral cavity during these changes and how to promote the health of their infants, including good nutrition. Older women experience the onset of menopause and increased vulnerability to osteoporosis. They may also experience xerostomia and burning mouth syndrome. Dental practitioners need to help women alleviate these symptoms and encourage them to continue good infection control and diet practices.

Age Factors↗
PubMed2006

Homecare issues in rotavirus gastroenteritis.

PURPOSE: This article will describe the burden of rotavirus gastroenteritis (RGE) and its management, highlighting educational issues that nurse practitioners can assist caregivers to enhance at-home management. DATA SOURCE: A Medline search of the medical literature was used to identify articles that describe the burden, clinical presentation, and management of RGE. CONCLUSIONS: RGE is a serious medical condition characterized by diarrhea and vomiting and is a major cause of morbidity and hospitalization among children aged 5 years or younger. Proper at-home treatment can be challenging; however, improved home care may limit emergency department visits and hospitalizations. IMPLICATIONS FOR PRACTICE: Mild to moderate RGE may be successfully managed at home if caregivers are adequately educated in deciding when a child needs to be evaluated in a physician's office and in managing dehydration at home.

Child↗
PubMed2000

Strategic planning for infection control.

Proper infection control procedures help to protect dental practitioners, patients, and the surrounding community. The two basic goals of dental asepsis are simple and straightforward: minimize the spread of potentially pathogenic microorganisms and neutralize organisms that have contaminated dental instruments, equipment, and other office environmental surfaces. Meeting these goals, however, can be complicated. A valuable tool would be the generation and maintenance of a written set of infection control procedures ("an office infection control manual"). One way to organize a procedures manual is to arrange required tasks in response to specific pathways of cross-infection. Also, the effectiveness of an infection control program can be positively affected by office design.

Community-Acquired Infections↗
PubMed2002

Guidelines for the prevention of intravascular catheter-related infections. The Hospital Infection Control Practices Advisory Committee, Center for Disease Control and Prevention, U.S.

These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The working group was led by the Society of Critical Care Medicine (SCCM), in collaboration with the Infectious Disease Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), Surgical Infection Society (SIS), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), American Society of Critical Care Anesthesiologists (ASCCA), Association for Professionals in Infection Control and Epidemiology (APIC), Infusion Nurses Society (INS), Oncology Nursing Society (ONS), Society of Cardiovascular and Interventional Radiology (SCVIR), American Academy of Pediatrics (AAP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC) and is intended to replace the Guideline for Prevention of Intravascular Device-Related Infections published in 1996. These guidelines are intended to provide evidence-based recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (ie, education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

Adult↗
PubMed2000

Survey on attitudes toward HIV-infected individuals and infection control practices among dentists in Mexico City.

BACKGROUND: The teaching of infection control is gradually being introduced at dental schools in Mexico. However, most practicing dentists have limited access to current infection control standards. Deficiencies of knowledge with regard to blood-borne pathogens such as HIV and hepatitis B virus may influence attitudes toward infected individuals and reduce compliance with infection control recommendations. OBJECTIVE: The purpose of this study was to assess (1) attitudes toward HIV-infected patients and hepatitis B virus-infected patients and (2) infection control knowledge and practices among dental practitioners in Mexico City. METHOD: A total of 196 dentists were interviewed by means of a questionnaire with Likert-type scales and open-ended questions (response rate, 86.1%). RESULTS: Most respondents had no previous social or professional contact with HIV-positive individuals. Nine percent indicated that they had knowingly treated HIV-positive patients. Perceived professional and moral obligations to treat HIV-positive patients were high. Thirty-five percent of the respondents perceived the risk of HIV infection as "considerable" to "very strong." The risk of hepatitis B infection was considered significantly higher than the risk of HIV infection (P <.01); however, 78% of the respondents had not been immunized against hepatitis B. Reported use of personal protective equipment was high. Most respondents used dry heat sterilization. The principal disinfectants used were quaternary ammonium compounds, bleach, and glutaraldehyde. Fifty-four percent of the respondents acknowledged that clinical precautions reduced occupational risks. CONCLUSIONS: This survey revealed contradictory attitudes toward HIV-positive individuals and limited understanding of infection control recommendations. Educational and regulatory efforts are needed to promote better adherence to current infection control standards.

Adult↗
PubMed2004

Autoclave use in dental practice in the Republic of Ireland.

AIMS: To assess by postal questionnaire, cross-infection control methods, especially sterilisation procedures, of 700 general dental practitioners in the Republic of Ireland, and to biologically monitor steam pressure sterilisers or autoclaves in their practices. MAIN OUTCOME MEASURES: Methods of instrument cleaning and sterilisation, autoclave efficacy. RESULTS: A response rate of 40% with all, except one practitioner, using steam sterilisation. 49% also reported the use of chemical sterilisation with a quarter of these using glutaraldehyde. However, instrument soaking time varied greatly from 2.5 minutes to 74 hours. Methods of instrument cleaning prior to autoclaving were as follows: scrubbing by hand 41.5%, ultrasonic cleaning 7.0%, combination of both 50%. 52.9% of the respondents did not autoclave their dental handpieces and only 44.7% disinfected impressions before sending them to the laboratory. The autoclaves of thirty practitioners (11.3%) did not pass the initial biological test. Following counselling about possible causes of failure, four autoclaves (1.5%) failed a repeat biological test. However, seven practitioners did not return the repeat biological test. CONCLUSIONS: Some aspects of recommended cross-infection control procedures are well adhered to, e.g. instrument cleaning, but further education is required in certain key areas, in particular the use of chemical sterilisation, dental handpiece autoclaving and impression disinfection. There is also a need to increase awareness of the importance of routine autoclave servicing and calibration, along with validation and monitoring.

Creutzfeldt-Jakob Syndrome↗