Microbial infections in hospitals: A review of the literature and some suggestions for nursing research

Abstract

The practice of infection control is the responsibility of the profession of nursing. This is not a new concept: the principles of hygiene, of sanitary controls, and of aseptic procedures have always been incorporated into nursing care to ensure the protection of patients from the threat of infections. However, a new dimension has expanded these nursing responsibilities from the need to protect each patient as an individual, to the need to protect the total community as a group within health care facilities. Epidemiologic method, a research method for public health,(l) was generated for the purpose of identifying and assessing hazards which threaten the health of groups. Epidemiology provides an intelligent basis for recommending changes in communities such as the hospital: it provides a method of obtaining information which can be quantified and substantiated and upon which decisions to prevent cross infection can be made with reliability and with confidence. Within the intramural environment, the prevention and control of infection is such a complex problem that it requires an interdisciplinary approach - it requires the coordination and cooperation of the total therapeutic community to ensure high quality patient care. Nonetheless, the major responsibility of infection control lies with the nursing profession - the only discipline which is committed to the 24hr provision of care for the sick in hospitals. It is the purpose of this paper to review the literature in hospital epidemiology in order to define the present problems in nosocomial (hospital-acquired) infections and other communicable diseases. The second objective of this discussion is to formulate generalized hypotheses which accentuate areas requiring research in nursing. This argument will postulate a clear distinction between those problems which are a focus for nursing research and those which are beyond the scope of nursing reference. Definitions in hospital epidemiology suffer from disorganized taxonomy due to the rapidity of the development of this field of interest and a significant pleomorphism of definitions. Nosocomial infections are a communicable disease. At present there is a trend to differentiate nosocomial infection, a term derived from the Greek noses, disease,