Contemporary Infection Control Research Articles

Florence Nightingale's Environmental Theory and its influence on contemporary infection control

BackgroundThe work of Florence Nightingale has laid the foundation for contemporary nursing practice, bringing the fundamental art and science of nursing into the 21st century. Her Environmental Theory was the beginning of a lifetime's work, being one of her many healthcare reforms which survive to this day as the practice of infection control. AimTo discuss the development of Nightingale's Environmental Theory in the 19th century and its application in contemporary 21st century nursing practice. MethodsA search of Nightingale's publications, biographers and theorists, selected journal articles and databases to build a picture of the origins, significance and practice of contemporary infection control. FindingsNightingale's Environmental Theory has changed the face of infection control exponentially. Today's guidelines are an integral part of nursing practice, to the extent that they continue to evolve, particularly as the coronavirus pandemic remains active around the world. DiscussionInvestigation of Nightingale's experiences in the Crimean War, of the disease, infection, death and dying that she encountered there and the subsequent development of her Environmental Theory and its application in 21st century nursing practice. ConclusionContemporary infection control is now an integral part of nursing and nursing practice the world over. It is an essential part of creating safe environments that help to promote good healing, good health and wellbeing and good patient outcomes, along with the opportunity for continued development to keep in step with changing patient and global need.

Riding the Shi: From Infection Barriers to the Microbial City.

How can a microbial approach to global health security protect life? Contemporary infection control mechanisms set the human and the pathogenic microbe against each other, as the victim versus the menace. This biomedical polarization persistently runs through the contemporary dominant mode of thinking about public health and infectious disease governance. Taking its cue from the currently accepted germ theory of disease, such mechanisms render a global city like Hong Kong not only pervasively “on alert” and under threat of unpredictable and pathogenic viruses and other microbes, it also gives rise to a hygiene and antimicrobial politics that is never entirely able to control pathogenic circulation. The article draws on recent advances in medical microbiology, which depart from germ theory, to invoke an ecological understanding of the human-microbe relation. Here, while a small number of viruses are pathogenic, the majority are benign; some are even essential to human life. Disease is not just the outcome of a pathogenic microbe infecting a human host but emerges from socioeconomic relations, which exacerbate human-animal-microbial interactions. In a final step, the article draws on Daoist thought to reflect on the ways that such a microbial understanding translates into life and city dwelling.

Using a checklist to identify barriers to compliance with evidence-based guidelines for central line management: a mixed methods study in Mongolia

This study aimed to determine the extent to which a checklist has potential for identifying barriers to compliance with central line management guidelines, to evaluate the potential utility of checklists to improve the management of central lines in Mongolia, and to define the gap between current and best practices. A 22-item checklist was developed based on the Centers for Disease Control and Prevention (CDC, USA) guidelines and existing central line-associated bloodstream infection (CLABSI) checklists. The checklist was used to observe 375 central line procedures performed in the intensive care units of four tertiary hospitals of Mongolia between July and December 2010. In parallel, 36 face-to-face interviews were conducted in six other tertiary hospitals to explain practice variations and identify barriers. The baseline compliance level across all components of the checklist was 68.5%. The main factors explaining low levels of compliance were outdated local standards, a lack of updated guidelines, poor control over compliance with existing clinical guidelines, poor supply of medical consumables, and insufficient knowledge of contemporary infection control measures among health care providers. The health authorities of Mongolia need to adequately address the prevention and control of CLABSIs in their hospitals. Updating local standards and guidelines and implementing adequate multifaceted interventions with behavioral, educational, and logistical components are required. Use of a checklist as a baseline evaluation tool was feasible. It described current practice, showed areas that need urgent attention, and provided important information needed for future planning of CLABSI interventions.

UK healthcare workers' knowledge of meticillin-resistant Staphylococcus aureus practice guidelines; a questionnaire study

Effective infection control practice requires knowledge of and adherence to contemporary infection control guidelines. Utilising a novel questionnaire tool, we evaluated knowledge of recently published guidelines on meticillin-resistant Staphylococcus aureus (MRSA) precautions in a number of relevant healthcare worker (HCW) populations. The questionnaire was developed from national UK MRSA practice guidelines and consisted of 10 'true or false' statements. The questionnaire was utilised to assess knowledge in 293 participants from HCW and control populations. The participants included 188 doctors attending the British Medical Association's Annual Representatives Meeting, 52 trainee surgeons attending the Association of Surgeons in Training annual conference, 30 members of a non-clinical control population and 23 infection control nurses (ICNs). The mean (SD) score for knowledge levels obtained from doctors was 6.6 (1.68), for non-clinical control population was 4.7 (1.8) and for ICNs, 8.4 (1.12). There were significant differences in knowledge levels between different population groups (P<0.001), UK employment region of the participant (P=0.01) and the doctors' medical specialty (P=0.02). Career seniority and gender of the participant were not significantly associated with differences in levels of knowledge. This questionnaire study evaluates a novel discriminatory questionnaire tool which differentiates knowledge levels of MRSA practice guidelines among a non-clinical population, HCWs and specialist infection control staff, thus providing a means for the rapid assessment of MRSA educational interventions. We identify demographics within HCW target populations which are associated with low levels of such knowledge. Consideration towards revising current HCW educational programmes to improve knowledge and best practice in MRSA prevention is required.

Fact or Infection: Do Surgical Trainees Know Enough About Infection Control?

There exists a high level of non-compliance with basic infection control measures by medical staff. One explanation may be a lack of familiarity with contemporary infection control guidelines. As surgical trainees represent a key group of stakeholders responsible for the delivery of recommended infection control practice, we assessed knowledge of infection control guidelines amongst current UK surgical trainees. Without warning, during the annual meeting of the UK Association of Surgeons in Training (ASiT), participating surgical trainees were asked to complete a questionnaire examining their basic knowledge of infection control and methicillin-resistant Staphylococcus aureus (MRSA) based on recently published guidelines. A total of 52 trainees (13 higher surgical trainees [HSTs]; 39 basic surgical trainees [BSTs]) returned completed questionnaires in the study. BSTs demonstrated a higher level of knowledge of infection control, outperforming the HSTs in 7 out of 11 questions. Of surgical trainees, 61.5% were misinformed regarding the prevalence of MRSA blood-stream infections and 69% were unaware of policies for transfer of MRSA-positive patients. Analysis revealed areas of concern in regards to an adequate general level of knowledge of infection control in surgical trainees, particularly in some key areas. To ensure patient safety and reduce hospital-acquired infections, it is vital that focused, co-ordinated programmes of education, in this rapidly changing field, are prioritised and formalised into surgical training, selection and assessment.

Nursing theories and their relevance to contemporary infection control practice

s nursing strives to be recognised as a profession the theories that underpin our practice are increasingly put under the microscope. Nursing theory and its relevance to clinical practice has long been a subject of controversy. Indeed, a lack of agreement in the professional literature serves to confuse nurses and has caused many to dismiss nursing theory as being long-winded and irrelevant to everyday practice. Such nonchalance can have far-reaching effects on the quality of patient care provided within hospital settings, particularly in matters pertinent to the control of healthcare-associated infection. This article examines these theories and identifies just how relevant they are to modern day infection control practice.

Collaborative Basic Infection Control in Budapest, Hungary

ISSUE: The APIC Minnesota chapter (APIC-MN) and Hungarian Association of Practitioners in Infection Control (HAPIC) have had a sister chapter relationship for 5 years. During exchange programs, a need was expressed by members of HAPIC for assistance in developing and offering a model infection control educational program. PROJECT: Members of APIC-MN International Committee developed educational materials including PowerPoint programs on basic aspects of infection control, including epidemiology, microbiology, surveillance, and the four major nosocomial issues: surgical sites, respiratory, vascular, and urinary tract infections. These modules were sent to our colleagues in Hungary for assessment of applicability to Hungarian practice. Preceding the October 2003 course in Budapest, the Hungarian and U.S. faculty reviewed materials and educational methods to be used. Following the course, faculty reviewed student evaluations, performed an assessment of teaching techniques and materials, and began preliminary plans for the next expanded course. Using materials from APIC-MN, the course was taught by five Hungarian ICPs and an APIC-MN ICP with a translator. The six registrants, from several facilities with varying levels of expertise in infection control, were encouraged to ask questions and to participate in group discussions. RESULTS: Six ICPs from Hungary may implement and practice contemporary infection control methods in their facilities. The Hungarian members of the faculty developed further expertise in education and were encouraged to continue offering courses. LESSONS LEARNED: Building relationships are critical to the success of collaborative ventures. Reviewing and using adult learning theories increases instructor and student learning. This project emphasized our common values to improve patient safety and meet the same standards of infection control.

Economical slotted screwdriver made from old dental instrument for implant prosthodontics

Implant dentistry has brought many possibilities for the restoration of edentulous and partially edentulous patients; however, the high cost of dental implant fixtures and components is a major concern. Contemporary infection control practices mandate heat sterilization of reusable dental instruments that have been placed in the oral cavity.l Therefore, the dentist with a busy implant practice must stock numerous duplicate instruments at considerable expense. Slotted screwdrivers are very often used in implant procedures, and the retail cost of an implant

Microbial Contamination of Dental Unit Waterlines: Prevalence, Intensity and Microbiological Characteristics

Microbiological studies on dental unit water samples from 150 operatories revealed widespread and unacceptably high levels of contamination. Biofilm formation along the walls of the fine-bore waterlines is primarily responsible. These findings are reviewed and their relevance to contemporary infection control concerns discussed.

DIAGNOSIS AND MANAGEMENT OF OROFACIAL HERPES SIMPLEX VIRUS INFECTIONS

HSV disease remains a significant problem for the dental profession because of its widespread occurrence and ready transmission. Fortunately, available diagnostic techniques are highly sensitive and specific, antiviral therapy is effective in limiting the course of infection, and contemporary infection control procedures adequately safeguard dental personnel and the patient. Unfortunately, there is still a large segment of the population already infected with HSV-1 and the number of immunosuppressed latently infected patients continues to increase. Thus, patients will continue to need the help of the knowledgeable and willing dentist who can diagnose HSV-1 infection, provide effective treatment, and prevent transmission.

Contemporary challenges for hospital epidemiology

According to conventional wisdom, it is time for hospital epidemiologists to look beyond traditional infection control responsibilities and to shoulder an “expanded role,” including quality assurance, risk management, and pharmacoepidemiology. Some see this as a matter of survival as the profession reacts to potent external forces that seek to curb the cost of health care while assuring quality service. Infection control specialists, it is argued, have the epidemiologic skills to measure adverse outcomes of hospitalization, adjust for confounding variables, and evaluate the impact of targeted interventions. Before embracing these new responsibilities, however, it should be noted that many hospital epidemiologists would require additional training in basic epidemiologic principles. Although hospital epidemiologists may seek a leadership role in hospital quality assurance and health policy research, they have generally not been innovators in these fields, even in some specific areas relevant to infection control. For example, while hospital epidemiologists have begun to consider severity of illness as a potential confounder in epidemiologic analyses, they have not participated in the development or validation of any of the most widely used indicators. For those hospital epidemiologists who wish to capitalize on their traditional background in infectious diseases, contemporary infection control provides numerous challenges. For example, the epidemiology of many common nosocomial infections, such as bacterial pneumonia in immunocompromised hosts, remains to be defined. Hospital epidemiologists need to incorporate a variety of sophisticated microbiologic methods into their practice to help them trace the spread of nosocomial pathogens. Finally, they should collaborate more closely with clinical and bench investigators in a number of areas, including microbial pathogenesis, immunology, and biotechnology.

Satellite infection control committees within the hospital: decentralizing for action.

The contemporary infection control program, whether independent or fully integrated into a hospital-wide quality assurance (QA) program, has a very broad scope including surveillance, outbreak management, education, policy/procedure development, environmental/construction surveillance, program evaluation and research (Table). The greatest problem organizing an infection control program has been identified as integration of its components so as to establish supervision and feedback among its participants, with the purpose of achieving steady progress.Programs have historically been “centralized” with the hospital epidemiologist, infection control practitioner and hospital infection control committee responsible directly or indirectly for the maintenance of the system.’