Hospital Infection Management Research Articles

Investigation of nursing students' recognition of and compliance with medical waste classification

Objective To understand the general knowledge of nursing students' recognition of and compliance with medical waste classification so as to provide basis which schools and teaching hospitals should be adopted to better implement teaching and management of hospital infection. Methods We investigated 81 nursing students by using a self-designed questionnaire which aimed to acquire nursing students' recognition of and compliance with medical waste classification. Results 85.2% nursing students could not correctly judge that the wasted sphygmomanometers were chemical waste and 77. 8% had a wrong concept towards the pathological waste. There was no statistical difference among nursing students with different educational backgrounds (χ2 =0.96,P＞0. 05). 75.3% thought that medical waste classification was very important and 74.1% had a poor compliance with medical waste classification. Conclusions Nursing students' recognition of and compliance with medical waste classification needs further improvement. Schools should establish hospital infection education;teaching hospitals should strengthen comprehensive education of hospital infection;teaching teachers shall set good examples as well as make a good supervision. Key words: Nursing students; Medical waste; Recognition; Compliance

Fine management of standardized to improve the quality of hospital infection

Objective To observe the fine management of standardizing to improve the quality of management of hospital infection. Methods In fine management of standardizing in 2008, the monitoring data was for the observation group including nosocomial infection rate, hospital infections rate of fail, rate of censorship specimens infections, antibiotics usage rate, disinfection concentration qualified rate, and environmental hygiene monitoring qualified rate. In 2007, the monitoring data was set as control group. Results Two groups data afterx2 teat monitoring, the differences were statistically significant, it showed that the observation group of hospital infection rates (x2 =3.94, P＜0.05), and rate of fail (x2 =4.09, P＜0.05), antibiotic usage (x2 =20.51, P＜0.01), were lower than those of control group. And all the while infections specimen inspection rate (x2 = 3. 89, P ＜ 0. 05 ), and disinfection concentration qualified rate (x2 =3.92, P＜0.05), and environmental hygiene monitoring qualified rate (x2 = 97. 56, P ＜ 0.005), were higher than those of control group. Conclusions The fine management of standardized can decrease hospital infection rates and reduce risks of hospital infection, improve the quality of management of hospital infection. Key words: Nosocomial infection; Fine management of standardized; Quality

Medical waste management in the hospital

Enhanced management of the entire process of medical wastes, ranging from sorting collection, delivery, transport to temporary storage: compilation of the computerized management system for medical wastes: development of quality control inspection standards for medical wastes: all-staff training for the awareness of legal compliance for medical wastes, prevention of medical wastes from jeopardizing both human being and the environment. Key words: Medical wastes; Hospital infection management

Optimising outcomes of hospital infections through appropriate empirical antimicrobial therapy

Despite advances in antimicrobial therapy, better supportive care modalities, and the use of a wide range of preventive measures, hospital-acquired infections continue to be important causes of morbidity and mortality. Advances in the field of hospital infection management were explored at a symposium entitled ‘Optimising outcomes of hospital infections through appropriate empiric antimicrobial therapy’ at the 17th European Congress of Clinical Microbiology and Infectious Diseases in Munich, Germany, on 1 April 2007. The specific aims of the symposium were to present relevant findings and concepts regarding: (i) the evolving microbiology of resistant bacterial pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and important Gramnegative pathogens; (ii) the clinical and pharmaco-economic impact of inappropriate antimicrobial therapy in an environment of increasing resistance and patient complexities; (iii) current and emerging strategies for managing today’s prevalent bacterial infections in hospitalised patients; and (iv) new and emerging therapies for the management of resistant pathogens. The presentations detailed in this supplement can be summarised as follows. Jean Chastre, of the Groupe Hopital Pitie-Salpetriere in Paris, explained that conditions in intensive care units are particularly conducive to the emergence of resistance, and this resistance is not uniform in its geographical distribution. He discussed the clinical implications of the increasing prevalence of MRSA as well as the increasing rates of antimicrobial resistance seen in other Grampositive and Gram-negative pathogens, and presented recommendations for appropriate antimicrobial stewardship to achieve optimal efficacy in managing today’s resistant pathogens. Peter Davey, from the University of Dundee, defined ‘inappropriate’ antimicrobial therapy as either ineffective against the causative pathogen or effective but delayed by the time that elapsed before effective therapy was started. They showed that inappropriate treatment is common in today’s clinical setting and is associated with a greater risk of adverse clinical outcomes, including increased overall treatment costs. Davey described several computerised decision-support systems that are being developed to help clinicians identify the optimal approaches to antimicrobial treatment in their hospitals. Yehuda Carmeli, from the Tel Aviv Sourasky Medical Center, discussed the clinical impact of today’s problematic bacterial pathogens, particularly noting the virulence associated with Panton–Valentine leukocidin, which is now found in many MRSA strains. He also suggested treatment strategies that incorporate empirical therapy, noting the risks of delaying appropriate empirical therapy. Finally, Philippe Moreillon, from the University of Lausanne, focused on the mechanisms by which S. aureus acquires resistance to the penicillins and how the emerging resistance of S. aureus to vancomycin, first seen in the USA and now documented worldwide, underscores the continuing need for antimicrobial agents that counter these new mechanisms. Stressing the ongoing need for new classes of antimicrobial agents, Moreillon further described the target mechanisms and properties of several recently approved agents and others in late Corresponding author and reprint requests: H. Lode, Research Center for Medical Studies (RCMS), affil. Institute for Clinical Pharmacology and Toxicology, Charite–Universitatsmedizin Berlin, Hohenzollerndamm 2, D 10717 Berlin, Germany E-mail: haloheck@zedat.fu-berlin.de

Control charts in hospital epidemiology and infection management: an update

Control chart methods were reviewed in Australian Infection Control in 20011. Since that time there have been improvements in these methods. A major advance has been the incorporation of risk-adjustment. In this article, what we regard to be the most useful control chart techniques currently available are described in a non-technical way. For those who wish to implement these methods, suitable non-mathematical references are included.

Economic impact and formulary positioning of linezolid: a new anti-Gram-positive antimicrobial

Gram-positive bacteria have emerged as major causes of colonization and serious infection within the nosocomial and increasingly also within the community setting. These infections have significantly contributed to patient morbidity and mortality as well as prolongation of hospital stay, a key determinant of the cost of an episode of infection in hospital. In many countries globally, infections due to methicillin-resistant Staphylococcus aureus (MRSA) are providing the greatest burden of clinical infection, often occurring in vulnerable patients or “high risk” therapeutic settings. Combined with this scenario is the increasing requirement for health care organizations to provide cost-effective health care as well as care that is delivered on evidence-based practice delivered through formularies or guidelines. This article aims to: 1) summarize the key economic considerations pertinent to these multiresistant infections but with an emphasis on MRSA, 2) discuss the current therapeutic options of managing MRSA infections, and 3) discuss the formulary positioning of linezolid by means of outlining its core strengths, weaknesses and the opportunity it provides to hospital infection management.

Measuring the saving attributable to an antibiotic prescribing policy

An analytical framework is suggested for the economic evaluation of policies to improve the management of hospital infection. Consideration of the costs and benefits to be expected from improved policies implies the existence of an optimal infection rate which is higher than the minimum attainable. It follows that hospitals can and probably do spend too much on infection control in, at least, some areas. This optimal approach is not operational at present but its data requirements might be thought of as an agenda for future research. In the meantime, progress in infection control economics depends on a piecemeal approach. An example is given in the estimation of the cost savings attributable to an improved antibiotic prescribing policy at the Royal Liverpool Hospital.