Educational programmes for infection control in Austria.

Educational aims and strategies (simply arousing awareness, sensitivity and understanding; and/or training in practical skills and knowledge; or the ability to teach infection control, and to convince those taught) depend on the target group. Infection control is part of the curriculum for students of medicine and other health care professions, and is included in course examinations. Postgraduate doctors may seek training on courses which are organized by the Hygiene Institute of the University of Vienna in co-operation with the Austrian Society of Hygiene, Microbiology and Preventive Medicine. Registered nurses may enroll in the Austrian Nurses' Association training scheme (6 weeks of theory with professional work for 2 years), leading to approval as Hygieneschwester/-pfleger. Postgraduate in-hospital education for all health-care professions occurs in many Austrian hospitals, with resources from Vienna and Linz. Hospital managements, health authorities and politicians are influenced via their own educational activities and via publications.

Surgical hand preparation: state-of-the-art.

Surgical hand preparation has been recommended since the nineteenth century as a measure to reduce infection resulting from surgery. We review the evidence and major objectives of surgical hand preparation, as well as the criteria for the choice of products currently in use. Test and validation procedures for selecting products for surgical hand preparation in North America and Europe are compared. Surgical hand antisepsis using medicated soap and alcohol-based hand-rub formulations is discussed, including the technical aspects, time required for the procedure, drying time, potential for side-effects, and the parameters for the selection of the most appropriate formulations. Brushes are not recommended for surgical hand preparation. Rapid antimicrobial action, wider spectrum of activity, lower side-effects, and the absence of the risk of hand contamination by the rinsing water, clearly favour the use of alcohol-based hand rubs for surgical hand preparation, even in countries with limited resources where the provision of water is scarce or of doubtful quality.

[Application of an infection control protocol at an anesthesiology intensive care unit]. / Anwendung eines Infektionsüberwachungsprotokolles auf einer anaesthesiologischen Intensivstation.

We studied the efficiency and practicability of a new protocol for surveillance of nosocomial infection in 99 patients admitted to our intensive care unit (ICU) between October 1985 and March 1986. The protocol contained the therapy given before admission to the ICU and daily records of: (1) therapy suspected to increase the risk of nosocomial infection (ventilatory support, operations, hemofiltration, central venous and arterial catheters, Swan-Ganz catheters, etc.); (2) parameters possibly associated with bacterial infections (white blood cell count, body temperature, platelet count, creatinine clearance, hemodynamic values, clinical suspicion of infection, suspected site of infection, pathological chest X-ray, etc); and (3) bacteriologic data (results of cultures from blood, tracheal aspirate, urine, wound secretions) and antibiotic treatment. Sepsis was diagnosed in 28 patients, and 28 had positive blood cultures; these two groups were not identical. Twenty-nine patients died, more than half of them having a serious nosocomial infection. Factors associated with nosocomial infection were: fever greater than 38.5 degrees C, recurrent fever, leucocytosis, leucopenia, thrombocytopenia; duration of stay at the ICU; ventilatory support, operations, mass transfusions, and therapy with catecholamines. Use of a Swan-Ganz catheter and hemofiltration were associated with nosocomial infection, but they were usually begun after the clinical onset of sepsis. Therapy administered before admission to the ICU was not associated with nosocomial infection. Bacterial colonization of tracheal aspirate was detected in 2/3 of the ventilated patients. The most common bacteria isolated were staphylococci in blood cultures. Pseudomonas sp. and Candida albicans in tracheal secretions, and Candida albicans in urine cultures.(ABSTRACT TRUNCATED AT 250 WORDS)