Assuntos
Hospitais Comunitários/organização & administração , Hospitais de Ensino/organização & administração , Controle de Infecções/organização & administração , Eliminação de Resíduos de Serviços de Saúde/métodos , Controle de Custos , Humanos , Eliminação de Resíduos de Serviços de Saúde/economia , Eliminação de Resíduos de Serviços de Saúde/estatística & dados numéricos , Estudos de Casos Organizacionais , Recursos Humanos em Hospital/educação , Avaliação de Programas e Projetos de Saúde , Garantia da Qualidade dos Cuidados de Saúde/organização & administraçãoRESUMO
OBJECTIVE: To report the effectiveness of use of comprehensive infection control measures to reduce the incidence of Clostridium difficile (CD) in an acute-care teaching hospital. METHODS: All CD infections were reviewed by the infection control coordinator from 1987 to 1996. The Centers for Disease Control and Prevention's nosocomial infection definition was used. CD-inclusion criteria remained unchanged during the study period. Interventions were started in 1990. INTERVENTIONS: The interventions used were: (1) Isolation policy-revision and enforcement, which included universal precautions policy, (2) educational program-monthly to all health care workers, (3) phenolic disinfectant for environmental cleaning, (4) triclosan (0.03%) soap for handwashing, (5) centralization of sterilization department, (6) cart-washer installation, and (7) aggressive surveillance activity. RESULTS: From 1987 to 1989, before the interventions, a total of 466 CD infections (mean 155 per year) occurred. From 1990 to 1996, after the interventions, 475 infections (mean 67 per year) occurred. Incidence of CD decreased by 60% from 1990 to 1996. CONCLUSION: The sustained decrease of nosocomial CD during the 7-year period demonstrated the effectiveness of aggressive infection control measures that involve multiple disciplines.
Assuntos
Clostridioides difficile , Infecção Hospitalar/prevenção & controle , Enterocolite Pseudomembranosa/prevenção & controle , Controle de Infecções/métodos , Feminino , Hospitais Comunitários , Hospitais de Ensino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Política Organizacional , Avaliação de Programas e Projetos de Saúde , VirginiaAssuntos
Infecção Hospitalar/transmissão , Surtos de Doenças , Hospitais de Ensino/estatística & dados numéricos , Infecções por Pseudomonas/transmissão , Pseudomonas putida/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Feminino , Humanos , Lactente , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/epidemiologia , Infecções por Pseudomonas/prevenção & controle , VirginiaAssuntos
Infecção Hospitalar/prevenção & controle , Doenças Profissionais/prevenção & controle , Equipe de Assistência ao Paciente , Dispositivos de Proteção Respiratória/economia , Tuberculose Pulmonar/prevenção & controle , Análise Custo-Benefício , Infecção Hospitalar/economia , Desenho de Equipamento , Humanos , Doenças Profissionais/economia , Tuberculose Pulmonar/economiaRESUMO
The Arlington Hospital Needlestick Injury (NSI) Prevention Program was created to protect healthcare workers from NSI and to assess the effectiveness of our interventions. Interventions included revising NSI policy and procedures. The average NSI rate dropped from 109 to 43 per year after the interventions, over a period of 4 years.
Assuntos
Patógenos Transmitidos pelo Sangue , Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Doenças Profissionais/prevenção & controle , Precauções Universais , Hospitais de Ensino , Humanos , Capacitação em Serviço , Fatores de RiscoRESUMO
BACKGROUND: Once established in an institution, methicillin-resistant Staphylococcus aureus (MRSA) outbreaks have proved difficult to eradicate, despite intensive infection control measures. This report describes the nosocomial infection with MRSA of 22 male infants in a neonatal nursery during a 7-month period and the infection control procedures that effectively brought this outbreak under control and eliminated recurrence for more than 3 1/2 years. METHODS: After a single index case of bullous impetigo caused by MRSA in a neonate discharged from the nursery 2 weeks previously, an additional 18 cases of MRSA skin infections were clustered in a 7-week period. Aggressive infection control measures were instituted, including changes in umbilical cord care, circumcision procedures, diapers, handwashing, gloves, gowns, linens, disinfection, placement in cohorts of neonates and staff, surveillance, and monitoring. RESULTS: These measures were not effective in slowing the outbreak. The single additional measure of changing handwashing and bathing soap to a preparation containing 0.3% triclosan (Bacti-Stat) was associated with the immediate termination of the acute phase of the MRSA outbreak. CONCLUSION: The nursery has remained free of MRSA for more than 3 1/2 years, attesting to the success of our program.