1. HOSPITAL INFECTION CONTROL & CURRENT PERCEPTIONS
Dr.T.V.Rao MD
Dr.T.V.Rao MD

2. A Tribute to Ignaz Semmelweiss (1818-1865)
Obstetrician, practised in Vienna
Studied puerperal (childbed) fever
Established that high maternal mortality was due to failure of doctors to wash hands after post-mortems
Reduced maternal mortality by 90%
Ignored and ridiculed by colleagues
Dr.T.V.Rao MD

3. What is Hospital Acquired Infections
Any infection that is not present or incubating at the time the patient is admitted to the hospital
Dr.T.V.Rao MD

4. Consequences of Hospital Acquired Infections
Additional morbidity
Prolonged hospitalization
Long-term physical, developmental and neurological sequelae
Increased cost of hospitalization
Death
Dr.T.V.Rao MD

5. Why Everyone Concerned with Hospital Infections
The Centers for Disease Control (CDC) estimates that 2 million U.S. patients a year acquire hospital-related infections. These infections cost an average of $47,000 per patient to treat and cause 90,000 deaths each year. The added cost to hospitals is $4.8 billion annually in extended care and treatment.
Dr.T.V.Rao MD

6. What is Infection Control
Infection control is the discipline concerned with preventing nosocomial or healthcare-associated infection. As such, it is a practical (rather than an academic) sub-discipline of epidemiology. It is an essential (though often under-recognized and under-supported) part of the infrastructure of health care. Infection control and hospital epidemiology are akin to public health practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.
Dr.T.V.Rao MD

7. Infection Control is Complex programme
Infection control addresses factors related to the spread of infections within the health-care setting (whether patient-to-patient, from patients to staff and from staff to patients, or among-staff), including prevention (via hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance), monitoring/investigation of demonstrated or suspected spread of infection within a particular health-care setting (surveillance and outbreak investigation), and management (interruption of outbreaks).
Dr.T.V.Rao MD

8. Beginning of Hospital Infection Programme
Modern hospital infection control programs first began in the 1950s in England, where the primary focus of these programs was to prevent and control hospital-acquired staphylococcal outbreaks. In 1968, the American Hospital Association published "Infection Control in the Hospital," the first and only standards available for many years.
Dr.T.V.Rao MD

9. Centre For Disease Control and Prevention
The Communicable Disease Center, later to be renamed the Centers for Disease Control and Prevention (CDC), began the first training courses specifically about infection control and surveillance.
Dr.T.V.Rao MD

10. CDC Initiates Hospital Infection Branch
In 1972, the Hospital Infections Branch at the CDC was formed and the Association for Practitioners in Infection Control was organized. By the close of the decade, the first CDC guidelines were written to answer frequently asked questions and establish consistent practice.
Dr.T.V.Rao MD

11. First Data on Infection Control Efficacy
In 1985, the Study of the Efficacy of Nosocomial Infection Control (SENIC) project was published, validating the cost-benefit of infection control programs. Data collected in 1970 and suggested that one-third of all nosocomial infections could be prevented
Dr.T.V.Rao MD

12. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
In 1969, the Joint Commission for Accreditation of Hospitals--later to become the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)--first required hospitals to have organized infection control committees and isolation facilities
Dr.T.V.Rao MD

13. CDC formulates Guidelines on Infection Control
In 1972, the Hospital Infections Branch at the CDC was formed and the Association for Practitioners in Infection Control was organized. By the close of the decade, the first CDC guidelines were written to answer frequently asked questions and establish consistent practice.
Dr.T.V.Rao MD

14. Break the Chain of Infections
1. Organisms that can cause infection are subject to risk assessment under the COSHH regulations and Management of Health and Safety at Work Regulation 1992.
Dr.T.V.Rao MD

15. Risk assessment of Substances in use for ICP
Various substances such as disinfectants used to prevent cross infection are subject to risk assessment prior to use. Health and Safety guidance highlights the importance of the risk assessment process i.e. Identify the risk
Assess the risk
Note current measures which are being used to control or mitigate the risk
Inform/train staff
Monitor outcomes
Implement policies and procedures
Dr.T.V.Rao MD

16. Beginning of AIDS Pandemic Necceciates Stronger Infection Control Protocols
The second and certainly most significant factor influencing infection control at the time was the advent of acquired immunodeficiency syndrome (AIDS). The human immunodeficiency virus (HIV) has taken an enormous toll in terms of loss of life and productivity. For infection control professionals (ICPs), HIV has been a challenge for education, risk reduction and resource utilization.
Dr.T.V.Rao MD

17. Study of the Efficacy of Nosocomial Infection Control (SENIC) project
Study of the Efficacy of Nosocomial Infection Control (SENIC) project was published, validating the cost-benefit of infection control programs. Data collected in 1970 and suggested that one-third of all nosocomial infections could be prevented if all the following were present:
One infection control professional (ICP) for every 250 beds.
An effective infection control physician.
A program reporting infection rates back to the surgeon and those clinically involved with the infection.
An organized hospital-wide surveillance system.
Dr.T.V.Rao MD

18. Infection Control Challenges of Healthcare in 2000
Decreasing reimbursement
Increasing emerging infections
Increasing resistant organisms
Increasing drug costs
Institute of Medicine Report--healthcare-associated infections
Nursing shortage
OSHA safety legislation
Multiple benchmark systems
FDA legislation on reuse of single-use devices
Dr.T.V.Rao MD

19. Interesting, right?
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