Control of infection: a survey of general medical practices

Knowledge of infection control practices among intensive care nurses in a tertiary care hospital

BACKGROUND

The threat of hospital-acquired infections persists despite advances in the health care system. A lack of knowledge regarding infection control practices among health care workers decreases compliance with these practices. We conducted a study to assess the knowledge of infection control practices among nursing professionals at our hospital.

METHODS

In total, 100 nurses in the intensive care units at our hospital were given a questionnaire with 40 multiple choice questions, including 10 questions each regarding hand hygiene, standard and transmission-based precautions, care bundles and general infection control practices. The responses were scored as percentages.

RESULTS

The overall knowledge and awareness regarding different infection control practices were excellent (>90% positive responses) in 5% of the nursing professionals, good (80-90% positive responses) in 37%, average (70-80% positive responses) in 40% and below average (<70% positive responses) in 18%.

CONCLUSION

The infection control knowledge among the nurses was fairly good; however, there is still a wide scope of improvement with regular educational programs and in-house training.

Infection control in general practices in Buffalo City and OR Tambo District Municipalities, South Africa

Background

Good infection control practices are effective in reducing rates of infection in health care settings. Studies in primary care in developed countries indicate that many general practitioners (GPs) do not comply with optimal infection control practices. There are no published studies from developing countries in Southern Africa.

Objectives

The aim of this study was to describe infection control practices in private GP surgeries in the Buffalo City and OR Tambo District Municipalities in the Eastern Cape Province, South Africa.

Method

A literature review was conducted to appraise current best practice with respect to Standard Infection Control and Transmission Based Precautions. A questionnaire, inquiring into GPs’ actual practices, was posted to each surgery.

Results

The valid response rate was 34% (47/140). Methods used to sterilise instruments in 40 practices were: ultraviolet sterilisation (23), chemical disinfection (14), boiling water (7), and steam autoclave (2). Compounds used for chemical disinfection included organotin quaternary, chlorhexidine and benzyl ammonium chloride with a quaternary complex. Twenty-two (47%) used a hand rub. Sixteen (35%) GPs stated that they had a policy to promptly triage patients who are coughing, and 23 (50%) had a policy for airflow movement in the surgery. All practices appropriately disposed of sharps. Thirty-seven (80%) expressed interest in a seminar on infection control.

Conclusions

Overall, GPs were aware of infection control precautions. Ultraviolet sterilisers and chlorhexidine are not recommended, however, for sterilisation or high level disinfection of medical instruments, and their use should be discontinued. Hand rubs are underutilised. GPs should implement Transmission Based Precautions to prevent airborne and droplet infections.

The cost of needlestick injuries associated with insulin administration

The administration of insulin by a carer or healthcare professional is associated with a risk of needlestick injury. Such injuries create a burden for carers and professionals in terms of anxiety, stress and morbidity as well as the NHS in terms of lost productivity, treatment costs and litigation. This study estimates the economic burden of these injuries to the NHS in the UK based on published estimates of the incidence and cost of needlestick injuries. The findings suggest that such injuries cost the NHS approximately 600,000 pounds sterling per annum. Many of these injuries and their associated costs could be avoided through increased adoption of safety devices. Indeed, evidence suggests that the increased acquisition cost of safety devices could be more than offset by savings resulting from the reduced incidence of needlestick injuries. Trusts are encouraged to implement improved monitoring and surveillance procedures to inform the debate on the appropriate use of safety devices.

Bacterial contamination of children's toys used in a general practitioner's surgery

General practitioners--and other healthcare professionals are encouraged to make their premises child friendly. One way of doing this is to provide toys for children to use. We looked at the appearance and bacterial colonisation of 50 toys after a busy morning surgery in an inner city general practice. The toys appeared generally unclean and 10% were contaminated by potential pathogens. Bacteria were cultured more frequently from soft toys than from hard toys (odds ratio 8.14; 95% confidence range 0.74-107.49). Although toys may appear to be physically dirty after use, the bacteria isolated from their surfaces are generally non-pathogenic to children with normal immune function and probably no worse than other objects in the environment. However, there does exist an appreciable (1 in 10) risk of cross-infection with the use of toys in a clinic. Toys with a hard surface are preferred as these are less likely to be contaminated and are more easily disinfected.

Handwashing facilities in the clinical area: a literature review

Handwashing is without doubt the most important intervention in the control of cross-infection. However, many healthcare staff do not comply with the procedure. One of the factors that contributes towards this is a lack of adequate and appropriate handwashing facilities. This article looks at the literature relating to handwashing and identifies what adequate and appropriate facilities actually are, with recommended standards for clinical areas. It concludes by highlighting that a greater commitment is needed from managers in this area in order to improve compliance with handwashing and therefore reduce infection rates.