HOSPITAL INFECTION CONTROL PROGRAMME

NOSOCOMIAL INFECTION SURVEILLANCE SYSTEM

The objectives of NISS should be to

1. Estimate the extent and nature of nosocomial infections in the hospitals

2. Identify the changes in the incidence of nosocomial infections and the pathogens that cause them.

3. Provide hospitals with comparative data on nosocomial infection rates.

4. Develop efficient and effective data collection, management and analysis methods.

5. Conduct collaborative research studies on nosocomial infection.

Knowledge of nosocomial infection rates serves as a stimulus for hospitals to evaluate their infection control programs and can provide a benchmark for national comparisons. These methods can also be used for assessing nosocomial infection outcomes of hospital care.

EPIDEMIOLOGIC INVESTIGATIONS

It is necessary to carry out Epidemiological investigation in the management of acute outbreaks of nosocomial infection. Most outbreaks require only local assistance with technically trained personals of that area. Onsite Epidemiological assistance will help in early id identification of the cause and source of the infection and the appropriate measures to control and prevent it.

Recently epidemiologic studies have been focussed more on intensive care units, where the nosocomial infection with resistant strains of pathogens in causing havoc among the old, debilitated patients as well as patients with chronic illnesses. It has increased the morbidity and mortality among those patients admitted to the ICU's.

Epidemiologic studies also indentify risk factors for endemic infections so that preventive strategies can be formulated and implemented. These strategies include measures to reduce the risk for infection associated with invasive techniques for intravascular pressure monitoring and hyperalimentation.

LABORATORY INVESTIGATIONS

Laboratories provide support for epidemiologic investigations and longitudinal studies. The laboratories

1. Determine the etiology of an infectious illness by isolating and identifying pathogens in specimens from patients, medical devices or environmental sources.

2. Isolate microorganisms in pure culture and identify them by using automated or semiautomated systems;

3. Type strains of microorganisms, by a variety of techniques, to determine whether a cluster of isolates of the same species are from the same clone.

Antimicrobial resistance is an important area of active laboratory investigation.


HIV TRANSMISSION IN HEALTH CARE SETTINGS

Health care workers are at risk for HIV infection from blood contact in their work environment. These workers include surgeons, obstetricians, other operating/delivery room personnel, nurses, phlebotomists, physicians, dental workers, laboratory and autopsypersonnel, and those who provide emergency medical care. HIV transmission has also been reported from patient to patient and, in one case, from a health care worker to patients.

The latest set of guidelines, referred to as Universal Precautions, identifies blood and certain body fluids from all patients as potentially infectious and recommends the use of appropriate barrier precautions to prevent blood contact.

BIOHAZARD
As part of preventing any Bio-hazards, we have to follow the Universal work precautions in the Laboratories which handle the hazardous and infectious materials. The WHO Biosafety guidelines for protections from infections in the form of selection and care of gloves, processing needles and syringes (re-usable), sterilization and disinfection and the care that has to be taken by the persons at risk of doing various Laboratory procedures, are to be strictly followed. Following these Universal work precautions in the Laboratories plays a major role in prevention and control of many a Nosocomial infections and Iatrogenic infections.

HEALTH EDUCATION AND COMMUNICATION

Recognizing a need for training hospital epidemiologists, we should develop a training programme for hospital epidemiologists and the laboratory researchers.