Content area
Full text
Chapter 4
ABSTRACT
Transmission of infection in the hospital has been identified as a patient safety problem adversely affecting patients, visitors, and health care workers. Prevention of infection should not be limited to the hospital epidemiology staff but also must involve the entire multidisciplinary team, including nurses. This chapter reviews the literature related to patient safety of nursing-authored studies of infection control in the hospital. The review indicated that there were key areas of research interest including drug resistance; hand hygiene products, procedures, and surveillance; preoperative skin preparations; health care worker transmission of infection; common procedures associated with an increased risk of transmission; and organisational issues.
Keywords: infections, patient safety, nursing
In the past 20 years, the overall incidence of health care-associated infections has increased 36% (Institute of Medicine, 2000). Infections acquired in acute care hospitals continue to be a leading cause of death in the United States (Wenzel & Edmond, 2001). Annually, more than 500,000 of the nearly 2 million patients stricken with these infections are patients in intensive care units (ICUs), and most of these infections are associated with the presence of an invasive device (such as a vascular access line, ventilator, or indwelling urinary catheter). Nearly 90,000 of these patients are estimated to die (Centers for Disease Control and Prevention, 1992). As a result of the persistent nature of this insidious problem, an objective of Healthy People 2010 is to reduce health care-associated infections in ICUs by 10% (objective 14-20) (United States Department of Health and Human Services, 2000). The total hospital-related financial burden of health care-associated infections in the United States was estimated to exceed $4.5 billion in 1992 (using the Consumer Price Inflator, this converts to $6.5 billion in 2004 dollars) (Centers for Disease Control and Prevention, 1992). However, this estimate is based on infection rates measured in the Study on the Efficacy of Nosocomial Infection Control, which was conducted in the mid-1970s, and current expenditures are likely to be higher (Haley et al., 1985).
Risk of health care-associated infections is not limited to patients (Stone, 2004). All health care workers face a wide range of hazards on the job, including blood and body fluid exposure. Nursing personnel experience these hazards most frequently (Centers for Disease Control and...