Hospital Epidemiology - Health - Lecture Slides, Slides of Public Health

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Hospital EpidemiologyWhat is it and what is it good for? docsity.com

"It may seem a strange principle toenunciate as the very first requirementin a hospital that it should do the sickno harm"Florence Nightingale docsity.com

History of infection control and hospital epidemiology^ ^ Pre 1800: Early efforts at wound prophylaxis^ ^ 1800-1940: Nightingale, Semmelweis, Lister, Pasteur^ ^ 1940-1960: Antibiotic era begins,

Staph. aureus^ nursery outbreaks, hygiene focus  1960-1970’s: Documenting need for infection controlprograms, surveillance begins  1980’s: focus on patient care practices, intensive careunits, resistant organisms, HIV  1990’s: Hospital Epidemiology = Infection control, qualityimprovement and economics  2000’s: ??Healthcare system epidemiologymodified from McGowan, SHEA/CDC/AHA training coursedocsity.com

Why do we need hospital epidemiology??^ Hospitals are complex institutions wherepatients go to have their health problemdiagnosed and treatedBut, hospitals and medical/surgicalinterventions^ introduce risks

that may harm a patient’s healthdocsity.com

Challenges to the hospital epidemiologist^ ^ Make a hospital safe^ –^ Prevent harm to the patient andemployees^ •^ initial focus on infectious diseases^ •^ increasingly all adverse (harmful) eventsare targets^ ^ Improve hospital efficiency^ –^ Eliminate unnecessary costs^ –^ Eliminate wasteful practices docsity.com

What is hospital epidemiology?The fundamental roles of hospitalepidemiology are to:^ –^ Identify risks^ –^ Understand risks^ –^ Eliminate or minimize risks docsity.com

What is the role of hospital epidemiology?^ Eliminate or minimize risks to a patient’s health^ ^ organize care to minimize risk– eliminate risk factors– work around risk factors– develop improved policies and procedures^ ^ educate physicians and nurses regarding risks^ ^ study risk factors to learn more about them andhow to eliminate themdocsity.com

Responsibilities of the Infection Control Program  Surveillance of nosocomialinfections  Outbreak investigation  Develop written policies forisolation of patients  Development of writtenpolicies to reduce risk frompatient care practices  Cooperation withoccupational health  Cooperation with qualityimprovement program

^ Education of hospitalstaff on infection control ^ Ongoing review of allaseptic, isolation andsanitation techniques ^ Monitoring of antibioticutilization ^ Monitoring of antibioticresistant organisms ^ Eliminate wasteful orunnecessary practices docsity.com

Areas of interest to a hospitalepidemiologist  Antibiotic use^   Antibiotic resistantpathogens  Microbiologysupport  Nationalregulations oninfection control

Infection controlcommittee  Quantitativemethods inepidemiology docsity.com

Organizational topics in hospitalepidemiology^ ^ Relationship of Hospital toExternal Agencies andOrganizations^ ^ Personnel^ ^ Who does the hospitalepidemiologist report to?^ ^ Authority^ ^ Resources docsity.com

QI versus Regulatory Strategies inInfection ControlRegulatory approach  External organizationsestablish rules andregulations  Data collection forcomparison with outsidestandards  Inspections forcompliance  Penalties for non-compliance

TQM/QI approach  Internal organization ofhospital staff to developgoals and methods  Data collection for internalreview  Continuous efforts toimprove  Failure belongs to theentire system, not anindividual docsity.com

Organizing for Infection Control  Requires cooperation, understanding andsupport of hospital administration andmedical/surgical/nursing leadership  There is no simple formula:^ –^ Every hospital is different^ –^ Every hospital’s problems are different^ –^ Every hospital’s personnel are different  The hospital must develop its own uniqueprogram docsity.com

Essential Components of an EffectiveInfection Control Program (after SENIC)  One full time infection control practitionerper 250 beds^ –^ optimal ratio may be different  A physician with training and expertise ininfection control  Surveillance and feedback of rates toclinicians  Control activities (interventions, policies,training) docsity.com

Personnel  Hospital Epidemiologist – MD with clinical training – Usually part time salaried by the hospital forinfection control duties and part time asinfectious diseases clinician – Training in infection control  Infection Control Practitioner – Usually a nurse but can be a microbiologist – Has clinical experience before entering infectioncontrol – Full time in infection control, no other clinical oradministrative duties – Training in infection control docsity.com