Hospital acquired infections (HAI) are complications of health care which affect on average 10 percent of patients admitted to hospital world wide. They have serious public health implications by changing the quality of life of patients and sometimes causing disability or even death. The purpose of this comprehensive text is to provide nurses and junior doctors with an understanding of the basics of infection control by explaining the methods employed and their purpose. The book is based on lectures presented by the author at training courses for nurses and doctors and gives simple, understandable and essential information that is vital knowledge for medical staff in hospitals.
With advances in technology and medical science, children with previously untreatable and often fatal conditions, such as congenital heart disease, extreme prematurity and pediatric malignancy, are living longer. While this is a tremendous achievement, pediatric providers are now more commonly facing challenges in these medical complex children both as a consequence of their underlying disease and the delivery of medical care. The term healthcare-associated infections (HAIs) encompass both infections that occur in the hospital and those that occur as a consequence of healthcare exposure and medical complexity in the outpatient setting. HAIs are associated with substantial morbidity and mortality for the individual patient as well as seriously taxing the healthcare system as a whole. In studies from the early 2000s, over 11% of all children in pediatric intensive care units develop HAIs and this figure increases substantially if neonatal intensive care units are considered. While progress has been made in decreasing the rates of HAI in the hospital, these infections remain a major burden on the medical system. In a study published in 2013, the annual estimated costs of the five most common HAIs in the United States totaled $9.8 billion. An estimated 648,000 patients developed HAIs in hospitals within the US in 2011 and children with healthcare-associated bloodstream infection have a greater than three-fold increased risk of death. While a number of texts discuss HAIs in the broader context of infectious diseases or pediatric infectious diseases (such as Mandell’s Principles and Practice of Infectious Diseases or Long and Pickering’s Principles and Practice of Pediatric Infectious Diseases) no single text specifically focuses on the epidemiology, diagnosis and management of HAI in children. Many infectious diseases texts are organized based on the microbiology of infection and from this starting point then discussing the clinical syndromes associated with the organism of interest. For instance, a chapter on Staphylococcus aureus may contain a brief discussion of the role of S. aureus in surgical site infections in the wider context of all staphylococcal disease. For clinicians caring for children at the bedside, however, the clinical syndrome is typically appreciated and intervention necessary prior to organism identification. We propose a text that details both the general principles involved in HAIs and infection prevention but also provides a problem oriented approach. Such a text would be of interest to intensivists, neonatologists, hospitalists, oncologists, infection preventionists and infectious diseases specialists. The proposed text will be divided into three principle sections: 1) Basic Principles of Infection Control and Prevention, 2) Major Infectious Syndromes and 3) Infections in Vulnerable Hosts. Chapters in the Major Infectious Syndromes section will include discussion of the epidemiology, microbiology, clinical features, diagnosis, medical management (or surgical management as appropriate) and prevention of the disease entity of interest. Chapters will seek to be evidenced based as much as possible drawing from the published medical literature as well as from clinical practice guidelines (such as those from the Infectious Diseases Society of America) when applicable. We intend to include tables, figures and algorithms as appropriate to assist clinicians in the evaluation and management of these often complex patients. Finally, we intend to invite authors to participate in this project from across a number of medical specialties including infectious diseases, infection control, critical care, oncology and surgery to provide a multidisciplinary understanding of disease. It is our intent to have many chapters be co-written by individuals in different subspecialties; for instance, a chapter on ventilator-associated pneumonia may be co-written by both infectious disease and critical care medicine specialists. Such a unique text has the potential to provide important guidance for clinicians caring for these often fragile children.
The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to improve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants. Definitions of health-care settings are proposed in Appendix 1. These Guidelines and the associated WHO Multimodal Hand Hygiene Improvement Strategy and an Implementation Toolkit (http://www.who.int/gpsc/en/) are designed to offer health-care facilities in Member States a conceptual framework and practical tools for the application of recommendations in practice at the bedside. While ensuring consistency with the Guidelines recommendations, individual adaptation according to local regulations, settings, needs, and resources is desirable. This extensive review includes in one document sufficient technical information to support training materials and help plan implementation strategies. The document comprises six parts.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
For 50 years, antibiotics have been dispensed like sweets. This must not be allowed to continue. This unique book assembles contributions from experts around the world concerned with responsible use of antibiotics and the consequences of overuse. For the first time, it provides up to the minute texts on both the theoretical aspects of antibiotic stewardship and the practical aspects of its implementation, with consideration of the key differences between developed and developing countries. All concerned with teaching, practice and administration of clinical medicine, surgery, pharmacy, public health, clinical pharmacology, microbiology, infectious diseases and clinical therapeutics will find Antibiotic Policies: Theory and Practice essential reading. Antibiotic use and resistance is not just the responsibility of specialists in the field but the responsibility of all doctors, pharmacists, nurses, healthcare administrators, patients and the general public.
Health care-associated infections (HAI) are one of the most common adverse events in care delivery and a major public health problem with an impact on morbidity, mortality and quality of life. At any one time, up to 7% of patients in developed and 10% in developing countries will acquire at least one HAI. These infections also present a significant economic burden at the societal level. However, a large percentage are preventable through effective infection prevention and control (IPC) measures. These new guidelines on the core components of IPC programmes at the national and facility level will enhance the capacity of Member States to develop and implement effective technical and behaviour modifying interventions. They form a key part of WHO strategies to prevent current and future threats from infectious diseases such as Ebola, strengthen health service resilience, help combat antimicrobial resistance (AMR) and improve the overall quality of health care delivery. They are also intended to support countries in the development of their own national protocols for IPC and AMR action plans and to support health care facilities as they develop or strengthen their own approaches to IPC. These are the first international evidence-based guidelines on the core components of IPC programmes. These new WHO guidelines are applicable for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
Learn from key leaders in the field of neurosurgery with the practical guidance presented in this first-of-its-kind resource. Complications in Neurosurgery uses a case-based format to explore complications across the full range of commonly performed neurosurgical procedures. As you review dozens of up-to-date, real-life cases, you'll become better equipped to identify pitfalls ahead of time and have the knowledge to handle difficult situations that arise during surgery. - Presents commonly encountered cases provided by experienced neurosurgeons in all areas of this challenging specialty. - Includes high-quality photographs, images, and dynamic video to ensure complete visual understanding of the procedures. - Uses a consistent, easy-to-read format throughout, covering a wide range of surgeries including general neurosurgery and cranial complications, as well as spinal and peripheral complications. - Numerous videos depict possible complications for each type of surgery; for example, Complications of Cerebral Bypass Surgery includes videos showing how to obtain venous hemostasis without risking injury to the STA, how to manage atheroma within the donor vessel, and how to manage intraoperative occlusion of the bypass.
Thoroughly revised and updated for its Fourth Edition, this highly acclaimed volume is the most comprehensive reference on hospital epidemiology and infection control. Written by over 150 leading experts, this new edition examines every type of hospital-acquired (nosocomial) infection and addresses every issue relating to surveillance, prevention, and control of these infections in patients and in healthcare workers. This new edition features new or significantly increased coverage of emerging infectious diseases, avian influenza, governmental regulation of infection control and payment practices related to hospital-acquired infections, molecular epidemiology, the increasing prevalence of community-acquired MRSA in healthcare facilities, system-wide infection control provisions for healthcare systems, hospital infection control issues following natural disasters, and antimicrobial stewardship in reducing the development of antimicrobial-resistant organisms.
Although nosocomial, or hospital-acquired, infections have been well cataloged and are fairly well understood, traditional solutions have failed to completely eliminate the problem. Even the most modern hospitals find themselves stymied by the persistence of these pathogens in hospital wards and operating rooms. The degree to which most of these infections are airborne is not known, but a growing body of evidence indicates that airborne transmission plays a role in many hospital-acquired infections. Addressing one of the most important topics in health care, Hospital Airborne Infection Control is the first book to deal with the control of airborne nosocomial infections in detail. It identifies all pathogens known or suspected to be airborne, along with their sources in hospital environments. It also summarizes all epidemiological evidence for airborne transmission. The text addresses respiratory, surgical site, burn wound, immunocompromised, pediatric, nursing home, and non-respiratory infections. In each category, an extensive number of examples show that inhalation is not the only airborne route by which infections may be transmitted. Noting that airborne transmission and surface contamination are virtually inseparable, the author emphasizes that both air and surface disinfection, including hand hygiene, are important factors in controlling the transmission of airborne disease. He also proposes a variety of new solutions and technologies, including ultraviolet, ionization, ozone, plasma, and vegetative air cleaning systems. A compendium of scientific and medical information, this book helps hospitals control nosocomial infections and outbreaks spread by the airborne route as well as by direct contact and contact with fomites or contaminated equipment.
