Infection-control an overview of the discussions on the subject of Cross Infection Control

Definition of control of infection in general terms

Infection-control refers to policies and procedures used to minimise the risk of spreading infections, especially in hospitals and health care facilities within the UK.

The Purpose of Infection-control

Infection Control in Hospitals

These occur in approximately 5% of all hospital patients. This results in increased time spent in the hospital and, in worst cases, death.

There are many reasons Nosocomial infections are common, one of which is that many hospital patients have a weakened immune system, which makes them more susceptible to infections.

This depressed immune system can be caused either by the patient's diseases or by treatments given to the patient. Secondly, many medical procedures can increase the risk of infection by introducing infectious agents into the patient.

Thirdly, many patients are admitted to hospitals because of infectious disease. These infectious agents can then be transferred from patient to patient by hospital workers or visitors.

Infection-Control has now become a formal discipline since the 1950s, due to the spread of staphylococcal infections in hospitals, which has meant that there has been an increase in the number of autonamous Infection Control Departments that report to the management of hospitals directly. Because there is both the risk of health care providers acquiring infections themselves and of them passing infections on to patients, Centres for Disease Control and Prevention have established guidelines for infection control procedures.

In addition to hospitals, infection control is important in nursing homes, clinics, child care centres, and restaurants, as well as in the home.

Threat of emerging infectious diseases in Infection-Control

Many new contagious diseases have been identified in the past 50 years, such as AIDS, Ebola and Hantavirus and recent the Swine Flu H1N1 and Bird Flu epidemics H1N15.

Increased travel between continents makes the world-wide spread of disease a bigger concern than it once was, as has been shown by the extremely fast spread of the bird flu recently. Additionally, many common infectious diseases have become resistant to known treatments.

Problems of antibiotic resistance

This means that newer antibiotics must continually be developed in order to treat an infection and keep up with the immunity to the drugs.

However, further resistance seems to come about almost simultaneously.

This indicates to many scientists that it may well become more and more difficult to treat infectious diseases.

The use of antibiotics outside of medicine also contributes to increased antibiotic resistance. One example of this is the heavy use of antibiotics in animal husbandry.

These negative trends can only be reversed by establishing a more rational use of antibiotics through treatment guidelines, and to control the rogue farmers and their drug suppliers into being more responsible in their drug sales and use, where in the past there has been a totally unregulated use of the drugs used in the promoting growth of livestock.

Description of Infection-Copntrol

An infection control officer is a specially trained professional, most often a qualified nurse, who oversees infection control programs within the hospital or business but is independent from the rest of the team to allow unbiased reports to be provided with peace of mind.

Recommended precautions to avoid and control the spread of infections include:

Cook food thoroughly.

Controlled Laundry facilities.

Controlled Disinfection crockery and utensil washing facilities.Use antibiotics only as directed.

See a doctor for infections that do not heal.

Avoid areas with a lot of insects.

Be cautious around unfamiliar animals.

Do not engage in unprotected sex or in intravenous drug use.

Make enquiries prior to travel about infectious diseases in the area.

Because of the higher risk of spreading infectious disease in a hospital setting, higher levels of precautions are taken.

Typically, health care workers should wear gloves with all patients, since it is difficult to know whether a transmittable disease is present or not. Patients who have a known transmittable infectious disease are isolated to decrease the risk of transmitting the infectious agent to another person.

Hospital workers who come in contact with infected patients must wear gloves and gowns to decrease the risk of carrying the infectious agent to other patients.

All articles of equipment including clothing that are used in an isolation room are decontaminated before re-use.

Patients who are immune-compromised may be put in protective isolation to decrease the risk of infectious agents being brought into their room. Any hospital worker with infections, including colds, are restricted from that room.

Hospital infections can also be transmitted through the air. Thus care must be taken when handling infected materials or even suspect laundry, so as to decrease the numbers of infectious agents or possible contaminants that become airborne. Special care should also taken with hospital ventilation systems to prevent recirculation of contaminated air.

Controlled Laundry facilities –

Hospital in-house controlled Laundry facilities are becoming more compact within Health Trusts, as Infection Control attempts to localise and contain infection spread at source.

Many of the larger area Hospital Laundry units are now closing down.

In-house Laundry is also now becoming a standard feature within Residential & Nursing Homes, Day Centres, Clinics, Health Centres and Community Care Units, as these facilities and organisations are increasingly taking up the burden of Care responsibility, in line with the major Community Care strategies being followed in the United Kingdom.

MOP cleaning, for example, often overlooked, is now seen as a priority issue, as without proper and controlled cleaning/disinfection, MOPs can lead to a rapid spread of infection throughout a HealthCare premises.

Infection Control, Disinfection recommendations and practices are now being recognised as an important requirement for this new Community Care approach and equipment to provide this level of containment and prevention has to be properly assessed.

Washing and rinsing temperatures are now being specified which must provide an adequate and reasonable level of infection control in fabrics, clothing and cleaning mops.

It is an important responsibility of the Home or Residential facility, to ensure ‘due diligence’ and proper compliance to such procedures.

Controlled Disinfection dishwashing – for Infection-Control

The spread of infection is easily transmissable via crockery and cutlery, therefore proper Disinfection must be provided at this level.

Hand washing of crockery for example has a 19% rejection rate as far as infection is concerned. Compare this with simple machine dishwashing, which has a rejection rate of only 3%.

Add in proper Disinfection specification dishwashing with Infection-control features, and this rejection rate drops still further.

DHSS recommendations for dishwasher Disinfection advise rinse temperatures of 82ºC for a minimum of 2 minutes.

This is NOT achieved, for example, by domestic dishwashers or standard catering ‘tank’ type dishwashing machines (where the wash water is used over and over again with just the overflow being replaced after each wash with a dash of detergent, and a rinse of uncontrolled temperature, or any audit procedure being possible i.e NO Infection-control at all).

Specialist Dishwashers are therefore required to do the task, which can meet these parameters.

Therefore the two areas of Infection-control as regards Miele equipment and systems are firstly, Laundry and the cleaning of fabrics and cleaning materials and secondly, in the area of controlled Disinfection Dishwashing.

Miele Professional machines can provide full Disinfection and cleaning for both processes and are continually developing new programmes and procedures for optimum results, these result are of an audited capability for full peace of mind for the management and all concerned both patients and staff, and not forgetting the general public, who depend on a professional standard being adhered to by our services in health care and catering.

References – 1) Gale Encyclopedia of Medicine - Infection control - Author/s: Cindy L. Jones

2) NHS Guidelines data & Advisory recommendations, 1995 –2001

3) the Miele Professional department UK

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