Failure Of Infection Control Procedures

Hospitals and other health care settings are major breeding grounds for antibiotic resistant organisms. While most practitioners are aware that infection control procedures such as handwashing and compliance with isolation procedures are important, their day to day behavior belies this understanding. Repeated studies have documented that health care practitioners fail to wash their hands when indicated and that physicians are the most likely to be noncompliant (22). This clearly facilitates the spread of resistant organisms to additional patients in the health care setting. Renewed emphasis on these basics is necessary for all practitioners.

Lack of knowledge of appropriate isolation procedures and noncompliance with regulations remains a major challenge in health care settings. The importance of following "standard" of "universal" precautions has been repeatedly emphasized but too often ignored. Failure to appropriately isolate patients with multiply resistant organisms has facilitated the spread of these microbes.

The CDC has developed a plan to respond to the threat of emerging infectious diseases including the problem of antibiotic resistance (23). A system of surveillance and response has been developed, including the Epidemiology and Laboratory Capacity (ELC) program, the Emerging Infections Programs (EIP) and provider based sentinel networks. A specific charge of the ELC program is to track antimicrobial resistance. EIP priorities include retarding the emergence and transmission of antibiotic resistance. The World Health Organization has a WHONET surveillance systems and a program for antimicrobial resistance monitoring (ARM), and continues its efforts in monitoring drug resistant tuberculosis on a global basis. It is critical that all practitioners interact with these programs, especially by reporting to their local health departments (24).

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