Damani N.N. Manual of Infection Control Procedures

2nd edition. — Cambridge University Press, 2003. — 365 p.This manual addresses the need for patient care and recognises that the factors involved in HAI are complex and that cost-effective measures to combat them are needed which are based on evidence-based guidelines. Reliable comparisons of infection rates between units, hospitals and countries are difficult without ongoing monitoring with risk factor adjustment and benchmarking. The new section on Epidemiology and Biostatistics will facilitate worthwhile comparison and make benchmarking a challenge, not a threat.
The control of infection in hospitals has greatly improved in recent years; we have many more professional staff, who are better trained, and more resources are being set aside for infection control since the acknowledgement by management that infection control is part of the quality improvement process required of health care services. However, the free movement of patients between hospitals and the community, by breaking down invisible barriers, will always remain a challenge for HCWs. We still lack sufficient isolation facilities to contain the major problems of patients with antibiotic-resistant strains of bacteria such as multi-drug resistant tuberculosis (MDR-TB), methicillin-resistant Staphylococcus aureus (MRSA) and gylcopeptide resistant enterococci (GRE). A combined approach of prudent antibiotic prescribing, effective surveillance and good infection control practices is essential if antibiotic resistance is to be contained. This is a worldwide problem, and the spread of infection is a major problem in the developed world, but the principles of effective control are the same throughout the world.
In the developed world, people are having longer and more ‘adventurous’ surgery and transplantation is being carried out in hospitals in the face of emerging new diseases and newly-identified micro-organisms which are difficult to treat. There is a sharp increase in the use of minimally invasive surgery, with the widespread use of expensive, heat-labile equipment like endoscopes, which require a high quality system for decontamination. This manual contains most of the procedures necessary to carry out such a service, but the author has not forgotten that basic hand washing is generally considered to be the most important single measure in the control of hospital infection and is dealt with in detail in this manual.