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Hygiene & Medizin 1+2/18

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Contents issue 1-2/2018 Hygiene & Medizin

Review

Infection Prevention and Control in Sweden

Birgitta Lytsy

Hyg Med 2018; 43(1/2): E1–E4.

Keywords: Infection prevention and -control (IPC) · healthcare-associated infections (HAI)

Sweden, with a population of 10 million inhabitants, is a high-income country with one of the highest health indexes in the world according to the WHO and other similar institutes. Most Swedish hospitals are public and funded by taxes and almost free for the citizens. Overall national laws and policies concerning the health care sector are defined by the government. When it comes to the practical governing of the healthcare sector, Sweden is more a federation than a nation, since the country is divided into 21 regions, each with their own democratically elected representatives. Laws, regulations, organisations and authorities relevant for infection prevention and control (IPC) at the national level are described as well as the epidemiology of healthcare-associated infections (HAI). Organisation, planning, infrastructure, indications and activities of ICP are outlined based on the WHO 8 core components for IPC that were published in 2016. The most acute problem in Swedish hospitals today is the lack of qualified nurses resulting in understaffing and overcrowding. There is no national IPC strategy in Sweden. Most 21 regions have fulfilled the WHO 8 core components to some extent, some more and some less than others.

Healthcare-associated infection prevention in France

Pierre Parneix

Hyg Med 2018; 43(1/2): E5–E10.

Keywords: infection control (IC) · infection control (ICP) practitioners · healthcare associated infections (HAI)

In France infection control (IC) practitioners appeared in the late 1970s. It was only in 1995 that the French health authorities released a legal statement mentioning the concept of IC teams which became mandatory in November 1999. In 2000 a mandatory statement implemented an IC annual report for each hospital which remained confidential. Under the pressure of consumer associations, the Ministry of Health implemented public reporting indicators in 2004 with the first one called ICALIN. Through the years, consumer associations have been a powerful drive to strengthen the legislation around the prevention of healthcare-associated infections. Strong achievements have been obtained during the past decades with a major reduction in infection rates. The evolution towards a more global patient safety approach has been initiated, however this idea progresses rather slowly. IC has faced several challenges like the economic crisis and the spread of highly drug-resistant bacteria. The issue of a need to modernize and simplify the prevention approach has been raised, and this radical change is on the move.

Hospital Hygiene in Spain

Angel Asensio*, Mireia Cantero

Hyg Med 2018; 43(1/2): E11–E14.

Keywords: hospital hygiene · preventive medicine and hospital hygiene · prevalence surveys · antimicrobial resistance

Hospital hygiene (HH) emerged in Spain in the year 1973. The setting-up of the medical specialty “Preventive Medicine and Hospital Hygiene” fueled the growing up of this medical discipline. Nurses are the other main professionals involved in HH activities, however their training has not yet been regulated. Several Autonomous Communities require health institutions, public or privately owned, to have in place personnel responsible for Hospital Hygiene activities. 92% of the hospitals had an Infection Control Program (ICP). 36.2% and 17.4% of the hospitals have a ratio of one physician per 500 beds and one nurse per 250 beds, respectively. Currently most hospitals have an infection control committee as an advisory body to hospital management. In addition, some hospitals organize HH activities by functional units incorporating infectious disease, preventive medicine, and microbiologist specialists as well as nurses. Prevalence surveys of healthcare-associated infections (HCAI) in Spain using a common methodology have been performed annually since 1990. Numerous institutions perform HCAI incidence surveillance. Risk of infection for surgical procedures, critical care area patients, and device-related procedures are the main activities performed by 68%, 59% and 47% of the hospitals. Some regions have enforced public reporting of data. Antimicrobial use in Spanish hospitals has been increasing linearly since 1990 and nowadays, 46.1% of the hospitalized patients are currently receiving antimicrobials. Spain is among the European countries with the highest rates for antimicrobial resistance and antibiotic consumption both at the hospital and community level. Antimicrobial resistance awareness by healthcare workers and for the public should be raised. The administrative management should support effective actions to improve infection control politics and antimicrobial stewardship at the hospital level.

Infection Control and Hospital Hygiene in Italy: state of the art and perspectives

Silvio Brusaferro*, Luca Arnoldo

Hyg Med 2018; 43(1/2): E15–E19.

Keywords: infection prevention and control (IPC) · hospital hygiene (HH) · antimicrobial resistance

Infection Prevention and Control (IPC) and Hospital Hygiene (HH) have a long tradition in Italy since the first half of the last century. Medical doctors post graduated in Hygiene and Public Health are commonly those who are expected to run these programmes within hospitals and trusts as medical directors. The Italian National Health Service (INHS), which was founded 40 years ago, is changing rapidly in the last years, and quality and safety guarantees are some of the major drivers of its evolution. Recently adopted laws, standards and indicators on IPC, HH and Antimicrobial Resistance (AMR) have the potential to trigger a major improvement in the next years. Nevertheless a common challenge remains the reduction of variability in performances within and among regions and the strengthening of a national information infrastructure.

Infection prevention in hospitals and nursing homes in the Netherlands

Paul Bergervoet

Hyg Med 2018; 43(1/2): E20–E21.

Keywords: Infection prevention • MRGN • MRSA • hospitals • nursing homes

In the Netherlands hospital hygiene has played a key role since the 1970s in the hospital setting. One of the most important rewards is that antimicrobial resistances rates are relatively low. But issues around resistance will also be the greatest challenge in the coming years. The Netherlands would like to strengthen their unique situation in Europe in the field of infection prevention, not only in hospitals but also in nursing homes.

Infection prevention and control in Europe: the role of EUNETIPS

Silvio Brusaferro, Luca Arnoldo

Hyg Med 2018; 43(1/2): E22–E26.

Keywords: Infection Prevention and Control (IPC) · EUNETIPS

In Europe there is a long story of Infection Prevention and Control (IPC) programmes but most of them have been developed only at national level without a common coordination. In November 2008 in Berlin, 12 scientific and professional societies involved in IPC decided to meet and discuss about existing resources. At the end of this meeting they founded the European network to promote infection prevention for patient safety (EUNETIPS) by publishing the Berlin declaration. EUNETIPS was conceived not as scientific society but as European network that involves scientific and professional societies of European countries. This peculiar organisation makes its management more fragile from the structural point of view but also allows a valorisation of local history and peculiarities that are key points for ensuring a capillary dissemination of quality care actions and programmes to all European citizens. Nowadays EUNETIPS gathers about 30 scientific societies that represent over 9,000 healthcare professionals and 21 countries and develops programmes and activities that support IPC and patient safety activities sustaining the necessity to face these problems in a common European dimension that should not consider political borders but the geographical ones. Considering the status of network, the core elements of EUNETIPS for the dissemination of the knowledge, experience and programmes are the website (www.eunetips.eu) that contains documents, videos and other training material freely accessible by all users, and the newsletter that is sent quarterly to all the members.