Infection Prevention and Control: Theory and Practice for Healthcare Professionals

343 Pages·2008·3.471 MB·English

by  Debbie Weston

Infection Prevention
and Control
Theory and Clinical Practice for
Healthcare Professionals
DEBBIE WESTON
InfectionControlAdvisor,EastKentHospital
(cid:84)(cid:104)(cid:105)(cid:115)(cid:32)(cid:112)(cid:97)(cid:103)(cid:101)(cid:32)(cid:105)(cid:110)(cid:116)(cid:101)(cid:110)(cid:116)(cid:105)(cid:111)(cid:110)(cid:97)(cid:108)(cid:108)(cid:121)(cid:32)(cid:108)(cid:101)(cid:102)(cid:116)(cid:32)(cid:98)(cid:108)(cid:97)(cid:110)(cid:107)
Infection Prevention and Control
(cid:84)(cid:104)(cid:105)(cid:115)(cid:32)(cid:112)(cid:97)(cid:103)(cid:101)(cid:32)(cid:105)(cid:110)(cid:116)(cid:101)(cid:110)(cid:116)(cid:105)(cid:111)(cid:110)(cid:97)(cid:108)(cid:108)(cid:121)(cid:32)(cid:108)(cid:101)(cid:102)(cid:116)(cid:32)(cid:98)(cid:108)(cid:97)(cid:110)(cid:107)
Infection Prevention
and Control
Theory and Clinical Practice for
Healthcare Professionals
DEBBIE WESTON
InfectionControlAdvisor,EastKentHospital
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LibraryofCongressCataloging-in-PublicationData
Weston,Debbie.
Infectionpreventionandcontrol:theoryandclinicalpracticeforhealthcare
professionals/DebbieWeston.
p. cm.
Includesbibliographicalreferencesandindex.
ISBN978-0-470-05907-4(alk.paper)
1. Infection—Prevention. 2. Nosocomialinfections—Prevention. I. Title.
[DNLM:1. CrossInfection—prevention&control. 2. Hospitals. 3. Infection
Control—methods.WX167W534i2007]
RA761.W382007
362.196(cid:2)9—dc22
2007027379
BritishLibraryCataloguinginPublicationData
AcataloguerecordforthisbookisavailablefromtheBritishLibrary
ISBN:978-0-470-05907-4
Typesetin10/12ptTimesbyIntegraSoftwareServicesPvt.Ltd,Pondicherry,India
PrintedandboundinGreatBritainbyTJInternational,Cornwall,UK.
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atleasttwotreesareplantedforeachoneusedforpaperproduction.
Contents
Foreword vii
Preface ix
Acknowledgements xi
List of Figures xiii
List of Tables xv
Introduction xix
PART I
1 Infection Prevention and Control: Past, Present and Future 3
2 Bacterial and Viral Classification, Structure and Function 13
3 The Collection and Transportation of Specimens 27
4 The Microbiology Laboratory 35
5 Understanding the Immune System and the Nature and
Pathogenesis of Infection 43
6 The Principles of Infection Prevention and Control 61
7 Types of Healthcare Associated Infection 85
8 The Problem of Antimicrobial Resistance 111
PART II
9 Meticillin-resistant Staphylococcus aureus (MRSA) 127
10 Tuberculosis 141
11 Clostridium difficile 157
12 Invasive Group A Streptococcal Disease 169
13 Meningococcal Disease 179
vi CONTENTS
14 Norovirus 189
15 Campylobacter and Salmonella 201
16 Blood-borne Viruses 215
17 Severe Acute Respiratory Syndrome (SARS) 229
18 Pandemic Influenza 241
19 Creutzfeldt-Jakob Disease (CJD) 257
20 Legionella 271
References 279
Glossary 315
Index 319
Foreword
Duringthepasttwodecades,healthcare-associatedinfectionshavebecomeasignifi-
cantrisktopatientsafetyandacquiringanewinfectionduringepisodesofhealthcare
isaworldwidehazardforbothpatientsandhealthcareproviders.Prevalencesurveys
inEurope,AustralasiaandNorthAmericasuggestthatapproximately5–10percent
ofallinpatientswillhaveacquiredahealthcare-associatedinfectionduringperiods
of hospital care. Many of these infections are serious and sometimes fatal. Many
areresistanttotheantimicrobialdrugsusuallyusedtotreatthemandallofthemare
distressingandexpensive.Thefinancialandpersonalcostsofhealthcare-associated
infections, in terms of the economic consequences to the National Health Service
intheUnitedKingdom,andthephysical,socialandpsychologicalcoststopatients
and their relatives, are severe. The perceived threat of becoming infected during
careisunderminingthepublic’sconfidenceinourabilitytosafelyandcompetently
care for them and to protect them from adverse consequences of care.
Although not all of these infections are avoidable, research suggests that at
least 20 per cent are potentially preventable. Clinically effective care, i.e. infec-
tion prevention and control practices based on reliable evidence of efficacy, is a
core component of an effective strategy designed to protect patients from infec-
tion. Today’s healthcare practitioners need a complex repertoire of knowledge and
skills in order to develop and implement evidence-based care that consistently and
effectively minimise infection risks to patients and others.
Ready access to current and reliable best evidence for practice is a central
featureforensuringpractitionershavethenecessaryknowledgetoplananddeliver
safe and clinically effective care. This new text by one of today’s most respected
senior infection control and prevention specialists is an ideal resource for ensuring
access to pertinent and reliable evidence and associated practice information. It is
written in an engaging and easily understandable style, and throughout the text the
underpinningevidenceforbestpracticerecommendationsismadecrystalclearand
applicable. The description of critical learning outcomes at the beginning of each
chapterwillbeappreciatedbystudentsandpractitioners,aswillthecomprehensive
bibliographyofcurrentpolicyandevidencethatisthefoundationforbestpractice.
Debbie Weston has focused on the essential body of infection prevention and
control knowledge that all healthcare practitioners need to acquire, understand and
then translate into everyday clinical practice. This is a remarkable and totally
relevant resource that can support practitioners in continuing to develop more
effectiveevidence-basedapproachestoprotectingpatientsfrominfection.Formany,
viii FOREWORD
it will be the seminal basis for their enhanced understanding of one of the key
issues in healthcare that practitioners are confronting.
Protectingpatientsfromharmisattheheartofeverythingwedo.Understanding
the background science, evidence and infection prevention and control practices
describedinthistextcanpositivelyinfluenceourpotentialtodojustthatandensure
that patients are safe during care.
Robert J. Pratt CBE FRCN RN
Professor of Nursing
Director, Richard Wells Research Centre
Thames Valley University