Claire Dawson
Infection control refers to the policies and procedures implemented to minimize the spread of infections in hospitals and other healthcare settings. Hospitals have infection control committees that develop and enforce procedures to minimize the risk of healthcare-associated infections (HAIs). Hospital pharmacies play a crucial role in infection control by promoting the rational use of antimicrobials, collaborating with hospital committees and physicians, and educating patients about medication adherence and proper handling. While CDC guidelines provide a standard reference for infection control practices, hospitals may have varying levels of resources and manpower dedicated to infection control initiatives, such as ASPs (antimicrobial stewardship programs), which aim to optimize clinical outcomes and reduce adverse drug reactions.
| Characteristics | Values |
|---|---|
| Role of hospital pharmacies in infection control | To develop institution guidelines for the rational use of antimicrobials to prevent drug resistance, minimize adverse drug events, enhance patient outcomes, and prevent hospital-acquired infections. |
| Infection control practices | Should be implemented in all healthcare settings, including inpatient and outpatient settings, and non-traditional healthcare facilities such as pharmacies. |
| CDC's role | Provides information on infection control and clinical safety to help reduce the risk of infections among healthcare workers, patients, and visitors. |
| WHO's role | Provides technical leadership and coordination of infection prevention and control work at WHO headquarters. |
| Hospital epidemiologist's role | Interfaces with hospital departments and administrators to discuss responsibilities, expectations, and resources. Oversees the infection prevention program and, in some cases, the quality improvement program. |
| Infection control committee | Consists of an interprofessional group of clinicians, nurses, administrators, epidemiologists, infection preventionists, and laboratory representatives. |
| Infection control methods | Isolation, disinfection, sterilization, hand hygiene, and management of multidrug-resistant organisms. |
| ASP | Optimizes clinical outcomes while minimizing unintended consequences of antimicrobial use. ASPs are cost-effective and have demonstrated a decrease in suboptimal antimicrobial use. |
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What You'll Learn
Hospital pharmacies' role in infection control
Infection control refers to the policies and procedures implemented to control and minimise the spread of infections in hospitals and other healthcare settings. The goal is to reduce infection rates and provide safe and high-quality patient care. Hospitals can have multiple infection preventionists depending on the number of beds, the patient mix, and the recommendations of the CDC. The hospital's infection control committee, which includes clinicians, nurses, administrators, epidemiologists, and other representatives, usually develops these policies.
Hospital pharmacies play a crucial role in infection control by ensuring the rational use of antimicrobials. They work as part of an ASP committee to develop guidelines for antimicrobial usage, aiming to prevent drug resistance, minimise adverse drug events, improve patient outcomes, and prevent hospital-acquired infections. Pharmacists also have the opportunity to counsel patients on medication adherence, proper storage, and handling, as well as medical waste disposal, all of which contribute to infection control.
Additionally, hospital pharmacies should implement procedures to prevent microbial contamination, exposure to bacterial endotoxins, and variability in the strength of ingredients in compounded sterile products. Employee training in aseptic techniques is essential before medication administration. Furthermore, limiting the activities of staff members exhibiting symptoms of infection and adhering to single-dose vial usage guidelines are crucial aspects of infection control.
The CDC provides comprehensive guidelines and recommendations for infection prevention and control in healthcare settings. These practices are intended to be implemented across various settings, including inpatient and outpatient facilities, to ensure safe healthcare delivery and minimise the risk of infections among healthcare workers, patients, and visitors.
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Antimicrobial Stewardship Programs (ASPs)
ASPs have been shown to be cost-effective and have led to a decrease in suboptimal antimicrobial use. They involve optimizing antimicrobial dosing for patient-individualized characteristics and monitoring antimicrobial concentrations to ensure optimal pharmacotherapy. Pharmacists play a crucial role in ASPs by dispensing medications, educating patients on proper antimicrobial use, and collaborating with hospital committees and physicians to promote multidisciplinary collaboration.
The implementation of ASPs requires an economic value assessment, and there is limited data on their overall costs and implementation. However, ASPs are essential in addressing the global issue of antimicrobial resistance, which poses a threat to public health, economic development, and security. The rate of antimicrobial misuse in hospitals remains high, and ASPs offer a way to improve prescribing practices and patient outcomes.
Alberta Health Services (AHS) in Canada, for example, has implemented an ASP to improve the appropriateness of antimicrobial use within its acute care sites. This involves measuring and reporting on antimicrobial use, reviewing and optimizing prescriptions, and providing education to prescribers to align with best practices. AHS ASP is also committed to ongoing research and innovation to further enhance patient care and advance the field of antimicrobial stewardship.
ASPs are an essential tool in the healthcare setting to optimize antimicrobial use, improve patient outcomes, and combat the growing challenge of antimicrobial resistance. They require collaboration between pharmacists, physicians, and hospital committees to ensure effective implementation and positive impacts on patient care.
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CDC guidelines for infection control
Infection control practices are essential to providing safe and high-quality patient care. The CDC's guidelines for infection prevention aim to reduce the risk of infections among healthcare workers, patients, and visitors across all healthcare settings.
The CDC provides a comprehensive set of core infection prevention and control practices that are required in all healthcare settings, regardless of the type of healthcare provided. These practices are intended to be fundamental standards of care that remain stable despite emerging evidence or technological advancements. They serve as a standard reference to reduce the need for frequent evaluations of basic practices.
The CDC's guidelines cover various topics, including:
- Standard and transmission-based precautions: These are the two tiers of recommended precautions to prevent the spread of infections. Standard Precautions are applied to all patients, assuming that anyone can be a carrier of infectious microorganisms. Transmission-based Precautions are used for patients who are known or suspected to be infected with certain germs.
- Isolation: This is an expensive and time-consuming process aimed at preventing the transmission of microorganisms from infected patients to others. The CDC has issued guidelines outlining approaches to enhance isolation, balancing the need for isolation with the associated challenges and costs.
- Healthcare-associated infections (HAIs): Hospitals should develop, implement, and evaluate policies and interventions to minimize the risk of HAIs.
- Specific infection control measures: The CDC provides guidance for preventing the transmission of various infections, including viral respiratory infections, norovirus gastroenteritis, and central line-associated bloodstream infections in neonatal intensive care units.
- Surface and water management: The CDC offers guidance on preventing the spread of multi-drug resistant organisms (MDROs) through contaminated surfaces and water sources.
- Hand hygiene: The CDC provides guidelines for hand hygiene to prevent the spread of infections in healthcare settings.
- Training and resources: The CDC offers training and resources to healthcare workers to strengthen their infection control practices and reduce the risk of infections.
The CDC's guidelines are regularly reviewed and updated by subject matter experts to ensure they remain current and effective.
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Infection preventionists in hospitals
Infection preventionists (IPs) are professionals who ensure that healthcare workers and patients are taking the necessary precautions to prevent infections. IPs are typically nurses, epidemiologists, public health professionals, microbiologists, or doctors. They are responsible for identifying patterns of infection within a facility, observing practices, educating healthcare teams, advising hospital leaders, compiling infection data, developing policies and procedures, and coordinating with local and national entities. IPs play a crucial role in preventing healthcare-associated infections (HAIs) and improving patient safety and the quality of care.
The number of IPs in a hospital can vary depending on factors such as the number of beds, the mix of patients, and recommendations from the Center for Disease Control and Prevention (CDC). IPs work closely with hospital departments, administrators, and other hospital staff to discuss responsibilities, expectations, and available resources. They also collaborate with physicians and hospital committees to promote the rational use of antimicrobials, enhance patient outcomes, and prevent hospital-acquired infections.
In addition to IPs, hospitals may have an infection control committee that consists of clinicians, nurses, administrators, epidemiologists, IPs, and laboratory representatives. This committee develops and evaluates policies and interventions to minimize the risk of HAIs. They enforce procedures that are applicable to the entire hospital or specific departments.
Pharmacists also play a vital role in infection control by ensuring the optimal use of antimicrobials. They work with hospital committees and physicians to enhance patient outcomes and prevent hospital-acquired infections. Pharmacists can provide patient education on the proper use of medications, including antimicrobials, to prevent the emergence of resistance and adverse drug reactions.
Overall, infection prevention in hospitals is a collaborative effort involving IPs, pharmacists, and various hospital departments and committees. By adhering to infection control practices and guidelines, hospitals can provide safe and high-quality patient care, minimize healthcare-associated infections, and improve patient outcomes.
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Isolation precautions
Infection control refers to the policies and procedures implemented to control and minimize the spread of infections in hospitals and other healthcare settings. The main purpose of infection control is to reduce infection rates and improve patient outcomes. Hospitals typically have an infection preventionist, usually a registered nurse with a background in clinical practice, epidemiology, and basic microbiology, who oversees the infection prevention program.
The CDC's core infection prevention and control practices should be implemented in all healthcare settings, including pharmacies. These practices include hand hygiene guidelines, disinfection and sterilization techniques, and guidelines for managing multidrug-resistant organisms. Educational interventions can improve hand hygiene compliance among visitors, but it is important to continuously reinforce these practices due to the dynamic nature of hospital visitation.
In addition to following CDC guidelines, pharmacies should implement procedures to prevent microbial contamination of compounded sterile products (CSPs), exposure to excessive bacterial endotoxins, and variability in the intended strength of ingredients. Employees should be trained in aseptic techniques before administering medications, and those with acute respiratory, gastrointestinal, or skin infections should not handle medications. By adhering to these isolation precautions, pharmacies can play a key role in preventing drug resistance, minimizing adverse drug events, and preventing hospital-acquired infections.
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Frequently asked questions
Hospital pharmacies play a key role in developing institution guidelines for the rational use of antimicrobials to prevent drug resistance, minimize adverse drug events, enhance patient outcomes, and prevent hospital-acquired infections.
Some challenges include limited financial resources, inadequate staffing, and the lack of up-to-date susceptibility data, which can impact the ability to develop and implement effective infection control measures.
CDC provides guidelines and recommendations for infection prevention and control practices to reduce the risk of infections among healthcare workers, patients, and visitors in all healthcare settings, including hospital pharmacies.
A successful infection control program in a hospital typically includes the involvement of an interprofessional team, such as clinicians, nurses, administrators, epidemiologists, infection preventionists, and laboratory representatives. This team works together to develop and enforce policies and procedures to minimize the spread of infections.
Hospital pharmacies can optimize antimicrobial dosing based on individual patient characteristics and monitor antimicrobial concentrations to ensure optimal pharmacotherapy. Patient education is also crucial to ensure the proper use of antimicrobials after discharge, reducing the risk of infections and the development of antimicrobial resistance.
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