Infection control: principles for practice

This article discusses the general principles of infection control and outlines the role nurses can play in maintaining a safe environment. This article is the third and final part of our 1998 series on infection control.     

Infection control in dental radiology

Although exposure to blood is rare in oral and maxillofacial radiology, contact with saliva occurs. Thus the spread of infectious diseases is possible through cross-contamination, and specific infection control protocols and unit dosing of items are needed. This article outlines rationale for implementing state-of-the-art infection control procedures; and explains federal standards and guidelines with an impact on infection control and occupational safety in dental radiology procedures.     

Infection control issues and intraoperative care

The incidence of congenital dislocation of the hip (CDH) in Singapore and Malaysia has been reported as being lower than in the West. In our hospital, we have seen an increasing number of congenital hip dislocation as well as dysplastic hips. We undertook a prospective study from December 1989 to December 1994 of 20,000 live births. The neonates were all screened by a consultant neonatologist and the findings were confirmed by a consultant paediatric orthopaedic surgeon. All babies had plain X-rays at 3 months and an acetabular index (AI) of 30 degrees or more was considered dysplastic. All babies with positive signs were followed up for 1 year and again had radiographs taken at 1 year. Comparison of plain X-rays and ultrasound assessment in a subgroup of 130 neonates showed that 64% of patients with AI > 20 degrees had hip dysplasia by ultrasonographic (alpha angle < 60 degrees) The incidence of dysplastic hips was 16.8 per 1000 live births. The overall incidence of neonates with dislocated hips was 4.7 per 1000 live births. The Malays were most affected with an incidence of 5.4 per 1000 live births. The incidence of developmental dysplasia of the hip in Singapore is higher than previously reported, with the Malays having the highest incidence. A significant number of babies with clicking hips have radiological evidence of acetabular dysplasia (AI > 30 degrees). One-third of the babies' hips were still dysplastic at 1 year of age. A well-organised screening programme with experienced examiners has proved to be useful in making early and accurate clinical diagnosis.     

Infection control challenges in child-care centers

This article reviews the various disorders that result in abnormal iron and fat within the liver. MR techniques that detect and characterize fat and iron are discussed. Chemical shift images are useful in detecting intracellular lipid and can characterize diffuse hepatic steatosis as well as focal areas of fatty sparing and fatty infiltration. T2*-weighted gradient-echo sequences are useful in detecting hepatic iron. Typical imaging features of genetic hemochromatosis and hepatic iron from blood transfusions are described.     

Caring for dying children: nurses' experiences

Interviews with 25 nurses in this grounded theory study show that when nurses recognized that a child's death was inevitable, they struggled with both grief distress and moral distress. Their distress occurred within the context of the nurse-patient relationship. Nurses employed a range of strategies to manage their distress. Several conditions facilitated or constrained nurses' strategies, and resulted in far-reaching implications both professionally and personally.     

感染控制制度在CT室中的应用

近年来,随着新的医疗环境的改变及环境气候等多因素的变化,感染性疾病日益流行,潜在的医院感染现象越来越普遍,如果沿袭过去的管理模式,很难发现潜在的感染问题,而制度化管理更多的关注感染控制过程而不是结果,是通过对感染过程的控制来进行管理,具备及时的可测量性和评估性,可以及时发现实施过程中存在的缺陷,及时加以改进,从而进一步保证实施结果最大限度的达到管理目标.我们CT室在医院感染控制制度的基础上,结合CT室的工作特点,制定了一系列的相关感染控制制度并在临床工作中加以应用,取得了满意的效果.     

Infection control and outpatient parenteral antibiotic therapy

Outpatient procedures have become more complex, requiring outpatient providers to offer technical procedures in the home, office, and clinic. This shift in health care has brought about the need for staff members to become proficient in a variety of technical procedures that were once done only in the hospital setting. Outpatient i.v. therapy has caused home health care agencies, physicians' offices, and clinics to seek education and training regarding i.v. therapy and to develop basic infection-control guidelines and guidelines related to the insertion and maintenance of i.v. devices. The goals of the outpatient provider are to prevent i.v.-related complications and to provide quality patient care. These can be accomplished by strict adherence to sound infection-control guidelines and routine monitoring of procedure techniques and complications of care. Outpatient providers may wish to seek expertise and guidance from hospital infection-control personnel, infectious diseases specialists, or other infection-control consultants to meet the demands of the complexity of outpatient care.