Practical initiatives in the prevention of cross infection

Summary In Belgium Infection Control Nurses must register postoperative wound infections, sepsis and ventilation associated pneumonia. At the author's hospital, the incidence of pressure sores is scored four times a year and there is a register of new patients with M.R.S.A. (methicillin resistant staphylococcus aureus) and tuberculosis. Procedures for hospital hygiene can be consulted in order to see which patients must be isolated and what kind of precautions must be taken. The microorganisms and diseases are sorted alphabetically and the cause of cross‐infection, isolation procedure and duration of isolation are noted. These procedures must be translated to the different departments and individual patients. For instance a patient with M.R.S.A. is strictly isolated in the general hospital, but not in the psychiatric department. As far as the haemodialysis unit is concerned, patients with chronic renal disease are more sensitive to infections. For this reason correct hand hygiene is very important. Hand washing, hand desinfection techniques and the use of gloves must be promoted. A microbiological control of the hands of staff once a year, combined with an educational programme, can motivate staff in a positive way. Needle‐stick injuries present a serious occupational hazard for health care workers, especially those working in a haemodialysis unit. Information and needleless haemodialysis may reduce the risk of needle‐stick injuries and the risk of viral transmission. Can a nurse, at risk of viral contamination and transmission, refuse to treat a patient? Is the use of hats, overshoes, glasses necessary? How many times are these materials changed, etc.? This paper presents the data of 10 years of M.R.S.A. registration at the author's hospital. M.R.S.A. has become a serious problem in many hospitals since the mid 1970s. Strenuous efforts need to be taken to control its spread. Screening of the nose of patients and of staff can be helpful. The carriers can be treated with mupirocin ointment. Body washing with chlorhexidine is preferred. The use of vancomycin and teicoplanin is a decision for the physician.