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| US pediatrician delivers lecture on Hospital Acquired Infections at SKIMS | | |
Early Times Report
SRINAGAR, May 6: On the request of the Department of Hospital Administration, SKIMS, a renowned scientist of international repute, Dr. Nalini Singh, Professor of Pediatrics, Epidemiology & Global Health, GWU School of Medicine & Public Health, Children's National Medical Centre, Michigan Ave, Washington DC, delivered a guest lecture " Hospital Acquired Infection Control & Quality Patient Care". Faculty of SKIMS, Resident Doctors and nurses of SKIMS and SKIMS Medical College (Bemina) attended the lecture in large numbers. Professor A. H. Zargar and Dr. Syed Amin Tabish chaired the session.
Professor Nalini Singh made a thought provoking, useful and informative presentation. She spoke at length about the experience of Health Professionals and Hospitals in the United States of America. She said that studies throughout the world document that nosocomial infections are a major cause of morbidity and mortality. A high frequency of nosocomial infections is evidence of a poor quality of health service delivery, and leads to avoidable costs.
Many factors contribute to the frequency of nosocomial infections: hospitalized patients are often immunocompromised, they undergo invasive examinations and treatments, and patient care practices and the hospital environment may facilitate the transmission of microorganisms among patients. The selective pressure of intense antibiotic use promotes antibiotic resistance. Resistance to antimicrobial agents is a problem in the community as well as health care facilities, but in hospitals, transmission of bacteria is amplified because of the highly susceptible population.
Prevention of nosocomial infections is the responsibility of all individuals and services providing health care. Everyone must work cooperatively to reduce the risk of infection for patients and staff. This includes personnel providing direct patient care, management, physical plant, provision of materials and products, and training of health workers. Infection control programmes are effective provided they are comprehensive and include surveillance and prevention activities, as well as staff training. There must also be effective support at the national and regional levels.
The Director SKIMS Prof. A. H. Zargar said that the nosocomial infection rate in patients in a facility is an indicator of quality and safety of care. The development of a surveillance process to monitor this rate is an essential first step to identify local problems and priorities, and evaluate the effectiveness of infection control activity. Surveillance, by itself, is an effective process to decrease the frequency of hospital-acquired infections. Many patients receive antimicrobial drugs. Through selection and exchange of genetic resistance elements, antibiotics promote the emergence of multidrug resistant strains of bacteria; microorganisms in the normal human flora sensitive to the given drug are suppressed, while resistant strains persist and may become endemic in the hospital. The widespread use of antimicrobials for therapy or prophylaxis is the major determinant of resistance. Antimicrobial agents are, in some cases, becoming less effective because of resistance. As an antimicrobial agent becomes widely used, bacteria resistant to this drug eventually emerge and may spread in the health care setting.
Dr. Syed Amin Tabish, Medical superintendent of SKIMS said that while progress in the prevention of nosocomial infections has been made, changes in medical practice continually present new opportunities for development of infection. An effective surveillance system must identify priorities for preventive interventions and improvement in quality of care.
By providing quality indicators, surveillance enables the infection control programme, in collaboration with patient care units, to improve practice, and to define and monitor new prevention policies. The final aim of surveillance is to decrease nosocomial infections and reduce costs. Despite progress in public health and hospital care, infections continue to develop in hospitalized patients, and may also affect hospital staff. Nosocomial infections occur worldwide. Infections acquired in health care settings are among the major causes of death and increased morbidity among hospitalized patients.
They are a significant burden both for the patient and for public health. The highest frequencies of nosocomial infections have been reported from hospitals in the South-East Asia Regions (11.8 percent). The highest prevalence of nosocomial infections occurs in intensive care units and in acute surgical and orthopaedic wards. Infection rates are higher among patients with increased susceptibility because of old age, underlying disease, or chemotherapy. Hospital-acquired infections add to functional disability and emotional stress of the patient and may, in some cases, lead to disabling conditions that reduce the quality of life. The economic costs are considerable.
The increased length of stay for infected patients is the greatest contributor to cost. Prolonged stay not only increases direct costs to patients but also indirect costs due to lost work. The increased use of drugs, the need for isolation, and the use of additional laboratory and other diagnostic studies also contribute to costs. The advancing age of patients admitted to health care settings, the greater prevalence of chronic diseases among admitted patients, and the increased use of diagnostic and therapeutic procedures which affect the host defences will provide continuing pressure on nosocomial infections in the future |
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