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This document was made possible through support provided by the U.S. Agency for International Development, under the terms of cooperative agreement number HRN-A-00-00-00016-00. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the U.S. Agency for International Development.
RPM Plus works in more than 20 developing and transitional countries to provide technical assistance to strengthen pharmaceutical and health commodity management systems. The program offers technical guidance and assists in strategy development and program implementation both in improving the availability of health commodities—pharmaceuticals, vaccines, supplies, and basic medical equipment—of assured quality for maternal and child health, HIV/AIDS, infectious diseases, and family planning, and in promoting the appropriate use of health commodities in the public and private sectors. The materials may be freely abstracted, quoted and translated in part or in whole by non- profit or educational organizations (for reference or teaching only) provided the original source is acknowledged. They should not be sold nor used for any other commercial purpose. Management Sciences for Health and World Health Organization. 2007. Drug and Therapeutics Committee Training Course. Submitted to the U.S. Agency for International Development by the Rational Pharmaceutical Management Plus Program. Arlington, VA: Management Sciences for Health.
The goal of IC programs is to decrease and minimize the spread of infections between patients and providers in health care facilities. Evidence is clear that IC programs are effective in decreasing the rates of infection, morbidity, and mortality, as well as in decreasing costs associated with infections. The magnitude of the nosocomial infection problem is significant, because many hospitals will have infection rates that exceed 10 percent, although most of these infections are preventable. Who is responsible for infection control? Ideally, an Infection Control Committee (ICC) —but the entire health care community is responsible for developing and following procedures to prevent infections. Because it can play a pivotal role in assisting the ICC and in leading the hospital in IC activities, the DTC bears much of the responsibility. Some authorities believe that effective ICCs and DTCs will provide the basis for developing more comprehensive quality assurance programs throughout the health care organization.
Epidemiology of Nosocomial Infections
Simply stated, patients and health care staff can spread infectious diseases directly to each other, and then these diseases can be transmitted to family and community members. These infections are more prevalent in hospitals, where health care staff and patients are at risk. Primary health care clinics also have significant problems with nosocomial infections, although not to the extent found at the larger, overcrowded hospital centers. Hospital personnel most at risk for contracting and spreading infections include those involved with (a) invasive procedures; (b) direct exposure to patients during examinations; (c) exposure to blood, sputum, and other body fluids; and (d) exposure to environmental pathogens (air, food, water, or inanimate objects). Physicians and nurses are most at risk, but housekeeping personnel, who come in contact with infectious waste, needles, and other sharps and with contaminated disinfectants and supplies, also face a high risk. The most likely sites for nosocomial infections include surgical incisions, the urinary tract, the lower respiratory tract, and the bloodstream. Skin and soft tissue infections and gastrointestinal infections are also common.