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Chapter 125. Health Care– Associated Infections (Part 2) Organization, Responsibilities, and Increasing Scrutiny of InfectionControl Programs The standards of the Joint Commission on Accreditation of Healthcare Organizations require all accredited hospitals to have an active program for surveillance, prevention, and control of nosocomial infections. Education of physicians in infection control and health care epidemiology is required in infectious disease fellowship programs and is available by online courses. Diagnosis-related reimbursement has led hospital administrators to place increased emphasis on infection control. Federal concerns over "patient safety" have led to legislation that would limit reimbursement for hospital costs resulting from at least two (yet-to-be-determined) nosocomial. | Chapter 125. Health Care- Associated Infections Part 2 Organization Responsibilities and Increasing Scrutiny of InfectionControl Programs The standards of the Joint Commission on Accreditation of Healthcare Organizations require all accredited hospitals to have an active program for surveillance prevention and control of nosocomial infections. Education of physicians in infection control and health care epidemiology is required in infectious disease fellowship programs and is available by online courses. Diagnosis-related reimbursement has led hospital administrators to place increased emphasis on infection control. Federal concerns over patient safety have led to legislation that would limit reimbursement for hospital costs resulting from at least two yet-to-be-determined nosocomial infections. The patient safety movement has prompted major national efforts to improve measure and publicly report on processes of patient care e.g. timely administration and appropriateness of perioperative antibiotic prophylaxis and patient outcomes e.g. surgical wound infection rates . Surveillance Traditionally infection-control practitioners have surveyed inpatients for infections acquired in hospitals defined as those neither present nor incubating at the time of admission . Surveillance involves review of microbiology laboratory results shoe-leather epidemiology on nursing wards and application of standardized definitions of infection. Some infection-control programs use computerized hospital databases for algorithm-driven electronic surveillance e.g. of vascular catheter and surgical wound infections . Commercial health care information systems that facilitate these functions are considered value-added products. Most hospitals aim surveillance at infections associated with a high level of morbidity or expense. Quality-improvement activities in infection control have led to increased surveillance of personnel compliance with infection-control policies e.g. adherence to influenza
