[Reduction of nosocomial infections by a public health quality management concept in surgical patients. 1: Significant reduction of a high initial rate].

A successful introduction of surveillance of NI and quality circles for prevention of infection was achieved in hospital A. The major requirements therefore are according to our experiences determination of the topics of the quality circles by the participants themselves, interest and engagement for the work of the quality circles and the realization of ideas, support by the hospitals' management, acceptance of this work by the wards, continuous evaluation of the work of the quality circle. Often the most important problem was not identification of weaknesses and creating of possible solutions, but putting the ideas into practice on the wards. This was the case for problems in the field of care as well as in the responsibility of physicians. Altogether a significant 42% reduction of nosocomial infections was achieved.