Farrington Mark
Clinical Microbiology and Public Health Laboratory, Cambridge HPA, Addenbrooke's Hospital, Cambridge, UK.
J Hosp Infect. 2007 Jun;65 Suppl 2:128-32. doi: 10.1016/S0195-6701(07)60029-2.
Infection control education is difficult and time consuming, but there is persuasive evidence to demonstrate its effectiveness. When Infection Control practitioners are educating and influencing healthcare workers, compliance with the well-established guidance on implementation of health service research is advisable, and thus educative efforts must be repeated and administered as part of a concerted and multifaceted approach. Infection Control education must be specifically designed for and targeted at the groups of staff concerned, and medical staff pose especial problems. Recruitment of clinical champions from peer groups, and direct approaches from medical members of the Infection Control team are usually needed. Familiarity with only a limited range of published evidence is needed to answer the majority of clinicians who challenge Infection Control practices, and referral to higher medical and managerial authority is required very infrequently and as a last resort. Some recent initiatives in the NHS in England may make Infection Control education more difficult, and these are reviewed. New sanctions have been made available to hospitals and Infection control teams in the UK with the passing of the Health Act in 2006, and the effects of these allied to educative interventions on benchmarks such as hospitals' MRSA bacteraemia rates will be observed with interest.
感染控制教育既困难又耗时,但有确凿证据表明其有效性。当感染控制从业人员对医护人员进行教育和施加影响时,遵循关于卫生服务研究实施的既定指南是明智的,因此教育工作必须反复进行,并作为协调一致的多方面方法的一部分来开展。感染控制教育必须专门为相关工作人员群体设计并针对他们,而医务人员则带来了特殊问题。通常需要从同行群体中招募临床倡导者,并由感染控制团队的医务人员直接开展工作。回答大多数对感染控制措施提出质疑的临床医生的问题,只需熟悉有限范围的已发表证据,极少需要且作为最后手段才会求助于更高层级的医学和管理权威。英国国家医疗服务体系(NHS)英格兰分部最近的一些举措可能会使感染控制教育变得更加困难,本文对此进行了审视。随着2006年《健康法案》的通过,英国的医院和感染控制团队有了新的制裁措施,人们将饶有兴趣地观察这些措施与教育干预措施相结合对诸如医院耐甲氧西林金黄色葡萄球菌菌血症发生率等基准的影响。