Division of Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
Intern Med J. 2009 Sep;39(9):574-81. doi: 10.1111/j.1445-5994.2009.02004.x.
More than 177 000 potentially preventable healthcare-associated infections (HAIs) occur per annum in Australia with sizable attributable mortality. Organizational systems to protect against HAI in hospitals in Australia are relatively poorly developed. Awareness and practice of infection control by medical and other healthcare staff are often poor. These lapses in practice create significant risk for patients and staff from HAI. Excessive patient exposure to antimicrobials is another key factor in the emergence of antibiotic-resistant bacteria and Clostridium difficile infection. Physicians must ensure that their interactions with patients are safe from the infection prevention standpoint. The critical preventative practice is hand hygiene in accord with the World Health Organization 5 moments model. Improving the use of antimicrobials, asepsis and immunization also has great importance. Hospitals should measure and feed back HAI rates to clinical teams. Physicians as leaders, role models and educators play an important part in promoting adherence to safe practices by other staff and students. They are also potentially effective system engineers who can embed safer practices in all elements of patient care and promote essential structural and organizational change. Patients and the public in general are becoming increasingly aware of the risk of infection when entering a hospital and expect their carers to adhere to safe practice. Poor infection control practice will be regarded in a negative light by patients and their families, regardless of any other manifest skills of the practitioner.
在澳大利亚，每年有超过 177000 例潜在可预防的医疗保健相关感染（HAI），且造成了相当大的死亡率。澳大利亚医院预防 HAI 的组织系统相对较差。医护人员对感染控制的意识和实践往往较差。这些实践上的失误给患者和医护人员带来了巨大的 HAI 风险。患者过度暴露于抗生素是抗生素耐药细菌和艰难梭菌感染出现的另一个关键因素。医生必须确保从感染预防的角度来看，他们与患者的互动是安全的。关键的预防措施是按照世界卫生组织的五个时刻模型进行手部卫生。改善抗生素的使用、无菌操作和免疫接种也非常重要。医院应衡量并向临床团队反馈 HAI 率。医生作为领导者、榜样和教育者，在促进其他员工和学生遵守安全实践方面发挥着重要作用。他们也是潜在的有效的系统工程师，可以将更安全的实践嵌入到患者护理的各个方面，并推动必要的结构和组织变革。一般来说，患者和公众越来越意识到进入医院时感染的风险，并期望他们的护理人员遵守安全实践。无论从业者有任何其他明显的技能，较差的感染控制实践都将受到患者及其家属的负面评价。
