Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between £814 and £6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.

Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US $10 billion per year. No international evidence-based guidelines had previously been available before WHO launched its global guidelines on the prevention of surgical site infection on 3 November 2016, and there are inconsistencies in the interpretation of evidence and recommendations in existing national guidelines. These new WHO guidelines are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.

Provides a comprehensive overview of the main aspects of infection control, and gives practical, evidence-based recommendations.

This book is open access under a CC BY 4.0 license. It constitutes a unique source of knowledge and guidance for all healthcare workers who care for patients with sepsis and septic shock in resource-limited settings. More than eighty percent of the worldwide deaths related to sepsis occur in resource-limited settings in low and middle-income countries. Current international sepsis guidelines cannot be implemented without adaptations towards these settings, mainly because of the difference in local resources and a different spectrum of infectious diseases causing sepsis. This prompted members of the Global Intensive Care working group of the European Society of Intensive Care Medicine (ESICM) and the Mahidol-Oxford Tropical Medicine Research Unit (MORU, Bangkok, Thailand) - among which the Editors – to develop with an international group of experts a comprehensive set of recommendations for the management of sepsis in resource-limited settings. Recommendations are based on both current scientific evidence and clinical experience of clinicians working in resource-limited settings. The book includes an overview chapter outlining the current challenges and future directions of sepsis management as well as general recommendations on the structure and organization of intensive care services in resource-limited settings. Specific recommendations on the recognition and management of patients with sepsis and septic shock in these settings are grouped into seven chapters. The book provides evidence-based practical guidance for doctors in low and middle income countries treating patients with sepsis, and highlights areas for further research and discussion.

These guidelines provide recommendations that outline the critical aspects of infection prevention and control. The recommendations were developed using the best available evidence and consensus methods by the Infection Control Steering Committee. They have been prioritised as key areas to prevent and control infection in a healthcare facility. It is recognised that the level of risk may differ according to the different types of facility and therefore some recommendations should be justified by risk assessment. When implementing these recommendations all healthcare facilities need to consider the risk of transmission of infection and implement according to their specific setting and circumstances.

1. Introduction to Healthcare-associated Infections 2. Structural Organization of an Infection Control Program 3. Major Healthcare-associated Infection Types 4. Surveillance of Healthcare-associated Infections 5. Standard Precautions-I: Hand Hygiene 6. Standard Precautions-II: Personal Protective Equipment 7. Transmission-based Precautions 8. Infection Control in Special Situations 9. Disinfection Policy 10. Central Sterile Supply Department 11. Environmental Surveillance 12. Screening for Multidrug-resistant Organisms 13. Infection Control in Laundry 14. Infection Control in Kitchen and Food Safety 15. Waste Management in Healthcare Facility 16. Staff Health Issues-I: Needle Stick Injury Management 17. Staff Health Issues-II: Work Restriction and Vaccination 18. Outbreak Investigation 19. Antimicrobial Stewardship 20. Infection Control Requirements for Accreditation Index

This volume offers extensive information on preventive and infection surveillance procedures, routines and policies adapted to the optimal infection control level needed to tackle today’s microbes in hospital practice. It especially focuses on preventive measures for serious hospital infections. Each chapter includes a practical section that addresses the main aspects of procedures and treatment, and a theoretical section that contains updated documentation that can be used for further study, or to help select infection control measures. Infection control concerns all healthcare professional working directly or indirectly with patients; in diagnosis, treatment, isolation measures, operations, equipment, drugs, cleaning, textiles, transport, porter service, food and water, building and maintenance, etc. Hygiene and environmental control is central to infection prevention for patients, visitors and staff alike. Good hygienic practices, individual infection control, well implemented and frequent environmental cleaning, and a high professional standard of hygiene in the treatment and care of patients, are essential to patient safety and a safe working environment. Addressing this essential topic, this book is intended for doctors, nurses and other healthcare workers, students in health-related subjects, hospital managers and health bureaucrats, as well as patients and their families.

Infections, especially those occurring postoperatively, remain a major problem in hospitals. This handy pocket-sized manual provides guidelines and protocols for preventing infections, and managing them if they occur. It covers various types of infection, and is suitable for members of infection control teams.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/