History of Infection Control Guidelines: Difference between revisions
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== Introduction == | == Introduction == | ||
No matter what practice setting, maintaining good infection control methods are of vital importance to protect not only the clinician, but also the patients that they treat. Over the years, infection control practices have taken many different forms. Fundamental to the idea of infection control is the maintenance of barriers or safeguards between the clinician and the patient with the infection, disease, or pathogen. | No matter what practice setting, maintaining good [[Infection Prevention and Control|infection control]] methods are of vital importance to protect not only the clinician, but also the patients that they treat. Over the years, infection control practices have taken many different forms. Fundamental to the idea of infection control is the maintenance of barriers or safeguards between the clinician and the patient with the infection, disease, or pathogen. | ||
== United States<ref>United States Centers for Disease Control and Prevention - Hospital Infection Control Practices Advisory Committee, Guidelines for Isolation Precautions in Hospitals Hospital Infection Control Advisory Committee. 1996. Available from: https://wonder.cdc.gov/wonder/prevguid/p0000419/p0000419.asp [Accessed 21st November 2022].</ref><ref>United States Centers for Disease Control and Prevention, History of Guidelines for Isolation Precautions in Hospitals. Available from: https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/history.html [Accessed 21st November 2022].</ref> == | == United States<ref>United States Centers for Disease Control and Prevention - Hospital Infection Control Practices Advisory Committee, Guidelines for Isolation Precautions in Hospitals Hospital Infection Control Advisory Committee. 1996. Available from: https://wonder.cdc.gov/wonder/prevguid/p0000419/p0000419.asp [Accessed 21st November 2022].</ref><ref>United States Centers for Disease Control and Prevention, History of Guidelines for Isolation Precautions in Hospitals. Available from: https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/history.html [Accessed 21st November 2022].</ref> == | ||
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'''1850-1900'''<ref name=":0">Smith P, Watkins K, Hewett A. Infection control through the ages. American Journal of Infection Control. 2012; 40: 35-42.</ref> - Physicians in the US, as well as other countries, began to recognize the benefits of antiseptic techniques for the control of infections. | '''1850-1900'''<ref name=":0">Smith P, Watkins K, Hewett A. Infection control through the ages. American Journal of Infection Control. 2012; 40: 35-42.</ref> - Physicians in the US, as well as other countries, began to recognize the benefits of antiseptic techniques for the control of infections. | ||
* Physicians conducted first epidemiological studies concerning the implementation of antiseptic techniques such as handwashing. | * Physicians conducted first epidemiological studies concerning the implementation of antiseptic techniques such as [[Hand Hygiene|handwashing]]. | ||
'''1877''' - First hospital manual suggested housing infectious patients in separate facilities from non-infectious patients. | '''1877''' - First hospital manual suggested housing infectious patients in separate facilities from non-infectious patients. | ||
* Gave rise to infectious disease hospitals. | * Gave rise to infectious disease hospitals. | ||
'''1910''' - Cubic System of Isolation and Barrier Nursing | '''1910''' - Cubic System of Isolation and Barrier Nursing | ||
* Patients with infections were placed in separate wards. | * Patients with infections were placed in separate wards. | ||
* Hospital staff washed hands and equipment after contact with those in the ward. | * Hospital staff [[Hand Hygiene|washed hands]] and equipment after contact with those in the ward. | ||
'''1950s''' <ref name=":0" />- Staphylococcal epidemics within hospital patients and staff sparked the first implementation of formal infection control programs | '''1950s''' <ref name=":0" />- Staphylococcal epidemics within hospital patients and staff sparked the first implementation of formal infection control programs | ||
* Maintaining clean environments was a central focus of many of these programs. | * Maintaining clean environments was a central focus of many of these programs. | ||
'''1970''' - The United States Centers for Disease Control (CDC) first introduced a framework for hospital patient isolation. | '''1970''' - The United States Centers for Disease Control (CDC) first introduced a framework for hospital patient isolation. | ||
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* This framework consisted of color coded disease/infection categories with generalized precautions used for all diagnoses included in the category. | * This framework consisted of color coded disease/infection categories with generalized precautions used for all diagnoses included in the category. | ||
* Categories included wound and skin, discharge, blood, enteric, protective, strict, and respiratory. | * Categories included wound and skin, discharge, blood, enteric, protective, strict, and respiratory. | ||
'''1976<ref name=":0" />''' - Joint Commission on Accreditation of Healthcare Organizations mandates infection control programs. | '''1976<ref name=":0" />''' - Joint Commission on Accreditation of Healthcare Organizations mandates infection control programs. | ||
* In order to receive accreditation, hospitals must maintain an established infection control program. | * In order to receive accreditation, hospitals must maintain an established infection control program. | ||
'''1983''' - The CDC framework was updated to include disease-specific isolation guidelines. The previously used categories were also updated. | '''1983''' - The CDC framework was updated to include disease-specific isolation guidelines. The previously used categories were also updated. | ||
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* Disease specific guidelines tailored for a specific infection or disease. | * Disease specific guidelines tailored for a specific infection or disease. | ||
* Selection of precautions could be based on the ones suggested for a specific category or for a specific disease or infection. It was encouraged that the selection of precautions be customized to each patient with not all of the precautions from a category or diseased/infection needing to be utilized if not appropriate. | * Selection of precautions could be based on the ones suggested for a specific category or for a specific disease or infection. It was encouraged that the selection of precautions be customized to each patient with not all of the precautions from a category or diseased/infection needing to be utilized if not appropriate. | ||
'''1985''' - Universal Precautions | '''1985''' - Universal Precautions | ||
* Introduced in response to HIV epidemic and increasing reports of clinical staff becoming infected with HIV from accidental needle sticks and contact with patient’s blood. | * Introduced in response to [[HIV/AIDS|HIV]] epidemic and increasing reports of clinical staff becoming infected with HIV from accidental needle sticks and contact with patient’s blood. | ||
* Blood and Body Fluid Precautions now applied to all patients not just those in that category of isolation. | * Blood and Body Fluid Precautions now applied to all patients not just those in that category of isolation. | ||
* Blood and Body Fluid precautions expanded from only glove and gown use to the addition of eye protection and masking for specific procedures and the use of individual ventilation devices for CPR. | * Blood and Body Fluid precautions expanded from only glove and gown use to the addition of eye protection and masking for specific procedures and the use of individual ventilation devices for [[Cardiopulmonary Resuscitation|CPR]]. | ||
* Gloves to be worn if potential for contact with blood or specific bodily fluids and hands to be washing after removal. | * Gloves to be worn if potential for contact with blood or specific bodily fluids and hands to be washing after removal. | ||
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* “Stop Sign Alert” posted on door of patients with airborne transmittable infection/disease, instructing visitors/staff to check with nurse regarding the need to wear a mask. | * “Stop Sign Alert” posted on door of patients with airborne transmittable infection/disease, instructing visitors/staff to check with nurse regarding the need to wear a mask. | ||
* Staff immunization/immunity required for entry into rooms of patients with measles, mumps, rubella, or varicella. | * Staff immunization/immunity required for entry into rooms of patients with measles, mumps, rubella, or varicella. | ||
'''1989''' - Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Regulations | '''1989''' - Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Regulations | ||
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* Expansive guideline for the protection of workers from blood borne pathogens. | * Expansive guideline for the protection of workers from blood borne pathogens. | ||
* Has continued to be updated and clarified for specific environments and situations since creation. | * Has continued to be updated and clarified for specific environments and situations since creation. | ||
'''1996''' - Guideline for Isolation Precautions in Hospitals | '''1996''' - Guideline for Isolation Precautions in Hospitals | ||
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* Introduced of Standard Precautions, a combination of Universal Precautions and Body Substance Isolation. | * Introduced of Standard Precautions, a combination of Universal Precautions and Body Substance Isolation. | ||
** Precautions were to be utilized with all patients regardless of disease/infection status or other implemented precautions. | ** Precautions were to be utilized with all patients regardless of disease/infection status or other implemented precautions. | ||
* Replaced category and disease specific precautions with with Airborne Precautions, Droplet Precautions, and Contact Precautions, based on disease/infection mode of transmission. | * Replaced category and disease specific precautions with with [[Infection Prevention and Control|Airborne Precautions, Droplet Precautions, and Contact Precautions]], based on disease/infection mode of transmission. | ||
** Two criteria for assigning to a patient. | ** Two criteria for assigning to a patient. | ||
*** Confirmed presence of specific disease, infection, or pathogen. | *** Confirmed presence of specific disease, infection, or pathogen. | ||
Revision as of 04:07, 26 November 2022
This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (26/11/2022)
Original Editor - Jeremy Bryan
Top Contributors - Jeremy Bryan, Kirenga Bamurange Liliane and Vidya Acharya
Introduction[edit | edit source]
No matter what practice setting, maintaining good infection control methods are of vital importance to protect not only the clinician, but also the patients that they treat. Over the years, infection control practices have taken many different forms. Fundamental to the idea of infection control is the maintenance of barriers or safeguards between the clinician and the patient with the infection, disease, or pathogen.
United States[1][2][edit | edit source]
1850-1900[3] - Physicians in the US, as well as other countries, began to recognize the benefits of antiseptic techniques for the control of infections.
- Physicians conducted first epidemiological studies concerning the implementation of antiseptic techniques such as handwashing.
1877 - First hospital manual suggested housing infectious patients in separate facilities from non-infectious patients.
- Gave rise to infectious disease hospitals.
1910 - Cubic System of Isolation and Barrier Nursing
- Patients with infections were placed in separate wards.
- Hospital staff washed hands and equipment after contact with those in the ward.
1950s [3]- Staphylococcal epidemics within hospital patients and staff sparked the first implementation of formal infection control programs
- Maintaining clean environments was a central focus of many of these programs.
1970 - The United States Centers for Disease Control (CDC) first introduced a framework for hospital patient isolation.
- This framework consisted of color coded disease/infection categories with generalized precautions used for all diagnoses included in the category.
- Categories included wound and skin, discharge, blood, enteric, protective, strict, and respiratory.
1976[3] - Joint Commission on Accreditation of Healthcare Organizations mandates infection control programs.
- In order to receive accreditation, hospitals must maintain an established infection control program.
1983 - The CDC framework was updated to include disease-specific isolation guidelines. The previously used categories were also updated.
- Categories now included Blood and Body Fluid Precautions, Drainage/Secretion Precautions, Enteric Precautions, Tuberculosis Isolation, Strict Isolation, Contact Isolation, and Respiratory Isolation.
- Disease specific guidelines tailored for a specific infection or disease.
- Selection of precautions could be based on the ones suggested for a specific category or for a specific disease or infection. It was encouraged that the selection of precautions be customized to each patient with not all of the precautions from a category or diseased/infection needing to be utilized if not appropriate.
1985 - Universal Precautions
- Introduced in response to HIV epidemic and increasing reports of clinical staff becoming infected with HIV from accidental needle sticks and contact with patient’s blood.
- Blood and Body Fluid Precautions now applied to all patients not just those in that category of isolation.
- Blood and Body Fluid precautions expanded from only glove and gown use to the addition of eye protection and masking for specific procedures and the use of individual ventilation devices for CPR.
- Gloves to be worn if potential for contact with blood or specific bodily fluids and hands to be washing after removal.
1987 - Body Substance Isolation
- All moist body substances including blood, urine, feces, saliva, sputum, wound discharge, and any other bodily fluids were considered infectious, regardless of the patient’s actual infection status, and were therefore required to be isolated.
- Gloves to be worn if potential for contact with any moist body substance and, after removal, hands only needed to be washed if visibly soiled.
- “Stop Sign Alert” posted on door of patients with airborne transmittable infection/disease, instructing visitors/staff to check with nurse regarding the need to wear a mask.
- Staff immunization/immunity required for entry into rooms of patients with measles, mumps, rubella, or varicella.
1989 - Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Regulations
- Expansive guideline for the protection of workers from blood borne pathogens.
- Has continued to be updated and clarified for specific environments and situations since creation.
1996 - Guideline for Isolation Precautions in Hospitals
- Introduced of Standard Precautions, a combination of Universal Precautions and Body Substance Isolation.
- Precautions were to be utilized with all patients regardless of disease/infection status or other implemented precautions.
- Replaced category and disease specific precautions with with Airborne Precautions, Droplet Precautions, and Contact Precautions, based on disease/infection mode of transmission.
- Two criteria for assigning to a patient.
- Confirmed presence of specific disease, infection, or pathogen.
- Observation of selected signs and or symptoms suggestive of possible presence of disease, infection, or pathogen warranting the need for Airborne, Droplet, or Contact Precautions.
- Meant to be temporary until confirmation of diagnosis.
- Two criteria for assigning to a patient.
2007 - CDC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
- Current utilized guidelines
- Emphasized application to all healthcare settings.
Conclusion[edit | edit source]
It has taken a long time to reach the current infection control guidelines that we live by today and many factors have influenced their evolution. Undoubtedly they will continue to evolve as contagious diseases and infections change, but it will always be important to understand how they got to where they are.
Resources[edit | edit source]
- CDC Infection Control Resources
- CDC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings
- OSHSA Bloodborn Pathogen and Needlestick Prevention Homepage
References[edit | edit source]
- ↑ United States Centers for Disease Control and Prevention - Hospital Infection Control Practices Advisory Committee, Guidelines for Isolation Precautions in Hospitals Hospital Infection Control Advisory Committee. 1996. Available from: https://wonder.cdc.gov/wonder/prevguid/p0000419/p0000419.asp [Accessed 21st November 2022].
- ↑ United States Centers for Disease Control and Prevention, History of Guidelines for Isolation Precautions in Hospitals. Available from: https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/history.html [Accessed 21st November 2022].
- ↑ 3.0 3.1 3.2 Smith P, Watkins K, Hewett A. Infection control through the ages. American Journal of Infection Control. 2012; 40: 35-42.
