Lobbying: everyone's responsibility.

Health legislation is increasingly important to us as citizens and infection control professionals. The clearest need for influencing policymakers is in cost-cutting activities and the resulting impact on health care delivery. Health care professionals (HCPs) can highlight for lawmakers those health systems that are cost-effective and beneficial to the public.

Surgical wound infections.

At the last meeting of the SURGIKOS Operating Room/Infection Control Combined Advisory Panel, guest speakers reviewed current thinking and practices that have an impact on surgical wound infections. Presentation topics included the role of the CDC, nursing and classification systems in controlling wound infections; cost effective epidemiologic methods of reducing infections; and outcomes of surgical wound infection prevention practices deemed critical by the Joint Commission on Accreditation of Healthcare Organizations. The following is a brief overview of the presentations that guided panel discussions on these topics.

Description of case-mix adjusters by the Severity of Illness Working Group of the Society of Hospital Epidemiologists of America (SHEA).

Hospitals, insurance companies, and federal and state governments are increasingly concerned about reducing patient cost expenditures while maintaining high quality patient care. One method of reducing expenditures has been to tie hospital reimbursement with a prospective payment system based on diagnosis-related groups (DRGs). However, reimbursement under the DRG system is not acceptable for all patients in all hospitals because it is neither an accurate predictor of costs nor of clinical outcome.

Tendon echogenicity: ex vivo study.

Recent publications discussing the echogenicity of normal tendon have described it variously as hyperechoic or hypoechoic. Since the echogenicity of tendon has been used to define normality and abnormality, certain knowledge of the normal echogenicity of tendon is crucial. Fresh tendon and muscle from beef hock was scanned with sector- and linear-array-transducer imaging at multiple angles and distances.

Surveillance for postoperative wound infections: practical aspects.

Intensive surveillance for postoperative wound infections was conducted for one month on three separate occasions at the Veterans Administration Hospital, West Haven, Connecticut. The mean wound infection rates for clean, clean-contaminated, contaminated, and dirty wounds were 6, 11, 17 and 18%, respectively. During the second survey, the clean-contaminated rate was 25% and was significantly higher than at other periods (p less than 0.

The epidemiology of nosocomial enterococcal urinary tract infection.

Enterococci are the most frequent cause of urinary tract infections (UTIs) in our hospital, which is comprised primarily of elderly male patients. Thirty of 34 UTLs, associated with enterococci in a three-month study, were preceded by urinary tract instrumentation and not related to antecedent antibiotic therapy. Although most UTLs were polymicrobic and clinically asymptomatic, monomicrobic septicemia with enterococci did occur and in one patient polymicrobic bacteremia was observed.