Infection control and changes in management of hospitals: the European experience.

The general setting for the management of many European hospitals has undergone enormous changes during the last five to 10 years, especially with respect to economic, personnel and technical resources. This change has had a serious influence on the practice of infection control. To get an insight of the problems infection control practitioners in Europe today have to face, hospital epidemiologists representing nine European countries were asked to answer a questionnaire. In most countries, new laws on communicable disease prevention and infection control in hospitals have been implemented during the last few years. In conjunction with the widespread introduction of quality assurance and the accreditation of hospitals, organizational aspects of infection control have gained importance. However, budget restrictions and the growing competition between institutions are major challenges. In general, there has been a remarkable influence of the documented changes on the practice of infection control in European hospitals. Facing this situation, infection control practitioners should abandon unproven measures and implement those that are evidence-based, to prevent hospital acquired infection (HAI). Cost reducing initiatives, like the use of well designed multi-use devices and the reuse of disposables should be considered and scientifically assessed.