Infection control guidelines for the ICU

Infection control guidelines for the ICU are directed against the spread of pathogens and include an emphasis on handwashing and isolating or cohorting infected or colonized patients. Aseptic techniques and early removal of indwelling devices are also essential infection control measures. iCu infection control measures are listed in Table 1... Routine barrier precautions can significantly reduce endemic nosocomial infection rates.

Table 1 Infection control measures in the ICU

Handwashing remains a cornerstone of the prevention of nosocomial infection in the ICU. Unfortunately, compliance rates of ICU handwashing practices average 30 to 40 per cent, and are even lower for physicians. Hand disinfection (using antiseptic solutions or alcoholic preparations) should be promoted; it is faster, easily achievable at the bedside in the busy routine of patient care, and more efficacous than handwashing with soap and water. The higher the compliance with handwashing recommendations, the lower is the need for isolation and barrier precautions. Unfortunately, there is so little confidence in handwashing practices that hospital isolation policies now assume non-compliance.

The use of gloves has been advocated. However, there is no evidence that the addition of gloves in routine intensive care practices has any advantage over adequate handwashing in controlling infections. Major arguments against the routine use of gloves in the ICU are that health care workers frequently do not remove gloves when moving from patient to patient and forget to wash their hands after glove removal.

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