The prevention of hospital acquired infection is at the heart of good intensive care practice. It is especially important in patients who are intubated and ventilated, since this is the most important risk factor for the development of nosocomial pneumonia. The actuarial risk of developing pneumonia increases by 12% with each day of ventilation, reaching 28% by day 30,68 whilst the cumulative incidence rises from 8 5% during the first three days of ventilation to 45% in those ventilated for more than 14 days.69 Every unit should have a written infection control policy developed in conjunction with local microbiological experts. Central issues are local practices of hand washing, nursing numbers, strict intravenous line/urinary catheter and antimicrobial policies, and an infection surveillance programme.
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