Infection control in British hospitals: a study of the planning, administration and effectiveness of infection control in British hospitals with particular reference to the role of the control of infection officer

Abstract

ln 1967 the King Edward VII's Hospital Fund for London invited me to undertake an investigation into the Administrative Aspects of the Control of Infection in British Hospitals.

The terms of reference were:-

"To study the planning, administration and effectiveness of infection control in British Hospitals, with particular reference to the Control of Infection Officer."

This thesis embodies my findings and is submitted with the consent of the King's Fund.

I paid thirty-three visits to teaching, regional and mental hospitals, departments, regional hospital boards, hospital centres and medical schools. These were situated in England, Scotland and Northern Ireland.

The administrative structure for the control of infection differs for each hospital. The structures are of two main types corresponding to the two main types of medical administration. Irrespective of the type, one individual in each hospital - usually the bacteriologist - has all the problems on infection referred to him. He may be formally appointed Control of Infection Officer.

Various individuals - medical and science graduates, sisters and nursing officers - have been appointed to apply the results of the bacteriological examinations to the control of infection.

Opinions differ sharply as to the need for them and to their relative merits.

Some hospitals have, in addition, a Control of Infection Committee. These Committees differ widely in their constitution, activities and usefulness.

Many factors militate against the control of infection. These include the enforced use of obsolete buildings and equipment and inadequacies in the training of some undergraduates in bacteriology especially in its relation to clinical work.

Defects were found in the administrative structures for the control of infection. The placing of responsibility for executive action on the Control of Infection Office, without giving him adequate authority makes his position anomalous. Much time and energy of both skilled and semi-skilled worke s can be wasted in the compila¬ tion and surveying of records of infection, especially if they are unnecessarily detailed and widely dispersed throughout the hospital.

There is need for a better appreciation among the medical staff of the importance of the control of infection.

The most important single factor for the control of infection is the state of the personal relations among the hospital staff. There should be better liaison between them and the local Medical Officer of Health.

A detailed summary and detailed recommendations are included in the Thesis.