Infection Control in Acute Care Hospitals, Finland 2008

Background: Infection control (IC) in hospitals depends substantially on adequate human resources and organization. In Finland a previous survey concerning these issues was conducted in 2000 and now repeated in the beginning of 2009.

Objective: The aim of the study was to assess the IC resources and activities in Finnish acute care hospitals.

Methods: A questionnaire was mailed to all Finnish acute care hospitals, excluding only the region of Ahvenanmaa and private hospitals. The questionnaire covered information on hospital characteristics, IC staff and surveillance activities in 2008.

Results: All 57 (100%) hospitals responded: 5 tertiary (including 16 separate hospitals), 15 secondary and 26 primary care centers. Of the hospitals, 70% had infectious disease specialists and 37% had clinical microbiologists who both participated in the IC. They used a median of 10% (range, 1-66%) of their work time on IC activities. Of the hospitals, 89% had trained infection control nurses (ICN). ICNs used a median of 70% (range 25-100%) of their work time on the IC activities of their own hospital. The median of hospital beds per full-time equivalent ICN was 257 (range, 87-770). Of the hospitals, 16% had technical and 30% secretarial support. Most hospitals (95%) had IC committees as well as a link nurse system deployed for the entire hospital (96%). In the whole country, there were 187 isolation rooms equipped with an anteroom, own toilet/shower and negative air pressure. The hospitalwide median of hand rub consumption was 47 litres per 1000 patient-days and in the intensive care units 121 litres. All of the hospitals ran incidence surveillance at least in one specialty, most often on surgical site infections (83%). After the national prevalence study in 2005, 66% of the hospitals had reconducted a prevalence survey in the whole hospital.

Conclusions: In comparison with the results from 2000, the number of ICNs has improved (2000: range 394-953 beds/ICN; 2009: range 87-770, median 257). With there being adequate staffing, the focus should be on additional training and evaluation of the curriculum of the ICNs. Although most of the hospitals also had doctors participating in the IC, their input in the IC was limited, like in 2000. The status of surveillance being quite good, the focus could be shifted to the use of the results of the existing surveillance systems rather than starting new ones. In the future, parts of this survey could be updated with web-based questionnaire, and results used when planning national structure and process indicators for IC.