From personal interviews in a representative sample of hospitals, we found that 97 per cent of them had some type of infection surveillance system; most involved continuous, hospital-wide surveillance, written definitions of infections, active case-finding methods and basic analytic techniques. Infection control nurses spent an average of about half of their time on surveillance. In larger hospitals (≥ 200 beds), the heads of the infection surveillance and control programs reported a greater awareness of most nosocomial infections if they were in hospitals with more intensive surveillance systems, and most indicated that surveillance data were used for a variety of specific purposes. Although 81 percent of persons who described surveillance reported using surveillance data in inservice education, only 31 percent of U.S. staff nurses recalled its having been presented. "Clean" wound, surgeon-specific rates of surgical wound infection were reported back to surgeons in only 16 percent of the hospitals. Ninety-seven percent of the hospital administrators believed that surveillance data are not a hindrance in defending the hospital against litigation for alleged malpractice, and 65 percent considered the information more often a help.
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