Providing care to patients infected by resistant organisms invariably leads to considerable cost not only on the part of the patient, but also on the care providers. To reduce the cost, morbidity, mortality, and stakeholder dissatisfaction, therefore, administrative strategies have been used at the government and policy levels. These policies have significant implications towards solving these problems in the healthcare. For example, it has been noted that control of antibiotic usage, pharmacy or infectious diseases consultation for antibiotic usage, surveillance of resistance rates of specific and prevalent pathogens, development of institutional infection control policies and guidelines, all may cause a decline in healthcare associated infection rates (Johnston. and Bryce, 2009).
Policy only is not sufficient; in fact surveillance of policy implementation and evaluation of policy is a very important aspect of health system infection control policy. Almost in all countries including Australia, numerous hospital-based strategies have been developed and implemented in order to prevent such infections. Some of these policies have been tested also. In some cases these guidelines are augmented with regular updates to frame specific and mandatory guidelines that aim at prevention of transmission of pathogenic bacteria to people who are ill otherwise within the hospital based healthcare setting. Several studies unfortunately indicate gaps in implementation of these policies since there were variabilities in practices and outcomes (Reingold, 1998).
The CDC initiated study on nosocomial infection control policies identified the positive roles of infection control components in reducing the hospital-associated infection rates. Although this was conducted in a different country, it successfully identified the four main elements in any infection control policy effective in a hospital. These include a trained infection control physician in a hospital, an infection control practitioner for every 250 healthcare beds, organized surveillance and control mechanisms, and system for reporting rates of infection to practicing surgeons. Many studies indicate inclusion of rigorous hand hygiene, and expert opinions substantiate grounds for its inclusion. However, it was also indicated that in many institutional settings despite policies, the healthcare workers perform it in less than 50% of the times. On the top of that, there has been a shift in the patient population that healthcare facilities care for, specially in hospitals. The patient profile is now more complicated, with more severely ill patients with multiple comorbidities and the need for intensive care unit [ICU] level of care. Moreover, there is an increasing number of patients who are severely immunocompromised. More devices and procedures are used in patients nowadays and for longer durations of time. In the recent cost-conscious times, there are been staffing shortages indicated by decreasing staff to patient ratios. In addition, over several decades, antimicrobial resistant pathogens (ARPs) and emerging infectious diseases have emerged. All of these have added to the challenge of preventing and controlling healthcare associated infections (Queensland Health, 2001).
Hospital-acquired infections are now major healthcare