Surveillance of infections in a community teaching hospital.

The control of nosocomial infections depends on a surveillance system that will detect and identify problems at the time that they occur. During the past year, infection control at Springfield Hospital Medical Center was considerably strengthened by the addition of a full-time Infection Control Nurse and appointment of an Infection Control Officer. The latter position is presently filled by the full-time director of the microbiology laboratory and the clinical infectious disease service, but any other qualified member of the Infection Committee could perform these duties.' Springfield Hospital Medical Center (SHMC) is a community hospital with 481 beds. It is a general hospital with the usual clinical services except obstetrics and has post-graduate training programs in Medicine, Surgery, Anesthesiology, Pediatrics, and Pathology. Most chiefs of services and of the medical subspecialities are full-time employees of the hospital. The 340 "acute" beds provide about 11,400 patient care days per month with an average length of stay of 12.2 days. Infection control at SHMC is the responsibility of the Infection Committee of the Professional Staff which is organized in accordance with the recommendations of the American Hospital Association.1 In addition, an administrative Environmental Control Committee has been established, with members from all nonmedical services and from the Microbiology Laboratory, to coordinate the efforts of the Infection Committee to achieve the highest standards in hospital hygiene. In direct patient care, the Infection Control Officer and the Infection Control Nurse are responsible for control, surveillance and reporting of nosocomial infections. The Infection Control Nurse reviews all control measures on her daily rounds through the hospital. She serves as a consultant to the other nurses, especially in the interpretation of the isolation procedures,' which in our hospital are initiated by each head nurse without specific orders of a physician. She is also responsible for the collection of surveillance data used to determine the incidence of nosocomial infections. Such information is obtained from (1) the nursing units, during regular