The study organism which is the focus of this article is human. The study looks specifically at the spread of infectious diseases amongst people in correctional facilities. This is an important study as many of the nation’s most high risk groups are made up of those who are currently interred in correctional facilities.
One interesting fact discussed in the introduction is that in comparison to acute care facilities, little or no information of infection control related to correctional facilities is available. This is especially interesting as physicians who are employed to care in correctional facilities have to care for over 274,630 inmates at 344 facilities in 30 states. As such, it would be expected that more information would be available, especially since the information would be required from each individual facility if infection control and treatment were to be effective.
The major hypothesis studied in the article is that although the challenges facing those working in acute care are similar to those faced by people working in correctional facilities, the latter environment presents many unique challenges. These include the at-risk population with high levels of HIV infection and histories of substance abuse and a lack of published guidelines or frameworks within which to work. Important challenges also include the necessity of taking extra precaution in order to ensure the security of both staff and incarcerated individuals, as well the difficulties associated with procedures around patient transport and location. The article aims to aid the solving of some of these problems by demonstrating the effective role of ICP in situations of infection control in correctional facilities.
Those responsible for conducting the test sampled by contacting the areas which they had decided were most likely to provide an adequate strata of appropriate and useful information. These fields were split roughly into two sections. This first of these were the administrative or security focused areas of correctional facilities such as surveillance and case management. The second focused on areas with other forms of inmate contact such as education programs, and the healthcare facilities available for the workers in the facilities themselves.
The information needed for the presentation consisted primarily of a range of statistical analysis concerning infection rates. These were compared with infection rates in other care situations, specifically acute care institutions where the problems such as those mentioned do not exist. These findings were then compared with the relative demographics of the individuals concerned, specifically along the lines of race and class. Also several interviews were carried out with staff in the two kinds of work mentioned above. The interviewees were asked about their relative confidence in discussing matters such as sexual health and drug abuse with inmates for whose care or administration they were responsible. Once again these findings were compared and considered alongside the status of the facility and the demographics of the individuals involved.
The primary findings of the study were varied and at times complicated. It was found that given the fact that conditions in the institutions studied varied widely, so did rates of infection. It was demonstrated that one of the primary causes for the spreading of infectious diseases was often the result of drug abuse. Specifically this would refer to the transmission of diseases such Hepatitis, HIV and other conditions which could be spread by contact with used needles. However, once again, this varied greatly according to the facility. It was also found that staff at the facilities were often unsure how to treat such occurrences as this would often have involved crossing so-called institutional hierarchies. A similar situation presented itself within situations of the transmission of diseases via sexual contact between inmates. It was suggested, through the use of the presentation which forms the main part of the article, that the increased use of ICP programmes in correctional facilities would have to be accompanied by increased education programmes for both inmates and workers and that these programmes could enable the development of a better infection control culture within the facilities. It is believed that these will ultimately aid in the reduction of infection rates.
The conclusion was that, whilst it is obvious that conditions in acute care facilities and correctional facilities differ greatly, this is not a reason to consider that correctional facilities need necessarily to be places of endemic infection. Rather, a successful implementation of ICP procedures is possible and in the interests of all involved.
- Gemeinhart, N. & Briscoe, K. (1999). Infection Control in Correctional Healthcare. American Journal of Infection Control, 27 (2), 183.
