Effective Infection Prevention And Control Programs: Clostridium Difficile Infection In Acute Care Hospitals

The Importance of Clinical Governance in Infection Prevention and Control

Clinical governance is defined as the process through which healthcare institutions enhance their levels of responsibility and accountability for pertinent organizational activities such as enhancing the quality of the services offered, promoting high standards and instilling systems aimed at fostering clinical outcomes that are above board through institutionalization of operational environments that advocate for flourishing of excellence (Rowley, Clares, Poll, Thomas, and White, 2017). The processes of controlling and preventing infections in healthcare settings occupy a central position in clinical governance. According to Jackson, Lowton, and Griffiths (2014), Europe incurred over €7 Billion as the healthcare costs associated with infections acquired in hospital settings in 2011. However, Anderson et al. (2014) explain that despite the policy frameworks put in place to minimize the financial, social and economic burdens associated with the infections that are acquired by patients seeking services, the contributions made by caregivers is still minimal. The scholars reveal that while nurses in acute care settings raise their levels of concern on ensuring that they stir other stakeholders’ intuitions to be considered as good and knowledgeable professionals, minimal efforts have been adopted to ensure that the policies and procedures guiding their endeavors are followed. The caregivers inculcate their own behavioral positions and justifications for all forms of irrational deviations from the set institutional policies; an aspect that limits the effectiveness of applying the principles of clinical governance. On the other hand, AL-Rawajfah (2016) reveals that while healthcare associated infections have been considered as major challenges in critical hospital sections such as the intensive care units, they can be controlled through acquisition of effective frameworks aimed at educating caregivers on the most effective practices. In their study, Lo et al. (2014) demystify that medical institutions can instill the measures of controlling and preventing infections in hospital settings by adopting efficient collaborative frameworks with infection control link nurses (ICLNs). In their perspective, the scholars demystify that ICLNs are better placed to inculcate workplace trainings aimed at acquainting other caregivers with both technical and psychological skills necessary to alleviate the infections reported in acute care facilities.

According to Ocampo et al. (2017), clinical performance and evaluation by the use of nursing care plans plays a significant role in auditing the efficacy, validity and reliability of healthcare procedures such as identification of outcomes, diagnosis and implementation of the treatment procedures put in place. On the other hand, Louh et al. (2017) explain that professional development and management is a pillar of clinical governance aimed at advancing the healthcare workforce through impartation of the necessary skills and knowledge. Similarly, incident reporting is considered by Zingg et al. (2017) as an essential component of minimizing clinical risks based on its effectiveness in identifying the areas of weakness and advancing platforms on which learning will take place. Lastly, feedback in healthcare settings strengthens consumer value through inclusion of avenues aimed at evaluating the quality of services offered based on the clients’ viewpoints. According to Storr et al. (2017), proper implementation of clinical governance in medical settings is associated with an increase in the quality of services offered, overall outcomes in patient care, optimal performance and revenue generation.

Studies on Infection Prevention and Control

Infection prevention is one of the greatest challenges facing healthcare facilities. While nurses in medical settings are considered as the primary organs of driving the infection prevention initiatives adopted by their organizations, Lo et al. (2014) explain that system administrators and stakeholders at large need to share this burden by ensuring that the programs put in place are streamlined through: acquisition and proper management of institution based information in order to gauge the efficacy of the structure for reporting outbreaks; ensuring that the existing policy procedures are effectively updated; prevention of antimicrobial resistances through advancement of individualized remedies; and inculcating proper training initiatives targeting all stakeholders. In essence, the three scholarly materials put a lot of emphasis on nurses working in different healthcare settings as the major agents of preventing infections. For instance, the research conducted by Jackson et al. (2014) proceeds with the aim of investigating the infection prevention behaviors adopted by nurses in acute care settings by prompting the explanations offered by nurses for the traits observed. On the other hand, the cross-sectional descriptive study conducted by AL- Rawajfah (2018) investigates the practices of controlling infections among nurses working in critical care settings in Jordan. Lastly, Peter et al. (2018) ascertain the factors that act as facilitators and barriers to effective implementation of infection control programs among infection control link nurses. While the three studies are highly effective in vetting the roles of nurses in fostering infection prevention, they do not look into the efficacy of other contributing factors such as the efficiency of the entire healthcare system in forming the desired policies, audits and regulatory frameworks to correct this menace.

Nurses play a significant role in fostering and initiating the infection control programs adopted in their institutions. However, effective adoption of instruments aimed at strengthening the surveillance and audit functions in healthcare settings could be of critical essence in minimizing the rates of spread of infections in clinical settings. As revealed by Jackson et al. (2018), the system has seen an increase in the number of hospital based infections due to the suboptimal initiatives put in place by nurses. As a mater of fact, the scholars report that nurses resort to revealing behaviours that reveal higher levels of deviance from the set frameworks of clinical governance. While such traits could be as a result of the influences of the environments in which these practitioners offer their services, Ocampo et al. (2017) explain that training and education could play a role in inculcating the desired attributes.  For instance, Peter et al. (2018) demystify the effectiveness of while the acceptation of ICLNs in clinical settings is still minimal, these professionals have the potential of minimizing the infections acquired in healthcare settings through advancement of psychological and technical skills.

Factors Facilitating or Hindering the Implementation of Infection Prevention and Control Programs

The articles by Jackson et al (2014), AL-Rawajfah (2016) and Peter et al. (2018) provide an array of insights on the most effective ways of preventing acquisition and spread of infections in healthcare settings. Based on the literature presented by these scholars, healthcare related infections are real, a continuing challenge and are associated with massive cost implications both on the side of the users and that of the system. In their view, Jackson et al. (2018) reveal that unnecessary infections are reported by nurses to be highly attributed to the behavioral positions of their peers as opposed to one’s own; an aspect that calls for inclusion of corrective mechanisms that adopt multifaceted remedies which may not have been included in the existing institutional policies, guidelines and regulatory frameworks. On the other hand, AL- Rawajfah (2016) reveals that the flaws leading to the prevalence of hospital acquired infections can be minimized through implementation of educational initiatives aimed at enlightening practitioners on the most effective ways of reducing errors in acute care settings. In particular, the researcher reveals that medical institutions could induce the infection control programs by implementing organization based training programs. Despite the efficiency of these training initiatives, Peter et al. (2018) consider technical and psychological skills to be effective in instilling infection controls. However, they recommend that medical centers need to recruit ICLNs in order to minimize these errors. The findings in these three studies are of great relevance to healthcare professionals working as nurses. These caregivers need to emphasize on the importance of acquiring knowledge, adhering to the set institutional policies, rules and regulations as effective mechanisms of minimizing the infections acquired in hospital settings.

References

AL?Rawajfah, O. M. (2016). Infection control practices among intensive care unit registered nurses: a Jordanian national study. Nursing in critical care, 21(2), e20-e27.

Anderson, D. J., Podgorny, K., Berrios-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L., … & Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S66-S88.

 Jackson, C., Lowton, K., & Griffiths, P. (2014). Infection prevention as “a show”: A qualitative study of nurses’ infection prevention behaviours. International journal of nursing studies, 51(3), 400-408.

Lo, E., Nicolle, L. E., Coffin, S. E., Gould, C., Maragakis, L. L., Meddings, J., … & Yokoe, D. S. (2014). Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(5), 464-479.

Louh, I. K., Greendyke, W. G., Hermann, E. A., Davidson, K. W., Falzon, L., Vawdrey, D. K., … & Ting, H. H. (2017). Clostridium difficile infection in acute care hospitals: systematic review and best practices for prevention. infection control & hospital epidemiology, 38(4), 476-482.

 Ocampo, W., Geransar, R., Clayden, N., Jones, J., de Grood, J., Joffe, M., … & Conly, J. (2017). Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada. American journal of infection control, 45(10), 1116-1126.

 Peter, D., Meng, M., Kugler, C., & Mattner, F. (2018). Strategies to promote infection prevention and control in acute care hospitals with the help of infection control link nurses: A systematic literature review. American journal of infection control, 46(2), 207-216.

Rowley, S., Clares, S., Poll, K., Thomas, S., & White, K. (2017). a Standard Approach to Reducing Haematology/bmt “never events” and Other Clinical Incidents in a Bmt Setting: A Clinical Governance Framework: no005. Bone Marrow Transplantation, 52, S519.

 Storr, J., Twyman, A., Zingg, W., Damani, N., Kilpatrick, C., Reilly, J., … & Allegranzi, B. (2017). Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations. Antimicrobial Resistance & Infection Control, 6(1), 6.

 Zingg, W., Hopkins, S., Gayet-Ageron, A., Holmes, A., Sharland, M., Suetens, C., … & Cairns, S. (2017). Health-care-associated infections in neonates, children, and adolescents: an analysis of paediatric data from the European Centre for Disease Prevention and Control point-prevalence survey. The Lancet Infectious Diseases, 17(4), 381-389.

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