Healthcare-Associated Infections
Controlling and minimizing spread of disease and health care associated diseases is among the core functions of any health care institution. The environment in the health care facility contains potential elements to facilitate growth and spread of infectious diseases. The people, air in the environment and everything else can act as microorganism carriers (Centrak, 2018). According to the WHO (2018), injections are among the most widely used procedure in the health care institutions. Approximately 16 billion injections are administered to people per year with almost 90 percent given in curative care. In other countries, about 70 percent of the injections are administered by reusing syringes and needles and others administered unnecessarily. This could transmit airborne diseases. The WHO came up with a campaign (Get the point, make smart injection choice), whose aim is to make the injection practice safer for every stakeholder.
There are almost 200,000 cases of healthcare associated infections (HAIs) reported in Australia every year (Patterson, 2015). This is therefore, considered as the most commonly occurring complication for the patients, that makes them suffer along with their families. According to the Australian government, there have been almost 724 cases of healthcare associated bloodstream infections recorded in 2016 (Poggio, 2013). Out of the 724 cases, 13.4% occurred in non-inpatient patients, majority of which was related to hematology or oncology patients (Poggio, 2013). The rate of healthcare associated bloodstream infections in hospitals was 4.5 per 10,000 bed-days in 2016 (Patterson, 2015). Such adverse situations prolong the period of stay in the hospitals and thereby increase the cost of care as well.
In developing countries, surgical suite infections are more frequently contracted during health care delivery (Patterson, 2015). Poor hand hygiene leads to transmission of germs causing diseases, even the germs resistant to antibiotics. This exposes a patient to risks of contracting healthcare associated infections. Surgical site infections are the common health care associated infections and the bacteria causing them are in most cases resistant to commonly used antibiotics. Effective infection prevention and control is a fundamental aspect in delivering an effective, safe and high quality health care (WHO, 2018). This report focuses on how to deliver safe health care, risk management in infection control and the role of health care practitioners in delivering a safe health care.
According to Connors (2015), it is very devastating for a patient to contract infections in the health centre. He further makes it clear that it should be understood that infection control in hospitals should not be solely nurses and doctors responsibility. This is why health care managers and regulatory agencies are joining hands with infection control personnel to ensure improvement in infection control in health care facilities. Aspergillus infection causes 5000 deaths every year. Transplant patients who suffer from this fungi have a 74 to 92 percent likelihood of passing away. Legionella bacteria acquired in the hospitals has more than 40 percent mortality rate and is twice as deadly as that acquired outside the hospital. Therefore, it is of great importance that the concerned stakeholders work together for a vigilant infection control and prevention. This shed light on what should be done to prevent these infections.
Risk Management in Infection Control
Perioperative nurses have the duty of providing care services to all patients during the perioperative period, before and immediately following an intervention procedure and/or surgery. Perioperative nursing requires the nursing staff to adorn a range of specialty roles that commonly encompass circulating, holding bay, anaesthetic administration, use of instrument. They are also needed in the recovery rooms. Some other roles of nurses include evaluation of the patient and their education on the different infection control practices (Quick, 2013). There is mounting evidence that have establish high rates of hospital acquired infections (HAIs) with perioperative settings. These infections are commonly defined as those that occur during the course of providing care to a patient (Lewis et al., 2013). Without the presence of a clean environment or appropriate infection control measures that commonly comprise of decontamination procedure and/or hand hygiene, the nurses are not able to prevent the onset of infections in perioperative settings.
The patients being operated in theatres are considered as a potential source of contamination. Thu, perioperative nurses have the duty of putting on appropriate surgical attire, such as, PPE and scrub suits as the first step of infection prevention. Apart from hand hygiene practices, they are also responsible for preventing surgical site infection by accurately removing the hair from perioperative patients during their surgery and full washing of the patient body, with the use of antiseptics (Poggio, 2013). Some of the major issues related to priority safety are namely, pressure injuries, medication error, retaining surgical instruments, wrong site surgery, surgical fire and perioperative hypothermia (Steelman, Graling & Perkhounkova, 2013). Furthermore, putting on specific shoes, masks, and clothing in the operation theatre also helps the perioperative nurses to prevent the transmission of potentially dangerous pathogens in the controlled environment. Thus, the efforts that are usually taken by these nurses in preventing the onset of HAIs include skin antisepsis, prophylactic antibiotics, hand hygiene techniques, wound protectors, hair removal and normothermia prevention.
According to Mehta et al. (2014), nosocomial infections are a major concern to clinicians and patients as well. While considering the mortality, cost, duration of stay in the hospital and morbidity, efforts should be made to prevent these infections. In management of these infections guidelines have been set to guide the health care personnel. The principle of grading systems is used to access quality of care. Germs transmission is in most cases done through hands. Maintaining hand hygiene it the most effective means of controlling horizontal infection transmission in hospitals (Zorrilla-Vaca & Escandon-Vargas, 2017). This should be done before and after attending a patient, before aseptic procedures, after exposure to body fluids and after coming into contact with the patients’ environment. Some practices previously practiced during pre-surgical preparation, such as re-using a syringe to administer drugs for different patients, posed a great risk in disease transmission. This had to be dropped in the effort to managing the health care acquired infections. According to the University of Essex (2018), stated that prevention of these infection is much far better that treating them. Most health care facilities prevent through cleaning, sterilization, outbreak investigation and disinfection. It is also advisable to follow standard precautions regardless of the infection status of the patient. Wearing of sterile gloves, gown, mask, face shield or eye protection, shoes and head coverings are important precautions. Other than the standard precautions, transmission base precautions such as airborne, contact and droplet precautions should be observed (Nazeer, 2017).
Delivering Safe Healthcare
Connors (2018) thinks that a thorough and a clear understanding of the risk factors is prominent to the nurses. He thinks that they should also be aware of the role played by the physical environment in ensuring patients’ safety. AMN health care (2018) claims that nurses play a vital role in preventing the transmission and spread of heath care acquired infections through research, educating the patients and ensuring that their practice is evidence based. Nurses are the patients’ advocates and have the full potential and are in a unique position to improve patients care standards, build and maintain a safe environment for the patients through the tools available to them (nurses). Universal precaution is fundamental in maintaining a safe health care environment. It is designed to prevent blood borne pathogens transmission during health care practices. Sandra (2011) thinks that it is the duty of nurses and health care practitioners to practice and promote hand hygiene. It is in fact a leading measure to prevent infection spread in health care facilities, although most nurses’ compliance is low in most hospitals. Nurses should develop a habit of routine hand hygiene before performing any patient care services. Nurses should consistently apply antiseptic techniques so as to control pathogen contaminations.
According to Dancer (2009), nurses often use medical instruments for different patients. It is therefore there duty to clean and disinfect these devices and instruments before using them to the next patient. They should also make the environmental services aware of the cleaning and disinfecting expectations regarding computers and patient monitoring devices. Other very vital roles of nurses in ensuring infection control in health care facilities include: patient assessment and additional precautions, whereby the nurse would be able to tell any unexpected signs and symptoms on the patient; use of standard precautions; patient education whereby the nurse explains to the patient and their family about treatment progress and the rationale for treatment and strategies; use of safety devices and removal of unnecessary invasive devices (Rao, 2013).
Perioperative nurses work along with the clinical practitioners, surgeons, technologists or anaesthesiologists to ensure complete safety of the patients being operated or going through any invasive procedures. To effectively manage the risks, the nurses must make sure that the patients are given the antibiotics as prescribed, their wounds are properly cleaned and regularly treated with medications, and most importantly, the nurses or any care providers who would attend to the patient, must go through the general procedure of hand hygiene maintenance to ensure patient safety and reduce any chance of infection through the wound. A few infection control principles must be strictly followed by the perioperative nurses for effective control of any chances of infection and further management of risks to the patients. These include: cleaning and disinfecting the wounds of the patients, practicing safe injection procedures and maintaining a good hand hygiene, always adhering to using sterilized needles and wound care instruments and proper disposal of the waste materials.
It is therefore clear that everything in the environment can act as a microorganism carrier and potential agents to facilitate growth and spread of diseases. It is a great shame to health care delivery bodies for patients contracting infections at their look and therefore health care infection control is a fundamental aspect in preventing patients’ infection. Nurses should maintain high levels of cleanliness, both of themselves and the environment. They should also take frequent and close examinations on the patients so that they are aware when the patients show unexpected changes. This would reduce disease transmissions in health centres and also reduce deaths.
References
AMN Health care. (2015). The Nurse’s Role in Preventing Hospital Acquired Infections. Retrieved from: https://www.rn.com/nursing-news/nurses-role-in-preventing-hospital-acquired-infections/
Centrak. (2018). Infection Control. Retrieved from: https://www.centrak.com/infection-control/
Connors, B. (2018). The Importance of Hospitality Infection Control and What Facility managers Need to Do About it. Retrieved from: https://www.eheinc.com/blog/hospital-infection-control-and-what-facilities-managers-need-to-do/
Dancer, S. J. (2009). The role of environmental cleaning in the control of hospital-acquired infection. Journal of Hospital Infection, Vol. 73, No. 4, pp. 378-385. Doi: 10.1016/j.jhin.2009.03.030
Lewis, S. S., Moehring, R. W., Chen, L. F., Sexton, D. J., & Anderson, D. J. (2013). Assessing the relative burden of hospital-acquired infections in a network of community hospitals. Infection Control & Hospital Epidemiology, 34(11), 1229-1230. https://doi.org/10.1086/673443
Mehta, Y., Gupta, A., Todi, S., Myatra, S., Samaddar, D. P., Patil, V., … Ramasubban, S. (2014). Guidelines for prevention of hospital acquired infections. Indian Journal of Critical Care Medicine?: Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 18(3), 149–163. https://doi.org/10.4103/0972-5229.128705
Nazeer, Z. B. (2017). The Importance of Infection Control Risk Management in Health Care Settings. Journal of Infectious Diseases & Therapy, ISSN: 2332-0877. DOI: 10.4172/2332-0877-C1-035
Patterson, C. E. (2015). Basic Principles of Infection Control. Nursing Made Increadibly Easy, Vol. 13, No. 3, pp. 28-37. Doi: 10.1097/01.NME.0000462644.52688.6a
Poggio, J. L. (2013). Perioperative strategies to prevent surgical-site infection. Clinics in colon and rectal surgery, 26(3), 168. doi: 10.1055/s-0033-1351133
Quick, J. (2013). The role of the surgical care practitioner within the surgical team. British Journal of Nursing, 22(13), 759-765. https://doi.org/10.12968/bjon.2013.22.13.759
Rao, T. V. (2013). Role of Nursing in Infection Control. Retrieved from: https://www.slideshare.net/doctorrao/role-of-nursing-in-infection-control
Sandra, B. (2011). Your Role in Infection Prevention. Nursing made Incredibly Easy, Vol. 9, No. 3, pp. 36-41. Doi: 10.1097/01.NME.0000395995.78267.c9
Steelman, V. M., Graling, P. R., & Perkhounkova, Y. (2013). Priority patient safety issues identified by perioperative nurses. AORN journal, 97(4), 402-418. https://doi.org/10.1016/j.aorn.2012.06.016
The WHO. (2018). Infection prevention and Control. Retrieved from: https://www.who.int/infection-prevention/en/
University of Essex. (2018). Why Infection Control is Important. Retrieved from: https://online.essex.ac.uk/blog/infection-control-important/
Zorrila-Vaca, A. and Escandon-Vargas. (2017). The Importance of Infection Control and Prevention in Anesthesiology. Colombian Journal of Anesthesiology, Vol. 45, No. 2, pp. 69-77. Doi: 10.1016/j.rcae.2017.10.001
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