Rationale for implementation
Discuss about the Reducing Pandemic Influenza Transmission.
Influenza is generally categorised as a community based infection, transmitted across communities and households that makes most individuals seek ambulatory medical services. Owing to the fact that influenza viruses get transmitted through droplet transmissions and close contact between the source and recipient individuals, there is a need to implement effective control strategies that will prevent spread of the virus from Ms. Smith to other patients and healthcare workers. The two major infection control principles are cited below:
- Respiratory hygiene- This is a standard infection control technique that will prevent dispersion of viral respiratory secretions into the air. This control technique will involve making Ms. Smith cover her mouth and nose with disposable single-use tissues, while sneezing, coughing, blowing nose or sneezing. The tissues will be disposed in bins or waste receptacles (Zayas et al., 2013).
- Hand washing- All healthcare workers and patients will be made to adhere to appropriate hand hygiene techniques with the use of soap, water and alcohol based rubs that will prove effective in reducing presence of influenza virus on hands. This will involve several steps such as, wetting hands in clean running water, taking some amount of soap and rubbing the palms, back, finger interface, and thumb in a rotating manner, followed by thorough rinsing and drying (Warren?Gash, Fragaszy & Hayward, 2013).
Respiratory hygiene- These are effective infection prevention measures that are designed to restrict the transmission of harmful respiratory pathogens that are usually spread by airborne routes or through droplets. These etiquette or hygiene are generally employed as control measures and have proved effective in preventing seasonal outbreaks of infections in the viral respiratory tracts. Experimental evidence suggests covering the mouth and nose with tissues help in preventing dispersal of respiratory droplets during sneezing or coughing (Tacconelli et al., 2014). Research evidences also suggest that sneezing or coughing into the upper arm or elbow, in absence of disposable tissues, are also effective in infection control (Choi & Kim, 2016). This can be attributed to the fact that influenza viruses present in mucus get directly transmitted when an infected person sneezes. These series of actions that must be followed while coughing or sneezing have also been proved effective in controlling infectious respiratory droplets at their source.
Hand hygiene- This has been identified as one of the most important measure that prevents transmission of harmful germs, thereby preventing nosocomial or health care-associated infections. This can be attributed to the fact that hands are the primary pathways that result in transmission of pathogens in healthcare settings. Furthermore, influenza virus also gets transmitted through hands to the eyes, mouth or nose. According to research evidences, any healthcare worker, or caregiver, involved in direct or indirect forms of patient care need to remain concerned about hand hygiene practices (Wong, Cowling & Aiello, 2014). Cleaning hands with the use of soap and water, or alcohol based formulations have been found effective and better tolerated among individuals. Hand hygiene techniques, in combination with face mask have also shown statistically significant efficacies against spread of laboratory-confirmed influenza virus (Wood et al., 2018). Furthermore, studies that evaluated the effectiveness of personal protective measures in eliminating risks of influenza transmission also suggested that hand hygiene provides significant protective effects against pandemic influenza infections (Saunders-Hastings, Crispo, Sikora & Krewski, 2017). Thus, it can be suggested that an adherence to effective hand hygiene recommendations will help in reducing influenza risks among healthcare workers and other patients.
NSQHS standards for comprehensive care
The primary objective of these standards are built on protecting all individuals from harm and improving their quality of provision of healthcare services. The Comprehensive Care Standard is impetrative in the context of patient falls since it encompasses the coordinated delivery of healthcare services, as required by a patient. The importance of this standard can be attributed to the fact that it makes it necessary for all healthcare organisations to recognise the specific harms that the patients are subjected to, in addition to minimising the associated risks with the implementation of appropriate strategies. Thus, the fact that the care standard recognises the importance of screening and monitoring patients for falls and injuries, make it necessary in this context. The standard also aims to ensure meeting the goals for each patient. This is particularly useful in regards to falls since it would facilitate formulation of an appropriate care plan based on the actions of Preventing Falls, thereby improving patient health and wellbeing. Evidences have established the fact that a comprehensive fall evaluation should be conducted to reduce risks of falls in older adults (NSQHS Standards, 2018). Thus, this care standard will facilitate delivery of a coordinated healthcare service that will work towards preventing falls, conducting gait assessment and managing risks of falling.
Determine the risk of falling- Fall risks assessments form an important part of evidence-based fall safety initiatives. This assessment has been identified as an essential component of evidence-based fall safety initiative. This can be attributed to the fact that falls have devastating consequences on the older adults, in terms of their mortality, morbidity, and loss of independence (Howcroft, Kofman & Lemaire, 2013). Furthermore, a history of falls increases rates of hospitalisations in healthcare facilities, thereby accounting for adverse incidents. A comprehensive fall risk assessment will involve evaluation and treatment of Ms. Smith for falls. This assessment will be part of her overall geriatric assessment. The primary benefit of this intervention can be related to the fact that it will help in measuring her cognition, balance, gait, and mobility (Rantz et al., 2013). Although time consuming, the assessment will facilitate the identification of major intrinsic risk factors that might increase her likelihood of suffering from falls and fall related injuries.
Use of fall detection sensor- Automatic fall detection sensors will notify instances by detecting between normal activity and actual falls. These will comprise of an assistive device that will provide an alert when a fall has occurred. This is based on the potential to mitigate the adverse consequences of falls. Fear of falling are often associated with negative impacts such as, less physical activity, depression, social withdrawal, and poor quality of life (Rantz et al., 2015). Use of a wristband fall detector will focus on a movement sensor that will keep the patient under continuous monitoring. Bed alarms will provide an early warning related to movement of the patient from the bed, or wandering out for an exit. The alert will assist in quickly reaching for the aid of the patient, before a fall related event occurs (Mubashir, Shao & Seed, 2013). Thus, use of these detection sensors can be considered as essential nursing interventions as they will facilitate identification of all instances that involve an unplanned decent of the patient Ms.Smith to the floor.
References
Choi, J. S., & Kim, K. M. (2016). Predictors of respiratory hygiene/cough etiquette in a large community in Korea: A descriptive study. American journal of infection control, 44(11), e271-e273. https://doi.org/10.1016/j.ajic.2016.04.226
Howcroft, J., Kofman, J., & Lemaire, E. D. (2013). Review of fall risk assessment in geriatric populations using inertial sensors. Journal of neuroengineering and rehabilitation, 10(1), 91. https://doi.org/10.1186/1743-0003-10-91
Mubashir, M., Shao, L., & Seed, L. (2013). A survey on fall detection: Principles and approaches. Neurocomputing, 100, 144-152. https://doi.org/10.1016/j.neucom.2011.09.037
NSQHS Standards. (2018). Comprehensive Care. Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2017/11/Comprehensive-Care.pdf
Rantz, M. J., Skubic, M., Abbott, C., Galambos, C., Pak, Y., Ho, D. K., … & Miller, S. J. (2013). In-home fall risk assessment and detection sensor system. Journal of gerontological nursing, 39(7), 18-22. https://doi.org/10.3928/00989134-20130503-01
Rantz, M., Skubic, M., Abbott, C., Galambos, C., Popescu, M., Keller, J., … & Petroski, G. F. (2015). Automated in-home fall risk assessment and detection sensor system for elders. The Gerontologist, 55(Suppl_1), S78-S87. https://doi.org/10.1093/geront/gnv044
Saunders-Hastings, P., Crispo, J. A., Sikora, L., & Krewski, D. (2017). Effectiveness of personal protective measures in reducing pandemic influenza transmission: A systematic review and meta-analysis. Epidemics, 20, 1-20. https://doi.org/10.1016/j.epidem.2017.04.003
Tacconelli, E., Cataldo, M. A., Dancer, S. J., Angelis, G., Falcone, M., Frank, U., … & Singh, N. (2014). ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug?resistant Gram?negative bacteria in hospitalized patients. Clinical Microbiology and Infection, 20(s1), 1-55. https://doi.org/10.1111/1469-0691.12427
Warren?Gash, C., Fragaszy, E., & Hayward, A. C. (2013). Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review. Influenza and other respiratory viruses, 7(5), 738-749. https://doi.org/10.1111/irv.12015
Wong, V. W., Cowling, B. J., & Aiello, A. E. (2014). Hand hygiene and risk of influenza virus infections in the community: a systematic review and meta-analysis. Epidemiology & Infection, 142(5), 922-932. https://doi.org/10.1017/S095026881400003X
Wood, M. E., Stockwell, R. E., Johnson, G. R., Ramsay, K. A., Sherrard, L. J., Jabbour, N., … & Knibbs, L. D. (2018). Face masks and cough etiquette reduce the cough aerosol concentration of Pseudomonas aeruginosa in people with cystic fibrosis. American journal of respiratory and critical care medicine, 197(3), 348-355. https://doi.org/10.1164/rccm.201707-1457OC
Zayas, G., Chiang, M. C., Wong, E., MacDonald, F., Lange, C. F., Senthilselvan, A., & King, M. (2013). Effectiveness of cough etiquette maneuvers in disrupting the chain of transmission of infectious respiratory diseases. BMC public health, 13(1), 811. https://doi.org/10.1186/1471-2458-13-811
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