Role of Radiographer in the Areas of Infection Control and Prevention - Coursework Example

Role of Radiographer in the Areas of Infection Control and Prevention Introduction: Radiographers are in a unique position in the whole healthcare system due to the fact that they often perform the investigations that are use in diagnosis and followup of treatment in a diagnosed disease. As a result, this position can be precarious due to close association with the patient. The radiographers can function in the hospitals, nursing homes, freestanding surgical and outpatient centers, emergency care clinics, or during prehospital preadmission emergency care. Due to close proximity with the patients, there is a fair chance that the radiographer may need to handle blood, wounds, secretions, or other potentially infected materials as a result of direct contacts with them. They may acquire infections from or transmit infections to the patients, other healthcare personnel, household members, or other community members. Radiographers have the potential for exposure to infectious materials including body substances, contaminated medical supplies and equipments, contaminated environmental surfaces, or contaminated air. Since radiographers have contacts with patients and their bodies, especially while positioning the patients on the radiography table, they can contract or transmit infection through body surface, body fluids, specimens, or appliances, since this contact is not brief casual contact. Before enumerating the radiographers’ role in prevention, it would be thus worthwhile to classify the modes of transmission through contact since that would lead to specific roles in the radiography room. Direct contact refers to body surface to body surface contact and physical transfer of microorganisms between a susceptible host and an infected or colonized person. This can be exemplified by a situation when a radiographer performs a chest radiograph in a patient with empyema with a drainage tube. The chest drainage tube is potentially contaminated, and unless the radiographer exercises adequate precaution in handling the tube or if the radiographer does not wash his or her hands both before and after the procedure, either he/she may transmit infection to the patient’s pleural cavity, or he may contract an infection from the patient, or even he may transmit the contracted infection to the next patient radiographed. Indirect contact refers to contact of a susceptible host with a contaminated object. Contact with instruments or hands falls in this category. Droplet contact refers to conjunctival, oral, or nasal mucosal contacts with droplets containing microorganisms generated from an infected person by coughing, sneezing, and talking, such as, during radiography of an infected case that may be propelled for a short distance. Infections may be transmitted airborne, and this may transmit droplet nuclei containing microorganisms that may be disseminated through air currents. The radiographers should know that common vehicle transmission is a potential cause of spread of infection through food, water, medications, devices, and radiographic equipments (Guideline for infection control in health care personnel, 1998). The radiographers are particularly required to maintain, implement, and rigorously follow general medical aseptic techniques. These are simple to follow once the radiographer knows the principles of transmission of infection, and he/she would need to consider any patient to be potentially carrying infective agents or microorganisms that may prove harmful to other patients or himself/herself. Although by infection control guidelines, all radiographers are immunized against almost all potential pathogens, but they may serve as vehicles of transmission of pathogenic microorganisms to the immunocompromised, high-risk patients while performing a radiography unless the aseptic techniques are observed. The first step is to wash hands aspetically before and after handling a patient. Handwashing is often a neglected initial step in healthcare, and if routinely done, simple plain soap water handwashing can go a long way to prevent transmission of infection. The radiographer should also wear sterilized latex gloves in each radiography session, not only for personal protection, but also for the patient protection. Droplet infection can be minimized by use of cap and mask, and the use of appropriate uniform. Gamma-ray sterilized disposable set of uniform are very useful, and the radiographers must take adequate precautions while handling the appliances, secretions, drains, and equipments. Last but not the least, the radiographer must not forget that when he himself is having an infection he must abstain from work. The radiographers are at risk of occupational exposure to blood-borne pathogens including hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Exposure to the radiographers would most commonly happen from equipments contaminated with infected blood or through contact of the eye, nose, mouth, or skin with a patient’s blood. The radiographers can prevent such transmission by using safer techniques, disposing used and old and used equipments and needles in disposal containers, and using medical devices with safety features designed to prevent injuries. Use of appropriate barriers, such as, gloves, eye and face protection, or gowns when contact with blood and other secretions is anticipated can prevent many exposures to the eyes, nose, mouth, or skin (Exposure to Blood - What Health-Care Workers Need to Know, 2003). Radiographers must themselves be immunized against vaccine-preventable diseases. They must ensure that they are immune, and this is extremely essential. Optimal use of vaccines would not only protect the radiographers from a possible transmission while performing radiographic investigations, it would also prevent transmission of diseases and would eliminate work restrictions that would no longer be necessary. Prevention of illness through comprehensive immunization is far more cost effective than case management and outbreak control that may at all not be possible due to the severity of the disease and rapidity of spread in the hospital patients (Immunization of Health Care Workers MMWR, 1997). Dress in work place is extremely important for the radiographers. First, the radiographers must follow the radioprotective dress protocol to prevent radiation exposure. Apart from that, it is important for them to be aware of the fact that microorganisms present on the patient’s skin or that have been shed onto inanimate objects in close proximity to the patient must be transferred to the radiographer’s hands. These organisms may be capable of surviving for at least several minutes on the hands of the radiographer. If the skin coverage of the radiographer is incomplete, inadequate, or is omitted, or if adequate care or precision is not exercised in appropriate handwashing, the contaminated skin of the radiographer serves as the vehicle of transmission of the pathogen to other patients or to the community. Healthcare-associated pathogens can be recovered not only from infected or draining wounds, but also from frequently colonized areas of normal, intact patient skin. For positioning the patient on the radiographic table, the radiographers frequently handle axilla, groin, trunk, and extremities that are heavily colonized, and the environment of the radiography room can also be heavily contaminated (Guidelines for Hand Hygiene in Healthcare Settings-2002). Therefore, the radiographer must wear shoes that are fully covered, hair must be clean and covered by cap, and fingernails must be properly trimmed and preferably no nail-polish is used. Plain soap hand wash or hand wash with an antiseptic agent, such as, 60% to 95% alcohol hand rub can effectively decontaminate the hands. Many antimicrobial substances are applied to the skin, and the radiographers can use alcohol, chlorhexidine, or other such substances to reduce the number of microbial flora. Along with that after hand drying, the radiographer should wear protective gloves to prevent contamination, transmission, and infection by microorganisms of self, the patient, or other personnel. This in itself is a great preventative measure. This procedure would need to be more stringent while handling any equipments, drains, catheters, vascular catheters, or when there is a potential contact with body fluids, excretions, mucous membranes, or wound dressings (Guidelines for Hand Hygiene in Healthcare Settings-2002). To conclude, the radiographers can deploy the Center for Disease Control guidelines in practice in an efficient manner, just by following certain practices as outlined above, and that is possible by awareness about the principles of transmission of infection by contact transmission. References Guideline for infection control in health care personnel, 1998, accessed from http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/InfectControl98.pdf on November 2, 2007. Exposure to Blood - What Health-Care Workers Need to Know, 2003 http://www.cdc.gov/ncidod/dhqp/pdf/bbp/Exp_to_Blood.pdf accessed on November 2, 2007. Immunization of Health Care Workers MMWR, December 26, 1997 / Vol. 46 / No. RR-18 1997. http://www.cdc.gov/mmwr/PDF/rr/rr4618.pdf. accessed on November 2, 2007. Guideline for Hand Hygiene in Health-Care Settings, Recommendations and Reports October 25, 2002 / Vol. 51 / No. RR-16; http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf, accessed on November 2, 2007. Read More