The Risk Management Of Infection In Burn Unit - Coursework Example

The Running Head: Consequences of HIV on Health Workers     Your name:   Course name:             Professors’ name: Date: Identification of Risk Factors The advent of HIV within the hospital and laboratory setting has seen a great number of health workers infected through coming into contact with blood from the infected persons (Godwin, 2008). Many workers have reported of instances of infection though exposure to needles used to inject infected patients. The transfer of blood from the patient to the care giver is through percutaneous injury which exposes the body of the care giver to traces of blood of the patient. In most cases this injury could be as small as a skin crack or could be a big deep injury leading to faster spread of the disease (Bennett,2005). There are also instances where HIV infection can be passed to the health worker through mucocutaneous exposure. Research has shown that most infections to health care workers can be prevented through better awareness programs that teach them on how to react under such extreme situations. Through immediate washing of the infected area with soap and water, health care workers can greatly mitigate the chances of them being infected with the disease (Bennett,2005). Health care workers have been shown to be at a much higher risk than the general population in contracting the deadly virus especially where the percutaneous injury is much bigger (Seymour, 2005) . Below is a table that illustrates the occupation of health workers within the Hospital and the documented transmission as opposed to the suspected rate of transmission A study conducted in St. Nicholas Burns Unit concluded that health workers were at a higher chance of contracting the virus due to the open wounds that the resident health workers have to dress on a daily basis. This puts them in the frontline and exposes them to the risk of contraction. If proper procedures are not followed by the personnel in dressing the patients, It has been reported that the virus contributes to a big percentage of infections in the hospital setting. Application of pressure around the area of injury to promote bleeding is encouraged as this will stop the spread of the infected blood around the body (Grant, 2009). This paper will set out the role of different organizations in Australia in their attempts to mitigate this risk following the various different risk management processes. Levels within St. Nicholas Hospital Discussing from a corporate level, the department of health is tasked with the responsibility of enforcing legislations geared towards promoting the health of workers all across Australia. The same legislations also apply to health workers working in these hospitals. The Occupational Health and safety Act of 1991has established standards to be followed by all corporations (Cieri,2007). If these standards are well implemented, there is a lower chance of health workers within the Burn unit contracting HIV and other related complications. The way patients are to be taken care of is well illustrated under the Handling People Code of Practice 2001 (Cieri, 2007). This code ensures a fair standard is followed by all employers irrespective of the industry that they work in. If any entity does not follow these rules, they are liable to prosecution from the government and this is usually accompanied by hefty fines (Gottlieb, et al., 2004). Although it is common sense for all employers to take care of their most valuable resource labor, the department of health has realized that in some instances entities are not ready to care for their workers and protect them from risks that they could be exposed to in their work environment (International Labour Office, (2008). In our case, the department of health in collaboration with the hospital conducts regular audits to confirm that various practices are being followed. The government has made it mandatory for all employers to offer insurance to all employees. Insurance companies calculate premiums based on the exposure of employees to risk and in Australia, they have made it necessary for firms and hospitals in particular to have risk management programmes in place in order for them to be covered (Bohle, 2005). This not only reduces the chances of risks occurring in those entities but it also reduces the amount of money paid out in the form of premiums. When discussing about health workers, legislations have been put in place to ensure that they are provided with prevention kits such as gloves and coats that will be able to prevent them coming to direct contact with victim’s blood (National Health and Medical Research Council (Australia), 2009). Training of staff on what to do when the risk has occurred has also been made, a requirement in all hospitals. Institutions that do not implement these legislations are liable to hefty fines and to some extent closing down of the institution. It is not enough for the corporate bodies to have risk management programs but it also entails them to subscribe to bodies that are able to conduct sound and correct auditing in regard to how the program is run within the organization. In conjunction with corporate bodies, the health department is also responsible in coming up with policies and strategies that will ensure that the workplace and especially a hospital setting is safe and secure from all risks (Mayhew,2007). In our burn unit, the hospital should be at the forefront in coming up with better ways in which the risk of infection of HIV is completely eliminated. As we all know that HIV has no cure and no matter what kind of compensation from insurance or the hospital itself, its effects are far reaching and the consequences of infection not only affects the health worker but also their family (Godwin,2008). It is hence necessary that we prevent the workers from being infected at all costs. The risk management program should involve members of all departments within the hospital coming up to set up a task committee to look into how members within their departments are exposed to risks and which risks are most prevalent. Reporting of any risk should also be made obligatory, when all these risk factors are collected, reports into the nature and level of exposure of each health worker should be made in order to ensure that they form a basis in the creation of policies on how to prevent them. These policies should also include training programs for all employees within the hospital regardless of age, seniority, gender or race. The policy should be implemented on a step by step manner starting with senior managers who will later train junior members of staff. It should clearly state the cost of the programs including purchasing of the equipment and hiring auditing firms (Palmer,2009). Examples of what they will be taught on how to prevent themselves from HIV could be how to wash their hands after getting into contact with the patient’s blood and body fluids, how to apply safe systems when disposing off waste. At the management level, the staff should elect a representative from their departments whose task will involve the recognition of risks within their departments and offering advice to members of the department on how to prevent them from getting infected. It is also their responsibility to inform the patients on how best to cope with their injuries while at the burn unit. Meetings between management and the task committee must be held often so as to ensure that control measures are being followed. With a clear frame work and strategy in place the hospital will be at a better position to address the inherent risk. Each report of HIV infection should be reported by the health worker without any fear and a confidentiality clause should be invoked in order to protect the HIV health workers from being biased by fellow health workers or by management (Waters, 2007). At the departmental level, such as the burn unit, the department head has the responsibility of scrutinizing incidences of risk exposures within the department. The responsibility of the head will be to ensure that apart from members of the department achieving the key performance indicators set out by the management, they should also protect themselves from infections from patients. Initiatives geared towards the prevention of infection should be spear headed by the head of the department. The department head should guarantee that each and every member attends training and is able to implement the knowledge learnt (Mayhew, 2007). Being the head of the department, the manager is also liable to report these incidences to management. On the level, of the individual health worker, they should take the responsibility of preventing infection unto themselves. The worker should be able to use the provided equipment that has been provided by the institution as they will be the ones to bear the full brunt of effects of infection if instructions are not properly followed. These instructions include training they have acquired on how to deal with infections and policies that have been set out by the department of health. It is the responsibility of the worker to report any incidences of near or actual infection. Identification of Risk With the issue of staffing in Australian hospitals, it is important for the government and the hospitals to prevent all manner of risks that its workers may face. Critical departments such as the burn unit require specialized staff and it is a big loss to lose of even one staff for a few days as their services are critical to the survival of patients. HIV infections among health workers in the burn unit is a cause for concern and risk management policies should focus more on prevention of the disease through training of staff and offering a conducive working environment that enables workers to report any cases of any suspected infections. The impact of one staff leaving the hospital is directly felt by everyone (Bennett,2005). The Human immunodeficiency virus and is responsible for the syndrome known as AIDS (acquired immunodeficiency syndrome). The virus reduces the capacity of the human body to fight off diseases and other life threatening infections. It is transferred from one person to the other through exchange off bodily fluids such as blood, semen or breast milk, medical practitioners risk their lives when performing surgeries and other orations where blood is involved as they can easily contract other diseases including the virus. Although not many cases have been reported, it is suspected that many health workers have contracted the disease during their time while practicing their profession (Godwin, 2008). The fear of reporting stems from the perceived bias from colleagues and patients, they are likely to face. The virus was discovered in 1981 and by the year 1986, the virus had claimed over twenty five million lives and this represents about 0.6 % of the earth’s population. A good majority of people infected with the virus reside in Africa and other parts of the developing nations. It is the health workers practicing their profession in these nations who are at most risk from infection. We all know that medical facilities in these nations are lacking and equipments & kits for the staff to protect their workers in the hospitals are also lacking, it is hence appropriate for every medical facility to come up with clear policies and strategies that can best reduce the chances of infections being passed between the patient and the caregivers. HIV develops into full blown AIDS and increases the chances of opportunistic diseases (Godwin,2008). From a patient point of view, the risk of infection could also be viewed that the care giver could be the one with the virus in the first place but all in all also the patient should be dressed well and should also be handled well by the caregivers responsible. If both of them are well dressed and for the hospital environment then the chances of infection are likely to be lowered significantly. Also the policies set out by the hospital are also meant to protect the patient from any infection. The chances of a patient contracting the disease from a health worker are lower than when infection is from the patient to the health worker (Workplace Health and Safety Queensland, 2006). Repercussions of the patient contracting the disease are major as it may lead to the closure of the institution or even bad press which can still lead to the closure of the institution due to low revenue acquired. It is hence the work of the risk management staff to handle issues that can arise from such occurrences. The staff is to also deal with litigations that are likely to occur from such incidences. The impacts of the disease on the patient is also great as it means that additional cost in terms of health care and most of the time patients are found unprepared when disaster strikes. The virus incapacitates the patient hence making them dependent on their relatives. This can place an emotional strain on the family. The patient may fall into depression as they have a low self esteem. From the perspective of the health worker, the disease may render them jobless and this affects their families as it reduces the earning capacity of the family they are coming from. Apart from the death of the health worker, the family is bound to be affected psychologically as they may be also at risk from the virus infection as they could have shared (Godwin, 2008). It is reported that approximately about 5% of all the health workers in the Australian hospitals have reported of possible infections form patients. The impact of the disease on other employees and the company in general is also big. The disease promotes tension in the workplace. The institution will be impacted negatively as it will mean that lesser patients will be able to be treated at the same rate as when the health worker is around. The hospital will have to cough out more in terms of cash to compensate the health worker or the patients when this happens (Gottlieb, et al., 2004). When the incidence is about infection from the health worker to the patient, the hospital will have to settle e with the patient before they decide to sue the company. This will mean the hospital parting with a large amount of money. Lack of staff in any hospital can likely lead to other members feeling stressed as they feel overworked and taken for granted. All these risks are managed by the risk management committee (Crouhy, 2001). The risk to the corporate governance is immense as the cost to the insurance cover of the health worker is on both direct and indirect basis. The amount lost in the form of wages due to the sick nature of the worker will reverse the positive trends that the hospital may be striving to achieve. This coupled with the cost of rehabilitating the worker will impact the hospitals’ bottom line. Premium to the workers will be committed and this will also be hinged upon the willingness of the insurance firm to compensate the health worker (Bohle, 2005). As we all know that as the number of claimants’ increase, so does the amount of premiums that the hospital will have to pay to the insurance firm. It is hence a wake up call to the corporate governance to set up risk management teams or to boost current existing ones to be better at preventing and handling risks. There are some instances where the hospital may avoid reporting incidences to the insurance firm in cases where they may feel that they may be obliged to have their premium increased (Stellman,2008).Insurance firms are charging hospitals up to 60% increase on their premiums on new claims. Likelihood and Consequences of the Risk As a burns unit department we must be able to investigate and scrutinize the nature of the risk and when it is most likely to occur. In this analysis, a series of computations are carried out and consequences of the risk are also considered. The consequence of the HIV virus occurring within the hospital setting is loss of strength of the individual who could be either the patient or the health worker and the most severe consequence would be the actual death due to infection. This risk can result in major financial, medical and emotional implications for the persons and organizations involved. All the consequences have been discussed in latter discussions through the paper and it is of no use repeating abut in summary we can only say that the consequences of HIV infection in the hospital environment has damaging impact (Stellman, 2008). In our discussion of the likely hood of the risk occurring, the risk management team has to consider the frequency in which the health worker comes into contact with a HIV positive patient. In a typical urban Australian hospital the health worker may on average times attend to 20 patients in a day and out of all these patients there are about two patients who may be having the deadly virus hence the likely hood of the health worker contracting the disease are high. If this is done on a daily basis for about six days a week and considering the high number of health workers attending to the numerous patients all across Australia, then we are talking of many health workers at risk from infection. The risk is multiplied every time any patient is handled (Bohle,2005). Considering the role of the health worker in the society, then it will be disastrous to the economy and the lives of the citizens if even one health worker succumbs to the virus. The department of health in conjunction with the organization has come up with legislation that will lessen the effects of the risk occurring by a significant percentage. Control Measures Control measures within the hospital are wide and varied according to the policies set out by the medical institution itself. What may apply to one institution may be totally unacceptable or similar to another. The success of each control measure should be assessed on the basis of facts and data collected by the risk management team. The policies set out should be able to address the challenges currently facing the handling of risks by all parties including patients, health workers, the management and the government departments (Mayhew, 2007). In the case of St. Nicholas burns unit, members of the department are required to undergo specialized training on how to best handle victims who have undergone burn injuries. In most cases such victims may display open wounds that are susceptible to spreading blood to others who come into contact with them through an open wound that may not be covered by protective clothing such as gloves and lab coats (Seymour,2007). Previous Risk Occurrences Historical occurrences of risks in the burns department should be clearly documented as required by the workplace health and safety act of the year two thousand and one (Workplace Health and Safety Queensland. 2006). Studies conducted within the burns unit demonstrate that the occurrence of the risk of HIV infection is medium. Considering that data collected in the previous years have shown that a greater number of the hospital’s HIV infection among health workers. In St. Nicholas hospital the prevalence rate of HIV infection which was at 7% was attributed due to the occupational risk that the health worker faced and infection was caused by exchange of bodily fluid from patients or colleague health workers. This contrasted data collected across other departments within the medical institution. Below is a table comparing the different departments within the hospital (Palmer, (2009). Occupation Documented Occupational transmission Possible Occupational transmission Dental Worker including dentist 0 6 Embalmer/morgue technician 1 2 Paramedic 0 12 Health Aide 1 15 Hospital maintenance officer 2 13 Clinical Lab. technician 16 17 Nonclinical Lab technician 3 0 Nurse 24 35 Non surgical Physician 6 12 Surgical Physician 0 6 Respiratory therapists 1 2 Dialysis technician 1 3 Surgical technician 2 2 Burns Unit technician 0 9 Other health care professionals 0 6 Total 57 140 We must take into considerations errors in the above table as we are assuming that all the health workers reported all the cases of infection to the risk management task panel. We are expecting that all these number will be used to sensitize the health workers of the risk they pose themselves when they do not follow the rules and guidelines (Palmer, (2009). Strategy The risk management team is responsible in discussing present and effective strategy to form a better understanding of the problem at hand which is causing the members of the hospital to remain on edge (National Health and Medical Research Council (Australia), (2009). Conclusion We cannot conclude report without mention on the fact that the risk management is solely responsible for majority of all these tasks in addition to coming up with the required funds that will be used to drive more activities geared towards prevention of the virus within a hospital setting. Read More