Prevention of Sepsis in the Clinical Setting - Research Paper Example

? PREVENTION OF SEPSIS IN THE CLINICAL SETTING Introduction Sepsis and septicemia are medical conditions that involve widespread infectionand inflammation in a patient. Sepsis involves an inflammatory response of the whole body due to an infection in a part of the body that needs treatment so as to resolve the sepsis. Septicemia, on the other hand, refers to the presence of an infection in the blood, which in turn is a potential cause of sepsis. The two terms are sort of related hence the use of the term septicemia is commonly avoided in clinical practice because of the confusion about the definition. Similar treatments are used for the cure of both sepsis and septicemia since both of them are normally associated with the presence of aggressive bacteria in the body system of a patient. This requires treatment using strong antibiotics to fight the infection. Patients may also be admitted in ICU for a while so as to monitor the treatment of the infection. Patients suffering from sepsis may experience multi-organ failure since the inflammation spreads and generates a cascading sequence of medical problems as the body tries to fight off the infection (Brozanski, 2003). Prevention of Sepsis There is a common term people in the medical field love to use and it goes, “Prevention is better than cure.” This is quite true since curing an infection is expensive both on the hospital and the patient. It requires a use of resources that would otherwise be used for other reasons. This therefore calls for infection control a discipline that targets the prevention of healthcare-related infections. There are a number of factors that may lead to the spread of infections in a clinical setting. The infections maybe from patient to patient, from staff to patient, from patient to staff, and from staff to staff (Dyson & Singer, January 2009). There are a number of ways of preventing sepsis, but the most common and effective way is by ensuring hand hygiene, and this is done by constant hand washing. Hand washing In the clinical setting, hand washing is commonly known as the primary weapon of fighting infections. The main reason for hand washing is to reduce microbial in the healthcare setting so as to reduce the risk of nosocomial infections. Hand hygiene may be a major problem in gigantic health facilities in which several patients are treated and in rapid succession. Infection control is meant to reduce the spread of infection and provide a safe environment for every patient (Riedeman, Guo, & Ward, 2003). This has become extremely necessary due to the emergence of antibiotic resistant organisms. Examples of antibiotic resistant microorganisms include methicilin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). It is vital to note that there is evidence that shows that removal of antibiotic resistant organisms (AROs) from the hands by washing with detergent or soap and water is less effective than by the use of an antiseptic agent. For that reason, an antiseptic agent must be used in high risk areas within the clinic, with high risk patients especially those suffering from immune-deficient disease, and with known antibiotic-resistant organism patients. High risk areas within a healthcare facility include areas such as intensive care units, burn units, hemodialysis units, transplant units, hematology units and oncology units. High risk patients within a healthcare facility were identified as those patients receiving multiple antibiotics or repeated treatments, patients who have had a prolonged stay in hospital and finally those patients with frequent admissions in hospital (Wang, Dorer, Fleming, & Catlin, 2004). There are a number of reasons as to why clinical personnel should always wash their hands. Firstly, personnel must wash their hands before performing any invasive procedures such as surgery. Personnel should also wash their hands before taking care of principally susceptible patients such as those suffering from immune-deficient diseases and newborn babies. Personnel must wash their hands before and after touching wounds, whether the wounds are surgical, traumatic, or associated with invasive surgery. Personnel should also wash their hands after coming into contact with mucous membranes, body fluids or blood, and excretions or secretions. Hands must also be washed after touching inanimate sources that may be contaminated with epidemiologically significant or virulent microbes; these sources include urine-measuring devices or secretion collecting apparatuses (Brozanski, 2003). Curiously, drying of the hands after washing them is an essential part of hand hygiene. A study shows that the number of bacteria levels that remain in the hands vary with the method of drying whether, by the use of paper towels, warm air hand dryers, or modern jet-air hand dryers. Research shows that the use of paper towels reduced the total amount of bacteria on the hands. Sterilization, disinfection and cleaning. Sterilization is a means of killing all microorganisms and is considered the best means of killing microbial. There are a number of means for sterilization and they include direct heat, steam or a liquid chemical such as ethanol or disinfectant. The use of direct heat is used to sterilize metal equipment in the hospital especially used for surgery, these medical equipments may include scalpels. Dry heat sterilization is normally performed in ovens at a temperature of 121 degrees centigrade for a minimum of 16 hours. It is vital that after sterilization these equipments are kept sterile to prevent contamination before their use (Dyson & Singer, January 2009). Disinfection, on the other hand, is the utilization of liquid chemicals to destroy disease causing microbes at room temperature. This means of killing microbes is less effective than sterilization since it does not kill bacterial endospores. Chemical sterilization can also be called cold sterilization, and is normally used to sterilize equipment that can be destroyed by heat. Different concentrations of the chemical disinfectant requires different periods of disinfection. For example 2-4% formaldehyde solution requires a minimum of 10 hours soaking, while 8% formaldehyde requires a minimum of 24 hours soaking. It is vital to note that there are four main ways of sterilizing medical instruments, and they are autoclaving, which is the use of high pressure steam to kill microorganisms, by use of dry heat in an oven, by the use of radiation especially gamma rays, and finally, by use of chemical sterilizers such as formaldehyde and glutaraldehydes. Autoclaving and use of dry heat are the most commonly used methods in a clinical setting and most hospitals have their own autoclaves and ovens for this purpose (Parliamentary Office of Science and Technology, 2005). Autoclaving or steam sterilization is normally done in certain conditions. The temperature of super-heated steam is normally 121 degrees centigrade at a pressure of 106kPa. The medical equipment need to be sterilized under these conditions for roughly 30 minutes to kill all germs. There are other means of steam sterilization such as the use of double pressure. Use of Personal Protective Equipment. Personal protective Equipments (PPE) are special types of attire or apparatus that are worn by medical workers to protect themselves possible infections. This is because healthcare workers are exposed to several hazards due to exposure to blood, saliva, and other bodily fluids such as sweat and urine that may be carrying infections. Personal protective equipment include apparatus such as face shields, gloves, gowns, CPR masks, goggles, surgical masks, shoe covers, bonnets, and respirators. These equipment help protect the introduction of infection into the body through the skin barrier or respiratory system. It is regulation that healthcare workers immediately remove and dispose of personal protective equipment before leaving the work area where exposure to infectious material took place (Wang, Dorer, Fleming, & Catlin, 2004). Vaccination of Healthcare Workers. Health workers are normally vaccinated against diseases especially when there is an outbreak of a certain disease. This is because during an outbreak health workers are constantly exposed to infected patients in an attempt to treat their illness. There are a number of diseases healthcare workers may take vaccinations and they include; influenza, common flu, tuberculosis, hepatitis B, mumps or rubella, Tetanus, N. meningitides, and diphtheria. Vaccines are not completely safe, and there is the potential of some individuals having adverse effects to the vaccine (Riedeman, Guo, & Ward, 2003). References Brozanski, B. S. (2003). Prevention of Early-onset GBS Sepsis: Evaluation of a Changing Paradigm. Journal of Perinatology , 263-264. Dyson, A., & Singer, M. (January 2009). Animal models of sepsis: Why does preclinical efficacy fail to translate to the clinical setting? Critical Care Medicine Volume 37 - Issue 1, 5-17. Riedeman, N. C., Guo, R.-F., & Ward, P. A. (2003 August 15). The enigma of sepsis. The Journal of Vlinical Investigation , 460–467. Parliamentary Office of Science and Technology (July 2005). INFECTION CONTROL IN HEALTHCARE SETTINGS. Postnote , 1-5. Wang, M. L., Dorer, D. J., Fleming, M. P., & Catlin, E. A. (2004). Clinical Outcomes of Near- Term Infants. American Academy of Pediatrics , 3-9. Read More