Infection control:nosocomial infections - Essay Example

? INFECTION CONTROL: NOSOCOMIAL INFECTIONS Nosocomial infections or hospital-acquired infections (HAI’s) are health risks that can affect patients within healthcare facilities or organizations, represented by examples such as catheter-associated urinary tract infections, surgical site infections (SSI), and ventilator-associated pneumonia (VAP). As medical community members interacting frequently with different patients at any given time, nurses have a major role in the reduction and prevention of these infections and keeping the patients’ wellness by following aseptic protocols in personal hygiene and providing care to various patients, proactively participating with other healthcare personnel in such efforts, as well as educating every patient with aseptic techniques not just to prevent them from infecting others but also to avoid getting infected as well. Infection Control: Nosocomial Infections Many microbiologists were able to discover the route of disease infections since the late 19th century, and the knowledge that they were able to gather based on how bacteria and other pathogens are spread as well as in preventing these agents from becoming transmitted to others is now known to be the practical but important field in medicine as infection control. However, even when the modernization of medicine has been possible during the last century, there are still numerous infections happening worldwide, with the most significant and lethal ones occurring within the hospital settings. These infections are called nosocomial infections, also known as hospital-acquired infections or HAI’s and patients as well as hospital workers can get affected, but with greater risks to the patients (Doran, 2011). Such kind of infections happening in hospitals or health care settings often happen when there is a pathogenic contamination during procedures that bypass the normal defenses of patients by cutting through the skin such as in surgical or operative procedures, and in the insertion of foreign materials into the body such as catheters and artificial ventilations. Other ways by which such infections could become transmitted to patients are when health care workers such as nurses or aides constantly interact with different kinds of patients, and harboring some pathogens such as bacteria, viruses, or fungi along the way (Headly, 2012). In any kind of situation, the transmission of HAI’s among various patients can pose significant health risks, especially among those with weaker immune systems, which brings up the importance of the prevention of HAI’s from spreading within hospitals and beyond. In this light, nurses have a major role in the prevention of such infections from happening by performing aseptic techniques when interacting with each of their patients, collaborating with other healthcare workers in preventing the spread of diseases, as well as educating the patients and their families in the importance of disease prevention and contracting infections within and outside the hospital settings (Vandjick, et al., 2010). By being proactive in breaking the chain of infection among patients and hospital personnel, nurses could not only give better care among patients but also keep their wellness by keeping them comfortable and their bodies healthy as well as continually recovering without having to suffer additional diseases before and after leaving the health care facility. Nosocomial Infection Research The increase in the interest on nosocomial infections or HAI’s was borne out of the increasing incidences of antibiotics having no effect on some bacteria found within hospital settings such as methicillin-resistant Staphyloccocus aureus (MRSA) and Clostridium difficile, among others (Headly, 2012; Upshaw-Owens & Bailey, 2012). Infection control programs were initiated to effectively-reduce the onset of HAI’s, and precautionary measures such as wearing personal protective equipment (PPE) which include the use of disposable items like gloves, goggles, and face masks were integrated into these procedures, along with the increased use of intensive care units to isolate immune-compromised patients, and countering the spread of drug-resistant pathogens (Doran, 2011). One of the most well-known and important procedures in the prevention of HAI’s is frequent hand washing and disinfection, wherein the compliance to the procedure has been known to cause significant improvements in the incidences of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI), as well as in the onset of surgical site infections during operative procedures (Browning, et al., 2012). By incorporating aseptic techniques in such procedures as well as with patient interactions, it is expected that there would be higher chances to prevent mortalities and morbidities among patients by blocking all potential sources of infection from reaching other patients, especially those with greater susceptibility such as infants, geriatric patients, and those with weak immune systems (Dunn-Navarra, et al., 2011). Isolation in various forms is also effective in preventing the onset of HAI’s among patients. Intensive care units (ICU’s) are made for this purpose through mandatory wearing of PPE’s when interacting with patients. The room itself is made to block the entry of foreign particles which could affect the health of patients, separating them from others and increasing the chances of HAI’s from entering the premises (Doran, 2011). Nurses and other healthcare personnel are not exempted from the use of PPE’s since they could also harbor pathogens due to the mobile nature of their jobs. But isolating patients is not just the way by which HAI’s can be prevented, and there are simpler methods to prevent these even without the constant use of PPE’s. For example, hand hygiene is in itself a form of isolation by removing pathogens from nurses’ hands, thereby isolating these disease agents from potential hosts. Most findings regularly stress that hand washing is one of the most important components in the prevention of HAI’s since most pathogens are removed from the hands through such measures (Dunn-Navarra, et al., 2011). Experiments regarding the adherence to hand washing and disinfecting procedures were able to gather sufficient data that would support the claim that frequent hand washing can reduce the onset of HAI’s by up to a third, and not following such aseptic procedures could cause high levels of mortality among patients despite the preventable nature of HAI’s within hospital settings (Randle & Clark, 2011). However, there were other reports suggesting that only around 50% of hospital personnel, including nurses in actively-participating in frequent hand washing and other hygienic procedures, which suggests that there is a lack of active participation in most personnel despite the numerous data surrounding on the importance of hand hygiene (Dunn-Navarra, et al., 2011). This may not seem like a big problem but still, hundreds of thousands of Americans die each year due to HAI’s, and these would have been reduced or even prevented if the personnel were proactive in aseptic techniques when dealing with many patients (Machan, 2012). Nurses have an active role in tending to various kinds of patients, and thus their knowledge and attitude towards keeping up with hygienic and aseptic practices is vital in the prevention of high mortality and morbidity rates among hospital patients (Randle & Clark, 2011). Relationship to Roles of Nurses The provision of care by nurses is not limited to committing to keep the patient comfortable and giving correct medications every time, but also avoiding potential health risks such as transmitting infections from patient to patient or from healthcare personnel to patients, or vice-versa (Vandjick, et al., 2010). This is their role in being a provider of care among the ill. Having sufficient knowledge on how HAI’s can affect patients and hospital workers alike can affect greatly a nurse’s attitude on being constantly vigilant in adhering to aseptic protocols both in personal hygiene as well as when dealing with multitudes of patients within hospital settings. Also, the adherence to such procedures and protocols increases the value of nurses by being agents to the prevention of the onset of HAI’s such as diarrhea from C. difficile to patients by having the ability to block the chain of transmission of diseases in many ways (Headly, 2012). One example is by properly disinfecting the hands, which are the most contaminated parts of the body since it often the body part with most proximity to patients, as well as constantly holding on to things that are frequently in contact with contaminants, such as doorknobs, bed rails, and light switches. By disinfecting the hands often, especially before and after visiting each patient, pathogens that could potentially transfer to others can be eliminated before these could further affect others. Another example of preventing the spread of HAI’s within hospital settings, before interacting with severely-immune compromised patients, nurses have to thoroughly wash hands as well as wear PPE like face masks or gloves that not only prevents the transmission of pathogens to patients, but also to prevent the transmission of infection agents from patients to nurses (Doran, 2011). By reducing the chances of infecting and getting infected, nurses can reduce the chances of both infecting other patients as well as getting infected themselves. Another example is by performing aseptic techniques before, during, and after assisting in surgical procedures. This is vital especially since the patient has lowered immune defenses due to having the skin broken and the internal organs exposed to the environment (Machan, 2012). Lastly, in inserting foreign objects into patients that need assistance in breathing or expelling urine, additional precautions must be made such as keeping all equipment to be used as sterile as possible, aside from the mandatory hand disinfection so as to prevent the entry of bacteria and other pathogens through the catheter or the breathing tube or through the urethra or the windpipe, respectively (Upshaw-Owens & Bailey, 2012). The second role of the nurse in preventing the spread of HAI’s is by collaborating with other healthcare personnel in its prevention and reduction. It is important that aside from creating a set of instructions and protocols that are acceptable and easy to follow among all hospital staff levels, there must also be sanctions so that everyone within the hospital or health care settings would be prompted to follow (Browning, et al., 2012). For the nurses, these would include following regulations on antibiotic usage and strict adherence to practices concerned with controlling the spread of infections such as hand hygiene and the proper disposal of used medical devices such as syringes and other items not made for reuse. It is imperative that aside from strictly following aseptic protocols, nurses must also combine frequent hand disinfection as well as careful administration of antibiotics to patients so as to prevent disease transmission and the creation of antibiotic-resistant bacterial strains such as MRSA, which would cause high rates of mortality especially when the affected patient is already immune-compromised (Upshaw-Owens & Bailey, 2012). By making the rules available to everyone as well as having them understand the importance of following these, such procedures could thoroughly eradicate the chances that pathogens would become transmitted from personnel to patient or from patient to patient. The third and last role of nurses is as a member within the nursing discipline comes with this responsibility of continuously learning new ways by which infections can be transmitted as well as prevented by being proactive in learning and getting education from updates such as new researches and evidence-based trials (Randle & Clark, 2011). This role is deemed important especially with the rise of numerous pathogenic strains that have high-resistance to numerous antibiotics such as MRSA and Clostridium difficile. Nurses not only block the chain of disease transmission through hand hygiene but also do this by effectively educating the patients to do aseptic techniques as well. In extending their knowledge to others, nurses have the vital role of teaching the patients their own roles in the prevention of transmitting and acquiring infections themselves, but also they can become aware of simple things that could actually pose as potential health risks for them, even more so when they have decreased immunological functions themselves (Doran, 2011). Nurses also have the responsibility to be constantly updated with new information regarding the prevention of disease transmission and following protocols set forth by the hospital or other governing agencies such as the Centers for Disease Control and Prevention (CDC) in preventing some infections incurred within hospital settings (Browning, et al., 2012). This gives much more importance not just to the nurse’s role in preventing HAI’s but also increasing the value of hospital care by preventing disease and infection transmission. Application to the Self Learning the importance of being fully aware on how HAI’s can affect patients is very important for nursing students to remember in their profession because they interact with patients more often than other healthcare workers, which increases their chances of harboring diseases and passing these onto others, not just co-workers but also to other patients. This is exemplified by them constantly checking the vital signs of each one and giving them their regular medications, and by moving from one room to another. Since the roles of nurses is not limited to checking for vital signs and administering drugs, they also have to make sure that the patients are comfortable and giving them support during their hospital stays. This includes the prevention of HAI’s while within the health care premises by making sure that no pathogens are transmitted to patients, especially among immune-compromised ones. Nurses being proactive in performing aseptic techniques have major impacts both with patient interaction as well as in their personal lives because the effects of these skills are not limited within hospital settings, but also when they deal with lives outside the hospital. Similarly in the hospital where there are various kinds of patients and severities of diseases, nurses could also get infected from environments other than inside the health care facilities, especially when they go to public places with high potentials of individuals unwary of spreading their infections to others. By having sufficient knowledge about disease transmission, nurses could also prevent themselves from being infected and getting diseases even through simple washing of hands before eating or covering their mouths and noses when other people suddenly cough or sneeze. It can be said that in practicing such skills both in the hospital and outside the nurses can learn these aseptic skills by heart, which could help them become much more effective agents in blocking most HAI’s from spreading and causing additional problems to many patients that they take care of. Conclusion Hospitals and other health care facilities are built in order to help patients recover quickly through the use of different equipment and the service of health personnel, including nurses. However, health risks such as nosocomial infections or hospital-acquired infections (HAI’s) are also present that can affect many patients, and the transmission of such infections is more often than not facilitated by the improper hand hygiene and aseptic techniques of various personnel. Examples of such infections are catheter-associated urinary tract infections, central line-associated bloodstream infection (CLABSI), surgical site infections (SSI), and ventilator-associated pneumonia (VAP), which are all preventable if there is strong adherence of frequent hand washing and the use of protective personnel equipment among nurses or other health care personnel that interact with them. In particular, nurses have a major role in reducing and eradicating these kinds of infections since they are most often the ones tending to patients and also has greater liabilities of bringing in and taking out bacteria or other infection agents. They can avoid the spread of such infections by following aseptic protocols in personal hygiene while providing care to various patients. Nurses can also be proactive in participating with the development of aseptic protocols as well as strictly following them, and also educating themselves constantly about the recent developments in the field of infection control. It is also important that nurses are able to disseminate such information not just to their patients but also to their respective families so as to prevent becoming infected or infecting others. By taking pre-emptive measures in performing the three roles of nurses in caring for their patients, not only would they be able to prevent morbidity and mortality among patients, but also they could keep the patients comfortable and allow them to keep recovering, which are important in the preservation of the health and wellness of these patients. It should be noted that disease prevention is not limited within the hospital but also outside in public settings since there are more people and thus more sources of potential infection. Thus hygienic and aseptic skills are also relevant to nurses since the knowledge of such things can be applied to both within and outside the workplace, which not only keep their patients healthy but also their selves. References Browning, M., Lough, A., & Wright, B. (2012). EB103 reducing nosocomial infections by creating an infection control committee in the surgical intensive care unit. Critical Care Nurse, 32(2):59-60. Doran, D. (2011). Nursing outcomes. Sudbury, MA: Jones & Bartlett Learning. Dunn-Navarra, A., Cohen, B., Stone, P., Pogozelska, M., Jordan, S., & Larson, E. (2011). Relationship between systems-level factors and hand hygiene adherence. Journal of Nursing Care Quality, 26(1):30-38. Headly, C. (2012). Deadly diarrhea: Clostridium difficile infection. Nephrology Nursing Journal, 39(6):459-468. Machan, M. (2012). Infection control practices of laryngoscope blades: a review of the literature. American Association of Nurse Anesthetists Journal, 80(4):274-278. Randle, J., & Clark, M. (2011). Infection control nurses' perceptions of the code of hygiene. Journal of Nursing Management, 19:218-225. Upshaw-Owens, M., & Bailey, C. (2012). Preventing hospital-associated infection: MRSA. Medsurg Nursing, 21(2):77-81. Vandjick, D., Labeau, S., Vogalaers, D., & Blot, S. (2010). Prevention of nosocomial infections in intensive care patients. Nursing in Critical Care, 15(5):251-256. Read More