Questions:
1. What is Infection control ?
2. Reflect on how infection control important in nursing?
3. What have I learned?
4. What are the implications for my future practice/placement (would anything be done differently)?
5. How is it going to help me in practice/placement?
Answers:
- Infection control refers to the discipline which is concerned with the prevention of nosocomial infection or the infection which is associated with healthcare (Barclay et al. 2014). It is a practical sub-discipline of epidemiology and is essential, but it is an unsupported part of healthcare infrastructure. Infection, as well as hospital epidemiology, are analogous to the practice involving public health and is practiced within the limitations of a particular system of healthcare delivery rather than intended at society altogether. Anti-infective agents comprise of antibacterial, antibiotics, antiviral, antiprotozoal and antifungal agents (Rosenthal et al. 2012).
Infection control deals with the factors that are associated with the spreading of infections within the settings of healthcare, including prevention, investigation/monitoring of a suspected infection spread within a particular setting of healthcare and management (Mayhall 2012).
In the majority of the facilities of healthcare several sick individuals are cared or treated in the confined places. This means that there is the existence of numerous microorganisms. The patients can come in contact with various staff members who could probably spread the microorganisms along with infections among the patients. Huge quantities of waste material contaminated with body substances and blood are handled as well as processed in the settings of healthcare and increases the risk of infection (Miller and Palenik 2014).
There exists a majority of diseases that may tentatively pass from the patients to the staff of the hospital. In several cases, the staff possesses additional risk if they are not well or have a compromised immune system. The infection of a pregnant woman may possibly pit in danger the baby which they carry- for instance if the woman is infected with chickenpox (O’Grady et al. 2013).
MRSA is a type of Staphylococcus aureus which is resistant to methicillin. It is frequently transmitted through hand contact; in this hand hygiene is predominantly essential in preventing the spread of MRSA (Barbut et al. 2013). A number of individuals are colonized with MRSA, but they do not present with any symptoms. Decolonization might be carried out in a number of cases. The patients are progressively being screened ahead of the elective measures. However, the staff screening is still exceptional (Tacconelli et al. 2014).
A bacterium named Clostridium difficile is found in the large intestine. As the patients take antibiotics, it leads to the disturbance of gut flora and this microorganism can increase and can lead to the production of toxins which can cause diarrhea. In severe cases, rupture and bleeding of the intestine together with inflammation and sometimes can even lead to death. C. dif can be very infectious in the environmental of a hospital (Apisarnthanarak et al. 2014). Norovirus is responsible for winter vomiting disease and causes viral infections. It usually affects hospitals and clinics. The transmission of infection occurs through one person to the other, contaminated foodstuff and drink and contaminated surfaces (Angelis et al. 2014).
We can prevent and control the infection of MRSA, Norovirus and C.dif by supporting the World Health Organizations (WHO) Five Moments of Hand Hygiene, which aims to inform when we should wash our hands. All the patients in the hospitals are provided with hand wipes to utilize before the consumption of meals, and the patients who are not able to wash their hands after using the washrooms are also provided with hand wipes containing antibacterials. All the relatives, visitors and care providers are asked to wash their hands before entering and after coming back from the wards and to apply ethanol on hands at the main entrance (Barclay et al. 2014).
2. Infection control is very much important in nursing because if the environment of the hospital or nursing homes is infectious, it will lead to the deterioration of the health conditions of the patients, the doctors and the visitors. Therefore, the following methods can lead to effective infection control:
- Hand Hygiene- The hygiene of hands is extensively known to be an essential activity for minimizing the spread of diseases. The term ‘Hand Hygiene’ comprises of washing of hands with soap which can be either simple or contain anti-septic along with water and utilization of the products that contain alcohol (Miller and Palenik 2014). For such a product, we do not require to use water for washing our hands. Improved practices of hand hygiene have been associated with a continual reduction in the incidence of infections mainly in the Intensive Care Unit (ICU). The usefulness of hand hygiene could be decreased by the type as well as the length of the nails of fingers The individuals who wear artificial nails have been revealed to harbor additional pathogenic microorganisms, particularly yeasts and gram-negative bacteria, on the subungual area and the nails (Talbot et al. 2013).
- Personal protective equipment (PPE) – It refers to the different barriers along with respirator that is utilized alone or in a combination for the protection of mucous membranes, skin, airways, and clothes from getting in contact with agents that are infectious in nature. We can select PPE according to the nature of the interaction between the patient and the possible modes of transmission. Designated containers for disposables that can be utilized or PPE that can be reused should be kept in a location, which is suitable for the location of removal to make easy disposal and control of contaminated materials. The hygiene of hands is at all times the ultimate step after taking off and disposing of PPE (Barbut et al. 2013).
Removing PPE, when we leave the area of patient care, the order in which we remove it is not as essential as the theory behind the selection of such an order by us. The principle behind it is that when we remove it, we should avoid contact with body fluids, blood, secretions, excretions, along with other contaminants. If in case our hands become contaminated then we should wash our hands or decontaminate them with 70% alcohol solution (Apisarnthanarak et al. 2014).
The following given example is regarding the removal of personal protective equipment:
We need to utilize our hands wearing gloves; we should loosen the string of the gown if it is tied in front and should remove the shoe covers. After that, we should remove the gloves and discard them in a proper way. Then, we should wash our hands and remove the gown along with an apron, and should not contaminate our clothes underneath. We need to touch simply inside of the gown along with apron while removing (Rosenthal et al. 2012). we should place in proper discarding bag. After that, we should remove the mask, cap, and goggles, and place in an appropriate container. We should dispose of according to the protocol of health care facility. We should remove the boots and keep in a suitable container. We need to wash our hands up to the wrists carefully with soap as well as water, make them dry and decontaminate them. We should apply a hand-rub which is 70% alcoholic and then leave the facility (Mai-Prochnow et al. 2014).
- Strict and Protective Isolation– the Patient having an infection or in case an infection is suspected, the patient can be kept isolated. There are several studies regarding the impact of such isolation on the patients and, despite the fact that they might at first feeling alone as well as neglected, these thoughts could provide a way to an approval of space which is calm and private. Everybody reacts in a different way in the surroundings that are stressful, and care must be individualized. While dealing with the infections for instance Ebola, strict as well as protective isolation is essential for control and must be the most important consideration. Each and every effort must be made to make the patients feel in these conditions as knowledgeable, comfortable and free from anxiety in every possible way (Miller and Palenik 2014).
- Aseptic techniques– Aseptic techniques are utilized to maximize as well as maintain aseptic conditions in which the microorganisms are absent in the clinical setting. The goal of an aseptic technique involves protecting the patients from infections as well as preventing the spread of pathogens (Barbut et al. 2013). Frequently, the practices that are employed to clean, disinfect or sanitize are not adequate to prevent the infection from pathogens. We can utilize these techniques any clinical setting. The disease-causing germs may possibly infect the patient by means of contact with the personnel, equipment or environment. Every patient is potentially prone to get infected, even though in certain conditions further enhance vulnerability, for instance, extensive burns or disorders of the immune system immune that create a disturbance in the natural defense system of the body. In some typical situations that require aseptic measures, surgery in addition to the insertion of intravenous lines, drains, and urinary catheters can be taken into consideration (Rosenthal et al. 2012).
3. The different methods of infection control have helped me in gaining the understanding of the risk of infection in the settings of healthcare. The patients, doctors, and visitors are always prone to develop infectious diseases by means of the substances that are found in the hospitals such as blood samples, secretions, and excretions of the body.
According to me, Infection control deals with the factors that are associated with the spreading of infections within the healthcare settings, including prevention, investigation/monitoring of spreading of a suspected infection within a particular setting of healthcare and its management in an efficient manner.
I have also learned the effective methods of infection control such as Hand Hygiene, aseptic techniques, strict and protective isolation and Personal protective equipment (PPE). All these methods have a definite role in preventing the infections caused by different pathogens in our surroundings (Angelis et al. 2014).
4. The implications for my future practice/placement will rely on the universal precautions that are meant to minimize the risk of transmission of pathogens from the recognized as well as unrecognized sources (Barbut et al. 2013). These precautions are the fundamental level of infection control which is to be utilized in patient care. For instance, Hand hygiene is the most important element of standard precautions and is one of the most efficient methods to prevent the transmission of pathogens related to health care (Barclay et al. 2014). Besides it, the utilization of individual protective equipment ought to be directed by assessment of risk and the level of contact expected with pathogens, bodily fluids, and blood (O’Grady et al. 2013). Besides, the practices that are carried out by workers of health while giving care, all the individuals should act in accordance with the practices of infection control in the settings of health-care. The control of spreading of the disease-causing germs from the starting place is essential to prevent transmission (Mayhall 2012).
Global escalation of the utilization of universal precautions would decrease avoidable risks related to the care of health. The Promotion of a climate of institutional safety assists to improve conventionality by means of recommended procedures and consequently a subsequent reduction of risks. Provision of sufficient personnel and provisions, in conjunction with guidance and instructing the health workers, visitors and patients are critical for an improved safety environment in the settings of healthcare (Tacconelli et al. 2014).
5. It can help me in practice/placement because as a nursing professional, the essential part of my role in the practice of Infection Prevention and Control is to develop, assist and assess the teaching as well as learning of the patients and healthcare workers. Though, it might be a challenging job to create an environment which is intended for participation, socialization and communication while successfully stimulating thoughtful along with critical thinking to facilitate and promote good practice of prevention of infection and control (Barbut et al. 2013).
By implementing all these measures, my professional skills will increase and I will able to assist the patients and the healthcare professionals to know the importance and mechanism of infection control along with techniques of prevention from the pathogens in an efficient manner.
References
Angelis, G.D., Cataldo, M.A., DeWaure, C., Venturiello, S., La Torre, G., Cauda, R., Carmeli, Y. and Tacconelli, E., 2014. Infection control and prevention measures to reduce the spread of vancomycin-resistant enterococci in hospitalized patients. Journal of Antimicrobial Chemotherapy,69(5), pp.1185-1192.
Apisarnthanarak, A., Pinitchai, U., Warachan, B., Warren, D.K., Khawcharoenporn, T. and Hayden, M.K., 2014. Effectiveness of infection prevention measures featuring advanced source control and environmental cleaning to limit transmission of extremely-drug resistant Acinetobacter baumannii in a Thai intensive care unit: An analysis before and after extensive flooding. American journal of infection control, 42(2), pp.116-121.
Barbut, F., Yezli, S., Mimoun, M., Pham, J., Chaouat, M. and Otter, J.A., 2013. Reducing the spread of Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus on a burns unit through the intervention of an infection control bundle. Burns, 39(3), pp.395-403.
Barclay, L., Park, G.W., Vega, E., Hall, A., Parashar, U., Vinjé, J. and Lopman, B., 2014. Infection control for norovirus. Clinical Microbiology and Infection, 20(8), pp.731-740.
Centers for Disease Control and Prevention (CDC, 2012. Vital signs: preventing Clostridium difficile infections. MMWR. Morbidity and mortality weekly report, 61(9), p.157.
Cheng, V.C., Chan, J.F., To, K.K. and Yuen, K.Y., 2013. Clinical management and infection control of SARS: lessons learned. Antiviral research, 100(2), pp.407-419.
Leblebicioglu, H., Erben, N., Rosenthal, V.D., Sener, A., Uzun, C., Senol, G., Ersoz, G., Demirdal, T., Duygu, F., Willke, A. and Sirmatel, F., 2015. Surgical site infection rates in 16 cities in Turkey: findings of the International Nosocomial Infection Control Consortium (INICC). American journal of infection control, 43(1), pp.48-52.
Mai-Prochnow, A., Murphy, A.B., McLean, K.M., Kong, M.G. and Ostrikov, K.K., 2014. Atmospheric pressure plasmas: Infection control and bacterial responses. International journal of antimicrobial agents, 43(6), pp.508-517.
Mayhall, C.G., 2012. Hospital epidemiology and infection control. Lippincott Williams & Wilkins.
Miller, C.H. and Palenik, C.J., 2014. Infection Control and Management of Hazardous Materials for the Dental Team5: Infection Control and Management of Hazardous Materials for the Dental Team. Elsevier Health Sciences.
O’Grady, N.P., Alexander, M., Burns, L.A., Dellinger, E.P., Garland, J., Heard, S.O., Lipsett, P.A., Masur, H., Mermel, L.A., Pearson, M.L. and Raad, I.I., 2013. the Healthcare Infection Control Practices Advisory Committee (HICPAC), et al. Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2011. Centers for Diseases Control and Prevention 2011: 1-83.
Rosenthal, V.D., Bijie, H., Maki, D.G., Mehta, Y., Apisarnthanarak, A., Medeiros, E.A., Leblebicioglu, H., Fisher, D., Álvarez-Moreno, C., Khader, I.A. and Martínez, M.D.R.G., 2012. International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009. American journal of infection control, 40(5), pp.396-407.
Seto, W.H., Conly, J.M., Pessoa-Silva, C.L., Malik, M. and Eremin, S., 2013. Infection prevention and control measures for acute respiratory infections in healthcare settings: an update/Prévention des infections et mesures de lutte contre les infections respiratoires aiguës en milieu de soins: le point sur la situation. Eastern Mediterranean Health Journal, 19, p.S39.
Singer, J., Merz, A., Frommelt, L. and Fink, B., 2012. High rate of infection control with one-stage revision of septic knee prostheses excluding MRSA and MRSE. Clinical Orthopaedics and Related Research®, 470(5), pp.1461-1471.
Tacconelli, E., Cataldo, M.A., Dancer, S.J., Angelis, G., Falcone, M., Frank, U., Kahlmeter, G., Pan, A., Petrosillo, N., Rodríguez‐Baño, J. and 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), pp.1-55.
Talbot, T.R., Bratzler, D.W., Carrico, R.M., Diekema, D.J., Hayden, M.K., Huang, S.S., Yokoe, D.S. and Fishman, N.O., 2013. Public reporting of health care–associated surveillance data: recommendations from the Healthcare Infection Control Practices Advisory Committee. Annals of internal medicine, 159(9), pp.631-635.
