Friday, February 22, 2019

Nursing in preventing hospital Essay

The aim of this essay is to ascertain what infirmary acquired transmitting entails, the prejudicious ca mathematical function it causes and to high gearlight the active berth nurses mint take in the pr pull downtion of this type of transmittal.infirmary acquired (or nosocomial) transmittal system is one that originated in the infirmary environment i.e. was not present or incubating on admission and which appeargond 48h or much later admission (Azzam et al. 2001). contagious disease is ca utilize by pathogenic organisms which overrun the multitudes immunological defence mechanism this can be through wounds odd by trespassing(a) military operations whereby the hosts natural luggage compartment defences watch been bypassed.It is the nurses responsibility to know the factors that can increase patients susceptibility to contagious disease (i.e. age, vestigial disease, drug therapy, or if they ar undergoing surgery), this en fitteds nurses to be able to assess whic h patients are most at essay so that they can develop a business plan and therefrom they get out know what extra, if each(prenominal), precautions to take and protocols to follow. Sproat and Inglis (1992) cited by Mal every(prenominal)owt et al. (2000, p, 40) suggest that the assessment of a patients risk of infection to others, in nursing apprehension plans, before the commencement of any operation is a fundamental principle of infection ensure. The Bowell-Webster risk assessment shoot for identifying patients at risk of infection (1990) cited in Alexander et al. (2000, p, 595) can be used to decide which protocols to follow.Steed (1999) states that not all nosocomial infections relate at present to the patients underlying disease provided that many another(prenominal) are caused by the actions of health care workers. Therefore great care must be taken by healthcare workers, especially nurses, who are directly involved in the care of patients. In this essay I am goi ng to discuss the procedures followed by nurses to blow out, if at all possible, cross infection.There are two slip agency of acquiring an infection in hospital Cross (or exogenous) infection is when the infection has been spread from other people, either patients, visitors, hospital staff or even food and the surrounding environment whereas self (or endogenous) infection is when theinfection is caused by microbes carried by the patient on their body, usually from septic areas.Compliance with universal proposition precautions should be rigorous as to avoid spread of infection. For example, failure to commute gloves between interactions with different patients can lead to the spread of disease (Piro et al. 2001). Ayliffe et al. (1992) contended that the geometrical regularity of infection in hospitals, caused by multiple types of bacteria, could increase to epidemic amounts if uninspired and hygienic measures in the hospital collapsed.According to the Healthcare-associated Infect ion surveillance plaza (2000) approximately 30% of nosocomial infections are receivable to urinary nerve tract infections, another 30% are due to bloodstream infections, 20% due to surgical site infections and 20% due to pneumonia. These infections tend to occur during invasive procedures or when the body is very susceptible due to illness.The NHSSB infection support manual (1996) states that the inter-hospital transportation of infected patients is the main means of spreading infection and in extreme circumstances of spreading an epidemic strain. The spread of infection in hospitals between patients, or between patients and staff, cannot be entirely eradicated but it can be keep downd, especially by nurses using methods I will discuss later.Evidence supporting the importance of infection reckon can be seen in a study by Worsley (1993) cited in Mallett et al. (2000, p,47) who put up that in 1991 out of 175 patients who had developed nosocomial Clostridium difficile diarrhoea, 17 died and the organism was a contributing factor in a push 43 deaths. The cost of managing this out commotion was at least 75000. Also in a study conducted by Plowman et al. (2001) they concluded that approximately 10% of patients will get infected during a stay in hospital and that this can lead to costs of up to one billion pounds per year in the U.K alone. These pieces of evidence and others (Chaudhuri, 1993) demonst straddle the prevalence of nosocomial infection, the dire effects of it and withal the extreme financial losses it incurs.infirmary acquired infection has many different consequences, it can Delay or prevent recovery practice increased pain, discomfort and anxiety Increase the patients stay in hospital which has financial losses due to drugs bills and extra staffing costs Cause psychological stress as a result of long periods spent in isolation (Knowles, 1993, cited by Mallett et al. 2000, p, 47) it is demoralising for both staff, patients and their families w hich can lead to lessen public confidence in hospitals and doctors. Mc Millan Jackson (1999) insists that infection streak and bidding is essential in healthcare settings to reduce the risks of morbidity and mortality in patients and healthcare workers.Nurses share responsibility with other healthcare professionals to reduce the risk of infection in patients. Patients need a right to be nurseed from preventable infection and nurses bring on a duty to precaution the well-being of their patients (King, 1998, cited by Mallett et al. 2000, p, 39).The nurse and Midwifery Council (NMC) Code of Professional calculate (2002) outlines the nurses professional rule, and also has implications for the subroutine of the nurse in infection control, requiring them to protect patients and fellow healthcare workers from risks such as cross-infection. Clause 1 of the code informs nurses that, You aim a duty of care to your patients and clients, who are entitled to intoxicate safe and c ompetent care. To fulfil these criteria, nurses must ensure that care is taken to ensure that dangerous or potentially painful substances (e.g. drugs) or articles are go alongled and stored safely and that all equipment and appliances are properly maintained.Nurses are role models to the people with whom they come into contact, whether it is patients, visitors, students, or any healthcare workers. Therefore they should insist on accordance with basic procedures and practices as part of their job. They must anticipate responsibility for these practices as they are also held accountable under the NMC code of conduct and so should be at the forefront of efforts to prevent and control infections.Many infections are acquired through the patients own overleap of knowledge of the effectiveness of simple procedure, such as hand process, therefore the nurse has role to fulfil in providing education for patients and their families to give them a greater understanding of the importance of the need for thorough configuration of these procedures. example precautions are designed to define a high standard of identification number care that will be effective in reducing the transmission of potential pathogens between patients/ clients whilst protecting staff from pathogens carried by patients/ clients (NHSSB, infection control policy, 1996).General principles of infection control which all nurses must adhere to jibe to the Royal College of care for (1995) are, to Wash hands before and after worldwide patient care Cover all cuts and abrasions with impermeable dressings Use useable gloves and aprons where necessary Clean up spills and body fluids immediately according to local anaesthetic guidelines Use and dispose of sharps safely, do not resheath needles Dispose of clinical float according to local guidelines Handle and transport specimens safely by hobby local guidelines Handle soiled linen according to guidelines Use disinfection and sterilization procedu res following guidelines.Healthcare professionals need to have basic knowledge close the steps in the chain of infection to be able to hold back how to control infection itself. These are the causative agent the reservoir the accession of exit from reservoir the mode of transmission from reservoir to susceptible host the portal of entry into susceptible host and the susceptible host. The main slipway to interrupt the transmission of infection between humans and therefore break this chain is through the mode of transmission, this is achieved by hand dry raceway antiseptic technique sterilisation and disinfection and isolation procedures.Overviews of epidemiological evidence (Gould, 1991, Sharir, 2001) have shown that hand washing techniques are often inadequate and infrequent, and that the tone of hand washing is more important than the quantity (Van derBroek et al. 2001). These conclude that hand medicated transmission is a major contributing factor in the current infection threats to hospital patients. According to RCN guidelines (1995) hands should be washed before and after any duty which involves close contact with a patient before and after unfertile technique or invasive procedures after contact with body secretions/ excretions after handling contaminated laundry or equipment after removal of gloves, masks and aprons before administration of food, drink and drugs and at the end of a duad of duty.Precautions relieveed to destroy pathogens, prevent the spread of infection and to protect patients against infection during their stay in hospital, include the use of barrier nursing and the aseptic technique. These are adopted to increase the patients resistance to infection, to eradicate the sources or potential sources of infection and to minimise, or if possible stop, the means of bacterial transfer to the uninfected patient.The idea of barrier nursing is to keep an morbific patient, and materials they have been in contact with, apart from vulne rable others. This can be achieved by isolating the patient in a single style or by isolating a number of infectious patients in a purpose built ward. Another method used is to seclude patients whose immune systems are severely depressed thereby protecting them from harmful organisms. This is usually referred to as reverse barrier nursing.Aseptic technique is the use of sterile equipment and fluids, when carrying out any invasive procedure that breaches the bodys normal anatomical defences, to prevent contamination of wounds and other vulnerable sites by pathogens in the operating theatre, the ward, and other treatment areas.These procedures can only be effective if the healthcare professional, i.e. nurses who are in contact with the patients adhere to the world(a) policies relating to the care of patients, especially infectious ones, such as hand washing and protection of personal clothing. It is my personal responsibility as a student nurse to ensure that I am fully immunised against public diseases, and diseases I may be in contact with in thehealthcare setting, if there is a vaccine available. If I feel that I am ill and suspect that my illness may put patients at risk of infection, it is my duty to inform the necessary people and to stay off work. It is also my duty to remove any jewellery (with the exception of a marry ring) before work, to keep my nails short and clean, and to keep my hair (if long) tied back. new studies have proven the importance of wearing a clean identical each day to work, and that you should ensure that your uniform is laundered at as high a temperature as the garment allows (Perry et al. 2001).During my clinical devotement I had to adopt barrier nursing techniques due to a patient on my ward having Methicillin Resistant Staphylococcus Aureus (MRSA). I was therefore required to adhere to more thorough precautions when dealing with this particular patient. Source isolation was partially used to deal with this patient as I was working in an spread out mental health ward, therefore the patient could only be segregated to a certain degree. The nursing staff then needed to be aware of this patients movement so that we were effectively able to disinfect the areas she came into contact with as detailed in the local procedure we used.During meal times this patient had her meal brought into the ward to her on a tray, once she was finished I had to follow the local procedure by washing my hands with chlorhexidine gluconate 4% before donning gloves, I then had to place her used tray in an alginate polythene bag (which dissolves in the dishwasher), where it would then have been brought to the kitchens to be cleaned separately and at a higher temperature from the usual dishes. attached I had to change my gloves and then disinfect the table and chair, at which the patient had been sitting, with Haz tab solution, then rinse the area with fresh water and let air dry. Finally I remove and dispose of my gloves app ropriately and wash my hands, with chlorhexidine in 70% Isopropyl alcohol solution, and dry with paper towels. In this way staff and the other patients are protected from contamination.As I have shown many hospital acquired infections can be easily prevented by the compliance of simple procedures, thereby reducing the extra costs hospital trusts and governments have had to pay, and most importantly reducing the ill effects caused to patients and their families. Not allhospital acquired infection can be prevented, but with nurses and other healthcare workers working together in the constant assessment and evaluation of all techniques utilised, so that they remain consistent and be improved if necessary, there is no reason why they cannot be severely reduced. In conclusion it is wanton to see that it is the nurse who has the primary role in implementing procedures used for the control and prevention of infection, with the intension to curb its spread and thereby ensuring that all pat ients are able to be cared for in a safe environment, as is their right.REFERENCESAlexander, M.F., Fawcett, J.N. and Runciman, P.J. (editors) (2nd edition) (2000) Nursing practice Hospital and Home The adult. Edinburugh Churchill Livingstone.Ayliffe, G.A.J., Lowbury, E.J.L., Geddes, A.M., Williams, J.D. (editors) (3rd edition) (1992) Control of Hospital Infection, A matter-of-fact handbook. capital of the United Kingdom Chapman and Hall MedicalAzzam, R. and Dramaix, M. (2001) A one-day prevalence survey of hospital- acquired infections in Lebanon. Journal of Hospital Infection, 49 74-78.Chaudhuri, A.K. (1993) Infection control in hospitals has its quality enhancing and cost effective role been appreciated? Journal of Hospital Infection, 25 1-6.Gould, D. (1991) Nurses hands as vectors of hospital-acquired infection a review. Journal of Advanced Nursing, 16 1216-1225.Symth, E.T.M. (director) Healthcare- associated Infection Surveillance Centre (2000).Mallett, J. and Dougherty, L. (e ditors) (5th edition) (2000) The Royal Marsden Hospital Manual of clinical Nursing Procedures. Oxon BlackwellScience.Mc Millan Jackson, M. Nursing Clinics of north America Contemporary Infection Control for Nurses. The healthcare marketplace in the next millennium and nurses roles in infection prevention and control. Vol 34, number 2, June 1999. pairingern Health and Social run Board, (1996) infection control manual.Nursing and Midwifery Council, Code of Professional Conduct, (2002). London NMC.Perry, C., Marshall, R. and Jones, E. (2001) Bacterial contamination of uniforms. Journal of Hospital infection, 48 238- 241.Piro, S., Sammud, M., Badi, S. and Al Ssabi, L. (2001) Hospital acquired malaria transmitted by contaminated gloves. Journal of Hospital Infection, 47 156-158.Plowman, R., Graves, N., Griffin, M.A.S., Roberts, J.A., Swan, A.V., Cookson, B. and Taylor, L. (2001) The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. Journal of Hospital infection, 47 198- 209.Royal College of Nursing Guidelines on Infection Control, for nurses in general practice. (1995) London RCN.Sharir, R., Teitler, N., Lavi, I. and Raz, R. (2001) High-level handwashing compliance in a community teaching hospital a repugn that can be met Journal of Hospital infection, 49 55- 58.Steed, C.J. Nursing Clinics of North America Contemporary Infection Control for Nurses. Common infections acquired in the hospital, the nurses role in Prevention. Vol 34, Number 2, June 1999.Van der Broek, P.J., Verbakel-Salomons, E.M.A. and Bernords, A.T. (2001) Handwashing quality not quantity. Journal of Hospital Infection, 49 297.

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