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Nosocomial Infections on Patient Care

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Introduction

Nosocomial infection or Hospital acquired infection (HAIs) in the recent past has been a health issue and is escalating at an alarming rate. To tackle the problem, one must primarily understand the meaning of it. Hospital acquired infection (HAIs) refers to any disease or infection acquired during treatment in the hospital, and it is secondary to the original admitting diagnosis of the patient (Gopee, 2010). If the infections first within forty-eight hours or more after hospital admission or within thirty days after discharge, then the disease is considered hospital-acquired infection. All patients at the hospital are at risk to contract HAIs. However, others such are the old people, premature babies, severely ill people, young children, and individuals undergoing treatments that affect the immune system are more vulnerable contract HAIs.

 Individuals go to hospitals to seek treatment. However, it is unfortunate that over two million people that visit hospitals yearly in U.S, according to Gopee (2010) research get sick with a HAIs. Over hundred thousand patients succumb to such infections. The HAIs are too expensive to handle due to the extended stay in hospital estimated at an average of 20.6 days in comparison to 4.5 days for normal patients (Gopee, 2010). The good news is, there are ways and steps that health care systems can take for patient protection and actions for the patient to protect themselves. This assignment is focused on the process healthcare system will take to combat the problem of Nosocomial infection in the hospitals. Being the chief nursing officer in charge, it vital that a reasonable action is taken in reducing the Nosocomial Infections.

Evidence-based Practices for Reducing Nosocomial Infections

Hand washing – the practice of washing hands thoroughly or rubbing hands with alcohol should be a common and regular practice by all medical personnel before and after contact with the patient (Khan, Ahmad & Mehboob, 2015). The practice should be systematical and consistency from one patient to the other. That way the transfer of Nosocomial Infections from one patient to the other will be prevented. Hand washing is a behavioral factor and must be internalized to take effect in real practice.

Wearing the required gears– gloves, gowns or aprons are mandatory gears medical practitioner and should always be worn in appropriate circumstances while dealing with patients (Khan, Ahmad & Mehboob, 2015).

Clean environment– the health care environment that surrounds the patient contains various pathogenic microorganisms arising from the diagnosed patients infected wound or intact skin. A study shows that patients or healthy person shed thousands of dead squamous epithelium cells that contain pathogen microorganism (Khan, Ahmad & Mehboob, 2015). Therefore, thorough cleaning and keeping of the environment where the patients are staying tidy is another vital way of controlling the HAIs. Extra Contact Precaution is advised to nurses in addition to Standard Precautions for patients with known diseases having multi-drug-resistant organisms to reduce the risk of transferring HAIs from the patient and his/her contaminated environment to others within the hospital.

Sterilization– Sterilization can be achieved through chemical or physical means by exposing medical devices and equipment to steam saturated with water at 123 °C for 35 minutes, or 135 °C for 14 minutes in an autoclave; (134 °C for 18 minutes for prions). The sterilized equipment and tools are then wrapped in sterilized bags for reuse (Saxena & Mani, 2014).

Finance– the hospital must be able to provide enough funding to buy new equipment and products for curbing the spread of HAIs (Saxena & Mani, 2014).

Community relation– it is in order, that community support and participates in the programs geared towards combatting the Nosocomial Infections manes. This way they can understand the impact of HAIs in the community.

Patient/family– it is important that both the patient and the family visiting in the hospital practice and observe hygiene during and after hospitalization such as hand-washing before and after handling the patient. They must follow nurse directives at the hospital to help control the instances of HAIs transmission.

Impact of Nosocomial Infections on Patients Care

Nosocomial Infections has many effects on the patient and the caretakers or their families. One, it prolongs hospital stay that in turn impacts heavily on the hospital bill for accommodation and other medical bills like laboratory test and diets (Mehta et al., 2010). HAIs patients are more likely to suffer organ failures, stress, shock, and probable death due to additional infection burden. The disease also makes the patient care complicated and challenging for the doctor, the patient, and the family (Mehta et al., 2010).

Gap Analysis

Main Routes of Transmission

Contact transmission– contact between the patient and other people in the hospital such as the nurses are the major the HAIs frequent mode of transmission.

Droplet transmission– droplets from the infected individuals containing microbes are carried through the air to the body of another patient. The droplets are generated from the infected person by talking, coughing, and sneezing among other activities during patient treatment.

Airborne transmission– these refer to droplets smaller particles containing pathogens that become and remains suspended in the air for a long time.  The air current carries these suspended droplets to the body of other patients causing HAIs. The pathogens transmitted this way include rubeola, legionella, and varicella viruses.

Vector-borne transmission– the transmission that occurs when the microbes are carried by vectors like flies, mosquitoes, and rats among other vermin that transmit microorganisms.

Impact of stakeholder role

Stakeholders have many functions and responsibilities as the fight of HAIs is concerned. They are the financial providers to run programs that make aware HAIs in hospitals, and other health centers as well (Mehta et al., 2010). Stakeholders also come up with strategies on how to curb and control the Nosocomial Infections problems in the hospital. Their intervention has seen a reduction of the Nosocomial Infections in many hospitals and has impacted positively on the life of the patients. Stakeholders also participate in coming up with policies that guide behavioral changes concerning simple routine practice like hand washing which forms the basis of HAIs control.

The Role of Infection Control and Education within the Organization

The following are the major the Infection Control and Education perform within the organization. One, they analyzes the principles, practices, and regulations associated with infection prevention in a health care setting or hospital. Two, the team examine the route of infection in the healthcare setting from its source to the susceptible host (Chajęcka-Wierzchowska et al., 2016). Third, the Infection Control and Education team come up with the evidence-based methods to break the chain of infection and prevent transmission in the health care settings. Additionally, they clarify the role of point of care instrument disinfection to prevent the spread of Infection Control and Education as well as develop creative strategies to adapt infection prevention processes to a variety of settings (Chajęcka-Wierzchowska et al., 2016).

Strategy to Combat the Increase of Nosocomial Infection

Isolation– nurses and physician, must assess the patient and make a decision if the patient needs to solitary confinement. All ICU must be screened for diseases such as diarrhea, Known carriers of an epidemic strain of bacterium, and skin rashes among other diseases to decide the kind of isolation (Chajęcka-Wierzchowska et al., 2016).

            Observe hand hygiene– the most common vehicle HAIs pathogen transmission is the hands. Therefore, hand hygiene is one of the most efficient ways to control the horizontal infection transmission among the health care personnel and the hospital patients. 

Goals for Reducing for Reducing Nosocomial Infection

Goals for reducing HAIs include the following, one, to reduce patients stay in hospital due to nosocomial infections. The second goal is to reduce the hospital bill that raises as a result accommodation and other medical expenses like laboratory and diet (Tagoe et al., 2011).

Possible Solutions to the Gap Analysis

The entire medical personnel between patient contacts to reduce transmission of HAIs must practice thorough and proper hand washing (Tagoe et al., 2011). Individuals mandated to sterilize medical equipment should be well supervised to ensure the time taken to expose medical equipment for sterilization is observed for better sterilization of equipment. Cleaners should be well supervised to ensure that surface cleaning is thoroughly done using the right detergent to all germs causing disease.

 Gap Analysis

Best Practice

Best Practice Strategy

Barriers/Challenges to Best Practice Implementation

Will Implement Practice (Yes/No; Why Not?)

Stakeholder Roles and Responsibilities to Implement Best Practices

Hand washing

Religious, frequent, and thorough hand washing between patient contacts is mandatory.

Medical personnel find the practice time wasting, and majority has not internalized the practice

Yes. It is the best way to prevent horizontal transmission of HAIs from one patient to another

Provide funds to buy equipment and train medical personnel towards internalizing the practice

Sterilization

Expose medical equipment to steam saturated with water at 121 °C for 30 minutes to kill germ and wrap the sterilized equipment until the of use. It should be routine between patients.

Exposer time is usually not correctly observed enabling some pathogens to pass through not killed

Yes. It is the only sure way that the medical equipment that is used again and again can be made free of pathogens after use

Should come up rules to govern the process of cleaning the medical equipment

Isolation

It should involve screening of all patient especially those in ICU and those with communicable diseases like diarrhea be isolated following the isolation procedures

Testing of the patient is expensive and time-consuming following that most hospital lacks enough doctors and medical equipment.

No, at the moment the facilities and workforce available are not sufficient to facilitate the process for every patient effectively.

Stakeholders should provide finance to acquire the lacking equipment as well as increase the number of doctors and nurses to the patient.

Surface sanitation

Modern sanitizing methods like Non-flammable Alcohol Vapor in CO2 system is the most efficient to kill surface germs like influenza agents

The products are expensive to acquire, and also most cleaners miss use the products during cleaning

Yes, it is the most efficient way to kill surface germs hence preventing transmission of HAIs from one patient to another

Stakeholders need to provide enough funds to acquire and make these products available all the time.

 

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