Although lack of compliance to hand hygiene protocol among nurses and other health care workers is the single most significant cause of nosocomial infections, there are other existing causes, such as the ones mentioned earlier, that must be addressed. An article by authors nunkoo & pickles titled infection prevention and control in general practice, suggests that nosocomial infections are the most challenging to prvent. The Association of perioperative registered nursing suggests in “Recommended Practices for prevention of transmissible infections” that proper immunization and education of nurses and other health care personnel are important factors that help prevent these infections.
Contact with patients and infective material puts nurses and other health care personnel at high risk for exposure to and possible transmission of certain diseases that can be prevented by vaccines. The Advisory Committee on Immunization Practices, also known as ACIP, illustrates the idea that preventing occupationally acquired infections as well as avoiding harm through proper immunization is a responsibility shared by nursing staff and their employers. Authors Nunkoo & Pickles and the Association of perioperative nursing support the ACIP in suggesting that in order to stay in compliance with evidence based guidelines, nurses and other health care personnel should stay current with their immunizations againgst hepatitis B, influenza, and other transmissible infections, unless it is medically contraindicated.If you look at the WHO website refersto vaccination as the mainstay in preventing hep b and as the “most effective health measure in preventing influenza.
In a study done by fitzpatrick et al that tested awareness of nurses and other hcp regarding proper hand hygiene as it relates to nosocomial infections, they found that the knowledge level was not up to par with guidelines set forth by the center for disease control. The results gathered from this study would incline many to question in what other infection prevention protocols do nurses and hcp lack knowledge? Poor knowledge and lack of compliance to evidence-based guidelines makes nosocomial infections a big challenge in health care. The same study concluded that the worldwide increase in rates of nosocomial infections suggests a dire need for improvement in education and training. Staff training and cognizance regarding guidelines for infection prevention is an important part of ensuring adherence to evidence-based guidelines.
To help protect patients and fellow workers against hepatitis B, influenza, and other communicable infectionsNurses and other health care personnel that acquire these infections should take proper measures to protect themselves and others.Performing Actions, such as double-gloving when carrying out invasive procedures or staying home when experiencing flu-like symptoms are just two suggestions that are helpful. Charge nurse and their employers can ensure staff competency and compliance by doing things such asConducting random multiple choice tests or surveys amongst staffProviding routine training and educational sessions often as needed to refresh skills that may have been forgotten, or if protocol changes.Compliance to evidence based guidelines is ultimately the responsibility of each individual nurse and health care workers.
Infection control ppt copy
INFECTION CONTROL AND NURSING PRACTICE
Audrey Bulacan, Kendra Koenig, Donna Morsaint, Matthew Smith, Yesenia TrevinoMiraCosta College RN Students Nursing 283
Hospital acquired infections affect nearly 2 millionpatients each year and contribute to nearly 100,000 deaths (Warye & Graneto, 2009).
CATHER ASSOCIATEDURINARY TRACT INFECTIONS aka CAUTI Incidence/ Prevalence: One of the most common types of nosocomial infections Attributable to over 40% of HAI’s Estimated costs increase $1,006 per patient
CAUTI Definition: A complicated urinary Diagnosis: “CAUTI is onlytract infection that is the result of diagnosed when signs & symptoms ofpathogen invasion and inflammation an infection coexist with microbiologicof the urinary tract. During catheter evidence of bacteriuria and a hostinsertion, a densely adhering biofilm response is present” (Parker etforms on the catheter tubing; this al., 2009, p.24)biofilm is an optimum medium forbacterial growth and reproduction andmakes offending organisms resistant totreatment.
GENERAL RECOMMENDATIONS Elimination/ avoidance of urinary catheters unless inserted forabsolute medical necessity (i.e. urinary retention, critical I & O’s, or asurgical requirement) Adopting the use of modified sterile technique, as compared withstrict aseptic technique, during catheter insertion Removal of the catheter ASAP; once the catheter isn’t needed tomanage the patient’s condition, it should be removed
PREVENTION OF CAUTI Prior to insertion: Appropriate catheter selection (i.e. size/ type of catheter) Smallest bore catheter size possible to prevent urethral trauma & subsequent bacterial colonization (preferably smaller than an 18 FR) Consider using a silver alloy catheter if short-term (< 2 weeks) indwelling time is anticipated Newton & associates found that “The incidence of catheter associated UTI’s fell from 7.2 per 1000 catheter days to 4.4 per 1000 catheter days following the introduction of silver alloy catheters” (Park et al., 2009, p.31) Consider using an antibiotic impregnated catheter if < 1 week indwelling time is anticipated
PREVENTION OF CAUTI After insertion: Ensure proper maintenance of the drainage system(i.e. drainage bag below the level of the bladder and tubing that is adequatelysecured and free of kinks) Perform routine perineal care at least Qshift Empty drainage bag regularly AVOID application of antibiotic creams and ointments AVOID routine bladder irrigation
CAUTI CONCLUSIONS The RN has a large role & many responsibilities in preventing CAUTI’s In general, CAUTI’s are common, costly, and complicate patient care The declaration that reimbursement for some hospital acquiredinfections, including CAUTI, will not be covered by CMS, has heightened awarenessand driven the implementation of standard protocols Continued evidence based practice guidelines, as well as alternatives such ascondom catheters and intermittent catheterization, should help to reduce CAUTIrates
INFECTION CONTROL AGENCIES The Care QualityCommission National HealthService Estates The JointCommission
DECONTAMINATING Low risk for infection areas High risk for infection areas
WRITTEN POLICIES FOR INFECTION CONTROL Waste disposal Color coding bags, bins and containers Spillage cleanup instructions Sharp containers
TRAINING FOR I N F E C T I O N C O N T RO L E-learning tools Regular infection control meetings Educational classes
PREVENTING NOSOCOMIAL INFECTIONS They are the most challenging to prevent. Preventing exposure to pathogens is the aim of preventinginfections. Proper immunization, education, and training are importantfactors. Compliance to evidence based guidelines is crucial.
IMMUNIZATION Nurses and other health care personnel are at high risk for exposure and transmission of certain diseases, such as Hepatitis B and influenza. The Advisory Committee on Immunization Practices illustrates that preventing occupationally acquired infections is a responsibility shared by nursing staff and their employers. Nurses and other health care personnel must stay current with their immunizations against hepatitis B and influenza, unless it is medically contraindicated. The World Health Organization website refers to vaccination as the “mainstay” in preventing hepatitis B and the “most effective health measure” in preventing influenza.
EDUCATION Study done by Fitzpatrick et al tested awareness of health care personnel as itrelates to nosocomial infections. Knowledge is not up to par with guidelines set forth by the Center for DiseaseControl. The worldwide increase in rates of nosocomial infections suggests a dire needfor improvement in education and training. Poor knowledge and lack of compliance to evidence-based guidelines makesnosocomial infections a big challenge in health care. Staff training and cognizance regarding guidelines for infection prevention is animportant part of ensuring adherence to evidence-based guidelines.
COMPLIANCE To help protect patients and fellow workers against hepatitis B, influenza, and othercommunicable infections: Personnel that acquire these infections should take proper measures to protectthemselves and others Actions, such as double-gloving when carrying out invasive procedures, is helpful. Ensure staff competency and compliance: Conduct multiple choice tests or surveys amongst staff Provide training and educational sessions as often as needed.
The most common modes of transmission are: contact, droplet andairborne (Collins, 2008). The proper use of personal protective equipment (PPE) and following EBPguidelines are key to reducing HAI.
CONTACT TRANSMISSION Direct or indirect Some of the most common infections transmitted through contact exposure are Clostridiumdifficile infections, Methicillin-resistant staphylococcus aureus (MRSA) infections from woundsand Vancomycin-resistant enterococcus (VRE) infections (Collins, 2008).
CONTACT PRECAUTIONS Glove and isolation gown Gowns are always worn first(Siegel, Rhinehart, Jackson, Chiarello, 2007). CDC guidelines requirehealthcare settings to follow contactprecautions for C. diff infectionsduring the length of diarrhea and upto 48 hours after (Collins, 2008).