Infection Control in Nursing Homes Essay
Infection Control in Nursing Homes Essay
Infections may be transmitted in many settings, and this process is often difficult to control and prevent. Although researchers attempt to find new treatment and preventive measures, the results are not always promising as hospital-acquired infections are still associated with a high level of patient morbidity and mortality. Moreover, hospital personnel is considered to play a significant role in the dissemination of microorganisms from one patient to another. Therefore, the research of infection control in nursing homes is of particular interest to me as it provides some areas for improvement. To collect evidence, I reviewed several recent studies on that matter. The results will be reviewed in the following paragraphs. Infection Control in Nursing Homes Essay.
Literature Review
In their paper, Herzig et al. (2016) describe infection prevention and control programs in nursing homes. During the research, they collected data from about a thousand nursing homes throughout the country. Infection Control in Nursing Homes Essay. The results revealed that more than half of the nursing homes that participated in this study do not provide personnel with infection control training (Herzig et al., 2016). Other barriers to better patient safety are described by Travers et al. (2015). They interviewed nurses from ten nursing homes and revealed that the lack of knowledge and experience, as well as excess workloads, were the main reasons for poor infection control (Travers et al., 2015).
Creating practical training courses and hiring more certified nursing assistants were suggested as the intervention strategies to the issue (Travers et al., 2015). Supporting this suggestion, the results from a nationwide survey presented in the article by Carter, Mancino, Hessels, Kelly, and Larson (2017) reveal that nurses consider themselves as the most responsible for preventing the spread of infections.Infection Control in Nursing Homes Essay. However, over 30% of responders stated that additional education in this field is highly necessary.
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In the qualitative research by Jackson, Lowton, and Griffiths (2014), links between nursing practices and infection prevention are identified. Twenty interviews with RNs were analyzed, and the results revealed that inadequate hygiene and misuse of medical equipment are the most common forms of safety code violations. Additionally, Mody et al. (2015) observe that the lack of experience in using indwelling devices such as catheters and wound drains increases the rate of MDROs. The researchers tested a new infection control program based on “preemptive barrier precautions” and “hand hygiene promotion” (Mody et al., 2015, p. 715). Results showed a decrease in the population of infectious organisms after the implementation of this program. Infection Control in Nursing Homes Essay.
Conclusion
Different approaches to the problem of infection control are described in the recent literature on the topic. Most researchers regard the maintenance of sanitary conditions as the main preventive measure. Moreover, they see a lack of competence as a crucial problem. Thus, apart from such well-known measures as handwashing, application of disposable items, or sterilization of medical equipment, which are widely used by any healthcare services, personnel should also be trained to implement advanced approaches. Hence, medical staff competency should be the highest priority of new infection control programs.
References
Carter, E. J., Mancino, D., Hessels, A. J., Kelly, A. M., & Larson, E. L. (2017). Reported hours of infection education received positively associated with student nurses’ ability to comply with infection prevention practices: Results from a nationwide survey. Nurse education today, 53, 19. Infection Control in Nursing Homes Essay.
Herzig, C. T., Stone, P. W., Castle, N., Pogorzelska-Maziarz, M., Larson, E. L., & Dick, A. W. (2016). Infection prevention and control programs in US nursing homes: Results of a national survey. Journal of the American Medical Directors Association, 17(1), 85-88.
Jackson, C., Lowton, K., & Griffiths, P. (2014). Infection prevention as “a show”: A qualitative study of nurses’ infection prevention behaviours. International journal of nursing studies, 51(3), 400-408.
Mody, L., Krein, S. L., Saint, S., Min, L. C., Montoya, A., Lansing, B.,… Rye, R. A. (2015). A targeted infection prevention intervention in nursing home residents with indwelling devices: a randomized clinical trial. JAMA Internal Medicine, 175(5), 714-723. Infection Control in Nursing Homes Essay.
Travers, J., Herzig, C. T., Pogorzelska-Maziarz, M., Carter, E., Cohen, C. C., Semeraro, P. K.,… Stone, P. W. (2015). Perceived barriers to infection prevention and control for nursing home certified nursing assistants: a qualitative study. Geriatric Nursing, 36(5), 355-360.
The information contained in this report was gathered in a private nursing home over 2 weeks that for the sake of this essay, be called “facility x”
During the medication round there is much time for resident contact, this can be in the form of physical reassurance, assisting with cups, or direct physical contact when applying lotions or eye drops. Any infectious agent transmitted by the contact or droplet route can potentially be transmitted during the medication round. Hand hygiene is…
This policy worked well.
Residents who are infected with MRSA, or similar superbug are treated with standard contact precautions while being given their medications.These include: * Hand wash before going into and leaving the patients room. * Avoid contact with tubes, bedding and surrounding area. * Wear gloves and gown when going into residents room. * Put used gloves and gown in to yellow infectious waste bin, which should be either just inside the room or outside the door before leaving the room. This policy was adhered to most of the time. Some nurses made the decision not to adhere to the policy and procedure regarding contact precautions, presumably because they had decided they would not going to be touching the patient or their surrounding area! As mentioned earlier this is a risky way to behave.
At the end of the medication round facility X’s policy and procedures state that the trolley shall be cleared of all items, washed down with alcohol cleaner, cups and spoons washed in hot soapy water and drug chart folder is to be wiped down then everything is to be put back together on the trolley again.
This is a sensible task to do after each round, but upon starting the next round it is only clean for a short time before the lack of hand washing contaminates the items on the trolley once more.
The trolley has a waste bin attached and is emptied of its disposable
A good understanding of the microorganisms that are encountered regularly is intrinsic for a better practice of infection control. Pathogenic organisms are disease causing microorganisms that are classified as: Bacteria, Viruses, Pathogenic, Protozoa, Parasites, and Prions. A distinguishing feature from other diseases is that infections can be spread. In various health care facilities, infection control is the process of preventing microorganism from spreading from; patient to patient, member of staff to patient, or patient to a member of staff. Infection Control in Nursing Homes Essay. Infections can be spread in a number of modes that include direct contact, indirect contact, fomite, hands, inhalation, ingestion, and inoculation. It is important therefore that infections are prevented and controlled by all healthcare givers, including staff working at nursing and residential homes for the elderly for the general health and wellness of the care giver and the patient, and in turn, the nation in general (“Essex Health Protection Team” 2013).
The major need for infection control to be practiced by care givers perhaps comes in majorly because a number of the infections have the ability to spread in the conditions and environments where the people that are vulnerable, for example the elderly persons, share living accommodation and eating. It is crucial that care givers have the awareness to promptly identify the possibilities of the infections spreading and swiftly act on them. Essex Health Protection Team (2013) indicate that every microorganism require a means to spread, and it varies from one microorganism to another. They note that playing a major role in the spread of infections is the hands. Microorganisms may exist in secretions and excretions of the body and if the hands come into contact with these microorganisms, unless they are decontaminated properly, can carry the infection from one person to another. Microorganisms like viruses that are responsible for influenza and colds that are found in sputum, saliva and secretion, may also spread through the air. This happens through coughing or sneezing close to other people will spread them among other means. Observing hand hygiene among other standard precautions can be problematic in nursing homes for the elderly because of the memory conditions and problems that majority of the elderly people have and the general attitude of carelessness.
Vulnerability to microorganisms can differ from one person to another and factors that increase the risk of infection entail hygiene, psychological well-being, physical well-being, immune status, underlying or chronic diseases or medical conditions, and age where the very young and very old are most vulnerable to acquiring the infectious diseases. A factor that contributes to vulnerability is the fact that majority of the care facilities, like the nursing home for the elderly, many elderly people are cared for in confined spaces. This implies that there is presence of numerous microorganisms and the chances of either the elderly people or the care givers being infected are relatively higher. Huge amounts of waste that is contaminated with body substances and blood are handled and processed in health care settings thus there are increased chances of infection if proper care is not observed. The poor hygiene behavior when coupled to the high vulnerability due to their old age, the elderly people in nursing homes are bound to be infected by different microorganisms regularly and therefore it is very important that care givers put in place standard procedures and precautions to prevent and control infections, especially in nursing homes.
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The care givers, apart from the danger of them acquiring the infections from the nursing homes, pose a greater danger of them potentially spreading the infections not only from one elderly person to another but also to the general public outside of the nursing homes and residential homes for the elderly. Most at risk of this situation are the family members and other person living in the same household as the care givers. Therefore to protect other people, outside of the nursing homes, it is very important that care givers strictly follow the laid out procedures for the control of infections. Furthermore, the National Audit Office (2000) reported that, at any given time, approximately 9 percent of patients have an infection that they acquired at the hospital. Some of the patients end up dying every year as a consequence of the infections acquired from hospitals. Infection Control in Nursing Homes Essay. These infections that are acquired in hospitals are becoming harder to treat compared to other infections. The hospital acquired infections is costing the government more than one billion pounds every year. The same can be extended to nursing homes and residential homes for the elderly. Therefore, infection control helps prevent the spread of resistant microorganisms, prevents unnecessary deaths, and saves the government a significant amount of funds for the government.
Infection control is important in health care settings for many reasons. For the specific case of nursing and residential homes for the elderly is mainly important because of the factors that increase vulnerability of these elderly people. The nursing homes are usually congested, there is sharing of accommodation and eating, handling of huge amounts of waste that contains blood and other body fluids, indicating a higher risk of contact whether direct or indirect with the microorganisms. This then implies that there are unnecessary infections within the nursing homes and hence the government spends more resources in treating the infections. In some scenarios, the infections lead to lose of lives. It is therefore important to control infections in order to avoid its spreading, unnecessary costs and unnecessary deaths in general.
- Department of Health. 2013. Prevention and Control of Infection in Care Homes – an
Information resource. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214929/Care-home-resource-18-February-2013.pdf - Essex Health Protection Team. 2013. Infection Control Guidelines: Care Homes. PHE
Publications. Retrieved from http://www.plymouth.gov.uk/infection_control_guidelines_for_care_homes.pdf - National Audit Office. 2000. The Management and Control of Hospital Acquired
Infection in Acute NHS Trusts in England. London. The Stationary Office. Retrieved from https://www.nao.org.uk/wp-content/uploads/2000/02/9900230.pdf. Infection Control in Nursing Homes Essay.
