Infection Control And Hand Hygiene Practices In Healthcare Settings Example Paper

Types Of Nosocomial Infections

Hospital acquired infection, also referred to as nosocomial infection refers to that is acquired in healthcare settings and/or hospitals. These are also called health care associated infections (HCAI or HAI) and are commonly prevalent in rehabilitation facilities, nursing homes, hospitals, clinical settings, and different outpatient clinics. The clinical practice issue identified in this assignment is infection control. Under such situations the infection gets spread to susceptible patients staying in clinical settings by different means. The health care staff are most responsible for the spread of infection due to their use of contaminated surgical equipment, and via air droplets (Dancer, 2014). Clinical governance refers to the system that makes the NHS organisations accountable and answerable for continuous improvement of their service quality and protecting high care standards through the creation of an environment that allows flourish of clinical care. Effective clinical governance is essential to upkeep developments in infection control. It is within the outline of monitored, assured and superior quality healthcare services that hospital workers in infection control domain must progress their own approaches of implementing clinical governance.

Ceballos et al. (2013) stated that some of the common types of HAI namely, (i) urinary tract infection (UTI), (ii) meningitis, (iii) pneumonia, (iv) gastroenteritis, and (v) surgical site infections. The major symptoms of the infections often comprise of fever, cough, shortness of breath, headache, nausea, diarrhoea, vomiting, and wound discharge. Bacteria, virus and fungi have been identified as the primary reason for onset of nosocomial infections. During their stay in hospitals, most patients are likely to get their immune system compromised, thus increasing their susceptibility to get affected by HAI. Some of the common bacteria that are responsible for these infection are Staphylococcus aureus, Escherichia coli, Enterococci, and Pseudomonas aeruginosa. Recent evidences for the transmission of HAI have focused on indwelling catheters as a major source of transmission (Barbier et al., 2013).  Infection Control And Hand Hygiene Practices In Healthcare Settings Example Paper

Contact transmission is the most frequent mode of transfer of nosocomial infections through direct contact between an infected person and a healthy person, or with contaminated hands and medical instruments. This calls for the need to place a due focus on hand hygiene techniques. Medical hand hygiene is a broad term that refers to hygiene practices that are linked to medical procedures. Hand washing prior to the administration of medicine or care services has the potential of preventing or minimizing the spread of infection by cleansing the hands of different pathogens (Schumacher et al., 2013). This assignment will summarise three pieces of scholarly literature on hand hygiene practices and will critically evaluate their content.

Critique of three articles- The CASP tool was used for critical appraisal of the three articles. Use of the CASP tool helped in systematically and carefully examining and assessing the consequences of the research evidences, with the aim of judging the value, relevance and trustworthiness of the findings, in relation to the phenomenon being investigated (hand hygiene practices) (Munn et al., 2014). All the three articles addressed a clearly focused issue. This can be attributed to the fact that nosocomial infections threaten the health and safety of the participants and might often prove fatal (Breathnach, 2013). The article by Luangasanatip et al. (2015) employed an accurate research design. Conducting a systematic review helped in collecting secondary data from several studies and also provided an exhaustive summary of the current evidences that were relevant to the research question (Moher et al., 2014). Use of the two step article extraction strategy was rigorous since it helped in excluding literature that were not relevant to the research topic. Furthermore, the network meta-analysis helped in combining direct and indirect evidences, thus drawing a comparison of the effectiveness of all interventions that were implemented.  Use of results from high quality recent evidences was a correct approach in determining the effectiveness of the interventions.

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Modes Of Transmission

The second article by Rodriguez et al. (2015) was also accurate in addressing the essential issue of hand hygiene improvement. The research design was appropriate since recent evidences have provided adequate facts for supporting the high prevalence of nosocomial infections in intensive care units (ICU) (Manzoni et al., 2013). Designing the study in the form of a randomised controlled trial helped in making causal inferences and also minimised chances of selection or allocation bias. Furthermore, data collection through focus groups was another correct approach that established validity of the results. This can be attributed to the fact that focus groups allowed exploring what the different groups of healthcare workers thought or felt about a certain topic (hand hygiene compliance), by adding a human dimension to the collected impersonal data (Cleary, Horsfall & Hayter, 2014). Another correct approach was that the research design was also able to recommend strategies that should be adopted for improving hand hygiene compliance rates across ICUs.

Sadule-Rios and Aguilera (2017) also adopted a correct approach in focusing the research question on exploring the perception behind low rates of hand hygiene compliance across healthcare settings. Use of an exploratory descriptive design was another accurate method since it helps in establishing priorities of a research question that has previously not been conducted. The research by Luangasanatip et al. (2015) was more rigorous since it summarised a large body of scientific evidences based on hand hygiene intervention and minimised bias, while reaching the research conclusions.

Findings- While the results presented by Luangasanatip et al. (2015) suggested that complex hand hygiene intervention such as, WHO-5 and lone interventions that comprised of training, system change, reminders, and education, were linked with enhanced agreement to hand hygiene practices by healthcare workers, who were present in hospitals, compared with typical practice. It was also suggested that addition of incremental interventions counting reward incentives, goal setting, and answerability to the strategy of WHO-5 resulted in further advances in compliance rates.

In contrast, Rodriguez et al. (2015) stated that infection control practices that focus on hand hygiene are imperative in averting the incidence of health care associated infections and also stated that multimodal practices that comprised of alcohol-based hand rub were better effective than usual infection control measures. Significant increase in the rates of hand hygiene practices during the intervention period suggested that the intervention was successful in increasing the knowledge and awareness among the healthcare workers on preventing transmission of pathogens. However, 98% hand rubs use suggested adherence to the method, prior to conduction of the study. Thus, the findings were able to establish the effectiveness of multimodal intervention for improving hand hygiene practices.

On the other hand, Sadule-Rios and Aguilera (2017) suggested lack of adequate healthcare workers and subsequent workload as the basic factors that were responsible for poor compliance to hand hygiene practices. Furthermore, lack of time management skills were cited as another primary reason for poor compliance to the infection control practices. Hence, it can be ascertained from the research that adhering to proper hand hygiene practices in healthcare settings will prevent the spread of deadly pathogens and will also enhance the health and wellbeing of the patients, staff and the family members of the service users. Owing to the fact that poor infection control is related to increased mortality rates, influenza, diarrhoeal and respiratory infections, introduction of this behavioural change that would make it mandatory to wash hands at regular intervals will act as the most inexpensive and effective way of preventing the spread of germs. Use of soap and detergents, solid soap, antibacterial soap, and hand antiseptics will kill the pathogens and prevent all kinds of detrimental effects on the human body.

References

Barbier, F., Andremont, A., Wolff, M., & Bouadma, L. (2013). Hospital-acquired pneumonia and ventilator-associated pneumonia: recent advances in epidemiology and management. Current opinion in pulmonary medicine, 19(3), 216-228.

Breathnach, A. S. (2013). Nosocomial infections and infection control. Medicine, 41(11), 649-653.

Ceballos, K., Waterman, K., Hulett, T., & Makic, M. B. F. (2013). Nurse-driven quality improvement interventions to reduce hospital-acquired infection in the NICU. Advances in Neonatal Care, 13(3), 154-163.

Cleary, M., Horsfall, J., & Hayter, M. (2014). Data collection and sampling in qualitative research: does size matter?. Journal of advanced nursing, 70(3), 473-475.

Dancer, S. J. (2014). Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination. Clinical microbiology reviews, 27(4), 665-690.

Luangasanatip, N., Hongsuwan, M., Limmathurotsakul, D., Lubell, Y., Lee, A. S., Harbarth, S., … & Cooper, B. S. (2015). Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. bmj, 351, h3728.

Manzoni, P., De Luca, D., Stronati, M., Jacqz-Aigrain, E., Ruffinazzi, G., Luparia, M., … & Farina, D. (2013). Prevention of nosocomial infections in neonatal intensive care units. American journal of perinatology, 30(02), 081-088.

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., … & Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic reviews, 4(1), 1.

Munn, Z., Moola, S., Riitano, D., & Lisy, K. (2014). The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. International journal of health policy and management, 3(3), 123.

Rodriguez, V., Giuffre, C., Villa, S., Almada, G., Prasopa-Plaizier, N., Gogna, M., … & Graciela, A. (2015). A multimodal intervention to improve hand hygiene in ICUs in Buenos Aires, Argentina: a stepped wedge trial. International Journal for Quality in Health Care, 27(5), 405-411.

Sadule-Rios, N., & Aguilera, G. (2017). Nurses’ perceptions of reasons for persistent low rates in hand hygiene compliance. Intensive and Critical Care Nursing, 42, 17-21.

Schumacher, M., Allignol, A., Beyersmann, J., Binder, N., & Wolkewitz, M. (2013). Hospital-acquired infections—appropriate statistical treatment is urgently needed!. International journal of epidemiology, 42(5), 1502-1508.  Infection Control And Hand Hygiene Practices In Healthcare Settings Example Paper