Infection Prevention In The Perioperative Environment: A Literature Review Assessment

ACORN Standards

The Australian College of Operating Room Nurses (ACORN) consist of standards. The primary standards are fatigue, infection prevention, environmental- sustainable, perioperative attire, asepsis, perioperative practice and surgical safety. The infection prevention standard ensures control of infection in patients who are undergoing surgery. This standard is the considered practice in an operating theatre department; it is applied for both young and adults’ patients. Infection prevention is an everyday practice and is followed by every individual. Infection prevention is a safety measure given to patients for the avoidance of adverse results from the practice of healthcare. Infection prevention is a significant issue which must be considered when nurse cut into patients’ skin; this is to prevent the high potential of getting an infection from pathogens. This standard aims to ensure that nurses give care to patients and prevent major possible infection (Gillespie et al. 2013). Infection Prevention In The Perioperative Environment Discussion Paper There are pathogens in the hair which cause infection; this is avoided through covering in an operating room. Reviewing of update policies on the dressing mode to pyjama-style minimizes the risks of infection, this is because it has fewer bacteria, it has to control the infection standards. Safe surgery practice is considered to prevent suspected infection in patients. Infection prevention standard give patient respectful and dignified treatments through a high standard of care.

Electronic sources have been a significant source of information, which has boosted several types of research, especially in nursing. Electronic data sources were used to search for evidence-based literature that supports the ACORN standard 9 of infection prevention. During the search, the concept of infection prevention and other related search concepts were used to get relevant information. Some of the keyword used were infection control, infection prevention, and infection prevention measures (Gillespie et al. 2013). Some of the databases used to obtain information include CINAHL (EBSCO), Trip database, Cochrane collaboration, OVID, UTS Library, Update, Wiley Inter-science, Google Scholar and the Joanna Briggs. Boolean operators were also employed during the search to expand searches. The search strategy used was efficient was to acquire information available on open-access directories and databases.

Cochrane Library (Wiley) is one of the databases with the desired literature review. Searches were made related to infection prevention standard. When a search was done on the keyword “infection prevention” 98 reviews matching the keyword were found. On a second search basing on the keyword infection prevention measures, 735 matches were found to match in the Cochrane Database of Systematic Reviews. On a third search basing a keyword related to topic infection control, a total of 1852 matches were found. Most of the searches relating to the topic were relevant basing on clinical answers. Cochrane provides high-quality research-based evidence that could help in making a health decision. Infection prevention. AlFaleh & Anabrees 2014 noted that Cochrane evidence offers reliable information on infection prevention in perioperative nursing that could be used to enhance healthcare knowledge and decision making.

ORDER A PLAGIARISM-FREE PAPER HERE

Literature Review Assessment

Berríos-Torres, S. (2017) conducted a systematic literature review in MEDLINE, EMBASE, CINAHL, and the Cochrane Library. Out of 5759 titles found, reviews were made and 170 studies were selected as evidences, analyzed and recommendation made. The integrated review articles aim at providing new and updated evidence-based recommendations for the prevention of surgical site infection and guideline that should include comprehensive surgical quality improvement programs to advance the patient safety. Some of the finding of the peer review include: encouraging patients to shower using an antiseptic agent at least a day before an operation day and recommended alcohol-based agent to be used in skin preparation during operation.

Dumville. J et al. (2016) carried out evaluation of research studies carried out by utilizing databases like Cochrane, Ovid MEDLINE, EBSCO CINAHL Plus until September 2016. The objective of the study was to make assessment of effects of wound dressings and the effects of alternative wound dressings in infection prevention. From the evaluations It is not certain whether dressing the wounds minimize the risks of infections, reduce the pain easy to remove. Majority of the studies in the review was small with a high chance of bias. Centered on the evidence available decision making may on dressing the wound may be based on cost and preference of the patient.

Webster, J et al. (2019), In the study summarizes the use of negative pressure on healing the wounds. The evidence obtained on the efficiency of this therapy is low and not certain and new trials needed in order to make an up to date review of the evidence. The uncertainty is about whether the normal dressing as compared to the negative pressure therapy increases or reduces the prevalence of the outcomes. From the study there is need to make another trials to conduct evaluations on the effects of new wound therapy products which can be used in closed surgical cuts.

Cho, S. & Chung, D (2017) conducted a searched at PubMed to identify relevant articles, using numerous key words such as: “healthcare-associated infections”, “hand hygiene,” “infection prevention standard,” “infection control,” “contact precaution and isolation,” “environmental cleaning,” “antimicrobial stewardship,” and “surgical site infection.”  The search from several relevant reviews was screened and evaluation made on the effect of interventions on surgical site infection (SSI) resulting from MRSA. Basing on the search reviews and questionnaire of the survey Cho, S. & Chung, D (2017) considered infection prevention strategies for health settings in the period of CA-MRSA.   The found that CA-MRSA is one of the vital cause of healthcare-associated infection.

Search Strategy

However, most of the search engines in most of the evidence-based resources does not support searches by use of synonyms. Also, most of the search results were irrelevant in almost all the databases. I addition the numerous amount of sources makes it difficult in getting the desired information. The inclusion of textbooks makes the searches to delay in accessing the data. It was also noted that some of the search results were relevant and useful.

Loveday et L. (2014) in their systemic reviews cited that infection associated with surgical operations have a lot of pain to the patient and substantial cost implications to the society. Therefore, prevention of the infections is necessary. The major causes of surgical site infection are the development of microorganisms, and this is dependent on the patient’s immune system and bacterial load. The bacterial load in the surgical environment can be restricted by adhering to guidelines which lessen the level of risk of infection. Actions, for example, ensuring staff compliance to hygienic practices and continuous cleaning during every procedure can reduce the bacterial load and thus a reduction in infections

The safety of the patient refers to avoiding and preventing serious outcomes from the healthcare process. Healthcare infection is one of the causes of patients’ death, and a lot of focus should be put on infection prevention. The ACORN standards mainly focus on making improvement and standardizing nursing care practices and providing education to the nurses to build their capacity and improvements in service provision to the patients. Furthermore, it minimizes risk exposure to patients through the prevention of infections. Control and prevention of infection are the most critical issues in the safety of the patient in healthcare (Loveday et L., 2014). As a way of protecting the interest of the patient, all the healthcare stakeholders need to participate in the prevention of infections. Utilization of standard practice contributes to a patient’s safety and minims healthcare risks such as infections. If the standards are effectively utilized, transmissions of infections will reduce.

The ACORN standards lay out the acceptable minimum quality standards for the perioperative nurses and what is required for visitors and healthcare facility, including representatives of medical organizations. The standards give guidelines and direction concerning wearing of perioperative attire, and the underlying principle is to address infectious organisms dispersible from the healthcare personnel to the patient through the skin and the hair. Use of perioperative attire is the best way of reducing contamination and ensuring a safe environment for providing care to the patient Bosco (2010). The standards on perioperative care provide that personnel have a duty to show that head covers meet the required standards for the perioperative attire in Australia. It further provides that health service organization to come up with policies to guide the use of the attire which meet the required standards as outlined in the standards for health care textiles, surgical attire and laundering are met. Infection prevention helps in minimizing the costs of medication to the patients and improvement in the quality of life.

Patient Safety

Healthcare-related infections are among the significant challenges faced by the patients. Some of the important ways of reducing the effect of the infections are;

Landers (2012) in is peer-review cited that hand hygiene is one of the critical areas of reducing infections risk, and hand hygiene involve washing hands with anti-bacterial soap and water and using alcohol-based sanitizer to disinfect the hands. In certain situations, when the hands are not soiled use of alcohol gel is the preferred way of ensuring hand hygiene during healthcare provision to the clients. Hand hygiene should be carried out before and after coming in contact with the patient, after handling the medical equipment’s, after using the restroom and after coughing or sneezing as this will remove microorganisms. Cuts should always be covered with a waterproof dressing, and any blood contamination washed with water and soap. Decontamination of hands should be done after being in contact with the patient as soon as the safety of the patient permits (Stulberg et al., 2010). Adherence to policies governing hand hygiene needs to be followed by all members of staff. Wearing of gloves needs to be worn whenever contamination is anticipated, and the gloves used should conform to the standards set. Changing of gloves should be done after every procedure or if torn or contaminated. The medical staff needs to remove gloves when handling clean medical equipment.

Use of Perioperative attire assists in minimizing contamination within the perioperative environment and helps in the provision of safe patient care by ensuring the ACORN standard 9 “infection prevention standard” is followed within the perioperative environment. Nixon, (2019) indicated that the use of aseptic technique help reduces the exposure risk of microorganisms to the patient. This technique involves the use of strict rules in surgery rooms and other healthcare settings. It consists of applying the most stringent regulations to minimize the risk of infection. Healthcare workers use aseptic technique in rooms, clinics, outpatient care centres, and other health care settings (Smyth, 2011). All members of the healthcare team are supposed to monitor the practice and initiate corrective action where necessary continuously. Use of protective attire has been proved to be the most effective way of minimizing the transmission of microorganisms and decrease the contamination of pathogens. The scrub if appropriately done, ensure that the medical team minimizes microorganisms in the hands. Preparation of the skin before the surgery removes contaminants and microorganisms and reduce the number of pathogens in the skin, which might cause the infections.

Perioperative Attire

Patient care areas, waiting for bays and any other areas where the patient may come into contact with needs thorough cleaning using disinfectants to eliminate infection-causing microorganisms. Housekeeping surfaces like the floors also need continuous cleaning using detergents or disinfectant. Spry, (2016) suggested that to guarantee good results from the use of disinfectants cleaning should be done because the results from using disinfectants depend on hygiene. Skin preparation immediately before surgery using an antimicrobial agent reduces the risk of postoperative SSI by removing soil, resident and transient microorganisms from the skin.

References

AlFaleh, K. and Anabrees, J., 2014. Probiotics for prevention of necrotizing enterocolitis in preterm infants. Evidence?Based Child Health: A Cochrane Review Journal, 9(3), pp.584-671.

Berríos-Torres, S.I., Umscheid, C.A., Bratzler, D.W., Leas, B., Stone, E.C., Kelz, R.R., Reinke, C.E., Morgan, S., Solomkin, J.S., Mazuski, J.E. and Dellinger, E.P., 2017. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA surgery, 152(8), pp.784-791.

Bosco III, J.A., Slover, J.D. and Haas, J.P., 2010. Perioperative strategies for decreasing infection: a comprehensive evidence-based approach. JBJS, 92(1), pp.232-239.

Cho, S.Y. and Chung, D.R., 2017. Infection prevention strategy in hospitals in the era of community-associated methicillin-resistant Staphylococcus aureus in the Asia-Pacific region: a review. Clinical Infectious Diseases, 64(suppl_2), pp.S82-S90.

Dumville, J.C., Gray, T.A., Walter, C.J., Sharp, C.A., Page, T., Macefield, R., Blencowe, N., Milne, T.K., Reeves, B.C. and Blazeby, J., 2016. Dressings for the prevention of surgical site infection. Cochrane Database of Systematic Reviews, (12).

Gillespie, B.M., Polit, D.F. and Chaboyer, W., 2013. The influence of personal characteristics on perioperative nurses’ perceived competence: Implications for workforce planning. Australian Journal of Advanced Nursing, The, 30(3), p.14.

Landers, T., Abusalem, S., Coty, M.B. and Bingham, J., 2012. Patient-centered hand hygiene: the next step in infection prevention. American journal of infection control, 40(4), pp. S11-S17.

Loveday, H.P., Wilson, J.A., Pratt, R.J., Golsorkhi, M., Tingle, A., Bak, A., Browne, J., Prieto, J. and Wilcox, M., 2014. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital Infection, 86, pp. S1-S70.  Infection Prevention In The Perioperative Environment Discussion Paper