Preventing Nosocomial Infections from Nurses to Patients
Preventing Nosocomial Infections from Nurses to Patients
The undesired effects of nosocomial infections also known as healthcare-associated infections have been vital topics in medical research for several decades. With the escalation of these complications, these occurrences have prompted the necessity to address the HAIs to reduce the high rates of morbidity and mortality (Jung, 2011, p. 190). Formerly, these infections were associated with acute-care hospital stay brought about by conditions within the healthcare setting. Due to their unanticipated occurrences, these infections develop over the course of treatment further worsening the health condition of the patient. The cost implications of treating these new infections, additional therapeutic and diagnostic interventions as well as prolonging of hospital stay are highlighted as the detrimental effects of HIAs (Kirk, 2015, p. 95). One of the compelling modes of reducing HAIs within the healthcare setting involves the introduction of the hand washing compliance program, which ensures the medical practitioners, and healthcare staff is compliant in adhering to the guidelines and regulations of this mandate to best provide proper treatment to patients.
HAIs often compromise patient’s safety, therefore, indicating the importance of its prioritization in preventing these conditions within healthcare institutions. In evaluating the impact of HAIs outcomes such as strong microbial resistance to antimicrobials, long-term disability and prolonged hospital coupled with patient emotional stress and financial difficulties in handling healthcare bills are denoted. Within developing and developed countries, HAIs are problematic given the ease of the mode of transmission through direct or indirect contact. One of the most common ways through which a healthcare worker such as nurse can transmit disease-causing microorganism is through their hands. With the inclusion of five sequential steps of transmission including the transference of organisms’ from nurse’s hand to the patient and survivance ability of the pathogen, this mode compromises the general health of the patient and healthcare worker.
Purpose of Change Proposal
The primary purpose of this proposal is establishing essential compliance strategies that ensure healthcare workers, particularly nurses, follow guidelines of hand hygiene when undertaking health treatment procedures and management (Gould & Brooker, 2008, p. 131). Through achieving this purpose, the perception of healthcare workers, nurses, in particular, will shift through eliciting an appreciation for hand hygiene and its effect in reducing hospital-acquired infections through consideration of guidelines and use of related equipment and alcohol-based formulations for clean hands (Gould & Brooker, 2008, p. 135). Given the association established between poor hands hygiene adherence due to overcrowding and understaffing of healthcare facilities and infections observed in outbreaks, this change proposed will ensure HAIs are addressed, and quality of life of affected patients is improved.
The patient problem in regards to the change proposal is nosocomial infections transmitted by healthcare workers to patients within healthcare facilities
The proposed change includes an introduction and implementation of a multimodal system geared towards improving hand hygiene in the healthcare staff population to reduce rates of mortality and morbidity associated with related HAIs (Gould & Brooker, 2008, p. 145)
An alternative proposed is gloves usage (Siegel, Rhinehart, Jackson, & Chiarello, 2007, p. E68)
Several outcomes are expected from this change proposed in addressing nosocomial infections transmitted from healthcare workers. Firstly, the cost-effectiveness element whereby healthcare facilities will implement a workable solution for reducing these infections and educating and training their staff without incurring extra costs in treating MRSA infections and additional expenditure on pharmaceutical products to expedite treatment, instead, those financial resources that can be directed into meaningful projects.
The timeline for application is dependent on the scheduling of the implementation plan by the healthcare facility in question.
Literature Search Strategy
Different methodologies will be applied in reviewing the literature on HAIs and preventing strategies with a central focus on healthcare workers, nurses in particular. The studies selected will focus on presenting a multimodal approach to hand hygiene targeting healthcare workers and disease management.
Evaluation of Literature
The studies selected will present multimodal strategies of nosocomial infection prevention including improvement of soap and water availability, education and awareness creation on hand hygiene, the inclusion of automated sinks, practices audits, reminders, and introduction of computerized sinks. Also, enhancement of institutional safety climate and the integration of alcohol-based hand rub on both patient and healthcare worker levels will be considered (Siegel, Rhinehart, Jackson, & Chiarello, 2007, p. S 70).
The change applicable and proposed is the Multimodal Hand Hygiene strategies with the inclusion of tools and mechanisms imperative in ensuring improvement in eradicating nosocomial infections. With the consideration of guidelines presented by WHO, the recommendations will be highly effective in reducing the cases of morbidity and mortality observed within healthcare facilities associated infections transmission from healthcare workers to patients. The innovative approach that can aid the efficiency of this strategy is termed as ‘My five moments for hand hygiene” (Wong, 2016, p. 56). This concept promotes five main steps of hygienically dealing with a patient including cleaning hand with soap and water before
- Physically contacting the patient
- Performing aseptic procedures
- Exposure to bodily fluids
- After engaging in physical contact with a patient during treatment operations
- Physically touching the patient’s surroundings
It inculcates scientific evidence indicative of the impact of this practice and its associated elements, which, allows for collaboration between observers and trainers regarding global adherence to this strategy imparting a worldwide appreciation for hygiene in controlling disease transmission.
Proposed Implementation Plan and Outcome Measures
The proposed implementation plan involves a multimodal system for hand hygiene based on evidence derived from epidemiological, experimental, and clinical studies on effective preventative measures of dealing with HIAs. The implementation protocol should align with the literature on behavioral change, implementation science, impact evaluation, innovation diffusion and spread methodology. The essential components of the plan will involve
- Evaluating Healthcare Facility Preparedness – assess readiness for hygiene improvement and overall reception
- Baseline Assessment- establishing the current HAIs situation within the facility
- Implementation – the introduction of activities aimed at improving hand hygiene which will involve five essential elements as follows
- Healthcare System Change – Involves in placing prominent structure within the institution to foresee the compliance to hand hygiene practices. Changes will include improved accessibility to surplus water supply, towels, and anti-microbial soaps as well as an alcohol rub (Wong, 2016, p. 60).
- Education/ Awareness Creation and Training- Implementing regular training sessions on hand hygiene and its importance hence promoting compliance to hand washing practices and hand rubbing procedures for all healthcare workers.
- Workplace Reminders- Establishing physical reminders like brochures, wall sticker indications, and procedures of hand washing processes.
- Healthcare Environment Safety Climate- through identifying and establishing a safe climate, the perceptions of awareness towards these infections are shifted hence leading to the prioritization hand hygiene thus facilitating hand hygiene improvement (Wong, 2016, p. 70).
Potential Barriers and Solutions
One of the main problems associated with the implementation of this change in healthcare facilities is the identification of governmental and institutional obligations in addressing nosocomial infections as per transmission from healthcare workers to patients (Wong, 2016, p. 78). One of the key solutions includes developing a workable list outlining delegated roles of each domain and its responsibility within the confines of collaborated efforts in addressing these infections.
Diagrams and Graphs
Fig 1: HIA Reductions by Handwashing. Retrieved from http://www.ihi.org/resources/Pages/ImprovementStories/ReducingMRSAInfectionsStayingOneStepAhead.aspx
Fig 2: Effect of handwashing on reduction of bacteria. Retrieved from http://www.bandolier.org.uk/bandopubs/RAMnhsfu/NHSfutur.html
Fig 3: Number of times had are washed versus onset of infections retrieved from http://www.australianfoodsafety.com.au/blog/2011/04/hand-washing-101/
- Educational Materials
- Peer Reviewed journals on NCBI pertaining to nosocomial infections and the effect of hand washing and hang hygiene
- Nosocomial infections and Modes of transmission journals.
Gould, D., & Brooker, C. (2008). Preventing infection in healthcare settings. Infection Prevention and Control, 131-148. doi:10.1007/978-1-137-04592-8_6
Jung, S. (2011). How to Prevent Transmission of Infectious Agents in Healthcare Settings. Hanyang Medical Reviews, 31(3), 190. doi:10.7599/hmr.2011.31.3.190
Kirk, J. (2015). Healthcare Worker Hand Contamination at Critical Moments in Outpatient Care Settings. Open Forum Infectious Diseases, 2(suppl_1), 90-95. doi:10.1093/ofid/ofv133.810
Pratt, R. (2009). Strategic risk management for preventing the transmission of Mycobacterium tuberculosis in healthcare settings. Tuberculosis, 23(12), 701-710. doi:10.1016/b978-1-4160-3988-4.00068-8
Siegel, J. D., Rhinehart, E., Jackson, M., & Chiarello, L. (2007). 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. American Journal of Infection Control, 35(10), S65-S164. doi:10.1016/j.ajic.2007.10.007
Wong, W. V. (2016). Efficacy of hand hygiene to reduce transmission of the influenza virus in community settings. American Journal of Infection Control, 2(23), 56-78. doi:10.5353/th_b4842639
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