INTRODUCTION
Every year, many lives are usually lost due to the spread of infections in the hospitals. Although all hospitals have infection control procedures and policies, the risk of infections seems to be impossible to completely eliminate. In the course of my clinical nursing experience, I have noted that these infections that are mostly picked up during a patients stay in the hospital mostly ranges from lung infections, urinary tract infections, Methicilin-Resistant Staphylococcus Aureus (MRSA), and blood stream infections among many others (Amos & Waugh,2010). These are commonly known as hospital-acquired infections (HIA). In this paper, I will expound on the problem of the spread of infections in hospitals, identify the concept relevant to the spread of HIA and also give suggestion on how to curb this problem. In addition, I will review numerous medical journals from different authors who have previously carried out researches on the spread, prevention and control of infections acquired in the hospital
- Mode of Transmission Concepts
The major avenues of transmission of infections acquired in the hospitals are through direct contact, airborne, droplet and common-vehicle transmissions. These four concepts generally form the key modes of transmission in hospital-acquired infections. Droplet transmissions can be explained as a form of transmission that occurs when droplets which are containing microorganism from an infected person are transferred through the air and ends up landing on the mouth, nose or eyes of another person. These droplets are usually generated when an infected person coughs sneezes or is talking. Airborne transmission occurs when a droplet which is containing a micro organism evaporates and tends to remain suspended in the air for a long period of time. On the other hand, contact transmission is the most common means of spreading infections in the hospital. In addition it is also one of the most easily preventable. It involves spreads of infections through both direct and indirect contact. In regard to direct contact, this form of transmission involves direct contact with body to body surface which ultimately leads to the spread of the microorganisms. Indirect contact, which is also known as cross-contact transmission, involves contact of a body surface with an object that has been infected or contaminated. The spread of infections in the hospital through contact transmission can be curbed through meeting the required levels of hygiene especially hand hygiene before and after contact with an infected person’s body or surface (Root & Waldvogel, 2009). Therefore, washing and drying the hands properly while in the hospital setting can greatly reduce ones chances of acquiring or spreading infections.
- The Need for a Research
I believe that a nurse plays a major role in the prevention and control of infectious diseases in any hospital setting. From the beginning as a nursing student, one participates in numerous prevention processes since their initial introduction to nursing care. One of the most important components in the preparation of clinical nursing practice is the ability to clearly understand the process of spreading and prevention of infectious diseases. In regard to the problem at hand, I can deduce different ways through which the spreading of infections occurs and can be contained in the hospital. Through my experience, I have come to realize that all patients who are usually admitted to the hospital are at given levels of risk of contracting Hospital acquired infections. Some patients are more vulnerable than the others, these chances of risk increases especially when the patient has been hospitalized for a long period of time or has had a surgery. Hospital –acquired infections have been known to cause adverse effects to both the patients and its community. They have known to cause patients to develop other types of illnesses other than those that they were being treated for, causing longer stay in the hospital, longer recovery time and also lead to increase in costs which can be related to the longer recovery time and longer stay in the hospital. It is for this reason that I consider this choice of my health problem requires attention and warrants a research so as to identify other measures that can lead to improvement in the current preventive measures.
HYPOTHESIS
Daily bathing and hand washing with a skin antiseptic such as chlorhexidine gluconate, is able to reduce the chances of a patient’s skin contamination and therefore indirectly decrease contamination of the healthcare worker’s hands and environment, and potentially play a significant role in preventing the spread of infections in hospital setting.
LITERATURE REVIEW
Understanding how the process of spreading of infections occurs ultimately leads to formulation of various measures that can be used to prevent further spreading. Infection spread control is especially vital within the healthcare setting. According to a medical journal by Stirling B and LittleJohn on Nurses and the Control of Infectious Diseases: Understanding disease transmission is vital to nursing care, the spread of any infectious diseases normally requires three components: An agent (this can be a virus, parasite, bacterium or other microbe), a vulnerable host and lastly a conducive environment. This journal has also explained the ways through which disease spread can occur, For instance, through vectors , fomites, water and food. In addition, Stirling B and LittleJohn have also explained that, the infection can be stopped by attacking the causative agent on time, changing the environment e.g. through providing negative pressure rooms or strengthening the host/patient especially through vaccination.
Post surgery wound care, use of protective equipment, importance of hand washing, need for education and training has been termed by a report by World Health Organization as the most vital approaches to combating the spread of infections in the hospital. In their report, they claim that wound care is imperative when delivering postoperative care and in reducing the spread of infections. This is achieved because the skin acts as a protective barrier which protects the body from infectious microorganisms (WHO,2011). Once the skin is broken, the chances of acquiring an infection increase. The WHO report states that 20% of all healthcare infections are as a result of surgical sites infections. In addition, it claims that 5% of all the patients who undergo surgery mostly develop surgical infections. This is therefore sited to be among the most common ways through which infections are spread in the hospital setting.
Another way by which infections are usually spread is through lack of wearing the essential protective gears especially by medical practitioners. Personal Protective Equipment should be worn all through the delivery of care, mostly during postoperative care. These protective equipments include gloves, masks, aprons and eye protection. These equipments plays a major role when dealing with surgical wounds, this is because they are capable of protecting an individual from all types of body fluids and contamination of other infectious surfaces (Amos & Waugh,2010). Additionally, the WHO report insists on proper disposal of this protective equipment so as to prevent any instances of contamination or spread of infections.
It is however worth noting that, nurses are among the most people affected by infections acquired from the hospital. A research on Nurses contacts and potential for infectious diseases transmission which was carried out by various medical scholars shows that their day-to-day contact with infected patients place them at a higher risk of contracting various diseases. These researchers used a representative population survey which was being compared to nurses daily contacts with their patients. A total of 129 nurses(N=129) recorded a median of 40 contacts (85% were cork related contacts) while the controls (N=129) reported a median of 12 contacts a day(33% were work related contacts). For the nurses, 52% of all work related contacts were with patients, whereby, 74% involved skin-to-skin contacts which lasted ≤15 minutes; 40% were contacts between the nurses and fellow staff members (Bernard, Fischer & Mikolajczyk,2009). In case of a pandemic, instances of hospital acquired infections can lead to an acute shortage of staff shortage due to acquired illnesses.
Infections pose a great challenge to public health as well as the related healthcare settings. Therefore, the procedures that are undertaken within the hospitals setting must protect both the patient and also the individuals from risks of infections acquired from the healthcare facility. A journal by Scottish medics states that, “it is estimated that around 11% of patients who enter Scottish hospitals acquire various forms of infections mostly during their admission. This can be calculated to at least 10,000 infections per annum (The Scottish Government, 2008). They have suggested that a public health program dubbed Cleanliness champions be rolled out which would be involving medical professionals who in turn would train the public in matters regarding prevention of spread of infections. This program would also emphasis on following guidelines and procedures on prevention and control by healthcare staffs. For instance, the use of alcohol gel dispensers is essential in maintaining high standards of cleanliness in our hospital settings. They explain that the use of these dispensers is very helpful in maintaining good hand hygiene.
CONCLUSIONS
Currently, healthcare workers such as nurses have an abundance of scientific knowledge on the spread and prevention of infections. Using this knowledge, we are able to formulate policies that may be used to help reduce these hospital acquired infections. Reducing the spread of HAI is essential for all the medical staff connected to the hospital environment so as to ensure that all the people who visit the healthcare facility are at minimal risk of exposure to infections. In particular, nurses are expected to demonstrate good infection control and ensure that, through their leadership skills, the risk of spreading of hospital-acquired infections has been reduced.
ReferencesTop of Form
Amos, A, Waugh, A. (2010) 'Caring for the person having surgery' in Brooker, C, Waugh, A.
(ed.) Foundations of Nursing Practice Fundamentals of Holistic Care. Philadelphia, pp. 692-693.
Bernard, H., Fischer, R., Mikolajczyk, R. T., Kretzschmar, M., & Wildner, M. (2009). Nurses’
contacts and potential for infectious disease transmission. Emerging infectious diseases, 15(9), 1438.
Bulkow, L. R., Singleton, R. J., DeByle, C., Miernyk, K., Redding, G., Hummel, K. B., &
Hennessy, T. W. (2012). Risk factors for hospitalization with lower respiratory tract infections in children in rural Alaska. Pediatrics, 129(5), e1220-e1227.
Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and
health care–associated infection. American journal of infection control, 40(6), 486-490.
Henry, M, Kilpatrick, C (2006) 'Prevention, control and management of infection', in Alexander.
F.M, Fawcett. N (Tonks) J, Runciman.J.P. (Ed) The Nursing Practice Hospital and Home. London: Elsevier, pp. 653-689.
In Bartlett, J. G., In Blacklow, N. R., & In Gorbach, S. L. (2012). Infectious diseases.
Philadelphia: Lippincott Williams & Wilkins.
Root, R. K., & Waldvogel, F. (2009). Clinical infectious diseases: A practical approach. New
York, NY [u.a.: Oxford Univ. Press.
Stirling, B., Littlejohn, P., & Willbond, M. L. (2008). Nurses and the control of infectious
disease. Understanding epidemiology and disease transmission is vital to nursing care. The Canadian nurse, 100(9), 16.
The Scottish Government (2008) HAI Task Force - Education and Training. Available at:
http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/19529/impareas/education [Accessed 15 Aug 2013]
WHO, infections and infectious diseases. A manual for nurses and midwives in the WHO
European Region, 2011 Web. Retrieved 15 Aug 2013
