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Chapter 5 infection control prinicples and practices
Chapter 5 infection control prinicples and practices
Literature review on hospital acquired infection
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Chlorhexidine Bathing Reduces Hospital Acquired Infections Healthcare-associated infections (HAIs) contribute to mortality, prolonged hospital stays, and increased healthcare costs. The Center for Disease Control and Prevention (CDC, 2016) announces, “one in 25 hospital patients has at least one healthcare-associated infection.” Given this astounding statistic and the fact that most of HAIs are preventable; nurses must seek out evidence-based research to employ interventions that prevent HAIs such as such as chlorhexidine gluconate (CHG) bathing. The use of this intervention is applicable to all adult patient populations. This intervention should be of interest to nursing organizations that initiate change in practices and treat adult …show more content…
al. (2012) sought to “evaluate, in a real-world hospital setting the effectiveness of CHG bathing via bed baths in preventing HAIs in hospitalized patients.” All inpatient care areas of a 689-bed medical center, except the neonatal intensive care unit, the newborn nursery, and labor and delivery unit, for this study utilizing a quasi-experimental method. The sample size is not specific in terms of the number of patients, however; there were over 188,859 patient-days in the intervention period and 68,302 CHG baths given. During the washout period 36,621 patient days, and soap and water bathing period at the baseline was 121,562 patient days. The independent variable is bathing with CHG and the dependent variable is the rate of HAIs. Other variables of the study were patients bathed 3 days a week with CHG, patients bathed daily with CHG, and patients not bathed with CHG, compliance with bathing, differing hospital units, and the types of infection VRE, MRSA, CLABSI, CAUTI, VAP, and C.difficile. Researchers measured variables by data collection, monitoring for HAI’s, Poisson regression general linear model, and statistical analysis. The findings demonstrate a significant decline in infections due to C. difficile (70%) with the use of CHG baths, even though there was not a consistent effect on other HAIs. Implications of this study associate CHG bathing with a significant decrease in C. difficile infections. The researchers expressed that …show more content…
The study is a meta-analysis, which is the strongest type of evidence; however, it could have been stronger if it had been inclusive of only randomized controlled studies. Contributing to the study’s strength was that it had homogeneity and a 95% confidence interval. In comparison, the other articles reviewed had a lower level of evidence for the use of bathing with CHG in the prevention of HAIs by the virtue of the design type. The well-developed articles did present a significant level of evidence with clearly defined results, limitations, and a confidence interval of 95%. The practice guidelines from National Guideline Clearinghouse (2013) utilized strong evidence with a systematic review with evidence tables and recommended that to reduce the risk of bloodstream infection, patients should receive a daily 2% CHG bath in inpatient critical care settings.
Discussion Whether Sufficient Evidence for Change Part of the research covered was in accordance with policies and procedures at Sentara Healthcare. The policy requires all patients that have a central line must have a daily CHG bath (Sentara Healthcare, 2015). The research did show a reduction in other types of HAIs, but a policy could not be located in regards to daily CHG bathing in general to prevent HAIs. Further assessment of this area needs to be done since evidence suggests that there
“The CDC is the primary developer of national infection control and prevention guidelines, often in collaboration with its Healthcare Infection Control Practices Advisory Committee, which is responsible for research and dissemination of the latest information for preventing disease transmission” (Griffis, 2013, p. 175). Infection control will continue to be a topic of discussion as long as germ transmission is still happening. Among these studies is the concern the frequent nonadherence to contact precautions is a huge issue that many studies are still very concerned about (Jessee & Mion, 2013, p. 966). The writer is also concerned with the blatant disregard for hand hygiene that appears to be happening in the medical field. What about what is best for the patient. Do the people that do not use proper hand hygiene not understand how important it
Pyrek, K. M. (2009, December 18). SPOTLIGHT ON PREVENTION: HAI-Related Litigation: What Infection Preventionists Need to Know. Retrieved December 30, 2013, from http://hospitalacquiredinfections.blogspot.com/2010/01/hai-related-litigation-what-infection.html?m=1
Obviously soap and warm water for 20 seconds or hand sanitizer. I will admit I was one of those that didn’t classify “handwashing” as using hand sanitizer, to me washing is soap and water, but it is considered washing and sometimes much more convenient than to be at a sink. But with all that in mind, we also need to remember when it is appropriate to use hand sanitizer. Alcohol based sanitizer kills most of the bad germs, but it does not kill C. difficile, a common healthcare-associated infection that causes diarrhea (CDC, May 5, 2017). If you are caring for a patient with this illness, then you must wash your hands with the real soap and water, no shortcuts! As well as when our hands are visibly soiled. Who wants to walk around with dirty hands anyway? In 2009, Cambridge University did a study correlating on compliance and no compliance with handwashing hygiene and guidelines in hospital care. There were 96 empirical studies, most of which were done in ICU units. They found and overall compliance of 40%. Unadjusted compliance rates were lower in intensive care units (30%-40%0, than in other settings (50%-60%), lower among physicians (32%) than among nurses and before (21%) rather than after (47%) patient contact. The majority of the time, the situations that were associated with low compliance rates were those with a high activity level/or those in which the physician was involved. The majority of the time, the situations that were associated with a higher compliance rate were those having to do with dirty tasks, the introduction of alcohol-based hand rub or gel, performance feedback and accessibility of materials (Cambridge, March
This literature review will analyze and critically explore four studies that have been conducted on hand hygiene compliance rates by Healthcare workers (HCWs). Firstly, it will look at compliance rates for HCWs in the intensive care units (ICU) and then explore the different factors that contribute to low hand hygiene compliance. Hospital Acquired infections (HAI) or Nosocomial Infections appear worldwide, affecting both developed and poor countries. HAIs represent a major source of morbidity and mortality, especially for patients in the ICU (Hugonnet, Perneger, & Pittet, 2002). Hand hygiene can be defined as any method that destroys or removes microorganisms on hands (Centers for Disease Control and Prevention, 2009). According to the World Health Organization (2002), a HAI can be defined as an infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. The hands of HCWs transmit majority of the endemic infections. As
The field of nursing is an ‘in-demand’ profession that strives for excellence in patient care and positive outcomes. A nurse’s care is always patient-focused with the goal of helping patients reach maximum medical improvement. The job of a nurse can be physically, mentally, and emotionally challenging at times. This can lead to occupational burnout which has been linked to suboptimal medical care (Cimiotti, Aiken, Sloane, and Wu, 2012). The impact of sub par health care, results in a higher number of hospital-acquired infections (HAIs) and poor patient outcomes. Implementation of infection control practices and HAI prevention programs are two of the most important aspects of nursing care being utilized to improve patient outcomes. The effect of nurse staffing configurations and nurse-to-patient ratios have also been shown to play a significant role in the relationship between nurses and HAIs.
“Failure to attend to hand hygiene has serious consequences: it has a negative effect on patient safety and the quality of patients’ lives, as well as on their confidence in healthcare delivery. However, the prevalence of hand hygiene omission is still high” (Canadian Disease Control, 2016 p 1). Washing hands before and after patient contact seems like a simple solution to prevent the spread of bacteria between patients. But it is not as simple as it seems.According to new CDC data, “approximately one in 25 patients acquires a health care-associated infection during their hospital care, adding up to about 722,000 infections a year. Of these, 75,000 patients die from their infections ( CDC, 2016 p 1).” Leaving a finacial burden on Canada’s health care
Prevention of hospital-acquired infections: review of non-pharmacological interventions. Journal of Hospital Infection, 69(3), 204-219. Revised 01/20 Haugen, N., Galura, S., & Ulrich, S. P. (2011). Ulrich & Canale's nursing care planning guides: Prioritization, delegation, and critical thinking. Maryland Heights, Mo. : Saunders/Elsevier.
It was previously thought that the type of water aspirated posed a serious threat to the patient and drastically increased their chance of mortality. In particular, salt water was thought to be one of the more potent types of water to aspirate due to it’s tonicity. This previous thought that salt water was more harmful to...
In conclusion researching and updating current studies are a major influence in creating new evidence based guidelines in treating sepsis. Continuing to study sepsis and reviewing newer guidelines will provide safer care for patients. The path toward reducing sepsis mortality begins with early recognition from both nursing and medical staff and also giving education to patients prior to them even presenting.
The systematic review; Interventions to improve hand hygiene compliance in patient care, conducted by the Cochrane Collaboration investigated inventions to improve hand hygiene compliance within patient care. The review included 2 original studies with an additional two new studies (Gould & Moralejo et al., 2010). Throughout the review it was affirmed that among hand hygiene is an indispensable method in the prevention of hospital-acquired infections (HAI), the compliance among nurses’ is inadequate. Nurses are identified within the public as dependable and trustworthy in a time of vulnerability due to their specialised education and skills (Hughes, 2008). Thus, it is imperative that evidence based practice is cond...
Medical asepsis plays an integral role in infection control within a health care facility. It includes procedures used to decrease and prevent direct contact with blood or bodily fluids and emphasizes keeping the environment clean on a regular basis (Curchoe, Astle, & Hobbs, 2014). In order to achieve optimal health, individuals depend on practices and techniques that control and ultimately prevent the transmission of infection. These practices and techniques can help avoid the transmission of infections by creating an environment that protects both health care workers and patients from communicable diseases. Good hand hygiene has been stressed as the single most important measure to prevent cross-infection to patients in health care facilities
“Researchers in London estimate that if everyone routinely washed their hands, a million deaths a year could be prevented” (“Hygiene Fast Facts”, 2013, p. 1). Hands are the number one mode of transmission of pathogens. Hands are also vital in patient interaction, and therefore should be kept clean to protect the safety of patients and the person caring for the patient. Hand hygiene is imperative to professional nursing practice because it prevents the spread of pathogens, decreases chances of hospital-acquired infections, and promotes patient safety. There is a substantial amount of evidence that shows why hand hygiene is important in healthcare
The Infection Prevention and Control (IPC) Program is an essential force maximizing quality, patient centered care, and safety throughout the Veterans Affairs North Texas Health Care System (VANTHCS). The VANTHCS “... is a progressive health care provider in the heart of Texas ... we serve more than 117,000 Veterans and deliver 1.4 million outpatient episodes of care each year to Veterans in 38 Texas counties and two counties in southern Oklahoma” (“VA North Texas,” 2016, para. 1). The purpose of the IPC Program is to guide a facility-wide approach toward identifying, preventing, controlling, and eliminating healthcare-associated infections (HAIs). This approach is facilitated through infection control (IC) practitioner’s role-modeling behaviors of assessing, supporting, guiding, and/or directing healthcare providers (HCPs) in the application of evidence-based practices (EBPs) to prevent HAIs. According to the Centers for Disease Control and Prevention (CDC), HAIs are often preventable adverse events that pose a major threat to patient safety (“Centers for Disease,” 2016). As a result, IC practitioners recognize the importance of preparing nurse faculty to engage clinical staff in the application of EBPs to prevent infections.
This was drew on three systematic reviews, two of them for the Cochrane Collaboration, focused on the effect of hand washing with soap on diarrhea, of water quality improvement and of excrete disposal, respectively. The risk reduction in this specific study was a reduction of 48%, 17%, and 36% respectively in reduction of diarrhea. They recognize that water, hygiene, and sanitation have important benefits to people’s health. It does not only prevent the spread of diarrhea, but also prevents other types of illnesses contracted through direct contact (Cairncros, Hunt, Boisson, Bostoen, Curtis, Fung, & Schmidt,
...98,000 Americans die from these each year (Braunstein, 2012). With the treatment of holistic health care, the incidence rate of HAIs in hospitals can be decreased as well.