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Infection prevention in hospital setting
Infection prevention in hospital setting
Infections in the hospital setting
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Recommended: Infection prevention in hospital setting
Healthcare-associated infections are a big issue in hospitals. They are the highest cause of morbidity and mortality rates in hospitalized patients. Due to increasing prevention methods, there has been a decrease in infections, but there is still a way to go. In detail, common infections are central line-associated bloodstream infections, catheter care urinary tract infections, surgical site infections and transmission of Clostridium difficile.
Lessons and Knowledge
Central line-associated bloodstream infections also known as CLASBI are infections that stem from microorganisms that spread from the catheter site to the surface of the catheter. To reduce the risk of infection, central lines should be medically necessary and shouldn’t be inserted for comfort. They are for administration of medication that cannot be given peripherally due to possible harm, or either for providing large volumes of blood and other fluids. Ways to prevent infections include making sure that sterile technique is followed, and bathing with chlorhexidine instead of povidone-iodine. Reassessment of needs for central lines is also critical when trying to prevent infection.
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Catheter-associated UTI’s are now the most common device-related healthcare-associated infection. It is estimated that 15 to 25% of patients at some point in their hospital stay receive an indwelling catheter, in which 38% of insertions are unnecessary. It is important not to use catheter care, for substitution of nursing care. For example, inserting catheters for patients with incontinence or keeping catheters in longer that medically necessary. Ways to prevent UTI’s include routine cleaning around the catheter and it is fundamental that the drainage bag stay below the
According to an article by Timsit, J., et al. an estimated 5 million central venous catheters are inserted in patients each year. CBIs, most of which are associated with central venous catheters, account for more than 11% of all health-care associated infections. Additionally, more than 250,000 central-line associated blood stream infections also occur annually, with an estimated mortality rate of 12-25%. For patients within the intensive care unit, the numbers were even higher. Each episode significantly increases the patient’s hospital stay, as well as increasing costs from $4,000 to $56,000 per episode.
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
A common hospital acquired condition that nurses see now days is clostridium difficile. This bacterium usually invades patients who have been on long-term antibiotics that have killed off bacteria that protect them from infection. C. diff is passed from host to host by both direct and indirect contact making it readily moved from patient to patient in hospital settings (Mayo, 2013, 1). Nurses can use the QSEN competencies and KSAs to help treat and prevent hospital acquired conditions such as C.diff.
Yacopetti, N., Davidson, P., Blacka, J., & Spencer, T. (2013). Preventing contamination at the time of central venous catheter insertion: a literature review and recommendations for clinical practice. Journal Of Clinical Nursing, 22(5/6), 611-620. doi:10.1111/j.1365-2702.2012.04340.x
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
Health care facilities - whether hospitals, nursing homes or outpatient facilities - can be dangerous places for the acquisition of infections (EHA). The most common type of nosocomial infections are surgical wound infections, respiratory infections, genitourinary infections and gastrointestinal infection (EHA). Nosocomial infections are those that originate or occur in health care setting (Abedon). They can also be defined as those that occur within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation (Inweregbu). These infections are often caused by breaches of infection control practices and procedures, unclean and non-sterile environmental surfaces, and ill employees (EHA). Immunocompromised patients, the elderly and young children are usually more susceptible to these types of infections. Nosocomial infections are transmitted through direct contact from the hospital staff, inadequately sterilized instruments, aerosol droplets from other ill patients or even the food and water provided at the hospital (EHA). The symptoms of nosocomial infections vary by type but may include inflammation, discharge, fever, abscesses, and pain and irritation at the infection site (Stubblefield).
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). ( book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa.(secondary) Urinary tract infections occur when one or more of microorganisms enter the urinary system and affect the bladder and/or the kidneys. These infections are often associated improper catheterization technique. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be cause by improper hand washing, dressing change technique, or improper surgery procedure. Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung in...
There have been an incidents of prolonged hospital stay due to central line infections putting patients at risk for mortality, morbidity, and increase in medical cost. When central lines are placed at bedside or in interventional radiology, the inserter is required to document the steps and sterile procedure that took place in the electronic health record. Furthermore, with weekly and as needed dressing changes, nurses are required to use central line bundles and document what was used (ex: Chloraprep, biopatch, tegaderm, etc.) to track how the dressing was done. From these documented records, staff can gather data and measure the compliance of sterile procedure. Additionally, if a patient with a central line develops a fever without an unknown cause physician will order blood culture from the central line if catheter-related infection is suspected. If the test comes back positive, the team will initiate antibiotics immediately. By integrating electronic health records it can assist in CLABSI prevention strategies, raise the standard for best practices, and essentially reduce central line infections. With the quarterly results of CLABSI in our unit, CVC committee have re-educated the staff on appropriate dressing changes using sterile technique, transitioned to a different end
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
Hospital-acquired bladder infections. These infections, occur in people in a medical care facility, such as a hospital or nursing home. Most often they happen in those who have had a urinary catheter placed through the urethra and into the bladder to collect urine, a common practice before surgical procedures, for some diagnostic test, or as a means of urinary drainage for older adults or people confined to bed.
Infection control, a term that describes procedures taken to reduce the spread of infection. The dental office is a place where many people are treated including patients with infectious disease such as tuberculosis, HIV/AIDS, hepatitis, and many other highly contagious diseases. It is imperative that in any dental office setting the prevention of the spreading microorganisms from patient to patient, patient to staff, or staff to patient is done in high precaution. Infection control has two main objectives; to protect the patients from harmful pathogens as well as dental team members. Infections can cause or add pain, deteriorate a persons health, and in worst cases even result in death. In order to understand the infection control in a dental facility, you must understand the standard precautions required by organizations that regulate or recommend infection control, the kinds of preventive measures taken, as well as when these measures should be taken.
One day, this writer happened to see another nurse changing a Peripherally Inserted Central Catheter Line dressing. As a nurse leader, this writer asked the nurse why she is changing the dressing. The caregiver explained dressing changes can prevent infection to the site and there are lot of patients readmitted because of central line infections and subsequent complications. This nurse demonstrated good kn...
There are numerous public health problems that can be addressed in my Southside of Chicago community. Among the several public health problems facing my Southside of Chicago community there are two that are more urgent. Health education or one might say lack thereof is a problem that needs to be addressed. My community is plagued with many of the residents suffering from high blood pressure, diabetes, and the killer virus known as HIV. In most cases these conditions can be prevented with healthier lifestyles and access to nutritious organic foods. In addition, environmental health is another urgent problem my community is facing. Access to clean, safe water and air is supposed to be a fundamental human right aimed at a healthy environment. Yet, my community consists a waste contaminated beach, numerous deteriorated building that are still occupied, and a countless number of restaurant and stores supplying our residents with services that are endangering their health.