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Chapter 17 infection prevention and control in the hospital and home
Chapter 17 infection prevention and control in the hospital and home
Importance of infection control in healthcare
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Opportunistic infections are caused by opportunistic pathogens. Although unusual, these infections occur when the normal flora of the host gets misplaced. These microbes, which have a commensal relationship with the host, take advantage of the host’s low immunity and therefore cause damage. Opportunistic infections are the most common in hospitals and can therefore be referred to as healthcare associated infections. In the past couple of decades, healthcare associated infections have increased. These infections are believed to be highly preventable but there are several reasons that account for the increase of such infections. For example, associated bloodstream infections are on a rise yet their prevention is something that is very basic.
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).
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
Healthcare-associates Infections (HAIs) are infections that patients acquire during the course of receiving healthcare treatment for other conditions and can be devastating or even deadly ("CDC - HAIs the Burden - HAI", 2013). An HAI was defined as a localized or systemic condition that (1) results from an adverse reaction to the pres¬ence of an infectious agent(s) or its toxin(s), (2) that occurs during a hospital admission, (3) for which there is no evidence the infection was present or incubating at admission, and (4) meets body site-specific criteria (Klevens et al., 2007, p.2).
The purpose of his article was to find a better way to prevent healthcare-associated infections (HCAI) and explain what could be done to make healthcare facilities safer. The main problem that Cole presented was a combination of crowded hospitals that are understaffed with bed management problems and inadequate isolation facilities, which should not be happening in this day and age (Cole, 2011). He explained the “safety culture properties” (Cole, 2011) that are associated with preventing infection in healthcare; these include justness, leadership, teamwork, evidence based practice, communication, patient centeredness, and learning. If a healthcare facility is not honest about their work and does not work together, the patient is much more likely to get injured or sick while in the
Infectious diseases are the disorders caused by organisms such as bacteria, viruses, fungi or parasite who live both inside and outside our bodies and are normally helpful but can cause infectious diseases to the human (body) system under certain conditions. And for a disease to be infectious, there is what is called ‘’chain of infection’’ that takes place before. And this can be seen in the below diagram:
Hospital acquired infections are one of the most common complications of care in the hospital setting. Hospital acquired infections are infections that patients acquired during the stay in the hospital. These infections can cause an increase number of days the patients stay in the hospital. Hospital acquired infections makes the patients worse or even causes death. “In the USA alone, hospital acquired infections cause about 1.7 million infections and 99,000 deaths per year”(secondary).
Ward-Smith, P. (2012). Nursing and Physician Attitre as Possible Source of Nosocomial Infections. Urologic Nursing, 32 (2), 94. Retrieved from Ebsohost
Acknowledging that the effects of antimicrobial resistance can negatively impact all healthcare settings, proper management over the use of antibiotics is crucial to control the emergence and transmission of antimicrobial-resistant organisms. Requiring every hospital to adopt an antimicrobial stewardship program (ASP) can create an effective way to ensure the appropriate, optimal antibiotic prescribing. The Infectious Diseases Society of America (IDSA) defines the primary purpose of these programs are to enhance clinical outcomes while decreasing unintended consequences of antimicrobial use, including toxicity, the selection of pathogenic organisms, and the emergence of antibiotic resistance (File, Srinivasan, & Bartlett, 2014).
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
Patient safety must be the first priority in the health care system, and it is widely accepta-ble that unnecessary harm to a patient must be controlled.Two million babies and mother die due to preventable medical errors annually worldwide due to pregnancy related complications and there is worldwide increase in nosocomial infections, which is almost equal to 5-10% of total admissions occurring in the hospitals. (WHO Patient Safety Research, 2009). Total 1.4 million patients are victims of hospital-acquired infection. (WHO Patient Safety Research, 2009). Unsafe infection practice leads to 1.3 million death word wide and loss of 26 millions of life while ad-verse drug events are increasing in health care and 10% of total admitted patients are facing ad-verse drug events. (WHO Patient Safety Re...
Quality Improvement or QI entails changes, due to collective efforts of healthcare workers and patients, that aim to improve “patient outcomes (health), better system performance (care) and better professional development” (Batalden & Davidoff, 2007). For a healthcare facility, QI activities can include implementing and perfecting an infection control policy. The purpose of improve the infection control policy is to prevent and reduce the spread of pathogens through patient to staff, staff to patient, and patient to patient contact (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2012). Following a facilities’ infection control policy involves all healthcare workers and anyone in contact with patients and used equipment
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.
Opportunistic infections are infections that occur more frequently and more severe in individuals that have weak immune systems. Like for example people with HIV/AIDS have the greatest risk of getting this infection. Ols are a sign of a declining immune system. These are known to be the greatest causes of people’s death with HIV/AIDS.
There are 5 main pathways of environmental transmission of pathogens. Those are air-borne, food-borne, water-borne, vector-borne and blood-borne. Air-borne transmission refers to any disease that is caused by a pathogen and transmitted through the air. These pathogens can be spread by coughing, sneezing, stirring dust, liquid spraying, or generally any activity that generate aerosol particles or droplets. These pathogens can include viruses, bacteria, or fungi. Some common examples of pathogens that are spread via air-borne transmission are rhinovirus, hantavirus, adenovirus, and influenza, among many others (cdc.gov).
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.