Infection Control in Health Care Systems

Infection control is among the most important factors in the health care system. In hospitals, infection control helps to manage Hospital Acquired Infections (HAIs). In the United States and other countries across the world, HAIs are the main reasons for readmissions and high mortality rates.  Mostly, these infections occur due to toxins that are in various locations across the health care system. In hospitals, the intensive care unit (ICU) is the most common ward where HAIs are most likely to occur. Moreover, statistics reveal that at least 1 in 10 patients admitted to hospitals are most likely to contract HAI (Fornwalt, Ennis, & Stibich, 2016). Hospital acquired infections are related to high hospital costs, morbidity, and mortality. Presently, as the health care system becomes more intricate and antibiotic resistant, cases of hospital-acquired infections are projected to grow. Therefore, hospitals need to come up with strategies for addressing this issue before it worsens. An analysis of health acquired infections will help come up with policies that can control infections in health care system.

Hospital Acquired Infections exist in most healthcare institutions all over the world. According to the World Health Organization (WHO), hundreds of millions of patients are affected by HAIs all over the world annually. As a result, this leads to increased mortality rates and financial losses for the health care system. Statistics from WHO reveal the rate of hospital-acquired infections is approximately 4.5 percent annually. Majorly, this corresponds to the 9.3 percent infections per every 100 patients. In intensive care unit, the rate of patients infected is 51 percent and most of them are HAI. Further, WHO reveal that about 30% of patients in the intensive care unit are affected by a scenario of hospital acquired infections. In fact, the longer a person stays in the ICU, the more they are exposed to the risk of getting an infection. Averagely, the increasing scenarios of infection are 17.0 per every 1,000 adults (World Health Organization). High levels of infection have been related the use of aggressive equipment, especially in central lines, urinary tubes, and ventilators.

The Centers for disease control and prevention released annual national and state hospital acquired infections report. The data was collected in 2014 and the report was released in 2016. In the report, the research found that there was a 50% decrease in central line acquired blood stream infections (CLABS) (Rahmqvist, Samuelsson, Bastami, & Rutberg, 2016). Mainly, this occurred between 2008 and 2014. Similar to the WHO, the center for disease control and prevention found that most of hospital-acquired infections are common in the intensive care unit wards.

Hospital acquired infections are linked to high mortality rates in the United States. In the health care system, HAI is linked to factors such as location of the infection, diagnostic procedures, severity of the diseases, and sensitivity of micro-organisms (Souza et al, 2015, Lima et al 2016). According to the authors, about 1.7 million health problems are seen in the United States. In the process, an estimated 99,000 people die annually due to these infections.

Current Problem of Hospital Acquired Infections

The high rates of hospital-acquired infections can be reduced by implementing new policies and procedures. In this context, it is proposed that medical experts should wash their hands before and after interacting with the patient. Through this, it will be able to lower HAI cases in the health care system. Clean hands procedures in hospitals help health acres providers to adhere to hand hygiene suggestions. At all times, it is recommendable for nurses to keep their hands clean to avoid transfer of dangerous infection micro-organisms. Equally, patients should be encouraged to observe hand hygiene while in the hospital to minimize HAI cases. Moreover, patients need to remind health practitioners to wash their hands before attending to them.

Hand hygiene has a significant influence in ensuring that patients are safe. The approach is proposed as it is simple and entails low costs in preventing the distribution of microorganisms that cause hospital acquired infections. Statistics reveal that about 70% of HAI result from unclean hands among health care providers. To reduce these infections, health care providers need to comply with the recommendations for hand hygiene. Scientific evidence shows that microbes that facilitate the infection are spread between patients using hands of health care providers (Ho et al, 2015). What is more, medical care institutions that encourage strategies that enhance hand hygiene are able to manage other forms of infection that occur in the health care system. Thus, it is essential for the healthcare facilities to focus on hand hygiene. In the process, this will lead to enhanced patient safety (Lloyd-Smith, Curtin,  Gilbart, & Romney, 2014). In fact, implementation of hand hygiene is a vital factor for enhancing the global patient safety challenge by World Health Organization, which promotes patient safety within the health care system.

Furthermore, healthcare practitioners need to ensure their hands are clean by washing them at least 100 times per 12-hour shift. Mainly, this should rely on the number of patients they serve and the intensity of care. In hospitals, everyone needs to understand the importance of clean hands and the role of alcohol-based hand cleaner. When washing hands, the alcohol-based hand cleaners kill severe microorganism or germs that facilitate hospital-based infections. Therefore, hospitals need to have alcohol sanitizer in all the wards and theater rooms in an effort of mitigating HAI. However, the alcohol handwashing sanitizer is unable to kill organisms that cause some hospital-acquired infections such as diarrhea. In this case, it is essential for patients to wash their hands with soap and water. At the same time, health care practitioner should put on their gloves when attending to such patients.

The alcohol-based hand cleaners are more effective less drying compared to using soap and water. Moreover, alcohol sanitizers do not develop antibiotic resistant microorganisms. Presently, hand hygiene should be a point of focus for health care practitioners and patients. Hospitals should come up with education programs that explain to health care experts on how and why they should clean their hands before attending to patients. Similarly, patients should understand why it is important to clean hands after and during patient care. What is more, it is important for patients to inquire health experts on their hand hygiene. Through this, it will be possible to reduce cases of HAIs in the health care system.

Proposed Solution: Hand Hygiene

The hands of health care providers come into close contact with patients. Therefore, the hands are contaminated after frequent patient care. According to Al-Busaidi (2013), the hands of nurses are contaminated when they touch dirty surfaces, equipment, or materials such as patients’ dresses. In fact, the author notes that clean hands are fundamental in managing hospital acquired infections. Moreover, the implementation of hand washing procedures is cheap and highly effective. In hospitals, hand hygiene is meant to save lives and offer a safe health care environment for patients and health experts. Other terms in the health care system that are used to refer to hand hygiene include disinfection and hands antisepsis. The most preferred approaches of maintaining hand hygiene include using alcohol-based hand sanitizers and washing hands with soap and water.

Incidentally, the main focus of hand hygiene is to remove dirt and kills microbes on the skin. As a result, this minimizes or stops transmission of pathogens from one patient to another. Nurses spend most of their time with patients in the hospital. Therefore, they must adhere to the hand hygiene policy and reduce hospital acquired infections. Despite the fact that HAI exposes patients to various risks such as death, health care providers still fail to adhere to hand hygiene policies. According to Cambell (2010), most nurses think that hand hygiene is not their responsibility, but the role of infection control staff.

Moreover, Narzako (2009) notes that nurses fail to comply with the hand hygiene policy as they are busy and think that washing hands consume more time. What is more, health care providers fail to maintain hand hygiene as they think gloves are the best alternative. In some hospitals, nurses use the same pair of gloves for multiple customers. A research study conducted by Ott & French (2009) reveals that about 20% of nurses wash their hands. In some cases, nurses are afraid of cleaning their hands as they are afraid of getting skin problems such as dermatitis, which is usually caused by alcohol-based hand sanitizers (Canham 2011). After an extensive research on hand hygiene in the healthcare system, Al-Busaidi (2013) recommends that health care providers should wash their hands before, during, and after patient care. In the process, this reduces cases of hospital cases of hospital-acquired infections.

Hospitals across the United States and the world should embrace effective hand hygiene. According to Beyfus et al (2016), effective hand hygiene entails eliminating visible dirt and minimizing microbial contamination of the skin. Further, the authors note that the hands of health care providers are potentially contaminated with kinds of pathogens, including resident and transient microbes. It is impossible for resident microbes to be removed by handwashing.

However, this microbe is less aggressive and causes fewer infections. According to Al-Busaidi (2013), effective handwashing entails applying non-microbial or antiseptic soap on wet hands. Afterward, health care experts need to rub their hands together until there is foam. To ensure all dirt and microbes are removed; the foam should cover the entire palms (Caham, 2011).  Moreover, hand drying is essential in preventing transmission of infectious microorganisms. Nurses need to ensure that their hands are completely dry before putting on gloves. Mainly, this is due to the fact that wet hands can capture moisture under the gloves that facilitate growth of infectious bacteria.

Literature Review on Proposed Solution: Hand Hygiene in Health Care

Hand hygiene in hospitals requires various intervention strategies to manage sustainable health care practices. Al-Busaidi (2013) notes that hand hygiene approach should not only be the mandate of the safety department, but everyone within the health care system should encourage hand sanity. In hospitals, health care practitioners should develop and culture and environment that highly supports hand hygiene (Mathur, 2011). The infection control can perform a significant role in enhancing adherence to hygiene policy by ensuring that patients observe hand hygiene among health care providers. Nurses need to be given educated and trained on the relevance of maintaining hand hygiene in hospital environment. Hospital management team should motivate health care workers to enable them to sustain hand hygiene in hospitals (Mitchell, Hall, MacBeth, Gardner, & Halton, 2015). Therefore, hospitals should formulate policies that ensure hand hygiene compliance at all levels of the health care system.

The hand hygiene policy will be implemented into the health care system after offering relevant education program to the health care workers. The policy will be implemented through collaboration where health providers will share relevant information regarding hand hygiene in the healthcare system. Collaboration will improve the hygiene standards and develop organizational cultures that promote handwashing. Further, collaboration can be executed to optimize strategic and functional planning of logistic practices.

The implementation of hand hygiene policy requires financial, human, and physical resources. The existing financial resources for implementation of the policy include cash balances, bank overdrafts, working capital, shareholders, and loans. The implementation of hand hygiene policy is cheaper and the hospital does not need to invest highly. The assessment tools used is in-depth interviews that help to analyze emotions and feelings of participants in regard to hand hygiene. Moreover, pretest questionnaires will be used to evaluate the knowledge of participants at the start and after intervention. 

References

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Beyfus, T., Dawson, N., Danner, C., Rawal, B., Gruber, P., & Petrou, S. (2016). The use of passive visual stimuli to enhance compliance with handwashing in a perioperative setting. American Journal Of Infection Control, 44(5), 496-499. https://dx.doi.org/10.1016/j.ajic.2015.12.021

Cambell, R. (2010). ‘Hand-washing compliance goes from 33% to 95% steering team of key players drives process’, Healthcare Benchmarks and Quality Improvement 17:1, 5-6.

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Center for Disease Control and Prevention. HAI Data and Statistics. Retrieved from www.cdc.gov/hai/surveillance/

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Ho, H., Poh, B., Choudhury, S., Krishnan, P., Ang, B., & Chow, A. (2015). Alcohol handrubbing and chlorhexidine handwashing are equally effective in removing methicillin-resistant Staphylococcus aureus from health care workers’ hands: A randomized controlled trial. American Journal Of Infection Control, 43(11), 1246-1248. https://dx.doi.org/10.1016/j.ajic.2015.06.005

Lima, J., de Aguiar, R., Leite, H., Silva, H., de Oliveira, W., & Sacramento, J. et al. (2016). Surveillance of surgical site infection after cesarean section and time of notification. American Journal Of Infection Control, 44(3), 273-277. https://dx.doi.org/10.1016/j.ajic.2015.10.022

Lloyd-Smith, E., Curtin, J., Gilbart, W., & Romney, M. (2014). Qualitative evaluation and economic estimates of an infection control champions program. American Journal Of  Infection Control, 42(12), 1303-1307. https://dx.doi.org/10.1016/j.ajic.2014.08.017

Mathur, P. (2011). Hand hygiene: Back to the basics of infection control. The Indian Journal Of   Medical Research, 134(5), 611. https://dx.doi.org/10.4103/0971-5916.90985

Mitchell, B., Hall, L., MacBeth, D., Gardner, A., & Halton, K. (2015). Hospital infection control units: Staffing, costs, and priorities. American Journal Of Infection Control, 3(6), 612-616. https://dx.doi.org/10.1016/j.ajic.2015.02.016

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Rahmqvist, M., Samuelsson, A., Bastami, S., & Rutberg, H. (2016). Direct health care costs and length of hospital stay related to health care-acquired infections in adult patients based on point prevalence measurements. American Journal Of Infection Control, 44(5), 500-506. https://dx.doi.org/10.1016/j.ajic.2016.01.035

Souza, E. S., Belei, R. A., Carrilho, C. M. D. D. M., Matsuo, T., Yamada-Ogatta, S. F., Andrade, G., … & Kerbauy, G. (2015). Mortality and risks related to healthcare-associated infection. Texto & Contexto-Enfermagem, 24(1), 220-228.

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