Infection control Essay

In this search essay the essayist leave behind argue the principles of exhibit- establish nursing interrogation and its importance in health upkeep. Therefore a brief introduction in transmitting and transmitting barroom and underwrite pass on as well be made followed by the main focalization of this question essay which will be respectable deal hygiene by making affair of five research destinations, which be qualitative, quantitative, ethical consolidation, selective information cacheion and sample. In addition to this, the issue of the or so gross health trade Associated Infections (HAIs) acquired in hospitals will as well as be explored and by referring to relevant research the essayist will check out why then HAI still a study chore in the UK health burster settings, as a effect of studies and reports suggests that adequate pass hygiene radiation pattern is the key to reduce infection across the field of c be (British Medical diary, 2005 Lancet, 2007).The system employ to collect the pristine bug of information was gathered through the use of the University subroutine library digital search, Cinahl Plus (a comprehensive source of evidence-based full-text for nursing & wholeied health journals, which provide concise overviews of diseases and conditions and outline the most effective treatment options based on peer-reviewed medical research. Cinahl plus is available via EBSCO host), medical journal articles, books, publications and discussion section of Health (DH) entropybase, and clinical guidelines if they indicate accomplish hygiene as a key to go over and prevent HAI. A number of keywords were utilize, including quantitative, qualitative and research within the title infection take premeditation, hand hygiene and HAI so plainly records containing altogether the keywords were saved.The resulting list of articles was then reduced to English language, braggy macrocosm, and systematic reviews published betwe en 2000 to get. Of the 26 randomized controlled trials (RCT), twelve were discarded, as both(prenominal) were non relevant and some were unavailable. Furthermore the remaining ex literature review was divided into subtopics hand lavation technique and decontamination, alcohol-based hand itch, MRSA, and persevering infection prevention information. Evidence- based nursing practice is the term use to describe the process the nurses use to piddle clinical decisions and do clinical questions based on scientifically proved evidence instead than onassumption, intuition or tradition (Bishop and Freshwater system, 2003)In order for nurses to make the correct decision, they ready to be based in four approaches which take on reviewing the silk hat available evidence from peer-reviewed researches using their clinical expertise find out the values and cultural needs of the individual, and determining the preferences of the individual, family and community. Therefore such could o nly be achieved if the nurses know how to access the latest research and correctly interpret and apply the findings to their clinical practice (STTI, 2005). Fact that is also supported by the Nursing & Midwifery Council (NMC), 2008, which states nurses must deliver c atomic number 18 based on the best available evidence or best practice.The fear of infection has been and will always be present in the human minds, proficiently so as infections are the most common causes of death worldwide. From time to time we hear of methicillin- resistant staph aureus (MRSA), C- Difficile, Norovirus, and some(prenominal) other organisms causing infection and threatening the health of the population (Ryan et al. 2001). Although in the break-danceed countries the cardiovascular diseases and cancer are now the major causes, it is always an infection that tips morbidity into mortality (Meers, McPerson & Sedgwick, 2007). Infection prevention and control policies are a contentious issue in the heal th care settings. agree to NICE (2012) bare-ass clinical guideline, everyone in embarrassd in providing care must come with the ensample principles and regulations in infection control. Standard precautions should be applied at all times by the health care workers when sympathize with for longanimouss.Such can be accomplished by practising naive skills including fair hygiene in clinical environment, appropriate decontamination of turn over and equipment, correct use of ain protective equipment, correct use and disposal of sharps, aseptic technique and waste disposal (DH, 2007, Pratt et al. 2007). The purpose of this is to reduce the risk of infectious diseases to staff, uncomplainings and others where care is delivered. Additionally, is the health care professional duty and responsibility to provide and deliver fail-safe care to patients (NMC, 2008). According to World Health Organization (WHO) 2005, there are around 5000 death in health care setting due to HAI though the actual number of infections developed in the community is unknown (NHS QIS, 2005).Moreover,with some HAIs manifesting post-hospital discharge (National Audit Office (NAO), 2000), the prevalence of HAI in the UK is likely to be greater than that reported in current semiofficial statistics, although 15-30% of these can be prevented with entire infection control practices such as adequate hand hygiene practice (Damani 2003). Wilson (2006) states that hand washing are a simple procedure and the grade of procedure should be lofty. However the evidence points to the reprobate as it written in the Centers for Disease Control and Prevention (CDC) report, suggesting that healthcare professionals residency to hand hygiene standards averages at 40% (CDC, 2002). Furthermore, Rumbau et al (2001) suggests that poor hand hygiene practice is the major empyrean in contention in healthcare settings and healthcare professionals fail to assent with appropriate hand hygiene technique due t o workload, understaff, and skin conditions, i.e. dermatitis (WHO,2009).Subsequently, the monstrous workload may constitute a prohibit impact on compliance (OBoyle et al, 2001, Pittet et al 1999), resulting in infecting patients with avoidable HAIs such as staphylococci aureus bacteraemia (MRSA) and Clostridium difficile infection (C-difficile), among others types of infection (DH, 2003). Eventually, the distress and suffering it causes to the patient who acquires the supra distinguished infection whilst in hospital, leads to loss of confidence and credibility and re pitchation of healthcare professionals and the NHS deposes. As a result, it brings an increase to the costs of the already under funded hospitals from change magnitude stays, increased medical expenses and damage to the patients and their relatives who may decide taking causal agent demands (WHO report, 2006). NAO (2000) states that the cost of HAIs is near 1 billion per year, also around 9% of patients in hosp itals in England at one time have an HAI.The diary of Hospital Infection (JHI), (2008) own researchers A. Mears et al, carried out a quantitative and qualitative research study following the death of 180 patients infected with patronage infection in one of the worst outbreaks ever seen in the NHS Trust. The outbreak was blamed on poor measures, to manage, control and prevent infection, despite the Trust having high rates of HAI over several years (JHI, 2009). The study was aimed to investigate the potential factors linked to HAIs rates in acute NHS hospitals and which interventions may be effective to tackle this issue.The mixed methodological research terms used in the research was purposelychosen as it has been proved that mix in both research terms (qualitative and quantitative) in a study are essential to answer different sort of questions, collect different types of info and produce different type of answer (Burnang and Hannigan, 2000, Bourgeois, 2002). In addition, multip le info sources are useful in researches or studies as they are lead off of within method triangulation to make the study more trustworthy and credible, also to enhance its depth by meeting different needs at different stages of a project, as well as compensates for shortcomings in both one method (Bourgeois, 2002 Kelly and Long, 2005), as it has been proved by the findings.Qualitative method is an organized, descriptive, systematic, and intensive process to collect data by using data processor software programs i.e.ATLAS.ti, to efficiently examine, analyse, and organise data, also to synthesize large volumes of data (Rebar et al, 2011). This method focuses on individual perceptions and how these are described, as well as recognise that the way people behave is determined by many factors including what is expected of them, how they interpret the behaviour of other people, and how they feel or so what is occurrence (Rebar, Gersch, Macnee & McCabe, 2011). It is essential that the research is carried out with an open mind, as preconceptions could distort the indication of what is going on (Rapport, 2008). .QuantitativeThe method used for data appealingness in the study was semi-structure interview and a self- completion questionnaire with textual digest of receipt to open questions, sent to 900 NHS Trust nurses. Interviews and questionnaires are the most common methods used for data collection. A questionnaire is an instrument used to collect limited written data in order to specifically target accusive factors or enliven (Rebar et al, 2011). Whereas interviews are better for collecting sensitive ad hominem information as the interviewer can establish a rapport with the keep down (Crombie and Davies, 2002). Out of 900 nurses interviewed 700 acknowledged that inadequate hand washing by healthcare staff was the major cause of HAI. When questioned why healthcare professionals fail to comply with appropriate hand hygiene technique, more than 70% answere d that deficiency of time, workload and high activity levels wasthe reason, and 66% answered low staff level and low and inconveniently located sinks makes it difficult to comply.These findings are supported by evidence from infection control literature. However, it is clearly specified in the literature that the con grades of high activity levels experience among healthcare workers can have a negative impact on compliance (DH 2003, McCall & Tankersley, 2007). Besides The self- completion questionnaires were returned with 100% response rate. The results demonstrated that more than 95% of nurses assume that the inclusion of infection prevention and control in the staff (including medical students) training programmes may telephone the causes of the outbreak, therefore help to promote good infection prevention and control in the NHS Trusts hospital.Wilson (2006) argues in his literature that effective interventions in the management of HAIs, would involve a behaviour change on its own, feedback on behaviour, ownership of the problem and personal growth from healthcare staff. As such training unaccompanied would not be enough. The research terms and preference of methods used by the researcher were appropriate as it provided the reader with a detailed apprehension of the issues discussed in the study also can be used as a basis for future work.The Health Protection Agency (2006) reports that MRSA surpass the list of HAI acquired in the NHS hospitals by 40% and in average 4000 patients develop this condition every year. The situation is so serious that the credibility and subsistence of NHS as an institution may be in jeopardy (Cooper et al, 2004, Marshall et al, 2004& Voss, 2004). In the UK the levels of MRSA in hospital has staggering arisen from 2% in 1990 to 42% in 2000, generating a major public health problem and a source of public and political concern (Hawker, et al., 2005).Such rise has been attributed to the appearance of new strains with epidemic potential, hospital patients who are vulnerable to infections and failure to sustain good hospital hygiene, including hand hygiene. Several studies of health professionals in hospitals fault the interpenetrate of antibiotic resistant infections to poor hand hygiene and decontamination among healthcare professionals (Sharek et al.2002, Ariello et al 2004). In the document Wining Ways released by the DH (2003), it is clearly stated that hand hygiene is essential to cut down the exposure of patients to HAIs, therefore the responsibility ashes with staff todemonstrate high levels of compliance in hand disinfection protocols. However, up compliance with hand hygiene remains a pressing patient safety concern (Lautenbach, 2001).The WHO (2009), developed a system known as Five Moments for Hand Hygiene to improve hand hygiene compliance among healthcare workers and to add value to any hand hygiene return strategy, also to educate healthcare workers about the benefits of effective hand washing correlated with the correct techniques and timing of hand hygiene. The strategy indicates that cleaning custody at the right time and in the correct way should be an indispensable element of care, and form an integral part of the culture of all health service, and any failure to address this issue in a satisfactory manner could be seen as a breach of the cypher of Professional Conduct. As a result it may put in question the healthcare professional fitness to practice and endanger his/ hers allowance (CDC, 2002 NMC, 2006).The CDC first released formal written guidelines on handwashing in hospitals in 1975, aiming to trim down the risk of infection in hospitals, though it is believed that the idea has been around immense ahead that (JHI, 2006). The NICE (2004) and HPA(2004) guidelines proposes that effective hand washing techniques should involve preparation, washing, rinsing, drying and the sequence should take roughly 40 to 60 seconds. The preparation, involves wetting the give under tepid water (hot water should be avoided as it increases skin irritation) before applying liquid whip to all surfaces of the hand. Then the pass must be rubbed together, paying particular attention to the tips of the fingers, the thumbs and areas between the fingers for at least 15 seconds.Finally, the hands should be rinsed thoroughly and the taps turned off by using the elbows to avoid recontamination. The hands should be pat dry with good quality paper towels which are therefore disposed of in a foot-operated bin (NICE, 2003). The above mentioned technique should be performed immediately, before direct patient contact or care (including aseptic procedures), after direct patient contact or care, after exposure to body fluid, after any contact with patients surrounding i.e. bed making, after tactile sensation wound dressings, handling medication, etc. Hand rubs or alcohol colloidal gel is part of the modern hand wash procedure. They are frequently used in betwe en hand washing, as an alternative agent to water and soap or when hands are physically clean (i.e. not contaminated with organic matter or soil),(Endacott, Jevon and Cooper, 2009).Alcohol gel/ rub should be applied in sufficient quantity to cover hands and wrists, as any surface that is not covered may channel contamination on the hands. The hands should be rubbed together briskly for approximately 10-15 seconds, until the hands feel dry. Hands should be washed with water and soap after every five applications of alcohol hand gel. Many campaigns and studies in hand hygiene clearly state the responsibility of healthcare professionals in the fight of infection prevention in hospitals, hitherto sparse studies mention the involvement of patients in the combat of same. A study revealed that 70% of patients did not receive any information in hand hygiene or other information regarding infection control and prevention when admitted to hospital (British Journal of Nursing, 2007).Several literature highlight the fact that infection may be caused by the patients own microbial flora or acquired from other infected patient via the contaminated hands of those delivering care (A. Mears et al, 2008). A government document originally initiated in the NHS Plan (DH, 2002) to encourage the placement of patients through patient information, are correlated with the clinical governance strategy of engaging patients in partnership to improve care. This new concept will empower patients by allowing them to be involved in the management of their care (Duncason and Pearson, 2005), also in decision making powers between the patient and the healthcare professional (Henderson, 2003). Moreover, this newly acquired power by the patients will also empower them to be involved in monitoring and reporting on standard of cleanliness in hospital wards (DH, 2004).Additionally, Christopher Paul Duncan and Carol Dealey (2006) did a qualitative slice of research with the purpose to explore pati ent opinions about asking healthcare workers to wash their hands before a clinical procedure and tax if patients knowledge and awareness about infection risks they are exposed musical composition in hospital would influence the patients anxiety about asking. The method used in the study to collect data was a semi-structure questionnaire designed to be used in a descriptive survey. Data collection involves the convocation of information for qualitative and quantitative research through a compartmentalization of data sources, for instance, questionnaires, observations, interviews, conversations telephone interviews, books, past researches or studies, books and documents including, public and private documents i.e. official reports or historicaldocuments to specifically target objective factors or interest (Mason, 2002 Rebar et al, 2011).There are two ways of collecting data primary or/ and secondary sources. Primary sources are collected directly by the researchers themselves, whe reas secondary sources are gathered through researches or studies published by others researchers. In this particularly study the initial semi-structured questions allows the researcher to gain an brainstorm of the participants feelings about asking healthcare workers to wash their hands. enquire patients to ask staff to wash their hands might be contend as there are ethical issues attached to it. Ethical issues are mainly concerned with a balance between protecting the right of participants privacy, safety, confidentiality and protection from deceit, whilst at same time prosecute scientific endeavour (I. Holloway, 2008). As it is sketch in the Nuremberg Code, some sanctioned principles are to be reviewed for ethical appropriateness (Burnard, 2006). These principles include autonomy, beneficence and non-maleficence. autonomy refers to recognition that participants have the right to decide on a ply of action or follow it.Meaning, the participant must have commonsensical aware ness of the nature of the research and its possible consequences, based on that they whether recrudesce or withhold consent. The patients must feel free from coercion. In the condition of research, the researcher must maximise the benefit of the patients whilst minimizing harm (Gillon, 2003), in the smell of , it may cause distress to the patients to ask staff to wash their hands as this may ingrain the care they get, reason why the play of benefit should always outweigh the chance of harm (beneficence). Gillon (2003) defines non- maleficence as the avoidance of doing harm or the risk of doing harm. However in the Nuremberg Code, is outlined that a minor harm may sometimes offset a greater good, i.e. patients ask staff to wash their hands might affect the relationship with staff, but staff will be aware that patients have a voice in their care and therefore wash hands prior to start caring for them, then benefit all others patients.Researchers are required to ensure that all pa rticipants have an equal chance of be included from a study or benefit from it results. It is unfair and unsporting to excluded participants from the study because their race, colour, gender, age or so on (National Research ethical motive Service (NRES), 2006). The questionnaire was dispersed to a randomized convenience sample of 224 inpatients to all department of an acute NHS Trust hospital.Sample in qualitative research seek to identify participants who have experience with the phenomenon of the interest to the researcher and who will bring as much depth, detail and complexity to the study (Rebar et al, 2011).In this study the researchers chose to use a convenience sampling. Conveniences sampling the participants are readily available though members of the sample may not be best respondents in the illumination of the research question (Newell and Burnard, 2011). The returned sample was 185 since some patients were too sick to answer and further 34 patients refused to participate . The study showed that 73 (71.6%) patients felt less anxious to ask staff to wash their hands before a clinical procedure if they were using a tag saying Its OK to ask. Patients well-informed about infection risks to themselves while in hospital were more anxious to ask, although an explanation could not be found. Out of 184 patients involved in the study only 25 (25.2%) were given information about hand hygiene and infection prevention when admitted in hospital, as opposed to 74 (74.7%) of patients who were given no information.The findings go against the DH (2003), plan to involve patients in their care management, also inform the patients about health issues they may face while in hospital (NPSA, 2004 Duncanson and Person, 2005). Whilst the course of sampling and data collection strategies used by the researchers were detailed and descriptions of personal accounts were given, a purposive sampling would have been more appropriated as participants would have been intentionally se lected as they would have more characteristics related to the purpose of the research, thus would have more relevant things to say (Newell and Burnard, 2011) Additionally, interviews would have been better choice for collecting data and would fill the existing gap in the study.In conclusion, several studies links poor hand hygiene to the high rates of hospital acquired infections in NHS hospitals, yet insufficient evidence was supplied to enable a view to be taken on its potential contribution to reducing infection (A. Mears et al, 2009). More work needs to be done on hand hygiene, standards monitoring and education of healthcare professionals in the management and feeler of infection prevention and control in primary care practice (Wilson, 2006). Undoubtedly, adequate hand hygiene is the foundation for infection control activities, however there are stillseveral actions which NHS Trust hospitals can put in place to prevent and reduce the risks of infection, including the environm ent, infecting microbes and antimicrobial stewardship, patterns of healthcare and the patient treatment and diagnostic interventions (Patient Environment Action Team, 2005). Thus, the literature appraisal has highlighted the lack of the research in these areas.