Discuss About The Health Essential Infection Risk Management?

The Importance of Clinical Audit in Infection Risk Management

Question:

Discuss About The Health Essential Infection Risk Management?

Clinical audit is an essential tool in infection risk management. Clinical audit is the assessment of the healthcare facility to determine whether the services being provided comply with the set standards. The aim of clinical audit is to check on the compliance to safety standards by the healthcare providers. In this case, the audit identifies areas prone to infections and providing an audit report, which details on the measures that can be taken to manage the risks. In addition, clinical audit identifies mistake and errors in the nature of healthcare delivery like the non- compliance to hand washing guidelines, therefore, ensuring that proper steps are taken to enhance patient outcome. Therefore, the focus of financial audit is to evaluate on the performance of clinicians in order to provide an assurance report that the services given by the health facility are in line with the guiding standards.

One of the benefits of clinical audit is that, it promotes professional growth. For instance, it gives clinicians the opportunity to engage in peer reviews from where they gain confidence in their clinical activities thus enabling positive patient outcome. Additionally, in the case where the audit presents a patient case study, professional come together, thus enhancing professional growth (Siebenaler, Czech & Roach, 2017). Through the clinical audit, clinicians are able to benefit from peer-pear reviews, which enhance self-confidence. In this case, through the peer reviews, clinicians are able to identify their strengths and weaknesses, which is imperative in healthcare delivery. Clinicians should be aware of the performance and their practice so that appropriate adjustments can be made to enhance professional growth and improve the healthcare services. Thus, clinical audit enables clinicians to be aware of what is expected of them and the adjustments needed in their profession to ensure patient safety.

A clinical audit is a systematic examination of the performance of team, individual, or organization’s clinical work. The process entails the measurement of clinical outcome to provide quality services; the outcome of the audit is interpreted through peer review and consultation. Further, the audit focuses on the performance of clinicians in terms of quality of services where the audit examines and gather evidence on the clinical actions, which is then, interpreted using patient outcome parameters, clinical performances, and the regulating standards in order to determine the areas that need improvement in order to enhance patient safely (Weiss, Simon,  Graf & Linsler, 2017).

Promoting Professional Growth through Clinical Audit

Clinical audit is key to an improved management (Sinha, Murthy, Nath, Morris & Millar, 2016). A good clinical audit gives the management the opportunity to report accurately on their outcome with the potential of comparing and analyzing patient outcome, perform peer review, and to reduce patient healthcare cost. Further, clinical audit gives the management an opportunity to assess the organization processes in relation to the clinical practice, this is important as it helps in the identification of problematic areas or weakness in management so that appropriate changes can be made to ensure patient safety. Therefore, through clinical audit, the management acquires knowledge on the areas within the operations that need improvement (Wilson, Bak & Loveday, 2017).

Sharing clinical equipments can lead to the spread of infections as it acts as a media between which infections can be transferred from one patient to the other (Solomkin, 2015). Some of the shared equipments that can spread infections include x- ray machines, haemodialyis machines, and dental instruments. Therefore, it is important for the auditors to examine whether proper mechanisms are used to prevent the contamination of equipment and surfaces as per the regulating standard.  Further, the auditors will assess on whether surface barriers like sheets, tubings, and other instruments are cleaned between patients to prevent the spread of infections (Wick, Siebenaler, Czech & Roach, 2017).

Clinical waste if not properly management can be a source of infections. Clinical waste management is essential in the prevention of infections (Zimmerman, Gilbert, Brown & Shaban, 2016). Clinical waste is anything that can endanger the life of both the clinician and the patient; this includes wound dressings, used needles, and many other substances like gloves or aprons which might contain human blood or body substances. In this case, clinical waste should be properly disposed or managed. Clinical waste can be managed starting from the source of production where the clinical wastes is collected using special tools and taken to a special room where segregation is done. From this point, the waste that is of value recycled while the harmful one can be gotten rid by burring deep into the earth’s surface to avoid injury to both human beings and the environment. In this case, the auditor should ensure that the clinical waste management procedures are followed as per the organizational policies. Clinical waste audit is imperative as it ensure proper disposal or recovery of clinical waste. Therefore, clinical audit plays a vital role in ensuring that clinical waste is properly treated or incinerated to avoid injury to human beings and the environment and the failure to conduct will add up to the failure of the duty of care the organization owes third parties.

Clinical Audit and Management

Hand washing is one of the most effective ways of reducing the spread of infections. Hand washing can be done using water and soap or alcohol based disinfectant. According to Zingg, Holmes, Dettenkofer, & Pittet (2015), when properly done, hand washing can get rid of about 99% of disease causing infections. It is for this reason that clinicians should adopt proper hand hygiene in order to avoid transmitting infections to the patients (Solomkin, 2015). It is the duty of clinicians to adopt good hand washing practices in order to safeguard safety of the patients. During the clinical practice, clinicians should develop a practical voice in the support of hand washing in order to manage the spread of infections. Montgomery & Cummings (2017) explains that, knowledge and power assist in the implementation of strategies that aim at preventing infections and improving patient outcome. Therefore, clinicians should use education, written materials, and performance feedback in order to yield a positive feedback in hand washing practices within the organization (Duff, O’Sullivan, Ainle & Buckley, 2017).  Further, nurses should be encouraged to advance their levels of education, which will enable them assume leadership position that will enable them to foster a culture of hand washing. In relation to this, the auditor has the responsibility of ensuring proper hand washing practices are done to avoid the spread of infections. In this case, the auditor should examine on whether the healthcare providers wash their hands before and after handling patients (Iqbal, Ponniah, Long, Rath & Kent, 2017).

1. Policy

In regards to PPE, the audit will review the compliance to PPE standards; this includes examination of whether the organization has implemented policies and procedures, which relate to Personal Protective Equipment. For instance, the audit will verify on whether face masks, gloves, and aprons are available for use in all the departments especially the high risk areas.

1. Gloves

Gloves are essential in the prevention of infections especially when the clinician comes into contact with the patient’s blood. Gloves can either be sterile, non- sterile, or rubber latex. Sterile gloves are used during surgical procedures. Non-sterile gloves are used when it is highly possible that the clinician will be in contact with body fluids like blood while rubber latex is used when the healthcare provider or clinician is allergic. 

In this case, the audit will assess whether the gloves are conventional to the European Community Standards and are available and fit to be used by the healthcare providers.  Additionally, the audit will also examine whether a different glove is worn for each patient and whether hands are disinfected on removal to avoid the spread of infection from patient to patient and from patient to clinician (Greene & Kaye, 2014).

1. Aprons

Examination of Shared Equipment and Clinical Waste Management

Gowns and aprons are used to prevent contact with body fluids and tissues. Aprons are essential in the prevention of infection from patients to the clinician. In this case, the audit will determine whether plastic aprons are disposed off when detected to contain body fluids like blood or when it becomes wet, this is very important as aprons can act as a media for the spread of infections, which might affect the safety of patient and clinicians alike.

1. Covers and bibs

Covers and bibs are used in the prevention of infections through direct contact.  They are used to break the chain of infection. The audit will determine whether covers and bibs are used properly as a single- use to prevent further spread of infections.

1. Eye and Face protection

Eye protection equipments should be used when there is a high risk of infection likes theatre rooms where splashing of body blood and other body substances is highly probable. Eye protection equipment are essential in the prevention of infection from reaching he clinician. Therefore, the audit should determine whether a complete set of eye equipments are available for use in all operating and theatre rooms.

1. Respiratory protective gear

Respiratory protective gears are used to prevent clinician from inhaling infected air in the case where there is a risk of airborne infections. These equipments are used when handling patients with or diagnosed with diseases (Lawes, Lozano & Gould, 2017).

Conclusion

Audit refers to the examination and assessment of process to determine whether they comply with the organizations set standards. In the health sector, audit is conducted in order to determine the quality of healthcare services. Clinical audit is a continuous process that focuses on specific aspects of healthcare. The audit are meant to assess on whether the healthcare services being provided comply to the organization goals, which is patient safety. One of the areas of focus is in infection risk management, where the auditor examines patient outcome and the clinical process against the set standard. In risk management, the audit should determine whether safety precautions like hand washing, clinical waste management, and sterilization of shared equipments are put in place in order to ensure patient safety. Therefore, with clinical audit, risky areas prone to infection within the organization can be identified and appropriate action taken to ensure patient safety.

References

Lawes, T., Lopez-Lozano & Gould, I. M. (2017). Effect of a national 4C antibiotic stewardship intervention on the clinical and molecular epidemiology of Clostridium difficile infections in a region of Scotland: a non-linear time-series analysis. The Lancet Infectious Diseases, 17(2), 194-206.

The Importance of Hand Washing in Infection Prevention

Gould, D. J., Creedon, S., Jeanes, & Moralejo, D. (2017). Impact of observing hand hygiene in practice and research: a methodological reconsideration. Journal of Hospital Infection, 95(2), 169-174.

Greene & Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S66-S88.

Gruendler, J. (2017). Clinical Staff Ownership is Associated with Decreased Incidents of Hospital Acquired Infections. American Journal of Infection Control, 45(6), S95-S96.

Iqbal, H. J., Ponniah, N., Long, S., Rath, N., & Kent, M. (2017). Review of MRSA screening and antibiotics prophylaxis in orthopaedic trauma patients; The risk of surgical site infection with inadequate antibiotic psychology in patients colonized with MRSA. Injury. 2(4)67-78

Duff, C., O’Sullivan, C., Ni Ainle, F., & Buckley, R. (2017, June). A clinical audit of Venous Thromboembolism Risk Assessment and Prophylaxis in the acute hospital setting, in the context of a national improvement collaborative. In IRISH JOURNAL OF MEDICAL SCIENCE (Vol. 186, pp. S271-S271). 236.

Montgomery, & Cummings, M. J. (2017). Measuring Infection Prevention Capacity in Long-Term Care Facilities (LTCF). American Journal of Infection Control, 45(6), S19-S20.

RABIAIS, I. C. M., VIVEIROS, A. M., & FREITAS, C. M. R. (2016). Prevention and Control of Infection: An Advanced Nursing Practice. International Journal of Nursing, 3(1), 81-88.

Ross, P., Hubert, J., & Wong, W. L. (2017). Reducing the blame culture through clinical audit in nuclear medicine: a mixed methods study. JRSM management, 8(2), 2054270416681433.

Sinha, A. K., Murthy, V., Nath, P., Morris, J. K., & Millar, M. (2016). Prevention of late onset sepsis and central-line associated blood stream infection in preterm infants. The Pediatric infectious disease journal, 35(4), 401-406.

Solomkin, J. (2015). Clean care is safer care: Surgical site infection. Journal of Microbiology, Immunology and Infection, 48(2), S1.

Siebenaler, R., Czech, C., Craig, J., & Roach, J. (2017). Central Line-associated Blood Stream Infection Reduction in an Intensive Care Unit Utilizing a Maintenance Bundle Audit Tool. American Journal of Infection Control, 45(6), S95.

Weiss, K., Simon, A., Graf, & Linsler, S. (2017). Clinical practice audit concerning antimicrobial prophylaxis in paediatric neurosurgery: results from a German paediatric oncology unit. Child’s Nervous System, 33(1), 159-169.

Wilson, J., Bak, A., & Loveday, H. P. (2017). Applying human factors and economics to the misuse of nonsterile clinical gloves in acute care. American Journal of Infection Control. 45(4) 56- 67

Wick, K., Siebenaler, R., Czech, C., Craig, J., & Roach, J. (2017). Central Line-associated Blood Stream Infection Reduction in an Intensive Care Unit Utilizing a Maintenance Bundle Audit Tool. American Journal of Infection Control, 45(6), S95.

Zimmerman, P. A., Gilbert, J., Brown, L., & Shaban, R. Z. (2016). Infection prevention and control learning and practice in pre-registration undergraduate nursing: The sociological influences of the clinical environment. Infection, Disease & Health, 21(3), 131-132.

Zingg, W., Holmes, A., Dettenkofer, & Pittet, D. (2015). Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. The Lancet Infectious Diseases, 15(2), 212-224.