Health And Disability For Infection Control Management System

Standard 3.1 (Infection Control Management) of the Health and Disability Service Standard (HDSS: 2008)

Discuss about the Health and Disability for Infection Control Management System.

The implementation of an effective infection control management system highly warranted in the context of preventing the pattern of nosocomial infections across the hospital setting. The administration of hand hygiene, respiratory care and sedative measures required by the healthcare teams for safeguarding the patient population as well as healthcare professionals from the debilitating manifestations that arise from the progression of various contagious conditions across the hospital environment. The infection control preventionists needs to track the causative factors of infection transmission and execute preventive as well as remedial interventions for enhancing the health and wellness outcomes of the treated patients across the hospital wards. The evaluation of the infection control program is required by the healthcare teams in proactively modifying the infection control strategies for reducing the length of patients’ stay across the healthcare setting (Mehta, et al., 2014).

The objective of HDSS 2008 standard 3.1 attributes to the effective elevation of the safety of healthcare consumers, providers and visitors during the operational hours across the healthcare setting (MOH-Manatu-Hauora, 2008). Infection control management strategies prescribed by the standard 3.1 of HDSS advocate the requirement of elevated focus on the basic infection control principles in the context of challenging the progression of various contagious conditions across the hospital environment. This section further emphasizes the requirement of configuring a consistent and dynamic infection control baseline requiring utilization during the administration of healthcare services to the patient population. The infection control measures emphasized by standard 3.1 of HDSS warrant the deployment of effective control systems and structures for elevating the quality of healthcare interventions for the treated patients. The administration of qualitative healthcare strategies assists in the effective implementation of infection control approaches for reducing the burden of infectious conditions among the treated patients in the hospital setting. Evidence-based research literature advocates the requirement of practicing hand hygiene measures and sedative interruptions for controlling the catheter related infections among the patients across the hospital setting (Reed & Kemmerly, 2009). The respiratory care measures across the hospital setting require the administration of interventions like deep breathing exercises, intermittent positive pressure breathing and incentive spirometry for reducing the onset and establishment respiratory complications and associated infectious processes among the admitted patients (Kleinpell, Munro, & Giuliano, 2008). The “infection control management system” across the hospital setting should include and emphasize the requirement of administering educational interventions and feedback sessions in the context of providing social support to the healthcare teams for effectively controlling the pattern of infection progression among the treated patients (Cimiotti, Aiken, Sloane, & Wu, 2012).

Nine criteria for effective infection control management system in a 500-bed hospital

2008). The teams must efficiently coordinate with each other for implementing infection control protocols and related measures in the context of elevating wellness outcomes among the patient population. The delineation of responsibilities between the healthcare governing bodies and management teams potentially assists in reducing the establishment of antibiotic resistant microorganisms among the treated patients in the hospital setting. Infection control teams require practicing stringent measures for implementing comprehensive infection control strategy while screening each patient for various infectious processes (Whitelaw, 2015). Infection control measures require configuration in accordance with the associated risk of the development of particular infectious conditions across the hospital setting. The risk of infection progression associated with the healthcare services also requires consideration while deploying effective infection control systems across the hospital settings (MOH-Manatu-Hauora, 2008). Evidence-based research literature emphasizes the risk of establishment of infectious conditions following the surgical interventions during the stay of patients in the hospital setting. Therefore, the practice of aseptic measures and principles of hygiene through the healthcare teams required across the hospital environment for reducing the acquisition of post-operative infections among the treated patients (Sydnor & Perl, 2011). The infectious disease conditions that require hospital admission complicate further with the onset of nosocomial infections and therefore, the deployment of hospital epidemiologists required for tracking the infection progression rate in the context of configuring remedial interventions for its effective treatment across the hospital setting (Sydnor & Perl, 2011). The endorsement of infection control policies and conventions required across the hospital environment for challenging the progression of infectious processes (MOH-Manatu-Hauora, 2008). Infection control policies and programs sponsored by New Zealand Health Quality & Safety Commission considerably assist in reducing the risk of establishment of infectious conditions among the treated patients in the healthcare facilities. These infection control programs also facilitate the effective reduction in the utilization of the central line in cases of bacterial infection of the surgical site for improving patient outcomes across the hospital setting (Roberts & Jowitt, 2015).

The nine – criteria (including their positives and challenges) warranted for an effective control management system in a 500-bed hospital categorized below with appropriate references:

Criteria 1.1: 

The hospital administration must effectively delineate the infection control responsibilities between the hospital teams for the systematic management of a potential infection control system across the 500-bed hospital (MOH-Manatu-Hauora, 2008, p. 22). For example, the medical lab technologist can be assigned the responsibility of tracking the blood stream infections through the lab analysis of blood samples and escalate the evidence of infectious conditions of patients to physician groups for their effective management (Yagi, 2010). However, the greatest challenge in assigning the infection control responsibilities to the medical teams attributes to the resistance offered by the team members in undertaking the additional measures in the absence of additional compensation.

Criteria 1.2: 

The hospital administration requires undertaking strict measures for defining the reporting lines as well as frequency of the issues related to serious infection control requirements for their instant escalation to the respective hospital authorities (MOH-Manatu-Hauora, 2008, p. 22). The biggest challenge in implementing these reporting lines is the systematization of the process of infection monitoring across the hospital setting. The appropriate implementation of the reporting lines by the healthcare professionals assists in systematizing infection control measures across the hospital environment for reducing the scope of establishment of nosocomial infections (Reed & Kemmerly, 2009).      

Criteria 1.3:

The documentation of a well-defined infection control programme by the healthcare authorities is highly warranted in the context of streamlining the infection control strategies across the hospital environment (MOH-Manatu-Hauora, 2008, p. 22). The documentation of infection control norms and policies will assist the healthcare teams in effectively monitoring the infection control approaches deployed for controlling the establishment of nosocomial infections. The greatest challenge in delineating an infection control programme attributes to the acquisition of a common consensus among the healthcare teams regarding the infection control measures and their implementation across the hospital environment.        

 Criteria 1.4:

The development of the infection control programme warrants the deployment of key – stakeholders while engaging them in monitoring the attributes of the programme prior to its approval by the governing body (MOH-Manatu-Hauora, 2008, p. 22). This will increase the effectiveness of the programme and assist in obtaining the necessary funding from the stakeholders for its implementation. However, the challenge in implementing the programme attributes to the acquisition of support and approval from all stakeholders regarding the programme implementation across the hospital environment.     

Criteria 1.5:

This criterion advocates the requirement of establishing a well-defined process for obtaining infection control support for the effective prevention of infectious processes across the hospital environment (MOH-Manatu-Hauora, 2008, p. 22). This will effectively reduce the time of taking necessary measures for controlling infection and facilitate its appropriate monitoring across the hospital environment. However, the unwillingness of hospital teams in attaining additional responsibilities in terms of implementing the predefined infection control process might challenge its establishment across the 500-bed hospital.     

Criteria 1.6:

The deployment of infection control team for managing the infection control processes and reporting of the findings to governing body warranted in the context of implementing a responsible infection control system across the hospital environment (MOH-Manatu-Hauora, 2008, p. 22). However, the selection of such a responsible team of healthcare professionals proves challenging for the hospital administration while implementing infection control approaches.

Criteria 1.7:

The segregation of roles and responsibilities of the infection control team required in the context of systematically implementing the infection control programme across the healthcare setting (MOH-Manatu-Hauora, 2008, p. 22). The challenge in delineating the infection control roles and responsibilities among the healthcare team members attributes to the resistance that they might exhibit in acquiring the additional roles in the absence of additional remuneration.

Criteria 1.8:

This criterion emphasizes the requirement of undertaking consultation with the infection control team prior to implementing significant changes in the healthcare practices and staffing across the 500 – bed setting (MOH-Manatu-Hauora, 2008, p. 22). This will assist the healthcare teams in recommending necessary infection control requirements in the process of amendments in the healthcare practices. However, the practical implementation of this process appears time-consuming and leading to operational mismanagement across the 500-bed hospital. 

Criteria 1.9:

This criterion advocates the requirement of preventing the clients as well as members of the healthcare teams exposed to the infections processes from contacting the uninfected people across the hospital setting. This will effectively reduce the scope of infection progression; however, the healthcare teams might experience ethical issues while selectively restraining their team members in contacting the treated patients in the 500-bed hospital (MOH-Manatu-Hauora, 2008, p. 22).

The infection control preventionists (IP) coordinates with the department of health for preparing effective policies, strategies and conventions in the context of reducing the onset of a pandemic event across the hospital environment (Uchida, et al., 2011). The IP provides necessary critical guidance regarding the potential resources that require deployment in a hospital setting during the state of public health crisis (Uchida, et al., 2011). The IP assists healthcare teams in retrieving and analysing the data related to past episodes of infection pandemics (Stone, et al., 2009). They also interpret this data in the context of identifying the causes and facilitators of infection progression across the hospital environment (Stone, et al., 2009). The tracking of causative factors of infection progression by the infection control preventionists subsequently assists healthcare teams in configuring prophylactic interventions for reducing the scope of infection pandemic among the treated patients and member of the healthcare teams in the 500-bed hospital setting. The IP configures various quality measures for preventing the establishment of infectious conditions among the patients treated with decubitus ulcer prevention and influenza vaccination interventions in the hospital setting (Wagner, Roup, & Castle, 2014).    

The IP requires coordinating with the laboratory units in the context of assisting them in following the safety measures during the evaluation of lab specimens for reducing the scope of the transmission of infectious organisms to the healthy persons in the healthcare teams and subsequently to the treated patients (Spencer, Uettwiller-Geiger, Sanguinet, Johnson, & Graham, 2016). They also retrieve the data related to the infectious conditions treated by the healthcare teams across the healthcare setting. The infection control preventionists requires the effective retrieval and dissemination of information regarding the establishment and progression food borne pathogens in the healthcare facility (Kosa, Cates, Hall, Brophy, & Frasier, 2014). This resultantly elevates the awareness of healthcare teams regarding the risk of the type of food borne infection and its adverse manifestations that exhibit detrimental effects on the treated patients as well as members of the healthcare teams in the hospital setting. Therefore, with this information in hand the IP configures and effectively implements the appropriate infection control program advocating the practice of hygiene and safety interventions for retaining the quality of food served across the hospital premises.   

The IP facilitates the configuration of a hospital culture that advocates the implementation of clinical excellence among the healthcare teams for reducing the scope of infection progression across the hospital environment. The IP also motivates the healthcare teams in identifying the potential barriers that hinder the process of administering prophylactic interventions warranted for challenging the establishment of hospital-acquired infections (Saint, et al., 2010). The IP advocates the practice of contact precaution for patients with a past medical history of an infectious disease condition (Shenoy, Hsu, Noubary, Hooper, & Walensky, 2012). This substantially reduces the risk of infection establishment among the healthy members of healthcare teams across the hospital environment. The infection control preventionists assists in the organization of antimicrobial stewardship programs that facilitate the effective coordination of IPs with the epidemiologists for the early identification of infectious processes across the healthcare setting (Moody, et al., 2012). The IP subsequently helps in the effective configuration of appropriate infection control strategies like education measures for the visitors, patients and staff in the context of elevating their compliance to the transmission-based precautions across the healthcare facility. The infection control preventionists also helps in the implementation of care bundle practices for preventing the establishment of infectious conditions among the treated patients. The IP utilizes electronic surveillance system and hospital intranet for expediting and disseminating the results of surveillance culture among the healthcare professionals and training the hospital staff for the needful implementation of “infection control prevention strategies” across the hospital setting (Conway, Raveis, Pogorzelska-Maziarz, Uchida, & Stone, 2013).

The evaluation of an infection control program requires the systematic assessment of the epidemiological surveillance system and operational structure of the infection control program across the hospital setting (Menegueti, Canini, Bellissimo-Rodrigues, & Laus, 2015). For example, the operational structure for preventing hospital-acquired pneumonia includes the human resources, physical space, legal obligations and implementation protocols for elevating the level of compliance of the healthcare teams to the infection control conventions. The IP requires evaluating the “nosocomial infection prevention manual” of the hospital to ascertain that latest and updated infection control strategies recommended for the healthcare teams and patient population. The hospital database containing the findings related to the adversities associated with pneumonia pandemic requires a thorough evaluation by the IP for testing its precision as well as authenticity in relation to infection control intervention. Another example of evaluating the infection control program includes the systematic analysis of the hospital infrastructure and healthcare resources deployed for effectively controlling the progression of drug-resistant tuberculosis among the treated patients (Farley, et al., 2012). The evaluation of the deployment of full time infection control officer, tuberculosis infection control plan, provision of regular screening interventions, cough hygiene, smear positive patients, sputum collection strategies and health protocols for visitors necessarily warranted by the IP for identifying the potential of the infection control program in controlling the progression of drug-resistant tuberculosis.    

Example – 1: The formative assessment strategies in IPC across the 500 – bed hospital include the following approaches requiring implementation by the healthcare teams during the process of implementation of the infection control programme.

Organization of interview sessions with the patients, caregivers and hospital staff in the context of evaluating their knowledgebase regarding infection control strategies requiring implementation for preventing the progression of infectious processes across the hospital environment

The organization of laboratory investigation including blood culture tests for tracking the extent of infection progression and establishment across the 500-bed setting

Administering questionnaires and organizing group discussions with the physicians, nurses and paramedics for evaluating the infection control measures deployed by them across the hospital setting

Tracking the sustainable outcomes and impact of the infection prevention program in the 500-bed hospital

Evaluating the preventive measures adopted by healthcare teams in terms of reducing the contact of infectious individuals with the uninfected people across the 500-bed hospital.

Example – 2: The summative assessment strategies in IPC across the 500 – bed hospital include the following approaches requiring implementation by the healthcare teams during the process of implementation of the infection control programme.

The execution of blood culture tests of the hospital teams as well as admitted patients for identifying the pattern of hepatitis causing organisms as well as bacterial transmission

Evaluation of the quality of personal protective equipments utilized by the hospital teams in preventing the infection transmission across the 500-bed hospital

Evaluation of the droplet precaution strategies adopted by hospital teams for infection prevention

Identification of the burden of infectious conditions across the hospital environment

Exploration of the level of immunity and pattern of infection exposure of the healthcare teams and patients after the implementation of infection control interventions.

Conclusion

The infection control preventionists require undertaking the thorough evaluation of the policies and procedures related to the infection control program across the hospital setting in the context of determining their effectiveness in challenging the progression of infection pandemic across the hospital environment. The inclusion and exclusion policies of the hospital concerning the requirement of isolating the infected patients as well as diseased members of the healthcare teams require evaluation for testing their appropriateness in facilitating the process of infection control across the healthcare setting. The IP must demonstrate the pattern of leadership across hospital environment for effectively channelizing remedial interventions warranted to control the transmission of infectious pathogens across the patient population.

References

Alp, E., Altun, D., Cevahir, F., Ersoy, S., Cakir, O., & McLaws, M. L. (2014). Evaluation of the effectiveness of an infection control program in adult intensive care units: a report from a middle-income country. American Journal of Infection Control , 42 (10), 1056-1061.

Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care–associated infection. American Journal of Infection Control , 40 (6), 486-490.

Conway, L. J., Raveis, V. H., Pogorzelska-Maziarz, M., Uchida, M., & Stone, P. W. (2013). Tensions inherent in the evolving role of the infection preventionist. American Journal of Infection Control , 959-964.

Farley, J. E., Tudor, C., Mphahlele, M., Franz, K., Perrin, N. A., Dorman, S., et al. (2012). A national infection control evaluation of drug-resistant tuberculosis hospitals in South Africa. International Journal of Tuberculosis and Lung Disease , 16 (1).

Kleinpell, R. M., Munro, C. L., & Giuliano, K. K. (2008). Targeting Health Care–Associated Infections: Evidence-Based Strategies. In Patient Safety and Quality: An Evidence-Based Handbook for Nurses. USA: Agency for Healthcare Research and Quality (US).

Kosa, K. M., Cates, S. C., Hall, A. J., Brophy, J. E., & Frasier, A. (2014). Knowledge of norovirus prevention and control among infection preventionists. American Journal of Infection Control , 676-678.

Masuda, N., & Holme, P. (2013). Predicting and controlling infectious disease epidemics using temporal networks. F1000 Prime Reports , 5 (6).

Mehta, Y., Gupta, A., Todi, S., Myatra, S. N., Samaddar, D. P., Patil, V., et al. (2014). Guidelines for prevention of hospital acquired infections. Indian Journal of Critical Care Medicine , 18 (3), 149-163.

Menegueti, M. G., Canini, S. R., Bellissimo-Rodrigues, F., & Laus, A. M. (2015). Evaluation of Nosocomial Infection Control Programs in health services. Revista Latino-Americana de Enfermagem , 23 (1), 98-105.

MOH-Manatu-Hauora. (2008). Health and Disability Services (Infection Prevention and Control) Standards. New Zealand: Ministry of Health Manatu Hauora.

Moody, J., Cosgrove, S. E., Olmsted, R., Septimus, E., Aureden, K., Oriola, S., et al. (2012). Antimicrobial stewardship: a collaborative partnership between infection preventionists and health care epidemiologists. American Journal of Infection Control , 94-95.

Reed, D., & Kemmerly, S. A. (2009). Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications. The Ochsner Journal , 9 (1), 27-31.

Roberts, S., & Jowitt, D. (2015). New Zealand Health Quality & Safety Commission infection prevention and control programmes: evidence for sustained improvement in infection prevention interventions. Antimicrobial Resistance & Infection Control , 4 (1), 58.

Saint, S., Kowalski, C. P., Banaszak-Holl, J., Forman, J., Damschroder, L., & Krein, S. L. (2010). The importance of leadership in preventing healthcare-associated infection: results of a multisite qualitative study. Infection Control & Hospital Epidemiology , 31 (9), 901-907.

Shenoy, E. S., Hsu, H., Noubary, F., Hooper, D. C., & Walensky, R. P. (2012). National Survey of Infection Preventionists: Policies for Discontinuation of Contact Precautions for Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE). Infection Control & Hospital Epidemiology , 33 (12), 1272-1275.

Spencer, M., Uettwiller-Geiger, D., Sanguinet, J., Johnson, H. B., & Graham, D. (2016). Infection preventionists and laboratorians: Case studies on successful collaboration. American Journal of Infection Control , 44 (9), 964-968.

Stone, P. W., Dick, A., Pogorzelska, M., Horan, T. C., Furuya, E. Y., & Larson, E. (2009). Staffing and structure of infection prevention and control programs. American Journal of Infection Control , 37 (5), 351-357.

Sydnor, E. R., & Perl, T. M. (2011). Hospital Epidemiology and Infection Control in Acute-Care Settings. Clinical Microbiology Reviews , 24 (1), 141-173.

Uchida, M., Stone, P. W., Conway, L. J., Pogorzelska, M., Larson, E. L., & Raveis, V. H. (2011). Exploring Infection Prevention: Policy Implications From a Qualitative Study. 12 (2), 82-89.

Wagner, L. M., Roup, B. J., & Castle, N. G. (2014). Impact of infection preventionists on Centers for Medicare and Medicaid quality measures in Maryland nursing homes. American Journal of Infection Control , 4 (1), 2-6.

Whitelaw, A. C. (2015). Role of infection control in combating antibiotic resistance. South African Medical Journal , 105 (5).

Yagi, T. (2010). Critical role of clinical laboratories in hospital infection control. Article in Japanese , 1099-1104.