Report On Health Care Associated Infection: Strategies And Prevention Measures

Background

Discuss about the Report on Health Care Associated Infection?

Health care associated infections (HCAIs), which are also popularly known as the nosocomial infection, are the infections acquired by people while receiving treatment for another condition in a health care setting (Calfee 2012). HCAIs is acquired from anywhere where health care is delivered, which primarily includes inpatient acute care hospitals, outpatient setting such as the surgical centers and renal disease facilities, institution providing long-term care facilities like the nursing homes and the rehabilitation center. HCAIs can also occur during the course of treatment at home (Wright et al. 2014). Thus, health care-associated infections are considered as the most common complications of the hospital care. HCAIs are caused by a wide variety of common fungi, bacteria, and viruses as well as by other less common types of pathogens (Nelson and Williams 2014).

HCAIs approximately occur in one out of every 25 patients. Most countries do not have a proper surveillance system for the health care associated infections. Those that do have the system often struggle in dealing with the complexity of the disease and lack of standardized criteria for an effective diagnosis of the diseases (Kallen et al. 2013). Although it is not possible to acquire reliable global information on the health care-associated disease, reports suggest that hundreds of millions of patient remain affected by the health care associated infection around the world in each year. HCAIs also contribute to a substantial increase in the health care costs every year. The five major and common types of HCAIs include surgical site infection, pneumonia, urinary tract infection, bloodstream infection and gastroenteritis. In England, up to 300000 patients has been reported with healthcare-associated infection having a prevalence rate of 8.2% (Rammaert et al. 2012). Thus, in order to control the high prevalence and incidence rates of HCAIs, involvement of environment teams have become a prime concern. Implementation of effective QA/QC measures to the health care sectors and evidence-based management can be therefore regarded to produce appropriate control over the spread of the health care-associated infections (Wachter 2012). Other prevention methods and control measures include proper hand hygiene and suitable application of the fundamental precautions during the process of invasion. The control measures are usually simple and cost effective but do require proper staff accountability in association with behavioral change. To reduce the overall rate of HCAIs, the main objectives and perspectives for improvement includes:

Management Strategies

Proper identification of the local determinants of the HCAI burden

Implementation of effective strategies to improve the reporting and surveillance system at the national level

Increase in staff education and accountability for conducting better research for adapting and validating the surveillance protocols based on the reality of the developing countries

Potential improvement of the patient and their families in the process of HCAI reporting and control

Implementation of standard precautions involving best hand hygiene practices at the bedside

Thus, the basic aim of this case study is to explore the strategies and means by which HCAIs among the patients can be prevented in healthcare settings. The primary objectives of the study are stated below:

To understand and develop the practices that will help in contraction of the HCAIs

To understand the basic understandings and knowledge of the hospital worker towards HCAIs

To make proper recommendations on the effective approaches to the prevention of the HCAIs

Suitable evidence from reports and research has already documented the existence and the complications of the HCAI’s. In order to achieve the aims and objectives of the present case study the author shall primarily focus on the management strategies and the effective methods that have already been implemented in order to keep control over the rapid spread of HCAI’s (Nelson and Williams 2014). Developing knowledge from previous studies will help the author to design successfully the methods and strategy interventions that is required to keep a control on the spread of HCAI’s. The report suggests that the National Institute for Health and Clinical Excellence (NICE) in partnership with the health Protection Agency have already implemented a guide for providing a control on the HCAIs (Loveday et al. 2012). Highlighting the concerns about HCAIs, the guide has introduced a range of policies to reduce the rate of infection.  The guide provided a set of rules that highlighted the key areas of practice. Infection control and prevention can thus be obtained by introduction of certain measures, which includes hand hygiene, antimicrobial stewardship, and cleanliness of the environment (Huttunen and Syrjanen 2014). Thus, this includes proper management of patients with urinary problems, cleanliness of the environment and equipment, proper education of patients, hand hygiene and proper use of the personal protective equipment (PPE). Thus, NICE provided a set of recommendations, which are considered as a critical factor for proper implementation of the effective strategies. It has been stated that everyone associated with the primary care shall need to get educated regarding the standard principles of control and prevention of the disease (Mayhall 2012). The healthcare while delivering the necessary care shall need to provide with suitable methods of hand decontamination and PPE as mentioned. Patients need to be provided with proper education regarding the benefits and use of appropriate techniques for reducing the contamination (Calfee 2012).

Prevention Measures

Standard principles of hand decontamination need to be implemented immediately before direct association with the patient, exposure to any body fluids of the patient, contact with the patient’s surroundings and after the removal of the gloves (Loveday et al. 2014). Thus, all features and recommendations suggested initiated the fact that each health care individuals shall need to maintain safe and aseptic procedures. Thus, the guidelines proposed by NICE provided the suitable set of recommendations that provides a proper guide regarding the control and prevention of the healthcare associated infections (Godfrey et al. 2013).  The care providers thereby shall need to meet the appropriate standards of hygiene and implement the correct procedures in order to minimize the risk of the healthcare associated diseases. Apart from the maintenance of suitable health and hygiene, the care provider shall also need to take into account the primary needs and preferences of the patient (Sianin and Maillard 2015). Thus, patients shall need to be provided with all suitable opportunities to inform about their decision in partnership with the primary health care providers. Good communication between the care providers and the patient is also an essential factor and thus, shall need to be supported by evidence-based information produced in accordance with the parents needs (Pham et al. 2012). The treatment, care, and the information about the patients shall also need to be culturally appreciated for better assessing the patients. The given framework of NICE has been found similar to another report (Loveday et al. 2014), who wrote on the basic evidence-based guideline for successful prevention of HCAIs. The recommendations thus suggested include proper maintenance of the hospital hygiene, hand hygiene, efficient use of personal protective equipment (PPE), and safe disposals of the sharp objects and the principle of asepsis. Thus, following the above recommendations, the author shall need to take the available options to achieve the goals of HCAIs among the patients. The available options are.

Environment and Hospital Environment- this involves making the surroundings and environment dust free that can be approached by use of disinfectants, proper cleaning, and decontamination of the cleaning equipment. The workers shall also need to be properly educated for keeping the environment clean

Hand Hygiene- as most of the infection in hospitals are directly transferred through hand-to-hand contact, use of alcohol rub, proper timing for the hand contamination and practical implementation of the hand decontamination procedure helps in controlling the infection.

Use of PPE- PPE is a material that is worn to facilitate protection from the associated risks of health as well as the safety risks associated with the workers at work. Use of suitable aprons, gloves, eye masks is some commonly known PPE, the appropriate use of this facilitate control of the infection.

asepsis is a condition governed by the absence of microorganisms primarily the bacteria and the fungi. Thus, during handling of invasive devices, use of aseptic techniques and conditions needs to be implemented. The present condition can also be applied during the procedures of insertion, infusion of sterile fluids, surgical incisions and care of wounds.

The intervention or strategy behind the successive outcome of the case study will include collaboration with the local health commissioning team. Local health commissioning team is the clinically led groups that primarily include general practitioners (GP) from the surrounding localities (Mayhall 2012). The basic objective of the group and the other associates is to implement their knowledge and commissioning decision to influence the patients. The NHS England manages the local commissioning groups.  Thus, the collaboration among different health care professional will help in particular to provide primary care to the patients suffering from the health care associated infections that are chronic in nature (Calfee 2012). The interaction between and among the various kind of clinical professionals will help in enhancing the ideas of the members of the group regarding proper treatment care by collaboratively understanding each other’s cultures, methods, and values (Wright et al. 2014). Collaboration with the team will also help in the suitable understanding of the various kinds of functions or methods that need to be implemented in order to accomplish the overall process of care. Thus to facilitate the process of care to be maximally effective, collaboration with the team will help in examining the approaches implemented by the team (Boots 2016). The procedures also assist in examining whether the key functions that are specified by each professional are properly carried out. Thus, analyzing of the collaboration is very much important for understanding the clinical roles of each member associated with the team. Studies reported that initially during the spread of the healthcare-associated infections, a small number of hospitals had already implemented suitable programs, which are primarily designed to understand, control and prevent the spread of the healthcare associated infection (Evans et al. 2014) . Local, federal and the state health agencies were asked to provide a report on the laboratory and the epidemiologic support for further investigation into the problems. Thus, it has been understood at the beginning of time by some of the members of a local team that the hospitals are considered as the communities in which the public health providers could implement the principles to provide a control and prevention over the HCAIs (Harrington 2014). The hospital-based clinicians and the epidemiologist had already started applying public health model, which eventually involved local commissioning groups in promoting and encouraging the effective clinical means for providing control upon the spread of the HCAIs (Sammon et al. 2013). The model was primarily built upon the surveillance data obtained for identifying the healthcare associated infections (Callaghan 2013). The ongoing analysis and interpretation of the surveillance data thus helped in recognizing the potential problems and application of the suitable epidemic investigation techniques for identifying the associated epidemic and endemic health care-associated infections (Kilpatrick, Murdoh and Storr 2012). Specific methods were thus incorporated for the successful implementation of the public interventions in order to protect the staffs, visitors, and patients who seemed to be at a potential risk of getting affected by the healthcare associated infection. (Sammon et al. 2013). However, reports suggest that initially none of the public health system have implemented the strategies for managing the public health approach towards the development of the HCAIs. Instead, hospitals used to maintain their control programs in order to keep a check on the spread of the infection associated with the HCAIs (Blaine, Pellowe and Hodgkinson, 2012). Thus, the absence of a traditional collaboration among the local health teams and the hospitals lead to the establishment of the research and development activities within the hospitals itself for encouraging participation from all the nearby health care associates. Thus, a national network of hospitals was primarily volunteered for successfully conducting HCAIs surveillance by using the appropriate CDC (Control of Healthcare Associated Infections) methods. The methods thus used helped in reporting of these data to the surveillance system that was primarily monitored by the National Healthcare Safety Network (Loveday et al. 2014).

Thus, in brief, it can be emphasized by the fact that the involvement of the local commissioning bodies will help in satisfying the basic needs and demands of the patients suffering from HCAIs by implementing suitable and effective intervention of the disease. Therefore, from the initial reports it can be suggested that the recommendations from the case study will be presented to the team in order to get a response for their input (Godfrey et al. 2013). There will also be a request to put up a committee in order to monitor the implementation of the suitable recommendations. Thus, an interdisciplinary approach will be adopted which will help in ensuring that a joint effort has been put forwarded to the members of the committee coming from different health disciplinary with a common goal to prevent the spread of HCAIs among the patients (Loveday et al. 2014). Thus, in order to carry out the intervention successfully, financial investment is also required. Finance will be sourced by seeking permission from the local authority of the health department as well as from the suitable nongovernmental organization. The table below helps in estimating the overall costs and the eventual benefits that can be anticipated from the implementation of the intervention strategy

Costs	Amount (£)
Purchase of PPE	10000
Purchase of hand rub equipment	8500
Purchase cleaning & decontamination equipment	9000
Employing and training more cleaning staff	30000
Purchase &maintenance of intrusive equipment	25000
Training of  healthcare workers	15000

Benefits	Amount (£)
Reduced hospital readmissions	30000
Improved staff performance	25000
Improved waste disposal practices	15000
Reduced hours lost to illness	50000

Thus, from the given recommendation, the basic need for measuring the progress of the given intervention by proper monitoring, communication and evaluation to an extent that can be performed. This can be primarily achieved by measuring the clinical outcomes of the patients. Thus, this can also be achieved by implementation of simple surveys of the status that will be administered directly to the patients. Data collection to obtain data over on year period hence will be analyzed.

The interventions thus mentioned will play a fundamental role in managing the spread of the healthcare associated infection (Gaskins 2012). Involvement of the local health commissioning teams will help in carrying out the suitable recommendations by proper monitoring, evaluation and communication to an extent in order to prevent the spread of the healthcare associated infections (Donskey 2013). Involvement of the team will also require implementation of certain practical and suitable strategies that needs to be carried out in order to maintain a proper hospital hygiene, health hygiene, education of the medical workers and safe use of the hospital instruments (Schmitt et al. 2013). Thus, in order to carry out the interventions by the local commissioning team, a proper strategy and planning are required in order to implement interventions for creating a control over the spread of the healthcare associated infections (Wick et al. 2012). The strategy will mainly emphasize the personal responsibility of the proposed by the health care commissioning team for development of a suitable Trust infection control infrastructure in order to facilitate the information regarding the spread and prevention of the healthcare associated infections at the directorate level (Wachter, Pronovost and Shekelle 2013). Establishment of trust will help in developing a local action plan for successful implementation of the strategies and thereby providing a regular update on the progress. The plan will also assist in building a suitable partnership for imitating rapid involvement of more health care workers from different professional attributes. Local action plans thus published will help in developing and implementing of a suitable national action plan in those areas where it is appropriate (Polin et al. 2012).

The strategy will primarily aim at reducing the healthcare-associated infections in acute hospitals. Although healthcare associated infections is a common issue that is spreading rapidly throughout the health care sectors and thus the next step will be to develop a suitable strategy that are primarily aimed at reducing the healthcare-acquired infections in the community settings (Gaskins 2012). Thus, this will help in working on the broader aspect of the infection control issue.  The strategy primarily aims:

To provide control of the healthcare associated infection in hospitals

To provide control of the healthcare associated infection in the community settings

To promote guidance on the infection control

To implement effective strategies and management of the infectious disease emergencies

The Trust chief executives will also need to work in close approximation with the Local Health Boards and the Local Authorities as the strategies developed help in ensuring seamless and authentic care and management for the healthcare associated infection (Pham et al. 2012). With the aims and objectives of the plan, it is clear to use the national standards for measuring the performance in the given area of work in association with the local health commissioning teams (Mayhall 2012). The relationship will also help in ensuring that the individuals are very much aware of their personal responsibilities in the particular area concerning the healthcare associated infections. Thus, the strategic objectives will ensure that all the staffs of the local health commissioning teams have a clear understanding of the impact of the infection and the infection control practices that will enable them in discharging all their personal responsibilities to patients, workers, visitors (Stewardson et al. 2013) . Patients will be treated in suitable physical environments that will help in minimizing the risk of infection associated with the particular disease. The Infection Control programs need to be supported by abundantly by resourced specialist infection control workers with sufficient skills in order to satisfy the needs of the local group commissioning infection control plan (Huttunen and Syrjanen 2014). Developing trusts will help in adopting suitable comprehensive surveillance programs for monitoring and directing the infection control programs (Schmitt et al 2013). Programs will be primarily based upon the local needs as directed by the Trust infection control plan and program of the local commissioning team. The team, if necessary, shall also need to adopt the national programs that are primarily developed and agreed based on creating control over the spread of the healthcare associated infection (Godfrey et al. 2013). Specific programs circulating the reduction in the rates of infection will also be a part of the local team for implementing the effective strategies that will provide a direct link and association to clinical governance, performance management, and risk management (Siani and Maillard 2015). Thus, trusts will help in developing systems for ensuring effective recording, sharing, analysis and access to the recorded data in order to manage the needs of the patients. Specialist epidemiological support will be made available to the members of the local health commissioning team as per the requirement in order to support their infection control programs (Wick et al. 2012). Practical training schemes shall need to be made available in order to meet the demands and needs of the staffs as well. In order to measure the proper hand hygiene adherence, the various opportunities for hand hygiene need to be defined in clear and measurable ways. The most commonly recognized framework that is used for measuring the hygiene opportunities is the World Health Organization five moments for Hand Hygiene represented in the given figure. These moments includes indications for implementation of proper hand hygiene that are defined in the guidelines of WHO (Stewardson et al. 2013).

Figure representing the five moments of hand hygiene according to WHO guidelines

Effective strategies and plans can thus be implemented in order to support the use of wide variety of disinfectants in order to keep the environment clean (Callaghan 2013). A wide range of disinfectants includes the use of ammonium and sodium compounds and the effectiveness of the chemical disinfectants thereby depends on the antimicrobial activity of the disinfectant and the suitable application, which includes cleaning and appropriate contact time. With the growing concern of the healthcare associated infections, the hospital room surfaces needs to need to be properly disinfected for the application of the interventions in order to improve the cleaning following the patient discharge, use of no touch modalities for providing a suitable method of hospital room disinfection (McNulty, Cookson and Lewis, 2012). Thus, the local commissioning team will provide the simplest method for evaluating the cleanliness and concerns about the visual inspection that serves to be the most simple method for maintaining cleanliness in the hospital environment. Thus, several strategies have been implemented to improve the quality of assessment in order to prevent the spread of the healthcare associated infection. Thus, the policies implemented places a strong emphasis on the need for the healthcare workers and the patients in order to understand their roles and responsibilities about the infection control to prevent and reduce the spread of the healthcare associated infections (Sammon et al. 2013).

The interventions and the recommendations in the given case study are thus based on the research-based evidence. The research-based evidence helps in the understanding of the fact that the healthcare associated infection, which are the most common form of the disease obtained during the health care treatment. Thus, the present discussion on the case study helps in understanding the suitable relationship between the heath care providing staffs and the patient’s safety outcomes (Blaine, Pellowe and Hodkingson 2012). The study provides growing evidence regarding the working conditions in general and the patients safety issues associated with the healthcare associated infections. Because the healthcare associated infections are one of the growing concern in today’s world, it can be analyzed from the case study that the healthcare associated infection needs proper monitoring and control measures for keeping a suitable control over the spread of the healthcare associated infections (Kiplatrick, Murdoch and Storr 2012).

The various interventions and strategies thus implemented from the previous studies thereby help in focusing on the relevant association of the present strategies and interventions that can be useful in context to the species study (McNulty, Cookson and Lewis, 2012).  Thus, it can be clearly stated that in order to reduce the increased risk of the healthcare associated infections, proper foundation programs, and public health care strategies plays a vital role in spreading knowledge for the betterment of the present scenario (Loveday et al. 2014). The interventions that have been developed in context to the present study will help to encounter problems in dissemination that according to the Centre for Interdisciplinary Research on AIDS is usually associated with the background due to some necessary limitations (Mayhall 2012). However, the initial investigation of the author in context to the present case study will help in ensuring that the interventions that have been applied will be sent directly to the various health departments. The various associated health departments include UK Department health, public health England, health protection agency, and the other local health department authorities for better appraisal, implementation, and monitoring of the health care-associated infection (Siani and Maillard 2015).

Conclusion

As per the discussions in the given essay, it can be concluded that the interventions that have been implemented for providing an impact on the rapid spread of the healthcare associated infection get directly linked to the UK public health domain. Particularly, the UK public health domain number 4 that primarily aims at eliminating the premature mortality and the health care of the public helps in reducing the outcomes of the preventable disease involving a large number of people, who might assist in encountering a large number of premature deaths. The effective strategies will also contribute to reduce the communication gap between the communities that will help in reducing the gap between the communities by promoting qualified worker and patient’s education.

Thus, with proper implementation and monitoring of the recommendations, the healthcare associated infections can be prevented with a vision to improve the patients health and safety.

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