Effective infection prevention and control

Nursing Practice in 2020
Nursing Practice
in 2020
Infection Control
(Hand Hygiene)
Student Name:
http://ohs.com.au Student ID: S0000
Introduction
Effective infection prevention and control is central to providing high
quality healthcare for patients and a safe working environment for
those that work in healthcare setting.
Healthcare associated infections (HAIs) are infections acquired as a
direct or indirect result of healthcare (Horan, Andres & Durdeck,
2008). International evidence suggests a considerable infection
burden exists among long- term care residents however, there are few
published studies on the rate of infection in Australia (WHO, 2016).
Australian acute healthcare facilities, have approximately 165,000
HAIs each year (Mitchell, Shaban, Macbeth, Wood & Russo, 2017).
HAIs are the most common complication effecting patients in hospital.
In addition to unnecessary pain and suffering for patients and their
families, adverse events can prolong hospital stays and are costly to
the health system. Approximately 7% of hospitalised patients will
acquire a HAI, with an estimated increase to the cost of a patient’s
admission of 8.6% (IHPA, 2017).
The problem not only effect patients and workers in hospitals – HAIs
can occur in any healthcare setting. These including office-based
practices(such as general practice clinics, dental clinics and community
health facilities), paramedic pre-hospital work settings and long-term
care facilities.
Any person working in or entering a healthcare facility is at risk.
However, healthcare associated infection is a potentially preventable
adverse event rather than an unpredictable complication. It is possible
to significantly reduce the rate of HAIs through effective infection
prevention and control.
Target Audience and Rationale for Resource
This document can be used by Third Year Undergraduate
Nursing Students and New Graduate Registered Nurses.
In assisting healthcare workers to improve the quality of the care
they deliver; best practice principles aim to promote and facilitate
the overall goal of infection prevention and control:
the creation of safe healthcare environments through the
implementation of evidence-based practices that minimise the risk
of transmission of infectious agents.
(Australian Government, 2020)
Outcomes and Learning Objectives
This resource has the following four objectives:
• Understanding the purpose of Infection Prevention and Control;
• Understand who is responsible for Infection Prevention and Control in
the healthcaresetting;
• Understanding Standard Precautions and when to use them;
• The identification of the 5 Moments of Hand Hygiene.
Why Infection Prevention and Control
Infection prevention and control practices can minimise the risk of
Infection transmission occurring between patients. Healthcare
Workers and other people in the healthcare environment and are an
Essential component of safe quality healthcare (Australian Guidelines
for the Prevention and Control of Infection in Healthcare, 2019)
(WHO, 2020)
The NSQHS Standards
The National Safety and Quality Health Service Standards [NSQHS], (2020)
aims to provide a nationally consistent statement and standard health care
that all the nation can expect from all healthcare organisations.
The Federal Government in collaboration with all Australian States and
Territories funded the NSQHS. There are 8 standards that all healthcare
organisations and health care workers must uphold, to ensure, patient
wellbeing, quality cod value, quality and safety, finally to support health
professionals to provide safe and high quality care as seen in the diagram
below.(NSQHS, 2020)..
(NSQHS, 2020)
Standard 3 Preventing and
Controlling Healthcareassociated Infections (HAI’s)the
focus of this education booklet.
What Are Healthcare Associated Infections?
Healthcare associated infections are infections that are acquired as
a direct or indirect result of healthcare (Webster, Faogali
&Cartwright, 2014). HAI’s can occur as a result of the provision of
healthcare in any setting. While the specific risks may differ, the
basic principles of infection prevention and control apply regardless
of the setting.
In order to prevent HIA’s it is important to understand how
infections occur in the healthcare setting and then institute ways to
prevent them. If effectively implemented, the two-tiered approach
of standard and transmission- based precautions recommended for
best practice provides high-level protection to patients, healthcare
workers and other people in the healthcare setting.
(NSQHS, 2020)
Infection Prevention is Everyone’s Business!
This responsibility applies to everybody working in and visiting a
healthcare facility, including administrators, staff, patients and carer
(Australian Guideline for the Prevention and Control of Infections in
Healthcare, 2019). Infection prevention and control is integral to clinical
care and often requires a range of strategies to be successful. It should
not be considered as an additional set of practices but as part of
standard care.
Successful approaches for preventing and reducing harms arising from
HAIs involve applying a risk-management framework to manage the
‘human’ and ‘system’ factors associated with the transmission of
infectious agents. This approach ensures that common (such as
gastrointestinal viruses) or evolving infectious agents (such as influenza,
CoVID or multi-resistant organisms) can be managed effectively.
Involving patients and their carers is essential in successful infection
prevention and control in clinical care. Patients and families that are
sufficiently informed have a fundamental role in managing the risks of
infection and the reducing the risk of transmission of infectious agents.
Contracting a HAI
Most infectious agents are microorganisms. These exist naturally
everywhere in the environment and not ALL microorganisms cause
infection. Transmission of infectious agents within a healthcare setting
requires all the following elements:
• Causative agent (pathogen)
• Reservoir
• Portal of Exit
• Means of Transmission
• Portal of Entry
• A Susceptible Host
(Australian Guideline for the Prevention and Control of Infections in Healthcare, 2019)
What Are Standard Precautions and When Should They Be Used?
Standard precautions refer to those work practices that are applied to
everyone, regardless of their perceived or confirmed infectious status
and ensure a basic level of infection prevention and control (Australia
Guidelines for the Prevention and Control of Infection in Healthcare,
2019).
Everyone has the potential to harbour infectious agents. The
implementation of standard precautions is a first line approach to
infection prevention and control in the healthcare environment. The
implementation of standard precautions minimises the risk of
transmission of infectious agents from person to person within the
variety of healthcare settings in Australia.
(Australian Guideline for the Prevention and Control of Infections in
Healthcare, 2019)
http://professionals.site.apic.org/protect-your-patients/follow-the-rules-for
isolation-precautions
How Are Standard Precautions Implemented?
• Personal hygiene practices, particularly hand hygiene, aims to
reduce the risk of contact transmission of infectious agents
(WHO, 2019)
• Appropriate use of personal protective equipment (PPE),
includes gloves, gowns, plastic aprons, mask/ face shields
and eye protection. The aim of PPE is to prevent exposure
of the healthcare worker and patients to infectious agents
(WHO, 2019)
• The safe handling and disposal of sharps assists in
preventing transmission of blood-borne diseases to
healthcare workers (WHO, 2019)
• Environmental controls, including cleaning and spills
management, assist in preventing transmission of infectious
agents from the environment to patients (WHO, 2019)
• Practicing respiratory hygiene and cough etiquette reduces
the risk of transmission of infections (WHO, 2019).
(AHPRA,2020)
Hand Hygiene and Best Practice
Effective hand hygiene is the single most important strategy in
preventing healthcare associated infections (WHO, 2019). Ease of
access to hand washing facilities (soap and water) and alcoholbased hand rubs can influence the transmission of HIA’s. Washing
hands with soap and water is required if hands are visibly soiled
while either product can be used if hands are visibly clean (WHO,
2019).
It is recommended that routine hand hygiene is performed:
• Before touching a patient
• Before a procedure
• After a procedure or body substance exposure risk
• After touching a patient
• After touching a patient’s surroundings
Hand hygiene must also be performed before putting on gloves and
after the removal of gloves.
(Australian Commission on Safety and Quality in Healthcare, 2018)
A Question?
How often do you use the Five Moments in your clinical practice?
References
Allegranzi, B., Nejad, S. B., Combescure, C., Graafmans, W., Attar, H.,
Donaldson, L., and Pittet, D. (2010). Burden of endemic healthcare-associated infection in developing countries: systematic
review and meta-analysis. The Lancet, 377. pp 228-241
Australian Commission on Safety and Quality in Healthcare (2018).
Australian Commission on Safety and Quality in
Healthcare: National Hand Hygiene Initiative User Manual:
5 Moments for Hand Hygiene.
Gown and gloves image: http://professionals.site.apic.org/protect-yourpatients/follow-the-rules-for isolation-precautions <accessed 7th August
2020>
Horan, T. C., Andrus, M., and Dudeck, M. A. (2008). NHSN
surveillance definition of health care– associated infection
and criteria for specific types of infections in the acute
care setting. American Journal of Infection Control, 36(5).
Pp 309-332.
Hand image: ohs.com.au <accessed 7th August 2020>
Independent Hospital Pricing Authority: Pricing Framework for
Australian Public Hospital Services 2018- 19.
Mitchell, B. G, Shaban, R. Z, MacBeth, D, Wood, C. J, and Russo, P. L.
(2017). The burden of healthcare associated infection in
Australian hospitals: A systematic review of the literature.
Infection, Disease & Health.
Webster, J., Faogali, J. L, and Cartwright, D. (2004). Elimination of
methicillin-resistant Staphylococcus aureas from a neonatal
intensive care unit after hand washing with triclosan. Journal of
Paediatrics and Child Health, 30, pp 59-64.
World Health Organization (2011): Report on the Burden of Endemic
Health Care-Associated Infection Worldwide.
World Health Organization (2018). Guidelines on core components of
infection prevention and control programmes at the national
and acute health care facility level.

 

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