In this paper “infection control” is an issue selected from a nursing care context. The practice or profession of offering care for the infirm and sick individuals is known as nursing. Nursing practice involves promotion, optimization and protection of individual abilities and health, injury and illness prevention, improvement of suffering through diagnosis and management of support and human response in care of populations, communities, families and individuals (Bain & Weese, 2004). Nursing care focuses very much on patient’s safety. In terms of safety, infection control is of utmost important. A healthy work surrounding is one, which is safe, satisfying and empowering. It is not simply the absence of perceived and real health threats, but a situation of mental, physical and societal well being, stated by the World Health Organization. A safety culture is paramount, where all the health care personnel, managers and leaders and nursing aides have accountability as part of client centered team to work with a professionalism sense, responsibility, involvement, transparency, effectiveness and efficacy (Howard, 2012). All the health care personnel need to be careful about safety and health for both health care professional as well as the care consumer in any care set up, offering a safety sense, healthcare, empowerment and respect to each and every individual. One key nursing theory that can be discussed here for the development and establishment of this issue is evidence based nursing practice.
Evidence based nursing practice consists remarkable control on existing and upcoming expert nursing practice (Mabbott, 2011). Consequently, evidence based nursing making it a vital element of nursing educational process. Evidence based nursing is considered as critical factor to nursing occupation and also considered as important component for maintaining developments, which sustain most favorable nursing care (Green, 2006).
Nursing professionals utilize research to provide evidence based care that promotes important health associated outcomes for families, communities, healthcare set ups and individuals (Oermann, 2011). The care personnel utilize research to structure health guidelines within an organization at federal, local and state levels. Care personnel carry out research; apply research studies in practice and educate about research.
Nursing skill is a strong requirement to structuring clinical expertise (Falzer & Garman, 2012). Education to create well structured scientific decisions is reliant on experiential learning where individual can disconfirm, challenge and refine various expectations.
Improvement is required for setting up trustworthiness important in clinical leadership provision. Nursing research has also established association with advanced nursing practice with the experiences of the nurses (Polit & Beck, 2008). To make the care personnel efficient in negotiating and initiating improvements, they should be positioned in managerial circumstances, which provide them authority and power to have an effect on change. The strength and the basis of advanced practice related to nursing responsibility lies in clinical expertise. Researchers and educators should be placed in view of the clinical practice primacy.
The elements of evidence based nursing practice include clinical expertise, patient preferences and morals and finest research evidences (Twycross, 2011). It is apparent that health care professionals are interested to execute efficient nursing researches for the care of the patients, but these are not that fruitful. Evidence based practices encompass different types of evidences, for example: reviews, research findings, integration of research evidences and theories for the betterment of the patients’ health (Williamson, Jenkinson & Proctor-Childs, 2008). Presently, this practice has been put in health care set up to improve an important and vibrant strength within disciplinary life of the healthcare personnel. Nurses are sometimes failed to understand the prospective for applying research conclusions as the source for making decisions and flourishing nursing interventions (Fawcett & Fawcett, 2005). Hence, researchers and discussions are still in place to overcome execution barriers of proof based nursing performances.
Prior to the advancement of the concept of infection control, the single situations which brought the clients near death necessitated the possibility of surgical involvement. If a client survived a surgical procedure, infection was expected and subsequently death by devastating sepsis was very common (Goldstein, 2011). During the late 19th century along with the “Germ theory” development by the scientist Louis Pasteur and the subsequent applications of this theory to surgical sterility by the scientist Joseph Lister, doctors were capable of performing operations with consequently lesser infection risk (Kurzen, 2005). In turn the surgeons became more self-assured and started to investigate more profligate processes comprising elective surgeries within cranial vault. In the 20th century as the scientific acquaintance expanded, advancement of infection control along with the application of antibiotic drugs, microbial barriers and instrument sterilization have also been improved.
Advancements in hemostasis, anesthesia, and infection control and localization techniques have reduced the chances related with surgeries in the late 19th century (Martin & Thompson, 2000). Yet after the improvement of tumor localization, doctors approached sanctuary of mind with fear of deadly problems. Infection was considered as the main contributor to mortality and morbidity rates, taking place after almost all the surgeries and taking away the lives of approximately half of all the surgical patients (Winchcombe, 2000). Subsequently, the surgeries were attempted only as the last option. The execution of Germ theory to healing wounds altered the surgical practice and set the arena for the improvement of brain tumor operation.
It is believed that historically Hippocrates may have been the first person to suggest suppuration idea, declaring that the pus formation was not any natural component during the healing process and this need to be avoided (Newsom, 2004). His advice for treating wounds was parallel to Sumerians, who believed cleansing wounds with wine, applying bandage and then drenched the bandage with wine.
The initiation and infection transmissibility were proved indefinable to science prior the 19th century. The scientist Hieronymus Fracastorius postulated that the source of infectious diseases was from living seeds that are invisible (Wright, 2014). He has given the three disease spreading modes: direct contact, indirect contact and airborne transmission. Ambroise Pare is considered as the father of contemporary surgery. According to him, infection was initiated from the surroundings and subsequently the concept of the importance of sterile environment in disease transmission prevention has also been evolved.
Prior, surgeries were performed with very little consideration of a germ-free environment. Doctors were not that conscious about hand sterilization and patients’ wounds were touched directly by the surgeons (Bergstrom, 2008). Often, viewers were permitted to take a note from the patients’ conditions for educational reasons. The medical and surgical instruments were not sterilized and wiped perfectly, kept back to the velvet carriers and used again (Staniszewska, Thomas & Seers, 2013). Sometimes it also happened that the sharp edge instruments poked into the surgeon’s boot. The surgical wards floor was kept untidy with pus, urine, blood or other biological waste materials, which is the most important reason of spreading infection within the hospitals. Subsequently, infection became the main reason for death, with almost 80% of surgeries infected by hospital gangrene and almost about 50% death rate (Cdc.gov, 2015).
All unnecessary furniture was shifted from patients’ room and the carpets were changed. The room ceilings and walls were cleaned prior to the surgical procedure and remaining furnishings were scrubbed with carbolic solution. The solution used to spray prior to the surgical procedure but not during the operation. During the surgery day, patients’ head was scrubbed, shaved with water and soap and ether and then covered with sublimate dressing during operation, and then ether washings were repeated (Rezaei-Adaryani, Salsali & Mohammadi, 2012). The operational instruments were boiled in water for almost 2hours and sponges were cleaned with carbolic solutions prior usage. The doctor’s hands were washed and disinfected by water and soap, sublimate solutions and alcohol (Zyblock, 2010). Thus, slowly heat sterilization process got introduced, that proved finer than chemical sterilization. Subsequently, sterile caps, gowns and surgical masks ere also introduced. The concept of rubber gloves has also been introduced to protect the hands of the nurses from sublimate solutions. Slowly the concept has become universally accepted.
Therefore, it can be said that in contemporary nursing practice the theory of evidence based nursing is very much crucial and strongly correlated with the issues of infection control.
Currently, infection control is considered as the discipline associated with preventing healthcare related infections or nosocomial infection (Kaye, 2011). This is a practical sub-discipline of community health (Ruef, 2000). Though it is a vital portion but often left unrecognized within the infrastructure of healthcare set up. Infection control deals with factors associated with transmission of infections within healthcare set up (Breathnach, 2013). The spread could be from patients to staff or from patient to patient or from the nursing staff to patient. Therefore, to concentrate on this sever matter evidence based nursing practice is very much important. Health care professionals can learn better from experience.
Previous literature searches have support the concept of infection control within clinical set up. Various researchers have focused on the mechanism of disease transmission, intensity of the transmission, causative agents and prevention of infections.
Scientist Shojania et al. (2001) have critically analyzed patient safety practices to make the healthcare safer (Shojania, Duncan, McDonald, Wachter & Markowitz, 2001). Their aim was to gather and critically review the already existing evidences o nursing practices pertinent to developing the safety of the patients. The practices associated with patient safety have been associated with those which diminish the possibility of adverse incidents associated with exposure to medical treatment across diverse conditions. They have performed literature review in order to set their research criteria. Their research was focused on hospitalized patients. They have reviewed literature from MEDLINE, INSPEC, ABI/INFORM databases. They have concluded that a proof based approach can assist indentify the practices which are about to develop patient safety. Such performances target a varied collection of safety issues. Therefore, from this review it can be obviously said that with the help of evidence based practices, the healthcare personnel have collected information regarding infection control within the health care set up.
The healthcare professionals are participating in different disciplines of nursing practices and they become familiar with different knowledge that is completely from their personal experiences. This also helps them to update their current knowledge in contemporary nursing practice. Bookish knowledge never provides sufficient information which personnel can acquire from his/her professional experience.
There is no initiation or end point where personnel can identify the entry or elimination of infection. Hence, they need to be careful enough in each and every step of patient care delivery in order to promote patient safety and avoid infection transmission within the healthcare set up.
Infection transmission not only affects the health of the patients but it is also considered as a financial burden on healthcare organizations.
Scientist Riley et al. (2015) have mentioned that contamination control is a main concern for the hospitals to diminish the health care associated infection transmissions (Riley, Laird & Williams, 2015). Uniforms are especially the possible path of health care associated infection transmission. Protocols are present to make sure that the hospital laundry facilities meet set standards, nevertheless, uniforms are laundered by care personnel at residences and discrepancies in practice take place. The researchers have applied survey questionnaire to carry out service evaluation in four different hospitals to evaluate how strongly health care personnel followed the guidelines set by the hospitals on laundering and aftercare of hospital uniforms at residences. The survey answers have demonstrated that not all the staff acted in accordance with the hospital guidelines and almost 44% of staffs rinsed their uniforms much below the set temperature (60â—¦c) that presents potential way for infection and cross contamination.
It is a serious matter of concern that the bacteria are becoming resistant to different antibiotics. This presents more complication in the context of infection control. This can be illustrated with an example. Methicillin resistant Staphylococcus aureus (MRSA) is resistant to different antibiotics and most infections are related with skin (Cdc.gov, 2015). In medical services, MRSA causes deadly blood stream infections, surgical site infections and pneumonia.
Scientist Lau et al. (2014) have illustrated on risk aspects of infections associated with surgical site (Lau, Neo & Lee, 2014). Their research aimed to demonstrate the risk aspects in aged patients who had his surgery after a fracture. Their results have shown that patients who stayed in the hospital for more than a week had statistically significant higher surgical site infection rate. The presence of infection was related with increased period of hospital stay. They have mentioned that the two most important microbes detected were Pseudomonas aeruginosa and Staphylococcus aureus, responsible for almost 26.3% and 50.9% of surgical site infection, respectively. Scientist Landelle et al. (2014) have assessed the function of disease control measures in diminishing the load of resistance in intensive care units, eliminating antibiotic stewardship plans.
The knowledge depend on the consequence of improved hand hygiene acquiescence in diminishing the load of methicillin resistant Staphylococcus aureus in intensive care units has been developed. They have funded that universal decolonization with chlorhexidine washing was related with noticeable decrease in multi-drug resistant organism pervasiveness, but attention for chlorhexidine resistance is needed (Gayet-Ageron et al., 2015). An important decrease of resistance for gram negative bacilli has also been illustrated with the application of selective decontamination. But the researchers have also encouraged for further research in order to establish the long term benefits or risk ratios. They have concluded that different infection control measures have the capacity to reduce the load of antimicrobial resistance (Young, Lye, Krishnan, Chan & Leo, 2014). Significant progress, for example: decolonization has been made, recognizing involvements effectual in avoiding multi-drug resistance organisms’ transmissions in intensive care units. Nevertheless, they have failed to exactly determine the relative significance of various infection control measures. Hence, any approach should eventually be adapted to the confined epidemiology f targeted intensive care unit.
Evidence based practices are not implemented always in patient care service and dissimilarity in nursing practices proliferate. Conventionally, research on patient safety has concentrated on the analysis of data to recognize the safety issues associated with clients and to identify that an innovative practice will guide to modified patient safety and quality. Much less attention in research has been given to the ways to integrate practices. Yet, implementing those in practices what is learnt from nursing research is very much helpful. Integration of these safety practices are complicated indeed, and require strategies which deal with complicatedness of care systems, senior leadership, individual practitioners and ultimately altering cultures related to health care to create evidence based safety practice set up.
In conclusion, it is justified to mention that this article provides the readers with an opportunity to think of infection control; inquire into the past of this issue with the help of literature review and how the concept of evidence based nursing practice can be correlated with infection control issue. This assignment will also help the readers to become familiar with literature and develop a plan, implement searches and create a precise literature review to support the explanations.
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