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Background

Discuss about the Control of Nosocomial infections in Delhi In India.

Background

Nosocomial infection is a disease acquired from the hospital. It can as well be described as an infection acquired within the health center by a patient admitted for other infections. That overwhelm the diseases acquired from the health center by the patients or the other members of the hospital like the nurses. According to the nosocomial illness occur within 48 hours after some patients are admitted to a specific hospital or within the three days of discharge. The infection affects about one patient out of 10 patients in a hospital. However, the hospital has implemented various policies to monitor and combat the germs through the rate of infection is still very high (Fritz & Wilson, 2018). This infection is different when compared to non-nosocomial diseases. The virus can be transmitted by the patient n that hospital or the members of the staff in a given hospital setting. Other conditions can be acquired from the other places outside the hospital, and Recently, health centers have been trying to tackle the nosocomial infections rate of the transmission (Agarwal & Sankar, 2016).

The Nosocomial infection has been recorded at a high rate in hospitals within the Delhi city in India. For instance, MRSA (methicillin-resistant Staphylococcus aureus) and the C. difficile bacteria have shown a significant decrease from the research conducted recently (Gelband et al. 2015). The report released by (HPA) health protection agency claimed that C. difficile decreased to 2 % of the patients with the infection in the year 2006 to about 0.4% in the year 2012. The methicillin resistance Staphylococcus aureus reduced significantly to 0.1% by the year 2012 from 1.8% observed in the year 2006 (Lamba, Graham & Ahammad, 2017). Though there still other bacteria on rise especially those caused by E. coli and the salmonella. The research has shown the mutual infections affect the respiratory tracts succeed by the urinary tract diseases and the surgical sites infections (Kumar et al 2017). It’s also clearly indicated that within Delhi the highest number of people affected by the nosocomial infections are the old people and the infants. The high rate of infections was recorded within the intensive care unit (ICU) and the surgical wards (Gupta, Krishnan, Sharma, Kumar,  Aneja & Ray, 2018)


Hospital in Delhi in India carry a significant burden of these infections, and the diseases are continuously affecting individuals at a high rate. Thus, making it the choice of my research site. Many of these infection within this locality are antibiotic-resistance to the treatment. This is with the respect to (GARP) global antibiotic resistance partnership for the India working groups. The report released by GARP stated that many of these nosocomial diseases can be prevented. Therefore, the primary objective of this report is to focus on how these nosocomial infections can be significantly reduced within Delhi's hospitals. The research conducted in the hospitals within Delhi in India has revealed that the rate of VRE (vancomycin-resistant enterococcus) and MRSA resistance rate is exceptionally high compared with the other world hospitals (Gelband et al. 2015).

Analysis of the Issue

The fact that these nosocomial infections resistance to the antibiotic are a significant challenge in treatment. The negative results of these infections are a prolonged period of stay in hospitals, more treatment expenses, and death in most cases. The global antibiotic resistance partnership (GARP), Delhi hospitals contribute a higher number of deaths associated with some nosocomial infections. Another research study carried out in the year 2001 in one of the hospitals in the Delhi city suggested that about 140 out of the possible 1253 people accounting for 11 percentage in 152 health centers had the infections. Some research proved that many hospitals in Delhi do not adhere to infection-controlled measures hence contributing to the high rate of the nosocomial diseases spread (Sharma, Ramani, Mavalankar, Kanguru & Hussein, 2015).

Analysis of the issue

In order to Control of the spreads of the nosocomial infections, there is need to understand how these infections are transmitted. Nosocomial infection is as a result of the microorganisms present within the hospital surroundings. The transmission of the disease between the nurses and the patient with a weak immune system. When the infection is transmitted from one person to another, the infection is referred to as exogenous infections. The transmission could happen for instance when the nurse has to apply the bandage to the wounds of the patient and moves to attend the next patient without disinfecting their hands. In case there are any infection-causing bacteria present, it can be transmitted to the nurse or the next patient (Kalil et al. 2016).

Nosocomial infections can also occur as a result of self-infection hence known as endogenous infection which is an infectious component within individual's body. Such contagious elements are the UTIS within the digestive tract. The growth of such bacteria is being facilitated by the proper environmental condition that favors its growth. These conditions are like water, nutrients, oxygen, and darkness. For many individuals within the Delhi city, acquire nosocomial infections when an individual is still admitted to the health center. These peoples' immune system is compromised thus unable to prevent the disease. The most individuals prone to nosocomial infection other than the old and the infants are the people who have cancer. These are the individuals who lost their lifetime undergo chemotherapies for cancer treatment since it has been proven the various therapies decrease the rate of white blood cells (WBCs). The reduction of the WBCs weakens the immune system since their primary purpose is to fight multiple infections in the body. In many cases, the cancerous individuals are provided with the antibiotics with the aim of preventing the infections (Ki,2015).

The Impact of the Nosocomial Infection

The Impact of the Nosocomial infection

The impact of nosocomial infection with Delhi city is a big problem especially when it comes to hospital expenses, mortality and the morbidity. With regards to (Kaye et al. 2014) out of eleven people admitted to Delhi hospitals one of them is diagnosed with the disease. About hundred thousand hospitals are found to have the infection in every year. Nosocomial diseases do not only impact the expenses of the hospital insignificantly but also has detrimental effects on the family and the patient. In case a patient gets into the hospital for the operation and transmit an infection, that can interfere with most of their lives. For instance, the family members will be very worried, and the patients will have to take a long illness leave their homes. The infection can affect the children of the infected person since they need childcare while he or she is hospitalized. That means many of the children within Delhi in India are faced with stress and depression due to the high rate of nosocomial infections in the place (Rynga, Shariff & Deb, 2015).

The rate of nosocomial diseases is still a big issue to all hospital in Delhi locality. Therefore, the medical practitioners within this area need to focus on different approaches to reduce the rate of nosocomial infection spread. These approaches range from the fundamental things like washing the hands to complicated procedures in preventing the spread of nosocomial infections. The health management with Delhi should focus on the hand hygiene with the health care systems having been noted that the nursing profession. These are the principal vectors for the nosocomial infections though not recognized within the field of medicine. The hospitals' management has significantly facilitated the hygiene has tried to correct the mess by the introduction of alcohol hand gel dispenses through the public buildings in the whole locality. The Indian government is also contributing a significant percentage to the hygiene of the Delhi locality by the introduction of hands washing day (Manoharan, Barla, Peter, Sugumar & Mathai,2016).

The leadership Attributes

The guidelines for the nosocomial infection incorporate different approaches and the methods to combat its spread. The centers have published these strategies for the disease control and Prevention (CDC) and the world organization for health (WHO). One of these approach is the holistic approach by Watson. This is one of the proposals that focus on the skills of the nursing professionals. One of the qualifications for the nurses to induce the control of the infection is allowing the decision of the patients about their healthcare. This has the potential of good health results of the patient. Therefore, every nurse must ensure they uphold the dignity and the autonomy of the patient and should have the right consent before initiating any disease intervention. They should involve the patient in deciding on their healthcare plans and the kind of the approach used in the treatment. The health researchers have supported the idea that the nursing professionals should make use of the autonomous in decision making. The outcome is the persistent and also the consistent behaviors accompanied by a high percentage patient satisfaction that facilitates significantly to the well-being and the wellness of the patient (Loveday et al. 2014). 

 The personalized theory of every person overwhelms the characteristics that develop the conducive autonomy environment in enabling the patient to exercise self-ability regarding their healthcare choices. These include the medications, surgery and the screening approaches. This will allow the patients to counter any procedure that might result in any nosocomial infection. According to (Mehta, Gupta, Todi, Myatra, Samaddar, Patil & Ramasubban,2014) failure to respect patients’ autonomy has resulted to suffering from the acquired infections and other related infections like the depression and the anxiety. The other aspect of the holistic approach is offering similar vital health care and also curing. A culture in curing can be termed as the culture that provided the appropriate medical intervention in helping the patients to overcome any pain. Though the kind of healthcare cannot be necessary if not applied appropriately.  The researchers propose that the curing is linked to ethics to provide conducive healing for the patient.

 Researchers have also discovered that the other issue that causes the spread of the nosocomial infection spread is understaffing. It has been noted that many hospitals in Delhi have the low number of nursing staff. This has led to patients’ overcrowding thus compromising the hand hygiene. In places like intensive care units and the surgical wards. It has been reported that understaffing of nursing professionals facilitated the spread of MRSA due to relaxed focus on the fundamental control of the infections approaches. It was observed that some assigned nurses were low in comparison with the high number of workload hence contributing to a high rate of nosocomial transmission (Fritz & Wilson, 2018).

Barriers to nosocomial infections control

The necessity for monitoring the nosocomial infections within the hospitals in Delhi has been growing at a high range since its establishment through the process is faced with a lot of challenges. Among the many problems is the high cost of improving the standards of the patient's healthcare. The high price has been facilitated by the need of medical epidemiologist to assist in implementing various approaches stipulate by the Indian government in preventing and controlling outbreak the infections within the medical institutions.

There are also difficulties being experienced in implementing the measures of the nosocomial infection control. These measures must be carried out on the new infection to restrain the spread and the expansion of nosocomial infection-causing microorganisms.


Technical activities within the healthcare require proper and immediate decisions important to patient's healthcare is the risk of their nature. It very clear that nursing practitioners are working very hard in coping with such complexity.

Lastly. It has been noted that there is need of enough PPE (personal protective equipment) within the nursing hospitals in Delhi. The apparatus overwhelms the gowns, medical lab coats and grooves (Voth, Lin, Balczon, Francis & Stevens, 2018).

Conclusion

 Nosocomial infections within the Delhi is a big concern of the Indian health researchers. The health management should focus on the hygiene of health professionals within the healthcare systems. These are the individuals who are most prone to the acquired infections.

References

Agarwal, R., & Sankar, J. (2016). Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centers in Delhi, India: a cohort study. The Lancet Global Health, 4(10), e752-e760.

Fritz, R. L., & Wilson, M. (2018). Evidence-Based Practice in Nursing. In The Intersection (pp. 1-17).

Gelband, H., Molly Miller, P., Pant, S., Gandra, S., Levinson, J., Barter, D., ... & Laxminarayan, R. (2015). The state of the world's antibiotics in 2015. Wound Healing Southern Africa, 8(2), 30-34.

Gupta, S., Krishnan, A., Sharma, S., Kumar, P., Aneja, S., & Ray, P. (2018). Changing pattern of prevalence, genetic diversity, and mixed infections of viruses associated with acute gastroenteritis in pediatric patients in New Delhi, India. Journal of medical virology, 90(3), 469-476.

Kalil, A. C., Metersky, M. L., Klompas, M., Muscedere, J., Sweeney, D. A., Palmer, L. B., ... & El Solh, A. A. (2016). Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clinical Infectious Diseases, 63(5), e61-e111.

Kaye, K. S., Marchaim, D., Chen, T. Y., Baures, T., Anderson, D. J., Choi, Y., ... & Schmader, K. E. (2014). Effect of nosocomial bloodstream infections on mortality, length of stay, and hospital costs in older adults. Journal of the American Geriatrics Society, 62(2), 306-311.

Ki, M. (2015). 2015 MERS outbreak in Korea: hospital-to-hospital transmission. Epidemiology and health, 37.

Kumar, S., Sen, P., Grand, R., Verma, P. K., Gupta, P., Suri, P. R., ... & Rai, A. K. (2017). Prospective surveillance of device-associated healthcare-associated infection in an intensive care unit of a tertiary care hospital in New Delhi, India. American journal of infection control.

Lamba, M., Graham, D. W., & Ahammad, S. Z. (2017). Hospital Wastewater Releases of Carbapenem-Resistance Pathogens and Genes in Urban India. Environmental science & technology, 51(23), 13906-13912.

Loveday, H. P., Wilson, J., Pratt, R. J., Golsorkhi, M., Tingle, A., Bak, A., ... & Wilcox, M. (2014). epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital Infection, 86, S1-S70.

Manoharan, A., Barla, G. S., Peter, R., Sugumar, M., & Mathai, D. (2016). Multidrug resistance mediated by co-carriage of extended-spectrum beta-lactamases, AmpC and New Delhi Metallo-beta-lactamase-1 genes among carbapenem-resistant Enterobacteriaceae at five Indian medical centers. Indian journal of medical microbiology, 34(3), 359.

Mehta, Y., Gupta, A., Todi, S., Myatra, S. N., Samaddar, D. P., Patil, V., ... & Ramasubban, S. (2014). Guidelines for prevention of hospital-acquired infections. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 18(3), 149.

Rosenthal, V. D., Maki, D. G., Mehta, Y., Leblebicioglu, H., Memish, Z. A., Al-Mousa, H. H., ... & Apisarnthanarak, A. (2014). International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module. American journal of infection control, 42(9), 942-956.

Rynga, D., Shariff, M., & Deb, M. (2015). Phenotypic and molecular characterization of clinical isolates of Acinetobacter baumannii isolated from Delhi, India. Annals of clinical microbiology and antimicrobials, 14(1), 40.

Sharma, B., Ramani, K. V., Mavalankar, D., Kanguru, L., & Hussein, J. (2015). Using ‘appreciative inquiry’in India to improve infection control practices in maternity care: a qualitative study. Global health action, 8(1), 26693.

Voth, S. B., Lin, M., Balczon, R., Francis, C. M., & Stevens, T. (2018). Nosocomial Lung Infection Induces a Pulmonogenic Prionopathy that Disrupts the Endothelial Barrier of the Brain. In D109. NEW PLAYERS IN LUNG INJURY AND REPAIR (pp. A7615-A7615). American Thoracic Society

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