Precautions To Prevent The Spread Of Infections In Healthcare Settings Essay.

Transmission of Infection in Healthcare Settings

Question 1

You work on an older person’s rehabilitation ward; your colleague is unwell but has come into work. She makes herself a cup of tea in the staff room coughing and sneezing without covering her mouth or nose.
a)Name and discuss the mode of transmission that is passed by sneezing and coughing.

b)Is your colleague well enough to stay at work? Justify your reasoning and explain the procedure you would follow if your colleague refused to go home.

c)Describe ‘immunity’ providing at least 4 examples of clients who may have low levels of immunity.

d)List 4 examples of respiratory etiquette.

Question 2
You are working on the obstetric ward caring for a client who had an emergency caesarean 2 days ago. When you enter the room your client is complaining of being cold and achy. You complete a set of vital observations and note that your client is febrile and tachycardic.
You are due to take down the dressing and check the wound site and when you do, you observe that it is very red and hot to touch.
a)Name and explain the term associated with this type of infection. Your answer must contain details of the possible methods of transfer and be supported with examples.

b)You discuss your findings with the Registered Nurse and the Dr is called to review; she asks you to take a wound swab and apply a clean dressing.
?Discuss the type of dressing technique you will use and why.
?Why it is necessary to clean a dressing trolley and when this needs to be undertaken.

c)List the 5 moments of hand hygiene and explain why they are important in the prevention of infection.

d)Justify the use of ABHR’s in the healthcare setting, include in your answer when the use of ABHR may be contraindicated

Question 3

You are working in an aged care facility which is in lockdown due to Norovirus. You are asked to gather the staff together and explain PPE and how to correctly remove it.
a)What is your explanation of PPE?

b)You finish showering and changing the bed linen of a client who has active diarrhoea and vomiting, list the removal of PPE in sequence before you leave the room stating when you would complete hand hygiene in this process.

Question 4

During the outbreak of norovirus at your facility, Betty, a client with dementia, comes out of her room and vomits on the vinyl in the hallway.
Betty is very distressed and opens the door to Pam’s room, Pam does not have norovirus. Betty leans on the wall in the doorway before staff manage to gently guide her back to her room.
a)Describe in detail the process for removing the vomit in the hallway, include the equipment you will need, any PPE which is to be worn and any safety signs which are to be used.

b)Will Pam’s room need cleaning? Justify your reasoning.

c)Discuss any reporting obligations you may have following this incident.


c)Explain the role of signage in the prevention and control of infection and the precautions or measures that may be taken by the facility to limit the spread of norovirus.

Question 5

Managing Employees with Symptoms

You are the nurse in charge of a small area on a medical ward. One of the HSA’s comes to you in a distressed state and informs you that whilst carrying a full urine bottle, she tripped and the urine splashed onto her face.
Discuss in order of priority what you would do next, detailing any reporting actions.

Question 6

What is the most important PPE to be worn when cleaning equipment for reuse?

Question 7

What is the difference, when discussing infection, between colonisation, infection and disease?

Question 8

Define viruses and how they work to cause infection and disease?

Question 9

Define fungi and how they can be involved in the infection process?

Question 10

A.Discuss the legislation that supports safe work practices in Australia.

B.What are the 4 key principles of WHS?

C.Describe the term ‘Duty of Care’ and provide 3 examples of how your compliance with policies and procedures can promote a safe workplace

Question 11

A.Discuss your role as an EN in minimising hazards during manual handling tasks.

B.Give a brief description of the musculoskeletal anatomy and discuss at least 4 ways in which you can reduce the risk of injury to yourself and others during manual handling tasks.

C.Discuss the link between infection prevention and control, and, compliance with WHS legislation.

D.Discuss how infection is transmitted in the working environment and what practices could you put in place to minimise this risk? Give an example of a common source of infection in your answer

Question 12

A.Identify the following symbols

Question 13

A.Discuss the importance of workplace policies and procedures for WHS using legislation to support your answer.

B.Outline the difference between a policy and a procedure.

C.Provide at least 3 examples of how work procedures assist the worker to remain safe
Question 14

A.Provide a definition for each of the following terms –
Hazard

Risk
Risk Assessment
Hierarchy of Control

B.At a meeting of the Lazy Dayz health and safety committee, a health and safety representative raises the issue of manual handling. The health and safety rep is particularly concerned about tasks that involve the handling of non-weight bearing clients. Complete the risk assessment matrix attached to document your findings and use the hierarchy of control to suggest ways for addressing the risks.

C.You witness your colleague injuring his back whilst trying to prevent a client from falling.
Describe in detail the reporting procedures that would follow this incident, including the key areas of information which must be completed on reporting forms.

D.Identify at least 2 ways in which you can raise WHS issues in the workplace

Question 15

A. Provide a definition of fatigue

B. Provide 3 examples of some of the early signs of fatigue.

C. Discuss who you would approach if you were concerned about your own levels of stress and fatigue and how debriefing can reduce individual levels of stress in the workplace.

Question 16

A.Provide 5 examples of possible emergencies in the workplace.
B.From your examples above, choose 2 and outline your role and responsibilities in each emergency situation.

Question 16

A.Provide 5 examples of possible emergencies in the workplace.
B.From your examples above, choose 2 and outline your role and responsibilities in each emergency situation.

Question 17

A.Outline the main WHS responsibilities of both workers and clients, when caring for someone in the home environment. (May be completed as a dot point list)
B.You are asked by a client whether they legally need to have a smoke alarm fitted in their home. Describe the legislation for smoke alarms in Queensland.
C.Discuss how you would assist the client to have a smoke alarm installed and maintained.
D.Discuss behaviours that may contribute to fire injury and fatalities.

Question 18

A.Discuss how you would minimise the risk of cross infection when caring for a client in the home

Question 19

A.Provide 3 examples of possible manual handling risks when caring for a client in the home. (Provide at least one for the worker and one for the client.)
B.Apply at least one strategy each to the client and worker, to identify how you would minimise those risks.
C.Discuss what you can do to maintain a healthy muscoskeletal system whilst caring a client in their own home.

Transmission of Infection in Healthcare Settings

1. You work on an older person’s rehabilitation ward; your colleague is unwell but has come into work. She makes herself a cup of tea in the staff room coughing and sneezing without covering her mouth or nose.

1. Name and discuss the mode of transmission that is passed by sneezing and coughing.

Transmission is the process of the pathogenic transfer from the infected host to another person. Transmission of the flu occurs coughing since the viruses live in saliva and mucus in the throat and nose (Teasdale, Santer, Geraghty, Little, & Yardley, 2014). During the sneezing and coughing the respiratory droplets tend to be inhaled by another person through the air thus causing infections. Additionally, the mucus can drop in other items such as books, keyboards that are frequently touched by other staffs in the office thus causing the transmission.

1. Is your colleague well enough to stay at work? Justify your reasoning and explain the procedure you would follow if your colleague refused to go home.

The colleague is not advisable to stay at work since even with more precautions; the infected air from the exhaled air has a high probability of escaping out unblocked through any precautions thus will still cause infections (Zayas, Chiang, Wong, MacDonald, Lange, Senthilselvan & King, 2013). After an advice to go home and my colleague refuses, first, I will report the matter to the supervisor, who will direct him on the correct measure. Secondly, I would urge him/her to use disposable handkerchiefs to avoid close contact with colleagues such as through handshakes. Thirdly, I will ask the colleague to avoid touching common items that are used by most of the colleagues in the workplace, thus will help in reducing the contamination.

1. Describe ‘immunity’ providing at least 4 examples of clients who may have low levels of immunity.

Immunity refers to the balanced state of a multicellular organism to poses a stable defense state to fight any infection and unwanted biological invasion as well as tolerance to avoid allergy (Gassen, Prokosch, Makhanova, Eimerbrink, White, Proffitt Leyva, Hill, 2018). There are types of clients that might have low levels of immunity, these include: children who in many occasions have low immunity; Clients with poor health status and suffering from  diseases such as AIDS since the HIV virus makes the body to be more susceptible to diseases; clients undergoing chemotherapy process are prone to infections since the process tends to eliminate some of the blood cells that are important in fighting infections. Clients with that have not been vaccinated have less vaccines that help in preventing the body from the viruses; Clients with improper nutrition have low immunity since they have inadequate nutrients such as vitamin and antioxidants responsible for fighting pathogens and lastly the clients that have inadequate sleep have low level of blood cells since there is inadequate production. 

1. List 4 examples of respiratory etiquette.

Managing Employees with Symptoms

Respiratory etiquette is recommended activities that aim at containing the spread of flu from one person to another. Examples of respiratory etiquettes include:

• Covering the mouth and nose with disposable tissues when sneezing,
• In absence of tissues cover the mouth and nose with inner elbow rather than the hands
• Use of the nearest waste receptacle to disposes of the used tissues
• Frequent hand washing with non-antimicrobial and water or rub hand with alcohol-based liquid (Zayas, Chiang, Wong, MacDonald,Lange, Senthilselvan & King, 2013). 

2. The term associated with the infection is known as Healthcare Associated infection; that occurs to a patient while receiving treatment of a different disease in a hospital. The infection in this scenario thus is known as pelvic cellulitis infection and is always an acute non-contagious inflammation of the connective tissues of the skins as a result of Staphylococcus bacteria; in the surface that usually found on the skin and gain entry through the cracked skin/wound (Collazos, de la Fuente, García, Gómez, Menéndez, Enríquez, Asensi, 2018) through contact, droplets and even through the air. The infection is characterised by hot and delicate feeling that makes the client to feel febrile and tachycardia.

1. You discuss your findings with the Registered Nurse and the Dr is called to review; she asks you to take a wound swab and apply a clean dressing.

• Discuss the type of dressing technique you will use and why.
• Why it is necessary to clean a dressing trolley and when this needs to be undertaken.

The best dressing technique to be used is sterile technique; since this is a bacterial infection (Xiao-ling Huang, Jing-qi Zhang, Shu-ting Guan & Wu-jin Liang 2016). The dressing trolley should be cleaned through sterilization to eliminate any possibility of contaminant before use of the equipment during the wound dressing. (Almulhim & Alotaibi, 2018). The dressing trolley should be cleaned before the wound dressing and after the wound dressing.

1. List the 5 moments of hand hygiene and explain why they are important in the prevention of infection.

The five moments of hand hygiene are:

• Before touching a patient to avoid infecting the patient.
• Before clean/aseptic procedure to ensure that the wound is out of contamination
• After touching the body fluid from a patient to eliminate any harmful agent that might be from the fluid.
• After touching a patient to avoid infecting you in case the patient is infected.
• After a patient surrounding to eliminate the deposits that you might have contracted from the patient surrounding (Lawal, Monsudi, Zubayr, Michael, Duru, Ibrahim & Aliyu, 2018).

1. Justify the use of ABHR’s in the healthcare setting, include in your answer when the use of ABHR may be contraindicated

When to use

• ABHR is a gold standard care for hand hygiene in most of the healthcare setting since it has the capability to eliminaterelated infections thus should be used when the hand washing is aimed at removing the bacteria spores in the hand (Macinga, Shumaker, Werner, Edmonds, Leslie, Parker, & Arbogast, 2014).

When not to use

• ABHR should not be used when the clinician is caring for patients with vomiting and diarrheal diseases
• ABHR should not be used in suspicion of norovirus infection
• ABHR should not be used in soiled or visibly dirty hands since they are disinfectant (Macinga, Shumaker, Werner, Edmonds, Leslie, Parker, & Arbogast, 2014).

3. PPE is an abbreviation of personal protective Equipment that aims at protecting users from any health and safety risk while at work. These include helmets gloves, eye protection, and clothing safety as well as the respiratory protective equipment (Ross, 2017). To remove the norovirus first I will revisit the control manual and apply the requirements such as wearing gloves and frequent hand washing can be used in preventing the spreading of the norovirus in this health setting. Secondly, I will eliminate the virus through extensive laundry with the use of hot and detergent water on all the soiled items without agitating them while wearing the correct gears such as rubber and disposable gloves. 

1. You finish showering and changing the bed linen of a client who has active diarrhoea and vomiting, list the removal of PPE in sequence before you leave the room stating when you would complete hand hygiene in this process.

During the showering and changing of the linen of a client with active diarrhea, protective gloves and apron should be worn throughout to protect the probability of any infection (Stull 2018). After the process of showering and changing the linen:

• First, I will appropriately dispose of the dirty linen inside a marked bucket that has a lid for laundry.
• Secondly, I will remove apron and the gloves by grabbing the outside of the opposite glove and peel off, then slide fingers on the ungloved hand and remove the same too, then apply sanitizer on the hands.
• Third, I will remove the eyewear and apply sanitizer too.
• I will remove the footwear and apply the sanitizer, remove the apron an apply the sanitizer too.
• Lastly, I will detergent the protective wears and thoroughly wash my hands using the antimicrobial liquid.

4. First, I will wear all the protective equipment such as disposable apron, gumboots, gloves, and headwear. I will place the signage and the signpost of ‘cleaning in process’ to avoid disturbances and indicate to the stakeholders of the possible outbreak thus they will take precautions and any possible accidents .After wearing a protective  and retrieving items from the spill kit such as a mop, bucket , chlorine and appropriate liquid soap. Water with a mixture of all will be sprinkled or cover the vomit spillage with  an absorbent  and leave for some time to be absorbed; I will use disposable  scrapper to scrap  the vomit with the use of detergent in hallway thoroughly and allow it to dry before used again. I will remove the disposable protective and appropriately dispose of them. I will place the contaminated items in a disposable plastic bag to be discarded. Then I will follow the fives hand washing steps to clean my hands as a precaution (Barclay, Park, Vega, Hall, Parashar, Vinjé & Lopman, 2014). Finally, I will thoroughly wash my hand using enough water and disinfectant.

1. Will Pam’s room need cleaning? Justify your reasoning.

Low Immunity Clients

Yes, Pam’s room will be cleaned to eliminate any traces of contamination that might be caused by the vomit particles on the wall where Betty leaned on, and to prevent any spread of the norovirus. (Green, 2014).Norovirus is easily spread through coming into contact with the infected surface, eating infected food among others,

1. Discuss any reporting obligations you may have following this incident.

The Betty’s incident should be reported to the relevant supervisor who will guide on the course of action (Murray, Edwards & Holmes, 2011). I will tell the supervisor on the vomit at the hallway and he/she will guide on the correct way to clean the vomit without causing further contamination, then I will fill in the Incidence Report Form, with the following information: name of the incidence, time, precautions undertaken and  nature of effect and 

1. Explain the role of signage in the prevention and control of infection and the precautions or measures that may be taken by the facility to limit the spread of norovirus.

The signage is always placed in case of an outbreak of infectious diseases in the workplace to alert staffs and any other person. It enacts the hygienic process and practices among the stakeholders such as appropriate hand washing, disinfection of paces to avert the spreading of the disease (Barclay, Park, Vega, Hall, Parashar, Vinjé & Lopman, 2014). The spread of norovirus can be prevented through encouraging effective hand washing hygiene, proper handling and cooking of food, through cleaning and disinfecting surfaces and washing of laundry with disinfectants.

5. I will tell the HSA’s to thoroughly wash the face with enough running water with soap and in case the urine spilled into the eyeballs.Secondly, I will help her/him with a saline to use alongside water to neutralize the acidity in the eyeballs (Raymond, 2016). Thirdly,  I will then report the incident to the relevant registered nurse for further assessment to be undertaken on the eyes in case of negative impact of the urine. Finally, I will clean the area, to eliminate the contaminants and any possibility of infection.

6. When cleaning equipment for reuse, the most important PPE to be worn is gloves since it will protect the hand from both the physical and bacterial harm (Stull, 2018).

7. Infection refers to the process by which germs get into a system /person affecting the health status resulting into sickness, whereas colonization is when the germs get into the body and fail to make an individual sick or affect any part of your body (Antia, Ahmed, Handel, Carlson, Amanna, Antia & Slifka, 2018). A disease refers to the condition that extensively affects the body cells thus inhibiting the normal functionality of the body.

Respiratory Etiquette

8. Virus refers to the biological agents that mutates and reproduce inside the body cells of the host to make numerous copies of them. They are made up of genetic material covered with a protein coating (Antia, Ahmed, Handel, Carlson, Amanna, Antia, & Slifka, 2018). The viruses tend to find their ways into the host through various means such as coming into contact with infected mucus and find a position at the cell membrane waiting for the best opportunity to come. When the opportunity arises, the viruses enter into the cell and fit themselves on their receptors and inject DNA into the cytoplasm to facilitate their replication (Wilk, Pandey, Leist, Hatesuer, Preusse, M., Pommerenke, & Schughart, 2015). After some time, the cell burst and thousand copies are released that eventually affect other cells affecting the functionality such as the reproduction of the white blood cells reducing the immune system of the body (Ibeneme,Maduako, Ibeneme, Ezuma,  Ettu, Onyemelukwe,& Fortwengel, 2017). The virus then eventually affects the other cells and tissues through the process known as lytic infection and kill them resulting in diseases such as flu.

9. Fungi refer to the group of eukaryotic saprophytes that include yeast molds and mushrooms (Santamaría, Sánchez, Fajardo, & Figueroa, 2018). A saprophyte refers to a single-celled organism that does not photosynthesis to produce their own food rather depend on the nutrients from the dead organic matter. fungus cause infection through dispersing the minuscule spore that is present at the atmosphere and soli and is always in direct contact with the skin and the air we breathe; thus, the fungal infection commonly affects the lungs and the skins.

10. Safe work practices across Australia are supported by WHS legislation of 2011 that included the model WHS Act; the model WHS regulations and; the model Codes of Practices (Pagura, 2013). The major aim of the WHS is to enact safe and protect the welfare, health, and safety of all workers with the removal of any risks in the workplace across Australia.

Model WHS Act forms the basis for provision of a balanced and nationally consistent framework to secure health and safety of all workers in their respective workplaces such as through: provision of fair and effective representation, cooperation and consultation, provision of advice, education, training for WHS and ensuring appropriate security and actions by the responsible persons among many others.

Model WHS Regulations forms the detailed procedural and administrative requirements needed to support the duties in the model WHS Act; for example, the requirement for the license of specific business and keeping of records.

Preventing Healthcare Associated Infections

Model Codes of Practices entail all the practical guidelines aimed at achieving the standard of health and safety needed under the model WHS Act and Regulations (Pagura, 2013).  The code or practices apply to everyone on duty of care in the prescribed circumstances to ensure that all the health and safety practices are undertaken to eliminate the risks; for example, the need to wear protective clothing while working in dangerous workplaces. 

1. What are the 4 key principles of WHS?

There are four major guiding principles in the WHS: communication, protected, responsible, and proactive:

• Communication: the communication principle requires all the organization to have a simple and clear communication strategy that will reinforce the right culture among all the stakeholders in a workplace to adapt the right health and safety practices.
• Proactive: the proactive principle requires all the stakeholders in the workplace to be part and parcel of the health and safety mission and the protection starts within an individual and spread across all the members.
• Protected: the protection principle requires that all the people in the workplace regardless of the position or the jurisdiction should be protected from any harm.
• Responsibility: The Responsibility principle requires that the protection should start by the top management who influence the junior to accept the involvement in the health and safety practices throughout the organization (Pagura, 2013). 

1. Describe the term ‘Duty of Care’ and provide 3 examples of how your compliance with policies and procedures can promote a safe workplace  

Duty Care refers to the personal legal obligation that guides against any misbehavers in the workplace that could cause harm to any person or property of the organization. Duty of care does not only entail   following of the policies and procedures of works, but also include respecting the rights of the clients, such as keeping some of the information private; and taking responsibility of choices and decisions. The compliance with the policies and the procedures help in promoting a safe workplace since accidents and serious injuries are avoided by taking proper measures and preventive precautions through the following (Jolly, 2014).

• The use of machines according to the provided guidelines by the manufacturer helps in avoiding frequent machinery breakdown and injuries that might be caused as a result of inadequate training or machine operating procedure.
• Putting the correct signage and signpost ensures that all people take precautions to avoid contracting any disease since they will take the precaution such as wearing protective and disinfecting surfaces among many others.
• Wearing all the PPE without anybody reminding you helps in protecting the body across vast risk such as corrosive liquids on the hands.
• Carefully following every instruction provided in the manual and the supervisor helps in avoiding mistakes that might result in damage of property or causing explosive in a chemical workstation.

11. Manual handling tasks always have a high probability of causing harm, especially to the hand. As an EN, my role to minimise hazards is to correctly refer to the WHS policies and regulations to remind myself of the needed PPE to minimise the potential risk. For example, after going through the WHS policies I will find out that the best way to use a slide sheet or hoist without causing harm to the patients and myself too (Edwards, 2012). Thus I will apply, these requirement during doing any manual talks such as transporting a patient, I will use the hoist to prevent strain on my back thus reduces chances of having musculoskeletal problems. 

1. Give a brief description of the musculoskeletal anatomy and discuss at least 4 ways in which you can reduce the risk of injury to yourself and others during manual handling tasks.  

Musculoskeletal is made up of bones, muscles, tendons, cartilages, joints, ligaments and other connective tissues that help the body to possess the shape, protection of the internal organs stability, aid movement and storage of necessary tissues (Liew, Del Vecchio & Falla, 2018). Thus, any injury to the musculoskeletal during any manual task exposes one to danger and these can be reduced through the following methods:

• Redesign the work area to ensure that the body is in a good position while performing the task, for example, use of hoist and slide sheets during the task or use of adjustable chairs to reduce the back strain.
• Reducing the amount of manual work thus will reduce the amount of pressure exerted on the musculoskeletal.
• Avoiding the repetitive manual tasks and awkward position while completing those tasks.

1. Discuss the link between infection prevention and control, and, compliance with WHS legislation.

Infectious diseases can be spread in many ways thus infection prevention and control are the set standards recommended to reduce the risk of transmission of an infectious disease from one person to another through various practices such as PPE and hand hygiene. On the other hand, compliance with WHS legislation ensures that all the set and approved health and safety practices are adhered to reduce and minimise any infection risk at the workplace (Schüssler & Lohrmann, 2015). Generally, infection prevention and control, and the WHS legislation compliance have the same objective: to bring control and prevent any risk of infectious diseases from spreading across the workplace. 

1. Discuss how infection is transmitted in the working environment and what practices could you put in place to minimise this risk? Give an example of a common source of infection in your answer

Dressing Technique for Bacterial Infection

Infections can be transmitted in a number of ways that are classified either direct or indirect. The direct transmission occurs when there is physical contact between the infected person and susceptible person. During the physical contact, the infected mucus tends to pass through the skin of the susceptible person thus bring the infections of various diseases such as flu (TAFE Queensland, 2016). The common practices that can be practised to minimise the direct infection transmission: washing and dry hand properly; avoiding physical contact with the infectious person; requesting the sick to stay at home.

On the other hand, the indirect contact transmission occurs when there is no-direct human-to-human contact thus are transmitted through vectors such as flies, rodents and mosquitoes or even sneezing and coughing. The indirect infection transmission can be minimised through spraying of the workplace to kill all the vectors such as mosquitoes and rodents; using the correct sneezing practices such using disposable tissues and covering the mouth and nose using the inner elbow.

12.