Discuss about the Infection Prevention and Control.
The report demonstrates an overview regarding the Health and Disability Service Infection Control Standard (HDSS) (2008) in relation to its implementation of an infection control program regime. The roles and responsibilities of an infection control preventionist at the local district health board (DHB) offering care in a 500 beds hospital setting to devise an appropriate infection control protocol has also been discussed. The description, requirements and relevance of the Standard 3.1 of the HDSS (2008) in the hospital scenario has been specifically mentioned as well. Apart from these, two examples concerning evaluation of infection control program has also been critically discussed in this report.
The Health and disability Services (Infection Prevention and Control) Standards put forward by the New Zealand Ministry of Health proposes the infection control management as part of the Standard 3.1 that encompass a set of systems and structures to be followed by the concerned organization to ensure quality healthcare facility with enough scopes of improvement within the given hospital framework (www.health.govt.nz, 2016). The Standard clearly refers to a manageable environment with the minimum possibility of infections for the patients, service providers as well as the visitors. In order to achieve this desired level of outcomes, the relevant organization needs to fulfill the following criteria (www.health.govt.nz, 2016):
Clearly defined duties for infection control and accountability for infection control issues leading to the hierarchic management including the senior authority and the governing body.
Explicitly defined reporting lines and frequencies within the organization encompassing the procedures to promptly notify regarding the infection control related matters.
Annual review of the properly defined and well documented infection prevention program in the organization.
Improvisation of the infection control program in collaboration and communication with the prime stakeholders through proper risk assessment method, information procured through effective supervision and surveillance, trends and pertinent management strategies subjected to approval from the competent authority.
In case of dearth of support from the concerned organization, clear instructions related to the availability of the necessary advice and support concerning infection control and prevention, combating outbreak of infectious diseases and microbiological pathogenicities.
Depending upon the size and working modality of the organization, recruitment of an infection control team or personnel or committee accountable to the higher management authority and held responsible to monitor the progress of the infection control program.
Clear cut defined duties and tasks of the engaged infection control team or personnel or committee.
Requirement and Relevance of Standard 3.1 within 500 bed Hospital setting
For cases requiring significant modifications related to recruitment of staff and provision of products, equipments, facilities, practices and implementation of novel services, strictly defined procedures for early consultation and feedback from the concerned team or personnel are essential.
Patients, service providers and visitors exposed to or susceptible to contagious diseases are to be prevented from further spread of those infectious diseases.
Within the set up of 500 beds hospital infrastructure, maintenance of a congenial atmosphere allaying the risk of spreading and contracting infection is imperative to safeguard the health and well being of the patients, care givers and the visitors and foster improved and updated healthcare facility. In this context, the competent authority occupying the management level administration for the smooth running of the hospital is pivotal to conduct and approve suitable infection control program by means of engaging thoroughly trained personnel or infection control team or likewise committee entitled to successfully carry out the proposed program through constant feedback and communication from all ends. Regular supervision and evaluation executed through proper risk assessment protocol, annual review of the undertaken program and identification of the chief stakeholders form the basis of such infection control programs. A 500 bed hospital setting accounts for quite a handful of diseased patients undergoing treatment of varied nature and interventional modes and therefore harbors the risk of contracting nosocomial infections of several types such as blood stream infection (BSI), urinary tract infection (UTI), ventilator associated pneumonia (VAP) and surgical site infection (SSI). Thus development of a suitable infection prevention and control program by the hospital authority in compliance with the established Standard 3.1 is necessary to tackle the situation and plummet the intensity of any possible contractible disease at its inception or outbreak.
In the Australian and New Zealand context, the roles and duties of the infection control preventionist has been amended corroborating with the existing policies and guidelines to successfully execute and implement several national strategies for infection combating. Study pertinent to this workforce considers the educational credibility, experience levels and scope of practice among the quintessential attributes to carry out their assigned jobs effectively (Hall et al., 2015). Further recent research in case of the New Zealand domicile suggest the potency of the active, prospective and continual hospital based severe acute respiratory infection (SARI) surveillance fully operational to mitigate the health concerns related to emerging influenza A virus infections and seasonal influenza pandemic (Huang et al., 2014). Moreover, in this regard efforts made by the World Heart Federation (WHF) to carry out a seamless transition from the position statement to a functional plan on the basis of a foundation laid upon rigorous research, science and measurable improvement indicators to deal with the patients suffering from rheumatic fever (RF) and rheumatic heart disease (RHD) may be mentioned (Remenyi et al., 2013). However comprehending the tasks and duties designated to be performed by the infection control preventionist and professionals, the following jobs have been identified to be of prime importance (Henman et al., 2015). A teamwork oriented approach is generally followed for control and prevention of infection by the infection control preventionist that includes infection prevention and control doctor, infection prevention and control nurse in conjunction with adequate administrative and information and communication technology (ICT) support through following of proper evidence based device associated infection prevention practice (Parriott et al., 2015).
Role of Infection Control Preventionist in Infection Control Program
The policy adopted to reduce the risk of acquisition of infection among the vulnerable population of patients, healthcare workers and anyone in contact with the healthcare setting need to be put into effectiveness through surveillance by means of detecting, monitoring and recording the infection in its different stages. In this matter, the competencies of the infection preventionist and nurses have been identified as crucial in performing their roles deftly and implementing strategies to deal with the situation (Gase et al., 2015).
Congruency in terms of roles and responsibilities performed by the infection control professionals demand frequent and thorough supervision by the concerned authorities of the relevant organization to assess the feasibility of the projected management strategies for infection control thereby ensuring further modifications and alterations as and when applicable. Quality and safety of the adopted measures can thus be safeguarded and timely reporting to the higher authorities of the concerned organizational framework will ensure timely and most appropriate action plan intervention for infection control (Huffaker, 2012).
In keeping with the changing trends in the healthcare practice, the mode of information storage and retrieval to document the medical records have simultaneously undergone a rampant modification. Telemedicine and usage of electronic algorithm have gained prominence in the modern era to update the data obtained from various case situations in a periodic manner. At least annual review of the action plan devised in accordance with the data procured from a particular healthcare setting has been suggested as essential to optimize healthcare facility and bring out the best possible outcomes. Education and awareness impart knowledge and training to the infection control professionals to better the service offered by them (Leone et al., 2015).
The legal obligation to protect against discrimination to facilitate the central theme of equal opportunities for all is propagated through the infection control preventionist roles by means of equality and diversity. The emphasis is laid on the electronic medical records to enhance the efficacy of the infection surveillance regime to ensure accurate documentation and subsequent actions to mitigate the contagious illnesses of varied types in a valid way (Shepard et al., 2014).
The infection control program may be evaluated categorically in two distinctive manners including the internal evaluation and external evaluation.
The embracing of the internal evaluation to assess the credibility and efficiency of a proposed plan undertaken to tackle the infection related hazards considers the reviews and data retrieved from surveillance. Intermediaries have been opined to be beneficial in promoting evidence based infection control practice under certain contextual situations. Internal evaluation carried out under the supervision of the members of the healthcare team function in a holistic teamwork scenario through data obtained in a passive manner and thus bear the possibility of inflicting biasness in assessing the outcomes of the proposed action plans to mitigate the infections (Williams, Burton & Rycroft-Malone, 2013). The rates of occurrence of cross infections and other possible infections are to be detected impeccably by the internal evaluators. Ethical compliance and scientific methodology adoption are the key features of internal evaluation to control and prevent the infectious states and hence act as boosters to escalate the efficiency of the infection control program (Zimerman et al., 2013).
Dissemination and Implementation
The specific evaluation method of external evaluation is generally carried out by some third party healthcare professional who are not directly engaged with the infection control program thereby lessening the chances of bias due to familiarity or suppression of facts whatsoever pertaining to a definite infectious disease condition. The evaluator in charge offers new perspective and insight into the proposed plan, however the lack of involvement and deeper knowledge regarding the plan from its commencement has been found to be a major hindrance in assessing the given scenario. Timely reporting and intervention as a result of the surveillance brought about by the external evaluators culminate in improvising public health care programs, infection control programs and immunization protocols globally (Evans, 2013). Gathering of qualitative information through methodical observational approach achievable through consideration of both the participants and non-participants group through conduction of interviews, rapport building, examination of the traces and the documents and exploration of more detailed information regarding the causative factor, time and frequency of occurrence and population susceptible to specific infection are the chief tasks of the external evaluators (Posavac, 2015).
The stringent following and compliance with the Standard 3.1 of the HDSS (2008) ensure a suitable and healthy environment with lesser chances of contracting infection within a given hospital framework for the consumers, health service providers and visitors. The pre defined tasks and responsibilities of the infection control preventionist working in harmony with other healthcare professional and practitioners play a considerable role in mitigating the health related issues due to infection borne out of hospital settings through improvisation and implementation of suitable infection prevention and control plan. Devising strategies to reduce the chances of infectious diseases through proper knowledge of the principles and practices may provide respite to the victims of the infections and ease the task of the healthcare providers (Bennett, Dolin & Blaser, 2014). Simultaneous and effective assessment of the infection control programs may be attained through both internal and external evaluation pattern. Approval and monitoring from the competent authorities provide scope for betterment and assessing the effectiveness of the proposed and undertaken projects in case appropriate situations of infection outbreak within a hospital setting. Surveillance, education and training, reviewing and documentation of the available data ensure protection from further infection spreading and curb any possible existing infection. A holistic and collaborative approach from all healthcare professionals involved in the infection control program offers hope of effective infection management strategy through dynamic changes and modifications. Additionally studying of the distribution and the determinants of the diseases and infections through hospital epidemiology might be of surmountable importance in control and prevention of infectious disease (Mayhall, 2012).
Monitoring Compliance and effectiveness of the adopted strategies
Bennett, J. E., Dolin, R., & Blaser, M. J. (2014). Principles and practice of infectious diseases (Vol. 1). Elsevier Health Sciences.
Evans, A. S. (2013). Viral infections of humans: epidemiology and control. Springer Science & Business Media.
Gase, K. A., Leone, C., Khoury, R., & Babcock, H. M. (2015). Advancing the competency of infection preventionists. American journal of infection control,43(4), 370-379.
Hall, L., Halton, K., Macbeth, D., Gardner, A., & Mitchell, B. (2015). Roles, responsibilities and scope of practice: describing the ‘state of play’for infection control professionals in Australia and New Zealand. Healthcare Infection, 20(1), 29-35.
Henman, L. J., Corrigan, R., Carrico, R., Suh, K. N., Team, P. A. S. D., Review, P. A., & Team, T. S. D. (2015). Identifying changes in the role of the infection preventionist through the 2014 practice analysis study conducted by the Certification Board of Infection Control and Epidemiology, Inc.American journal of infection control, 43(7), 664-668.
Huang, Q. S., Baker, M., McArthur, C., Roberts, S., Williamson, D., Grant, C., & Mackereth, G. (2014). Implementing hospital-based surveillance for severe acute respiratory infections caused by influenza and other respiratory pathogens in New Zealand. Western Pac Surveill Response J, 5(2), 23-30.
Huffaker, C. B. (Ed.). (2012). Theory and practice of biological control. Elsevier.
Leone, C., Gase, K. A., Snyders, R., Kieffer, P., Hoehner, C., & Babcock, H. M. (2015). Agreement of Infection Preventionists’(IP) Surveillance Assessments. American Journal of Infection Control, 43(6), S4-S5.
Mayhall, C. G. (2012). Hospital epidemiology and infection control. Lippincott Williams & Wilkins.
Parriott, A., Saint, S., Olmsted, R. N., & Krein, S. (2015). Associations between Hospital Infection Prevention/control Program Infrastructure and Evidence-based Device Associated Infection Prevention Practices.American Journal of Infection Control, 43(6), S3.
Posavac, E. (2015). Program evaluation: Methods and case studies. Routledge.
Remenyi, B., Carapetis, J., Wyber, R., Taubert, K., & Mayosi, B. M. (2013). Position statement of the World Heart Federation on the prevention and control of rheumatic heart disease. Nature Reviews Cardiology, 10(5), 284-292.
Shepard, J., Hadhazy, E., Frederick, J., Nicol, S., Gade, P., Cardon, A., & Madison, S. (2014). Using electronic medical records to increase the efficiency of catheter-associated urinary tract infection surveillance for National Health and Safety Network reporting. American journal of infection control, 42(3), e33-e36.
Williams, L., Burton, C., & RycroftÃ¢â¬ÂMalone, J. (2013). What works: a realist evaluation case study of intermediaries in infection control practice. Journal of advanced nursing, 69(4), 915-926.
www.health.govt.nz,. (2016). (infection control and management) Standards- Ministry of Health. Retrieved on 30 October 2016, from https://www.health.govt.nz/system/files/documents/pages/81343-2008-nzs-health-and-disability-services-infection-prevention-and-control.pdf
Zimmerman, P. A., Yeatman, H., Jones, M., & Murdoch, H. (2013). Evaluating infection control: A review of implementation of an infection prevention and control program in a low-income country setting. American journal of infection control, 41(4), 317-321.
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