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Role of Nurses

Discuss about the Role of Nursing in Preventing Hospital Acquired Infections.

Nurses play a very crucial role in preventing hospital acquired infections. These are infections that occur right after the patients have already been admitted to the hospital or any other medical facility; this is inclusive of those infections that are acquired within the facility but display the symptoms later when the patient has been discharged from hospital, and also work-related infections among the hospital employees. Being the patient crusaders, the nurses are capable of affecting change so as to enhance the patients’ welfare ( Ausserhofer et al.,2013 ) With many tools at their disposal, the nurses are able to create surrounding that is safe and free of infections for the patients. At any given moment, beyond a population of 1.4 million people in the world ails from diseases acquired in medical facilities and hospitals. The uppermost occurrences of hospital acquired infections were recorded in south East Asia (10.0%) and eastern Mediterranean regions with a pervasiveness of 9.0 for western pacific along with 7.7 for European regions. Practices carried out by nursing care can help improve on the figures and make hospitals and other medical facilities more safe and friendly to the patients and staff. Nurses are therefore key, in ensuring that the patients do not acquire hospital infections (Cantrell et al., 2009).

Wearing protective equipment when in contact with some specific body fluids – a number of  body fluids and secretions, including cerebrospinal fluids and amniotic fluid can be a pathway of transmission of blood borne pathogens, especially when the nurses are providing first aid or healthcare (Da Silva et al.,2016) .Disposable gloves must be put on when examining a lacerated or non intact skin, e.g. when dressing an open wound, examination of oropharynyx, gastro intestinal tract(GIT) and dental procedures and the gloves should be new and never been reused, be of good quality and material. Masks and protective eye wear should be in place when attending to patients in circumstances where there might be blood spillages and bone chips/fragments (Cornejo-Juárez et al., 2015).Nurses should make sure to protect patient’s wounds from staff breathings by ensuring that good quality masks are worn and properly fixed on the mouth and nasal openings. When spraying or spattering of blood or body fluids is expected, e.g. procedures to do with surgery, gowns /aprons are recommended (Fijan et al., 2012). The gowns should not allow for the body fluids to go through and for sterile procedures; sterile linen and disposable gowns are used. If exposed to body fluids or blood, nurses should ensure cleaning of wounds instantly and bleeding should be immediately ceased. if blood/body fluids splash towards the  mouth, it should be thoroughly flashed with clean water instantly. Sharp injuries and Needle stick that are capable of transmission of blood borne infections, should be disposed immediately in puncture resistant boxes.( Horlocker & Wedel, 2008)

Discussion


Contaminated material like linen must be handled with isolation safety measures and taken for cleansing in bags that are coded for prevention of spreading infection to infection free materials nurses should place infectious waste in labeled bags that do not leak which are later collected carefully to avoid contamination, and before disposing the material that is contaminated in a landfill, it should be autoclaved or incinerated. Nurses should ensure the environment within which they work is clean by ensuring proper air ventilation, examination of the water pipes and quality, cleaning and disinfection of equipment, proper collection of linen and proper disposal of waste products ( Fijan & Turk,2012).

Nurses can also prevent infection by irrigating the cutaneous wounds thoroughly between dressing changes, removing all dead materials that may promote infection and hinder healing process effectively and dressing a wound in an appropriate way so as to absorb exudates. Hand washing is also another means by which Nurses can prevent most of the hospital acquired infections, efficient hand washing process can be attained by using an antimicrobial soap and running clean water for at least 10-16 seconds, this will ensure removal of soil particles and bacteria. Use of hand antiseptics and hand rubs for at least 60 seconds to remove and destroy transient flora, alcohol based hand rubs can also be applied for hand washing and can be used as substitutes where suitable. Our hands and fingers if carrying infective organisms can lead to infectious diseases (Weinstein, Gaynes & Edwards, 2005). Sinks should be placed in every patients room and the nurses should always comply to the hand washing policy and ensure that hand washing is done especially before and after dressing a wound, before and after contact body fluids and removal of excretions and even after handling equipment that is contaminated or laundry, after visiting the toilets, after administering of medicines to their patients, before taking of meals, at the beginning and end of duty, also wash hands before putting on gloves, principles like removal of jewelry ,washing and drying thoroughly around the ring ,and always turning off the water using elbow- on elbow taps and ensure to dry the hands thoroughly. Oral care should be given to Neutropenic patients inclusive of gentle flossing and brushing of teeth, or even antimicrobial rinses in situations where the state hygiene is poor. Catheter dressings should instantly be replaced when moist, loosened or soiled. Replacement of IV administration sets, extensions and secondary sets in every 72 hours, unless infection is reckoned to occur or documented. 

Conclusion

Healthcare providers should be more worried than ever about promoting and supporting nursing care to ensure patient safety, any slight improvement made to nursing care will reduce the number of death cases associated with Nosocomial infections and diseases (Lalrindiki et al., 2014)

Nosocomial  infections that are acquired in  hospitals and other health care facilities have led to many cases of death and more mordibility among patients in hospitals and are a major challenge for both the hospitalized individuals and communal health as well, this is common when the nursing care given to the patients does not comply with the standards that are set out in prevention of hospital acquired infections .patients who are infants and aged individuals have low  resistance to infections  and hospitalized individuals that suffer from chronic ailments such as AIDS have high vulnerability to infections. Nurses therefore have a big role to play in ensuring that these kinds of patients are well taken care of in bid to ensuring no more infections occur once they’re admitted to a medical facility. (Cornejo-Juárez et al, 2015)

The nurse has the ability to directly prevent patient infection because they provide care at the bedside and thus resulting in positive outcomes in patients in terms of health care. The action of the nurses and other healthcare workers directly impact patient morbidity and mortality.

Practices like hand washing techniques, wearing of gloves, face masks and gowns when in contact with contaminated material and also when being careful not to contaminate in a sterile environment, proper disposal of contaminated material and other proper hygiene measures practiced in medical institutions improve the wellbeing of the hospitalized individuals and that of the care providers  as well.

Since hospital acquired infections contribute to a great number of deaths, prevention of these infections should be the primary goal of every hospital and medical institution across the globe (Tai et al., 2009). 

Conclusion

Nurses play a key role in prevention of infections and minimizing its spread.

The health and well being of their patients and the financial health of their employers depends entirely on the care of the nurses.

Hospital acquired infections can be  reduced by nurses  providing direct patient care using practices which minimize infections  like avoiding contact of body fluids and contaminated linen and dressing of wounds with extra care.

The role of nurses significantly reduces the cost of health care by reducing the recovery periods for their patients, reduction of extra costs of antibiotics and healthcare facility’s expenses

Reference

Ausserhofer, D., Schubert, M., Desmedt, M., Blegen, M. A., De Geest, S., & Schwendimann, R. (2013). The association of patient safety climate and nurse-related organizational factors with selected patient outcomes: a cross-sectional survey. International journal of nursing studies, 50(2), 240-252.

Bereket, W., Hemalatha, K., Getenet, B., Wondwossen, T., Solomon, A., Zeynudin, A., & Kannan, S. (2012). Update on bacterial nosocomial infections. Eur Rev Med Pharmacol Sci, 16(8), 1039-44.

Cantrell, D., Shamriz, O., Cohen, M. J., Stern, Z., Block, C., & Brezis, M. (2009). Hand hygiene compliance by physicians: Marked heterogeneity due to local culture?. American journal of infection control, 37(4), 301-305. 

Cornejo-Juárez, P., Vilar-Compte, D., Pérez-Jiménez, C., Namendys-Silva, S. A., Sandoval-Hernández, S., & Volkow-Fernández, P. (2015). The impact of hospital-acquired infections with multidrug-resistant bacteria in an oncology intensive care unit. International Journal of Infectious Diseases, 31, 31-34.

Da Silva, A. A., Zingg, W., Dramowski, A., Bielicki, J. A., & Sharland, M. (2016). Most international guidelines on prevention of healthcare-associated infection lack comprehensive recommendations for neonates and children. Journal of Hospital Infection, 94(2), 159-162.

Fijan, S., & Turk, S. Š. (2012). Hospital textiles, are they a possible vehicle for healthcare-associated infections?. International journal of environmental research and public health, 9(9), 3330-3343. 

Horlocker, T. T., & Wedel, D. J. (2008). Infectious complications of regional anesthesia. Best Practice & Research Clinical Anaesthesiology, 22(3), 451-475.

 Hojsak, I., Abdovi?, S., Szajewska, H., Miloševi?, M., Krznari?, Ž., & Kola?ek, S. (2010). Lactobacillus GG in the prevention of nosocomial gastrointestinal and respiratory tract infections. Pediatrics, 125(5), e1171-e1177. 

Lalrindiki, K., Shinde, M. B., Zagade, T., & VR, M. Knowledge and Practices regarding Advanced Patient Care among Staff Nurses Working in a Tertiary Care Hospital. 

Saxena, P., & Mani, R. K. (2014). Preventing hospital acquired infections: A challenge we must accept. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 18(3), 125. 

Tai, J. W. M., Mok, E. S. B., Ching, P. T. Y., Seto, W. H., & Pittet, D. (2009). Nurses and  physicians’ perceptions of the importance and impact of healthcare-associated infections and hand hygiene: a multi-center exploratory study in Hong Kong. Infection, 37(4), 320-333. 

Weinstein, R. A., Gaynes, R., Edwards, J. R., & National Nosocomial Infections Surveillance System. (2005). Overview of nosocomial infections caused by gram-negative bacilli. Clinical Infectious Diseases, 41(6), 848-854.

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