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Routine Molecular Evaluation Of Pathogen Clusters

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Discuss about the Routine Molecular Evaluation of Pathogen Clusters.
 
 

Answer:

Introduction:

The field of health care field is one of the most dynamic sectors that continue to experience fast growth rates day after day. To navigate through this dynamism, well-educated individuals with high skill levels are needed. Hendershot (2011) contends that this is what is needed to manage healthcare facilities. Working in healthcare management gives ample opportunities for professionals who seek a career in a fast-paced sector as pointed out by Raymond (2016).Infection control management refers to a set of structures and systems which an organization or health facility put in place to protect and ensure quality care services are delivered to the patient (Raymond, 2016).Infection Control Management in health and disability services is a framework that seeks to ensure quality and consistently facilitate safe health and disability services.It seeks to identify practices designed to minimize infection rates in the health and disability sector. According to Allegranzi et al., (2011), infection control management sector needs to be thoroughly polished for effective control.All health workers should take responsibility for infection prevention and control, an aspect that adopts infection control management to prevent cross transmission from recognized and unrecognized sources of infection as pointed out by Riley (2017).

Integral to managing population health, many health facilities are employing non-medicalstrategies to make communities healthier and at the lowest cost. Knoer (2017) denotes that it is achieved by partnering with community governments to improve neighborhood workability, make outdoor physical activities more accessible, promote healthy diets, eliminate smoking, and ensure access to medical and mental health services. According to Zingg et al (2015) health facilities vary in complexity, to size and the degree of risks associated with the services provide- these are all factors that determine how a health facility is programmed.

In a 500 bed hospital setting, Mutters et al. (2017)denotes that the facility needs to be well-sized. Therefore, the infection control management program is designed to ensure that all rooms within the setting run concurrently to minimize the chances of any infection occurrence either to the patients or the care givers. A 500 bed setting requires effective strategies that will help in managing risk of infection using a clearly defined procedure as stipulated in the infection control program. According to the standard, Riley (2017) denotes that every room with beds should be monitored in terms of the size and space available in the facility considering the kind of infection that may occur.

 

Within a 500 bed setting, the management practices adopted in the setting should be aimed at minimizing infection according to Raymond (2016). As per the standard, the strategies to be adopted should include;

  • Routine cleaning of the rooms with the most preferred detergent that reduces the survival of microorganisms that might lead to infection.
  • Thorough disinfection of the surfaces to kill the microorganisms like bacteria hence minimizing infection and development of other infections.
  • Routine washing of the beddings.
  • Wearing personal protection by the facility staff concerned with the cleaning of the rooms and washing of the beddings to avoid cross-contamination from the patients.

According to Henny and Gunther (2017), the major area covered in infection control management include cleanliness of accountability as well as clearly defined and documented infection prevention & control {IPC} program. Personnel involved in infection control should have access to ample resources to facilitate them in carrying out their responsibilities. Dedefo et al. (2016) denotes that these include safe storage for work records, ample working spaceand access to resources like current infection control text, journal, personnel, database, library; sufficient working time to avoid erroneous mistakes and a reliable information technology and audit officer to ensure the records are in check and up-to-date.The framework for infection prevention and control is stipulated by a committee that comprises of members from different departments within the health facility.

The program should be followed to the latter by all infection control personnel within the health facility. According to Lee et al. (2011), the key stakeholders play a big role in the management infection control within the 500 bed setting to ensure patient safety. Best results are always felt when work is done in harmony and therefore in infection control management especially in the 500 bed hospital setting which is a big facility needs team work among the staff. Team work makes work easier because the only requirement is good communication amongst the team members so that whatever infection control needed to be done happens at the same time according to the program and the team leaders ensure that it is done perfectly without errors (Panchalingam& Levine, 2016).

Infection control Preventionist is a professional who possess a comprehensive set of skills requisite for investigation, prevention and management of the spread of infections within healthcare centers as pointed out by Reidy et al. (2015). Their expertise and skills in clinical work helps improving patient outcomes and curb any emerging infection cases in the health facility. Any individual with primary professional training in microbiology, epidemiology, or other related field can work as an Infection Preventionist. Liddell, A, & Rollin (2016)also denotes that Infection Preventionist must have qualifications with regards to the requisite, training, experience and educationand must have the relevant certification. The bare minimum for an Infection Preventionist is part-time engagement at the health facility. The individual must have completed specialized training in infection prevention and control. The import of this is that a nurse already employed in a healthcare facility qualifies to assume the role of Infection Preventionist although additional training is an added advantage.

 


Any other personnel with relevant training can work as an Infection Preventionist.Working in this area enableshealthcare professionals to access varied clinical and managerial experiences owing to the fact that it entails collaborating with professional from diverse training backgrounds. This helps to forge working relationships across different disciplines. According to Knoer (2017) control prevention supports healthcare activities and therefore must be applied at all times in the healthcare provision setting. The anticipated level of exposure to blood and other body fluids and the level of interaction between healthcare giver and patient determinethe application of Control Prevention.

  • To consistently revise infection control policies and programs to ensure they are up to date. To ensure they are understood, and adhered to by all parties involved in the provision of health care. The effectiveness of policies is subject to thorough understanding by the staff members. Any staff training that has a direct impact on theinfection prevention and control is the responsibility of the Infection Preventionist.
  • He/she ensures that staff is well versed with policies regarding resident immunizations particularly pneumococcol diseases and influenza and that they adhere to the guidelines. The Infection Preventionist must work in collaboration with theresidents’ representative to see to nit that the nursing staff is informed on previously administered immunizations and those that the residents might be in need of.
  • The Infection Preventionist must also document all incidents regarding infections. Ensure a system is in place to document incidents. He/she should apart from documentation, further undertake to identify infection trends by applying root cause analysis sustainable corrective actions.
  • Monitoring the antibiotic use by patient is another key responsibity of Infection Preventionists (IP). They must planfor the antibiotic stewardship program and start trending. Having sufficient information on the facility on the current antibiotic trends is vital for the IP too. This places them at a position where they can supervise the antibiotic stewardship program and continuously making improvement to the system in place to monitor and evaluate the antibiotic use by the patients.
  • IPs must train on infection control. From the basics of infection prevention which encompasses hand hygiene and food handling to infection controlwhich includesisolation procedures, the training should take place on a continuous basis to ensure staffs are ready for incidents all the time.
  • IPs must take active part the formulation of local and national policies, procedures and campaigns that are relevant to standard infection control precautions. Subsequent to this, the IP should discuss with the facility leadership and report on infection control and prevention measures, trends, and issues in the facility as part of the training process.
  • The IP ensures that the stipulatedprinciples of standard infection control are observed by thecare givers, patients and residents, and visitors and other staff in the facility.

There are categories of patients whose management can be a challenge for the infection prevention and control. These are children or even adults who are living with disabilities and have to rely on invasive invasive devices such as tracheostomies central lines, dialysis catheters,gastrostomy tubes on a long term basis. Kawakami and Misao (2014) point out that this is category of patients have increased susceptibility to infections. Therefore, they are considered to be in need of primary healthcare by family members, an aspect that becomes a challenge because of the increased chances of multiple infections.

 

The Concept of Clinical Governance

According Pirkis (2017), clinical governance is a framework that guides the National Health Services facilities to ensure accountability and commits them to continuously undertake to improve the quality of services they offer to patients hence creating an environment that promotes clinical excellence. It focuses on the centrality of the patient’ welfare and advocates a multidisciplinary approach in developing effective healthcare systems. This commits the healthcare providers to ensure they minimize risks in the workplace both for the patients and for staff.

These provide a guideline for healthcare providers to then develop their own criteria and standards that adhere to clinical governance as outlined by Richards (2016) in the article infection control; taking the lead.Clinical governance has got various components that are kept in practice by involved parties and they include;

This concerns risk minimization. It involves identify the potential sources of risks to the patient during care and understanding the factors involved. Additionally, it includes evaluating the risk situations and adverse events and learning lessons from such incidents to inform future actions in a bid to ensure a recurrence is prevented and the risks minimized.

Clinical audit is a means of measuring the quality of work done by healthcare providers. These include nurses, doctors, medical lab personnel and others. They can measure their performance against the set standards and determine the quality of their services. The results of the audit should inspire change appropriately in the areas of weaknesses identified. Further clinical audits should be done to assess the effects of the changes made.

It is vital that staff mandated to provide patient care possess the knowledge and skills relevant to the delivery of services to the patients. That being a fundamental requirement, it is important that opportunities are provided for staff to bring their skill and knowledge at par with the emerging developments in the healthcare provision sector.

Evidence-based care and effectiveness

Care for patients should be based on good quality evidence from research by the healthcare staff. The National Institute for Health and Clinical Excellence (NICE) spells out national guidelines which regulate healthcare provision, the promotion of good health and provide a framework for the prevention and treatment of ill health hence providing the best care for the patients.

Given that the ultimate goal for the health care facility is provision of healthcare of the highest quality, it is imperative that the approach to healthcare provision is consultative and done with sufficient collaboration between staff and patients as the consumers of the services. According to Zador(2011) this means that healthcare providers must be involved in policy planning and implementation in order for them to understand the needs and concerns of patients as the consumers of their services. Care giver councils are one avenue for care givers to gain knowledge on patient views and concerns.

Health facility management also monitors the patients’ views through the Patient Services Department which receives complaintsand compliments from the clients (patients) and works in liaison with the Patient Advice and Liaison Service (PALS).

 

Staffing and staff management

The significance of staffing and staff management to the achievement of the objective of providing high quality care in a health care facility is paramount. Having staff with the requisite skills and having them work in an efficient team with proper support systems ensures that the services they provide are the best.

Clinical governance is very important in infection control and prevention in that there will be accountability in the case an outbreak of multiple infections as a result of cross transmission within a health facility and therefore measures will be taken as soon as possible to curb the situation. According to Clarke, Harcourt, and Flynn, M (2013), good clinical governance is whereeveryone who passes through health system is well cared for since the system enables the staff to work in the best possible way. The staffs are thus able to perform to the highest possible standards. Therefore, for clinical governance to be successful, Brown, Crawford, and Mullany (2015) denote that clear lines outlining responsibilities and accountability must be drawn if an effective program for quality improvement is to be realized. There should also be clear policies aimed at managing any health risk as well as proper procedures to identify and remedy poor performance.

The negative/bad aspect of clinical governance in relation to infection control management of health and disability service standards is evident when the patients receive unsatisfactory services from the staffs: this happens when staff fail to pay attention to the basic principles of infection control and as a result, patients’ safety is not given first priority according to Stoto and Smith (2016).

 

References

Brown, B., Crawford, P., &Mullany, L (2015).Clinical governmentality: a critical linguistic perspective on clinical governance in health care organisations', Journal Of Applied Linguistics, 2, 3, pp. 299-324.

Clarke, C., Harcourt, M., & Flynn, M (2013).Clinical Governance, Performance Appraisal and Interactional and Procedural Fairness at a New Zealand Public Hospital', Journal Of Business Ethics, 117, 3, pp. 667-678.

Dedefo, M., Zelalem, D., Eskinder, B., Assefa, N., Ashenafi, W., Baraki, N., DamenaTesfatsion, M, Oljira, L, & Haile, A (2016).Causes of Death among Children Aged 5 to 14 Years Old from 2008 to 2013 in Kersa Health and Demographic Surveillance System (Kersa HDSS), Ethiopia', Plos ONE, 11, 6, pp. 1-11.

Hendershot, E (2011). An Infection Control Program for a 2009 Influenza A H1N1 Outbreak in a University-Based Summer Camp', Journal Of American College Health, 59, 5, pp. 419-426,

Henny, N, & Gunther, F (2017).Improvement of infection control management by routine molecular evaluation of pathogen clusters', Diagnostic Microbiology & Infectious Disease, 88, 1, pp. 82-87.

Kawakami, K, &Misao, H (2014).Framework for controlling infection through isolation precautions in Japan', Nursing & Health Sciences, 16, 1, pp. 31-38.

Knoer, S. J (2017). Population Health Management: Improving the Community to Heal the Patient. American Journal Of Health-System Pharmacy, 74(2), 30-32.

Lee, B., Wettstein, Z., McGlone, S., Bailey, R., Umscheid, C., Smith, K, &Muder, R (2011).Economic value of norovirus outbreak control measures in healthcare settings', Clinical Microbiology & Infection, 17, 4, pp. 640-646, Academic Search Premier, EBSCOhost, viewed 28 April 2017.

Liddell, A, & Rollin, P (2016).Addressing Infection Prevention and Control in the First U.S. Community Hospital to Care for Patients With Ebola Virus Disease: Context for national Recommendations and Future Strategies', Annals Of Internal Medicine, 165, 1, pp. 41-49,

Mortensen, H., Alexander, J., Nehrenz, G, & Porter, C (2013).Infection control professionals' information-seeking preferences', Health Information & Libraries Journal, 30, 1, pp. 23-34,

Mutters, N. T., Heeg, K., Späth, I., Henny, N., &Günther, F (2017).Improvement of infection control management by routine molecular evaluation of pathogen clusters. Diagnostic Microbiology & Infectious Disease, 88(1), 82-87.

Panchalingam, S, & Levine, M (2016).Epidemiology, Seasonality and Factors Associated with Rotavirus Infection among Children with Moderate-to-Severe Diarrhea in Rural Western Kenya, 2008–2012: The Global Enteric Multicenter Study (GEMS)', Plos ONE, 11, 8, pp. 1-17, Academic Search Premier, EBSCOhost, viewed 28 April 2017.

Pirkis, J (2017). Implementing a Primary Mental Health Service for Children: Administrator and Provider Perspectives', Journal Of Child & Family Studies, 26, 2, pp. 497-510.

Raymond, L (2016). Importance of preventative hand hygiene practices in community nursing wound management. Australian Nursing & Midwifery Journal,  24(2), 32.

Reidy, M., Ryan, F., Hogan, D., Lacey, S, &Buckley, C (2015).Preparedness of Hospitals in the Republic of Ireland for an Influenza Pandemic, an Infection Control Perspective', BMC Public Health, 15, 1, pp. 1-9.

 Riley, L, Y (2017). Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital', Plos ONE, 12, 4, pp. 1-13.

Zador, D (2011). Injectable opiate maintenance in the UK: is it good clinical practice?', Addiction, 96, 4, pp. 547-553.

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