Exploring Medical Asepsis

These microorganisms are transmitted from poor hand hygiene from health care workers to patients as well as touching of contaminated equipment and environmental surfaces. Microorganisms are most commonly introduced to susceptible sites such as open wounds or other portals of entry by contaminated hands. Infection leads to adverse clinical outcomes and can directly threat patient recovery.

Dirty hands is the common source of spreading infection. It is very important to keep hands clean to avoid getting infected and spreading infection in the community. It is important to wash hands to keep hands clean. There are two ways to keep hand clean, one way is wash hands with soap and warm water while rubbing hands together for minimum 15 to 30 seconds. Indication of washing hands with soap and water is when hands are visibly dirty, before and after eating, feeding, using the toilet, after coughing or sneezing, after using gloves, taking care of patients. There is also second way to clean hands, but it is advisable to wash hands with soap and water all the time, but it can ignore when soap and water is not available so it is okay to use hand gel or foam in the form of sanitizer. This helps to clean hands or kill germs when hands are not visibly dirty.

Implementation of patient care practices for infection control is the role of the nursing staff. Nurses are responsible for maintaining hygiene, consistent with hospital policies and good nursing practice on the ward and monitoring aseptic techniques, including hand-washing and use of isolation. It is also in their scope of practice to promptly report to the attending physician any evidence of infection in patients under the nurse’s care and initiating patient isolation and ordering culture specimens from any patient showing signs of a communicable disease, when the physician is not immediately available. Limiting patient exposure to infections from visitors, hospital staff, other patients, or equipment used for diagnosis or treatment and maintaining

Keeping our hands clean is one of the most effcient and important steps we can do as humans to avoid getting sick or spreading germs to other people. Unwashed hands spread many diseases such as the flue, E. coli, and salmonella. Unfortunately, hand hygiene is still one of today’s most leading causes of infection in health care facilities. The risk of clinicians, patients, and visitors not complying with hand hygiene protocols creates a practice problem for nurses and their patient care. The cause of health care infections, also known as, health care-associated infections (HAIs) are increasing along with the rise of the inability to control or treat infections that are multi-drug resistant. Lack of proper hand hygiene is a major problem in clinical settings sourcing from critical care divisions where the most contaminations are prevalent. This paper will discuss how hand hygiene affects the nursing process and solutions of how to better prevent HAIs within the nursing scope of practice.

The standard precautions are implemented at all times to decrease the risk of transmitting infectious agents. Assuming that all patients could carry an infection, this minimises the potential spread of HAI’s. These standard precautions include routine hand hygiene, the use of personal protective equipment, safe handling and disposure of sharps and routine environmental cleaning.4,5 In this situation, where blood is present, this is considered a biohazard. Hand hygiene must be performed before touching the patient, before and after any procedures or exposure to bodily substances and after touching the patient or any of the patient’s surroundings. The use of Personal protective equipment should be used when attending to the patient. This includes protective eye wear, a surgical mask and an apron for protection from any splashes or sprays of blood generated by the patient. Gloves should also be worn for single use only when coming in contact with open skin and bodily fluids. To minimise the spread of blood, the bystander with visibly soiled hands should also be advised to thoroughly clean them with soap and

Follow Hand Hygiene measures set by the CDC and WHO: Using the CDC and WHO guidelines to improve proper hand hygiene. This will reduce the health care related infections and reduce the transmission of disease from staff to patients (The Joint Commission, 2012)

Health care providers and visitors are required to wear personal protective equipment (PPE) and follow strict hand hygiene procedures. Contaminated rooms, surfaces, and laundry items are properly disinfected to prevent the spread of MRSA. In addition to policy and procedures, patient teaching is also helpful for preventing exposure and spread of MRSA. As aforementioned earlier, hand hygiene is key to prevent exposer or transmission of the bacteria. To properly wash your hand effectively, first scrub hands rapidly for at least 15 seconds. Next, use a disposable towel to dry them and another towel to turn off the faucet. In addition, hand sanitizer that contains 62 percent or more of alcohol may be an adequate substitute when the individual does not have access to soap and water (Mayo Clinic Staff,

During this last visit, Dr. M made some mistakes which may have played a crucial role in Jacob acquiring an infection, or, in the least, contributed to negligence. After removing Jacob’s cast, Dr. M did not complete his examination of Jacob’s leg before he left the room to exam another patient, Sarah, in the room across the hall. Upon entering the room, he did not close the door. The most obvious mistake the doctor did was not washing his hands after his examination of Sarah, who has osteomyelitis, after which he returned to the first exam room to continue his examination of Jacob’s leg. Hand washing plays a major role in preventing cross-contamination when caring for patients. According to the Centers for Disease Control and Prevention (CDC, 2014), washing hands is an extremely important way to prevent the spread of infection from patient to patient or patient to health care professional. It is essential that all health care providers practice hand hygiene even if gloves are worn. There

Prevention strategies of nosocomial infections related to poor hand hygiene include revision of: orientation, training processes, competency assessments, equipment cleaning, handwashing procedures, switching to the use of single-use IV flush vials, adding strategically located waterless hand rubs, defining supervisory expectations, conducting in-services, team trainings, and tracking systems (Infection control related sentinel events, 2003). Potential solutions to noncompliance include: consistent skin protectant application, reduced time required for handwashing, and antiseptic stations at the bedside and room entry points (Boyce, 1999). Hospital administrators must create an organizational atmosphere in which adherence to recommended HH practices are considered an integral part of providing high-quality care (Boyce, 1999). Improvement in infection control

Evidence based care- There are mask, tissue and hand sanitizers are provided at all doors and elevators to reduce germs (hand sanitizers kill 99.9% of the germs and are most useful to reduce the microbial load, thus controlling the rate of infection (Vidyashankar, Varma, & Payki, 2011).

After microorganisms enter the patient’s body they can go to the lungs and cause pneumonia. Central line-bloodstream infections occur when microorganism enter the bloodstream by the intravenous line. Microorganisms are transfer into the blood stream by inadequate hand hygiene or improper intravenous fluid, tubing, and site care practice. Multidrug-resistant organisms can cause infections of the blood, skin, or organ systems. These infections can arise due to the overuse or misuse of antibiotics, which can result in the microorganisms becoming more resistant to antibiotic therapy. Methicillin-resistant Staphyloccocus aureus and Clostridium difficile are examples of this kind of infection. Health care employees need to know the different types of hospital acquired infections and how they are spread to be able to effectively prevent them.

As nurses, taking care of patients with MRSA can be seen in everyday practice. It can be seen in patients with sepsis from an infected wound, patients who have pneumonia, or patients who only have a colonization for it (“Methicillin-resistant Staphylococcus aureus (MRSA), 2015”). Regardless if it’s colonization or an active infection, and the source of the infection, proper policies and procedures are in place to reduce the transmission of MRSA to other patients in the hospital or nursing home setting. This includes performing proper hand hygiene and standard precautions, as well as wearing protective gown and gloves when entering the patient’s room. It is very important to adhere to these policies and procedures and educate others on the importance of these policies and procedures to reduce the transmission of MRSA to others.

Healthcare associated infections have an impact on patients - how? Can be prevented greatly with compliance to hand hygiene protocols (REF).

Research shows that Surgical site infections are preventable. According to the CDC, hand hygiene is the simplest approach to preventing the spread of infections and needs to be incorporated into the culture of the organization. Ensuring the use of infection control prevention is an important component of nursing care. Infection control prevention policies must be communicated undoubtedly to all employees. Staffers who do not comply must be re-educated to ensure that all are complying. Speaking up and pointing out that a nurse forgot to wash his or her hands, or notifying the surgical team that surgical instruments were not adequately cleaned may seem like small issues; but at the same time, not acknowledging a break in a sterile technique could mean the difference between life and death for a patient. One hospital that was struggling with high levels of infection related to surgical procedures, implemented a pre-procedure huddle as a team. This innovate way decreased the spread of infection and was a great way to improve the quality of care for patients. As mandated by the Joint commission, infection prevention personnel should provide multidisciplinary education on SSI prevention, to all team members, including

* Hand washing is the most important method of preventing the spread of infection by contact (Ayliffe et al 1999). The Nottingham University Trust Policy on Hand Hygiene (2009) states that there are three types of hand hygiene, the first is ‘routine hand hygiene’ which involves the use of soap and water for 15 – 20 seconds or the application of alcohol hand rub until the hand are dry. The second is ‘hand disinfection’ which should be used prior to an aseptic procedure by washing with soap and water and applying alcohol hand rub afterwards. The third is ‘surgical hand washing’ which is the application of a microbial agent to the hands and wrists for two minutes. In addition to which a sterile, disposable brush may be used for the first surgical hand wash of the day although continued use will encourage colonisation of microbes. The third example is the most appropriate to any O.D.P undertaking the surgical role as it is the best way for the surgical team to eliminate transient flora and reduce resident skin flora (World Health Organization 2010). The first and second are important to any O.D.P undertaking any other role within the Operating Department as this is the best way to reduce the transient microbial flora without necessarily affecting the resident skin flora