The Spread Of Infection In Atul Gawande's Better

Hand hygiene practices are important thing to infection prevention and control practice. As health provider especially ED staff or front liner, to follow hand washing protocols is necessary in any situation. According Practice Standard (2009) four major elements to preventing practice; hand washing, protective barriers, care of equipment and health practice of nurse. Cite from Health Promotion Agency for Northern Ireland, scientists has found around 45% of infections can be prevented by washing hands regularly. MOH (2010) increasing in hand-washing compliance by

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.

As a leader in health care, it is important that employees have the proper education and training for compliance with infection control. An infection control practitioner should be assigned surveillance of infections, calculate infection rates, and report these numbers to the appropriate personnel. Clinical nurses, such as nurses, should have periodic evaluations to ensure they are practicing patient safety. There are many other key factors that should be implemented in health care facilities to improve infection control. First is hand hygiene; there could be random observers periodically monitoring a certain floor or department for hand sanitation practices. Secondly, is the health care environment. This includes, making sure employees are sanitizing surfaces and equipment, educating visitors and families on infection control measures, and properly using personal protective equipment. Improper use, wear, and removal of personal protective equipment can cause serious health consequences to the worker and the patients, which means employees need be continuously trained and educated on this equipment.

(McCaughey, 2016). The Center of Disease Control recommends hand washing with vigorous scrubbing for at least 15 seconds with soap and water. Using alcohol based gel hand sanitizer can be an appropriate alternative if soap and water is not readily available but does possess drawbacks including being ineffective against alcohol resistant bacteria. Programs for surveillance have also been implemented in hospitals with the intention of monitoring staff to ensure that policies are being followed to ensure the safety of the patients. Mandated reporting of hospital-specific rates and statistics for healthcare-associated infections has the potential to serve a purpose that could result in bringing down the instance for infection. Being forced to announce to the public infections rates versus other healthcare organizations has the potential for higher administration to implement better policies to assure their good standing in the eye of the

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

A nurse does not have time to properly wash her hands, a doctor leaves a catheter in a day too long, equipment was not properly cleaned; all these things seem like minuscule mistakes but are they really? These mistakes can lead to hospital acquired infections, an issue that affects millions of patients every year in the US as well as all over the rest of the world. This is an issue that should not be taken lightly. Hospital acquired infections occur in high frequencies, with many reasons that could be prevented, leading to protocols put in place to try and reduce these incidents.

Hi Ushma. I enjoyed reading your post. I agree that hospitals have an enormous amount of paperwork which can be overwhelming, but they are necessary. I agree that hospital is starting to move away from paper to a paperless system. When I go to the doctor, I do not have to fill out too much paper work because they swipe my insurance card for my insurance information and the medical assistant keys in any other information that they need from me directly into their laptop. I agree hand washing and sanitizing are the best way for the medical staff to not only from contracting an infection, but from spreading an infection to other patients as well. I too would ask the medial staff to wash their hands if they came into my room and did not do so.

Healthcare-associated infection requires both a change in behavior and in the organization’s culture. It should be kept in mind the the goal of a culture of safety is to reduce harm to the patients and to provide the best care to the patient. It is important that we understand why certain skills and safety measures are put into place such as washing your hands before and after each patient or encountering any soil substances. Most of the healthcare-associated infections are not done intended. Unintended consequences occur due to lack of verbal, written, or any other form of communication. Also at times the realization that something was not done correctly is kept quite due to fear of the consequences. That is why now “The Institute of Medicine” has been trying to implement that the facilities try to address situations by seeing where the error occur and trying to prevent it from happening again instead of pointing the finger and trying to blame someone (Barnsteiner, 2011).

Ethical Considerations within Hand Washing Handwashing is one of the most important preventive measures when it comes to infection control and all healthcare professionals including nurses should have an ethical obligation to abide to proper hand hygiene. A study conducted by CUPE has exhibited that around 8,500-12,000 deaths in Canada per annum are attributed to healthcare associated infections (HCAI). HCAI usually develop as an outcome of the exposure to procedures and facilities of healthcare. If one needs to establish the simplest yet important nursing practice that helps in tremendous control and reduction in the contamination and infection spread, it would certainly be the maintenance of proper hand hygiene (Pratt, 2007). The various preventive practices that focus on interrupting the transmission

Hand hygiene is the most effective way of preventing the spread of infections. Most hospital-acquired infections are spread via the hands of the healthcare workers. According to the CDC, about 2 million or 1:20 patients are infected with a hospital acquired infection. Hand washing includes washing hands with warm water and soap or antiseptic hand sanitizers. (book, 540) Programs have be developed to observe the nurses, doctors, and other NICU workers to see if they were following the current hand hygiene guidelines. In this program faculty was observed for a baseline assessment then given a questionnaire asking the employees what they knew about hang hygiene. The assessment was monitored by nurses that were trained in hand hygiene and observation

When there are new guidelines and teaching in regards to hand hygiene it is important to involve patients so they become aware and contribute to improve their health as they will be practicing hand hygiene. The World Health Organisation (WHO, 2009) states that healthcare providers, care homes and hospitals have an obligation of making sure that patients are educated in various ways it can be by giving them leaflets to read or by showing them videos in their wards of hand hygiene practices that demonstrates how to wash hands properly, that will improve compliance among members of staff and patients. Communication is central to successful caring relationships, it brings people together and enables improvement amongst staff in the way they care for people. It is only through good communication at any work place environment that enables people to get to know things, without good communication patients and carers will lack the understating of how to prevent healthcare, associated infections HCAI (De Bono, Heling and Borg, 2014, pp.

This article explores the non-compliance among practitioners and the negative effects from it. Hand hygiene non-compliance may increase patient mortality and morbidity rates, and raise healthcare costs (Mortell, 2012, p. 1011). Multiple infection prevention and control programs to improve hand hygiene among staff have been utilized and yet these all appear to have failed to achieve the required and desired compliance in hand hygiene (Mortell, 2012, p. 1011). Throughout the whole article Mortell emphasizes that hand-hygiene evidence and advice has been continuously disregarded by clinicians. “We have all seen educated and knowledgeable clinicians fail to practice their organization’s hand hygiene recommendations. One possible explanation for this is that there is an ‘ethical gap’” (Mortell, 2012, p. 1012). This article discusses a study on hand hygiene compliance for 2010 and 2011 in a cardiac surgical intensive care unit; which was measured by observational surveillance and audited daily. During the first year of the study, the nurses in that unit provided the doctors and other paramedical staff with continual education of the WHO (2009) recommendations, training and observational surveillance feedback. By doing so, hand hygiene compliance was maintained at greater than 70% (Mortell, 2012, p. 1012). During the following year, doctors were not receptive to nursing requests to comply with WHO requirements, which made the nurses stop providing ongoing support to doctors as they had in 2010. The outcome observed was that physician compliance fell to 60% or less (Mortell, 2012, p. 1012). Only the nurses and paramedics kept up with compliance of greater than 80% because of ongoing education, observation, feedback and a genuine belief in the benefits of hand hygiene to patient safety (Mortell, 2012, p. 1012). Mortell (2012) states that given that most clinicians

Hand washing has been proven to be one of the most effective means of preventing the spread of infection in healthcare facilities (Centers for Disease, 2015). An outpatient dialysis facility noted that staff was very complacent about hand hygiene. The Joint Commission National Patient Safety Goal 7 (JCPSG) states” that healthcare organizations must perform an accurate “baseline assessment of hand hygiene in order to identify opportunities for improvement” (The Joint Commission, 2016). 90,000 people die each year from hospital acquire infections at about a cost of 4.5 billion dollars (Fairchild, 2009). By increasing hand hygiene compliance could save this facility many dollars and not only that many precious lives.

According to the Centers for Disease Control (CDC), an estimated 1.7 million infections resulting in 99,000 deaths occur as a result of hospital acquired infections each year. The health care worker’s hands are the most common mode of transmission of healthcare-associated pathogens. Hand hygiene remains the leading preventive practice that can break the chain in the spread of hospital infections. However, this problem is still one of the most overlooked preventive measures in patient care. To improve the performance of hand hygiene among health care workers, performance barriers such as time, forgetfulness, and poor access to hand hygiene materials need to be addressed. Consistent performance improvement with this practice insures a reduction in infection rates and is a major component not only of patient protection, but healthcare providers as well.

Recent studies show that at any time, over 1.4 million people worldwide suffer from hospital-acquired infections (Public Health Ontario). In Canada alone, approximately 250 000 patients every year contract infectious micro-organisms from their healthcare providers (Nagel 18). At London Health Sciences Centre (LHSC) we take pride in providing world class care in a safe, comfortable environment for patients. However, between 2008 and 2010 the LHSC still had between 20 and 30 per cent non-compliance to proper hand-washing protocol (Nagel 20). This data is very troubling considering it is following the launch of “Just Clean Your Hands” pilot project. As student nurses and volunteers of the LHSC team we are equally responsible to increase hand-washing compliance.