Healthcare Acquired Infections (HAI)

Healthcare Acquired Infections (HAI)

The purpose of this essay is to discuss the prevention of healthcare acquired infections (HAI) throughout Scotland during postoperative care. Highlighting post surgery wound care, the importance of hand washing, use of personal protective equipment, environmental changes and the need for education and training.

Healthcare acquired infections are infections individuals acquire during their stay within a healthcare environment. In today's society, hospitals in Scotland accommodate ensuring safe guards are implemented to eliminate causes of Healthcare Associated Infections (HAI's). Prevention and control of HAI is a high-profile priority issue for NHS Scotland (Scottish Government, 2005:1-51). Preventing HAI requires structure from multidisciplinary teams who are involved in delivering care. Nursing and Midwifery council (NMC) imply professionals have a responsibility throughout care delivery to ensure care carried out is at a reasonable competent standard (NMC, 2008). Postoperative care begins from the recovery room and continues throughout the recovery period. When caring for patients with postoperative wounds concerns increase due to the integrity of the skin. Observations obtained throughout this stage help assess the individual's condition and can highlight any problems that may occur and detect when HAI''s are developing (Brooker & Waugh 2007: 692-693). It is important that mechanism in place are implemented at the beginning of the postoperative stage this enables prevention of any infection that poses a risk.

Wound care is vitally important when delivering postoperative care in reducing and preventing HAI's. The skin is a protective barrier and it protects individuals from microorganisms that can enter the body, once the skin is broken it makes individuals more prone to HAI's. National Institute of Clinical Excellence, clinical guidelines state, "Surgical site infections compose up to 20% of all healthcare associated infections and at least 5% of patients undergoing surgery develop a surgical site infection" (National Institute of Clinical Excellence, 2008:4). Meticillin-resistant Staphylococcus aureus (MRSA) is one generally known infection that is acquired with in a hospital setting. MRSA carries on the skin and mainly spreads by hand contact from one individual to another; MRSA entering a wound can become more and cause blood poisoning. NHS Quality Improvement Scotland, 2007, state "Preventing and controlling the spread of MRSA infections is a national priority for NHS staff. Washing your hands thoroughly is one of the best ways of stopping the spread of MRSA" (NHS Quality Improvement Scotland, 2007:1-16).

When dealing with post surgery wounds health professional should be aware when to wash their hands. Tasks like these should take place prior to having contact with a patient and before and after a clean/aseptic non-touch procedure. Hand washing is a technique used to prevent infection entering the body. Good hand hygiene protects patients from microorganisms that can infect the body and it is a crucial procedure put into action to assist towards prevention of the spread of infection (NHS Education for Scotland, 2009:1).

Personal Protective Equipment (PPE) worn throughout delivery of postoperative care, include gloves, aprons, masks and eye protection play an essential role throughout the postoperative stage when dealing with post surgery wounds. PPE provided is necessary when dealing with all types of body fluids and remains a safeguard in protecting health professionals as well as protect the patient. The disposal of PPE is also a continuous process and it is vital that it is disposed of appropriately to prevent contamination and the spread of infection. Including any waste products collected when dealing with the patients wound. Using PPE sets standards in a work environment and using these effectively maintains safe work practices and limits and helps prevent the spread of infection (Health Protection Scotland, 2009:1-16).

Prior to implementing both these procedures precautions is required to prevent any bacteria entering the body. Bacteria can remain on any surface present within the environment. Preparations undertaken prior to wound management include preparing a dressing trolley. Cleaning before use is vital so contamination of equipment is not at risk, a requirement that is needed to decontaminate the patient's surroundings, so individuals within that setting remain in a clean environment. NHS Greater Glasgow and Clyde (2007:1) state, "The decontamination of near patientequipment and medicaldevices is crucial to the prevention of healthcare associated infection (HAI)".

Infections continually pose challenges to public health as well as to healthcare settings, the view proposed by Henry and Kilpatrick (2006:653-654). Procedures undertaken within a healthcare environment must protect both the patient and individuals from the risk of HAI's. The Scottish Government (2005:4) states, "It is estimated that approximately 9% of patients entering Scottish hospitals acquire an infection during their admission. This is equivalent to at least 10,000 infections a year. Evidence suggests that 35% of these may be preventable".

It is necessary for professionals to take into consideration other aspects that may pose risk to enable to prevent it. Changing the environment can assist in preventing HAI's, for instance changing a dressing on a patient when hospital staff undertake bed changing duties. Bacteria living of particles of skin contaminating the air may get into the wound and cause infection. Thinking ahead when delivering care is an essential part of nursing intervention. It is crucial for multidisciplinary teams to understand how microorganisms spread and cause infections. Professionals can then adjust their routine to protect the patient receiving care (Scottish Executive Health Department, 2005:1). NHS Forth Valley (2009:1-16) is working hard to lower the amount of HAI within hospital settings. Undergoing educational training helps reduce risk in healthcare settings. NHS Education for Scotland created a framework for mandatory induction training in HAI specifically for NHS Scotland. Within this framework, they state, "The more healthcare professionals that undertake training and gain a greater knowledge of HAI the more of a chance HAI will be reduced" (NHS Education for Scotland, 2004:6).

Cleanliness Champions is one programme developed for medical professionals to undertake infection control training. It enables them to have a deeper knowledge of infection control. It helps increase their own skills and knowledge in relation to infection prevention and control ensuring individuals benefit from safeguards put in place in regards to hazards of infection (NHS Education for Scotland, 2009:8-15). HAI Task Force - Education and Training scheme (2008:1) state "The Cleanliness Champions Training Programme will continue to be extended and promoted throughout all NHS Scotland healthcare staff". However, it is not just about staff members following guidelines and receiving training. Hospital settings have a high level of staff and public attendance daily. For individuals to maintain a clean environment alcohol gel dispensers are accessible on entering wards and throughout ward areas. The uses of these dispenser's helps individuals maintain good hand hygiene. Hygiene facilities are readily available, to protect the welfare of individuals and to reduce and prevent HAI. Educating the whole public sector helps reduce risk of infections throughout a clinical environment. The Scottish Executive Health department stresses the importance of accessible information on HAI's for the public. Having access to information would help the public become more aware of how to help prevent HAI's while in a hospital setting and help keep the spread of HAI's under control.


Prevention and control of Healthcare Acquired Infections (HAI's) throughout postoperative care is a major concern and Scotland is working hard to lower the amount of HAI's. HAI's is a priority issue and for prevention and control of infection to work effectively, critical activities such as hand, hygiene, the use of personal protective equipment has to be embedded into everyday practice. Integrity of hospitals maintained throughout Scotland minimise potential risk and exposure. Hand hygiene and PPE is a major method of decontamination used routinely to reduce risk of HAI's. Reducing and preventing HAI's is essential for all of those connected to the healthcare environment ensuring everyone at a minimal risk of exposure. All staff must transparently demonstrate good infection control and through leadership ensuring to do this, the importance of continuing professional development is essential reducing the risk of spreading a HAI. Infection Control is everybody's business and it is vitally important that in today's society continuingly using procedures to break the chain of infection.

Reference Page:

  • Amos, A, Waugh, A. (2007) 'Caring for the person having surgery' in Brooker, C, Waugh, A. (ed.) Foundations of Nursing Practice Fundamentals of Holistic Care. Philadelphia, pp. 692-693.
  • Health Protection Scotland (2009) Personal Protective Equipment Policy and Procedure. Available at: [Accessed 27 April 2010].
  • National Institute for Health and Clinical Excellence (2008) Surgical Site Infection Prevention and Treatment of Surgical Site Infection. Available at: [Accessed: 25 April 2010].
  • Henry, M, Kilpatrick, C (2006) 'Prevention, control and management of infection', in Alexander. F.M, Fawcett. N (Tonks) J, Runciman.J.P. (Ed) The Nursing Practice Hospital and Home. London: Elsevier, pp. 653-689.
  • NHS Education for Scotland (2004) A Framework for Mandatory Induction Training in Healthcare Associated Infections (HAI) for NHS Scotland. Edinburgh, Scottish Executive.
  • NHS Education For Scotland (2009) An Evaluation of The Impact of the NHS Education for Scotland Cleanliness Champions Programme on Clinical Practice. Available at: [Accessed 27 April 2010].
  • NHS Education for Scotland (NES) (2009) Promoting Hand Hygiene in Healthcare. Available at: [Accessed: 25 April 2010].
  • NHS Forth Valley (2009) NSH Forth Valley Healthcare Associated Infection Reporting Template (HAIRT). Available at: [Accessed: 29 April 2010].
  • NHS Greater Glasgow and Clyde (2007) Infection Control: Decontamination. Available at: [Accessed 29 April 2010].
  • NHS Quality Improvement Scotland (2007) Understanding advice: The clinical and cost effectiveness of screening for meticillin-resistant Staphylococcus aureus (MRSA). Available at: [Accessed 27 April 2010].
  • Nursing & Midwifery Council (2008) Duty of care. Available at: [Accessed: 5 April 2010].
  • The Scottish Government (2008) HAI Task Force - Education and Training. Available at: [Accessed 27 April 2010]
  • The Scottish Government (2005) Preventing Infections Acquired While Receiving Health Care. Available at: [Accessed 27 April 2010].
  • The Scottish Government (2005) Preventing Infections Acquired While Receiving Health Care. Available at: [Accessed 27 April 2010].
  • Scottish Executive Health Department (2005) HAI's Public Information: MRSA. Available at: [Accessed 27 April 2010].

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