Healthcare Acquired Infections (HAI)
The purpose of this essay is going to discuss how healthcare acquired infections in Scotland, post surgery can be reduced and prevented from occurring, highlighting the need for hand washing, the use of personal protective equipment and the importance educating and training.
Healthcare acquired infections are infections that patients can acquire during their stay within a healthcare environment. Concerns regarding healthcare associated infections throughout healthcare settings are heightened especially after receiving surgery, during the postoperative stage of care delivery. Postoperative care begins in the recovery room and continues throughout the recovery period. During this stage of care, delivery professionals assess the patient's condition and essential observations are taken, for example temperature, pulse, respiratory rate, blood pressure oxygen saturation levels and inspection of wound site. These observations are essential to assess the progress of the patient throughout care delivery. Taking patients observations can highlight any problems that may occur (Brooker & Waugh 2007: 692-693).
There are several actual and potential problems that can take place during postoperative care, including dehydration or fluid over load, wound infection and patients unable to maintain their own personal hygiene (Brooker & Waugh 2007:694-695). Professionals must be aware of what signs to look out for during postoperative care and realise the risk of healthcare acquired infections that can be contracted while delivering care and dealing with problems that arise.
Preventing HAI requires structure from multidisciplinary teams who are involved in delivering care to ensure the safety of the patient. The Nursing and Midwifery council (NMC) suggest that professionals have a duty of care to ensure that the care carried out is at a reasonable competent standard and health professionals are accountable for their actions throughout care delivered towards the patient (NMC, 2010).
The NHS Scotland Code of Practice for the Local Management of Hygiene and Healthcare Associated Infections scheme (Scottish Government, 2005) state "Prevention and control of HAI is a high-profile priority issue for NHS Scotland".
Catheter Associated Urinary Tract Infections (CUTI) scheme (Health Protection Scotland, 2005) state "Urinary tract infections (UTI) are the most common infections acquired in hospitals and long-term care facilities. Several studies have indicated that between 75 and 80% of all healthcare associated UTIs follow the insertion of a urinary catheter". Infection remains a significant cause of ill health and while patients under go procedures to promote their health and well being infection control precaution is implemented throughout Scotland. On occasions, postoperative catheterisation may have to take place depending on the client's condition. The range of reasons for catheterisation vary, fluid over load during postoperative stage would be one indication to pursue this process. In trying to reduce the risk of healthcare acquired infection. An aseptic technique is used throughout Scotland the use of aseptic non-touch technique is required to try and prevent any bacteria entering the body. Health professionals must prepare themselves while undergoing this procedure, preparations are required for example hands must be washed before and after dealing with patient's, a trolley with all the equipment required must be prepared so contamination of equipment is not at risk and personal protective equipment must be used for the protection of staff and patient's (NHS Quality Improvement Scotland, 2004).
Throughout postoperative care, wound care is also particularly important in prevention of HAI. The skin is a protective barrier and it protects individuals from microorganisms from entering the body, once the skin is broken it makes individuals more prone to healthcare associated infections. NICE 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". (NICE, 2008).
Throughout procedures health professional should clean their hands, before touching a patient, before clean/aseptic procedure, after body fluid exposure, after touching a patient and after touching patient's surroundings. Hand washing is a technique used throughout dealing with patient care to prevent infection entering the body. Good hand hygiene protects patients from microorganisms that can infect the body and it is a single most important activity for preventing the spread of infection from one person to another (NHS Education for Scotland, 2009).
Infections continually pose challenges to public health as well as to healthcare settings, the view proposed by Henry and Kilpatrick (2006, p. 653-654). Procedures undertaken within the healthcare environment must protect both the patient and individuals giving care from the risk of infection. The Scottish executive's action plan 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". This is why care is vitally important and several procedures are put in place to protect the patient from infection and any known HAI. It is crucial for multidisciplinary teams to understand how microorganisms spread and cause infections. Ensuring the need to follow guidelines throughout undertaking daily procedures, the need for hand washing, used of personal protective equipment allowing the course of prevention to take place.
Training and education:
NHS Education for Scotland (2004:6) produced a framework for mandatory induction training in HAI for NHS Scotland. Within this framework, they state that the more healthcare professionals that undertake training and gain a greater knowledge of HAI the more of a chance HAI will be reduced. It is not just about staff members following guidelines presented by hospitals. Hospital settings have a high level of staff and public attendance daily throughout the wards. To protect the welfare of individuals and to reduce and prevent HAI, it is important to educate the whole public sector.
- 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.
- 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. 694-695
- Nursing & Midwifery Council (2008) Duty of care. Available at: http://www.nmc-uk.org/aArticle.aspx?ArticleID=4011 (Accessed: 5 April 2010).
- The Scottish Government (2005) NHSScotland Code of Practice for the Local Management of Hygiene and Healthcare Associated Infections. Available at: http://www.scotland.gov.uk/Publications/2004/05/19315/36631 (Accessed: 25 April 2010)
- Health Protection Scotland (2005) Catheter Associated Urinary Tract Infections (CUTI). Available at: http://www.hps.scot.nhs.uk/haiic/sshaip/cautisurveillance.aspx (Accessed: 24 April 2010).
- NHS Quality Improvement Scotland (2004) Best Practice Statement - Urinary Catheterization and Catheter Care Available at: http://www.nhshealthquality.org/nhsqis/1461.html (Accessed: 25 April 2010).
- National Institute for Health and Clinical Excellance (2008) Surgical Site Infection Prevention and Treatment of Surgical Site Infection. Available at: http://guidance.nice.org.uk/CG74/NICEGuidance/pdf/English (Accessed: 25 April 2010: pp 1-10).
- NHS Education for Scotland (NES) (2009) Promoting Hand Hygiene in Healthcare. Available at: http: http://www.nes.scot.nhs.uk/hai/osc/hygiene/ (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
- The Scottish executive's action plan
- NHS Education for Scotland (2004) A Framework For Mandatory Induction Training IN Healthcare Associated Infections (HAI) for NHS Scotland. Edinburgh, Scottish Executive.