An increase in the emergence of infections in hospitals and other health facilities is a crucial issue in the health sector. These infections include severe acute respiratory syndrome (SARS), plaque, and tuberculosis among others. The causes are mainly through pathogens, which include, staphylococcus, candida, E. coli, Pseudomonas, Clostridium difficile, viral agents such as respiratory syncytial virus and influenza, and multidrug resistant organisms. This life threatening infections have increased the need for establishing infection control programmes, and capacity building programmes in health care facilities. Failure to adhere to these control rules increases the chances of the spread of these infections from the patients to the health care staff, attendants, or other patients. Therefore, it is necessary for all the affected parties to strictly adhere to these practices, with the hospital management ensuring the implementation of such control programmes in all health care facilities. Infection control precautions require that all the workers in health care facilities treat all substances from the body, from all patients’ ans staff, as a potential cause of infection, regardless of the patient’s diagnosis, and infection status. The standard infection control guidelines provide rules and directions which encompasses the required equipment, facilities and procedures for implementing the control of infections, waste management, practices for infection control, cleaning and disinfection of reusable equipment, and the protection measures for the health care workers (Burke, 2003).
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These health care associated infections (HAI) also known as hospital acquired or nosocomial infections commonly affect hospitalized patients. Prevention of these HAI begins by identifying the risk factors involved, which helps in developing the targeted interventions and preventive measures in reducing the risk infections. These include avoiding the use of invasive devices, reducing the duration device usage in the effort to reduce the occurrence of these infections. The main challenge faced in implementing these safety practices is the attitude or resistance to change in behavior. For example, all the health care workers are aware that the major source of HAIs is the cross infection with contaminated hands by patients and health workers. Despite educational efforts, health care workers, including physicians, continue to fail to adhere to standards for hand hygiene, which is universally considered the single most eminent method for infection control. This barrier in curbing HAIs can be addressed by advocating for the use of waterless antiseptic hand rubs, shown to be more practical than standard hand washing alone. It also ensures the improvement or adherence of health care workers to hand hygiene guidelines, and to prevent the transmission of methicillin resistant Staphylococcus aureus to patients (Stelfox, Bates & Redelmeier, 2003).
There is need to acknowledge that infection control is not an antimicrobial resistance containment program. The role and management of infection control is to limit the transmission of resistant organisms when they emerge in a health facility, and is not effective in the absence of an effective antimicrobial use program. HAIs may or may not be considered in the category of medical errors because some infections are not preventable even in the best of optimal practices. Certain elements of infection control practice, including use of epidemiological principles, an expert knowledge base, cost effective analysis, practice for surveillance and containment, are also applicable in all case of medical errors. However, infection control also takes into account the unique problems of transmissible organisms, with a possible negative impact for the victims of infection including the patients and staff. Despite the challenges encountered, the practice of infection control in health care facilities is proving to be quite effective (Pittet et al, 1999).
The guidelines for effective control of HAIs need to be validated and regularly reviewed. Potential outbreaks need to be recognized early, followed by implementation of appropriate investigation and control activities. Such programs should also provide expert health support for staff in matters relevant to infections in staff members, or transmission of infections between patients and staff. There should also be development of appropriate policies and procedures for practices targeting patient care in order to minimize the incidences of HAI acquisition, updated and monitored regularly for compliance and effectiveness. These control measures include hand-washing practices, use of invasive devices, isolation practices, outbreak control, preparation of food, maintenance of the environment, and disinfection and sterilization of equipment. Infection control staff must work effectively with public health department, and liaise with other facilities providing health services where appropriate. Finally, infection control programmes need to conduct educational trainings to patients and staff in the health care facilities (Nicolle, 2001).
Burke, J. P. (2003). Infection Control — A Problem for Patient Safety. J. Med. 348; 7.
This article by John Burke is a health policy report that explores the issue of infection control in the effort of protecting the patients and staff in health care facilities. This article describes the nature of commonly occurring nosocomial infections, the main problems encountered in implementing infection control measures, approaches to their solutions, and a proposed model in infection control program. This involves the role of National Nosocomial Infections Surveillance System (NNIS), which is a program established by the (CDC) Center for Disease Control and Prevention. The system emphasizes the need for a renewed commitment to the infection control measures in ensuring the safety of patients. The main topics of discussion of this report are highly applicable to study in question as it widely covers the relevant issues from the nature of the infections to the control measures, as well as the challenges involved. The report can also be considered as a highly relevant source of information because data used was from the hospitals, the primary focus of the study in question. The main limitation of the article is the bias on antibiotic resistance as a key factor or risk of developing infections, while neglecting other notable causes.
Nicolle, L. E. (2001). Infection control in acute care facilities: Evidence-based patient safety. Can J Infect Dis Vol 12 No 3.
This report discusses the different infection control measures in acute care facilities. The author compares and contrasts the different control practices, their successes and limitations. However, the articles do not provide sufficient information on the implementation of different control programs in health care facilities as it only draws its points for discussion from secondary data, and what has been reported by other studies. The author did not carry out a practical study to ascertain the points mentioned. However, the discussions brought forth in the article are quite relevant as it effectively includes the advantages and disadvantages associated with various control measures, as well as further suggestions on other policies that can be implemented to improve the acquisitions of these infections.
Stelfox, H.T., Bates, D.W., and Redelmeier, D.A. (2003) Safety of Patients Isolated for Infection Control. American Medical Association. Vol. 290, No. 14.
This article examines the infection control measures for isolated patients because of the spread of nosocomial transmission of infectious diseases. Questions are raised on the quality of care and attention given to isolated patients. The authors claim that several reports indicate that receive less attention, as they are less likely to be examined by physicians, and, therefore, sought to examine the quality of medical care given to these patients. The results confirmed the research questions by the authors as they found that isolated patients are prone to adverse effects as well as less medical care, as compared to other patients. This article is a quality piece with quality research methods and study samples. However, the major portion of the article is not particularly sufficient for study at hand, apart from the for the purpose of literature review, which comes out clearly in the introduction part.
Pittet, D., Dharan, S., Touveneau, S., Sauvan, V, Perneger, T.V. (1999) Bacterial Contamination of the Hands of Hospital Staff During Routine Patient Care. Arch Intern Med. 159:821-826
This article explores the cross transmission of infection through the hands of the patients and health care workers, a method proven to be the main cause of transmission of nosocomial or HAI infections. The authors set to assess the process of bacterial transmission by hands during routine practices in health care facilities. They reported increased incidences of infections in people who did not use gloves, and among patients through direct contact, respiratory route, and exchange of bodily fluids. The authors finally advocates for an intervention of hand antisepsis as a key measure in reducing cross contamination in health care facilities. This article is particularly relevant for the study as it encompasses the various ways of infection transmissions, and ways of intervention. It also provides meaningful information as it draws its results from a primary study conducted by the authors. However, it only focuses on the intervention of hand washing as a sure way of preventing HAIs, while avoiding other relevant measures that equally contribute to reducing such infections.
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