APA Advanced Professional Roles, Nosocomial Infection Nursing

Running head: ADVANCED PROFESSIONAL ROLES 1

Advanced Professional Roles: Nosocomial Infection

Name of Student

Institution Affiliation

ADVANCED PROFESSIONAL ROLES 2

Introduction

Nosocomial infections also known as hospital-associated infections are infections that

develop during the stay in a health care facility and which are not the core reason for

admission. These include the occupation infections that infect nurses and doctors during their

entire stay in health care facilities. Significantly, healthcare operators more so the nurses can

put in place necessary measures while caring for patients in an attempt to reduce the cases of

nosocomial infections.

Only 6% of nosocomial cases occur thirty days after admission. More than 80% of

these cases occur within thirty days of admission. These infections include urinary tract

infections, pneumonia, bacterial infection, wound infections among others. They mostly

occur due to morbidity and the poor conditions of health care centers. According to Jeong,

the most common infection cases were pneumonia at 28%, bloodstream infection at 26%, and

conjunctivitis at 22% (Jeong, 2014). Additionally, he stated that major pathogens for example

Staphylococcus aureus were the main causes of these infections. This, he said, was due to the

handling of patients by nurses, doctors, and their family members without proper hygienic

strategies, for example, poor hand washing and lack of protective gadgets. It is in many cases

because of these nosocomial infections that the patients’ stay in hospital is extended.

According to a recent research by The Centres for Disease Control and Prevention (CDC),

more than two million get nosocomial infections and more than 100,000 dies each year

(Rosenthal et al., 2014). Despite the improvements in the state of health care facilities and the

cleanliness and protection of nurses and the general public, health care-related infections

continue being a big threat to human existence. Due to the rising costs of treating nosocomial

infections, it has led to financial constraints to many countries across the globe. According to

Doctor Jernigan from CDC, health care related infections result in an additional 29 billion

dollars in health care expenses all over the world annually (Rosenthal et al., 2014). Hospitals

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could help reduce nosocomial infections by putting up more strict rules in the way patients

are handled and the general infection control actions.

Due to the rising risks imposed on health care safety by nosocomial infections, it has

become an essentiality to come up with proper ways to curb them. This essay seeks to

analyze Palmer Health Centre to identify the areas of concern as far as nosocomial infections

are concerned. It will discuss the areas that need improvement so as to see health care-related

infections a thing of the past in this health care facility.

Evidence-Based Practices for Reducing Nosocomial Infections

Palmer Hospital has been faced with many nosocomial cases over the last few years.

In fact, it is one of the hospitals experiencing many deaths due to these infections. This

problem has brought attention to all the departments of the hospital and has made the facility

experience a big financial blow in two ways. First, due to the rising costs of treating

nosocomial infections, the hospital has been forced to increase its expenditure. Second, as a

result of increasing number of deaths due to these infections, the facility has lost most of its

regular clients as they lack trust and confidence in the facility (Yepez, 2017). This has

reduced the revenues for running the facility. We have however come up with necessary

measures to control the situation and find long lasting solutions. The solutions will be based

on products, technology, patients/family, finances and community relations.

Products

Reducing nosocomial infections involves directing all the necessary products and material

towards dealing with the problem. These products involve necessary protection attire when

handling patients and using copper surfaces. According to a research conducted by the

Medical University of South Carolina, use of copper surfaces on bed rails, tables, and all

ADVANCED PROFESSIONAL ROLES 4

buttons could reduce health care-related infections by 60%. During the publishing of this

study in the journal of Infection Control and Hospital Epidemiology, one of the researchers

Michael Schmidt stated that copper steals electricity and power inside microbes (Suganya,

2014). This makes them die due to lack of water.

Technology

Most hospitals across the globe use the latest technology to reduce healthcare based

infections. Portable machines have been used to kill bacteria that cause infections. These

machines are mostly used for cleaning. They have been noted to reduce C.diff pathogen at

Cooley Dickinson Hospital by 68%% and Staphylococcus aureus pathogen at North Carolina

Health Centre by 40% (Suganya, 2014). Biosensors have also been used in New York to

detect bacteria causing infections.

Patients/family

Hygiene is the most important aspect in a health facility. Patients should be educated on

the need to stay clean and safe. They should be tasked with the responsibility to ask their

nurses if they washed their hands before and after an examination. Patients, family and health

care providers should take responsibility to reduce nosocomial infections. At Emory

Healthcare facility in Atlanta for example, stickers on the wall indicate that “We urge you to

encourage your nurse to clean their hands every time after interaction” (Ider, B et al., 2016).

This has helped reduce infections in this hospital by 60%.

Finances

Increasing financial support towards the fight against nosocomial infections is probably

one of the solutions to this problem. This is by conducting clear diagnosis before doing blood

transfusions and surgery. Although these procedures may be expensive and time-consuming,

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they are of great importance as far as reducing nosocomial infections is concerned. Therefore,

hospitals need to make sure that they invest in them heavily in terms of finances and time. A

major nurse at Rochester General Hospital Neil Blumberg states that since the hospital started

devoting its time and money towards fighting nosocomial infections, they have seen a 75%

decrease in the cases of such infections (Ider et al., 2016). They scan all blood for bacteria

before transfusion and whenever it proves impossible to scan the blood, the transfusions are

canceled.

Community Relations

Community relations mainly involve teamwork and communication. To reduce

infections, teamwork is an essential aspect. Teamwork is created by forming a group of

persons dedicated to cleaning all surfaces across a health facility. At Louis Stokes Medical

Centre, a team was appointed to clean high-touch surfaces in the hospital. This reduced

healthcare related infections by 90% (Mehta, Y et al., 2014). Additionally, at Rhode Island

Hospital, communications between the ministry of health and the hospital’s officials on

nosocomial infections helped reduce them by 60%.

Impact of Nosocomial Infections on Patient Care

Health care related infections have undoubtedly substantial effects on finances,

patients, families and the entire health care. In terms of finance, nosocomial infections have

had a heavy economic burden on health care centers and governments. It has become very

expensive for health centers to meet the costs of handling cases of nosocomial infections.

Machines used to check for infections are expensive and treatment is also expensive in terms

of drugs and doctors. Consequently, many health facilities have lost many of their regular

clients due to lack of trust and confidence in them. A recent report from North Carolina

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Health Centre shows that the health facility increased its expenses by 38% due to unexpected

healthcare related infections (Vega-Galvis, 2016).

Patients are faced with high risks of additional body problems than the ones that led to

admission. When patients are subjected to unhealthy environments, they may contract

infections they did not have previously. This poses a threat to the period they stay in the

hospitals. Parents, on the other hand, are subjected to an increased economic burden due to

the long stay in the health facilities leading to accrued costs. The worst blow to the family is

the death of their patients due to deadlier nosocomial infections (Vega-Galvis, 2016). Nurses

are also faced with the risk of infections whenever they are in contact with their patients. At

Rhode Island Hospital, 23 nurses were reported to have contracted infections in 2015.

Gap Analysis

Modes of Transmission of Nosocomial Infections

Nosocomial infections can be transmitted from one person to another through various

ways. These modes include:

1. Contact transmission- Bacteria and virus may be transmitted through infected body

skin or contact via shared items such as door handles, benches, towels and taps.

Infections that are transmitted in this way include Staphylococcus aureus.

2. Airborne transmission- This includes disease causing bacteria that remain embedded

in the air for hours and days. This may be carried through infectious dust particles.

Airborne transmitted infections may be widely dispersed by air movements and are

highly susceptible to people within a room. This calls for better ventilation systems.

An example of airborne transmitted infection is Mycobacterium Tuberculosis.

ADVANCED PROFESSIONAL ROLES 7

Area

Major causes

that lead to

the

transmission

of nosocomial

infections

Role of

stakeholders

on patient

care

outcomes

Role of

Infection

control and

education

Strategy to

combat

increase of

nosocomial

infections

One goal for

reducing

nosocomial

infections

Products

Lack of

suitable

equipment and

surfaces to

reduce

nosocomial

infections. For

example good

ventilations

systems.

Provide

necessary

equipment

for handling

patients

Collaboration

between

clinical

microbiology

and infection

prevention

helps in

educating

nurses on the

importance of

using

protective

gadgets while

interacting

with patients

Adopting

copper surfaces

and investing in

safety

equipment.

Jeong

appreciates the

fact that putting

in place copper

surfaces is the

first step of

controlling

nosocomial

infections.

Reduce the

number of

deaths caused

by nosocomial

infections

Technology

Failure to

adopt

necessary

technological

advancements

Support

projects

aimed at

adopting

new

technologies

to reduce

nosocomial

infections

Education on

surveillance

and outbreak

detection helps

enlighten

people on the

need to move

from old

technology to

new methods

of reducing

nosocomial

infections

Adopt the latest

techniques in

order to detect

and kill virus

and bacteria that

cause

nosocomial

infections.

According to

Vega-Galvis,

technological

advancements

for example

surveillance of

nosocomial

infections can

be used to

control

infections by

evaluating the

efficacy of

treatment.

Reduce stay of

patients in

hospitals which

leads to further

financial

constraints on

the families

ADVANCED PROFESSIONAL ROLES 8

Patient/family

Lack of

adequate

education on

the need to

stay clean and

safe.

Help print

flyers to

enlighten

people on the

damages

caused by

nosocomial

infections

Antimicrobial

stewardship

help emphasize

the need of

washing hands

before and

after attending

to patients

Print flyers that

will be placed

in all corners of

the hospital in

order to reduce

damages caused

by infections

Instill

confidence and

trust in families

towards

healthcare

centers

Finances

Lack of

adequate

finances to

fight

nosocomial

infections

Increase

financial

support

towards the

fight against

nosocomial

infections

Infection

control

committee

participation

educates on the

need to invest

time and

money towards

fighting

nosocomial

infections

Form a new

department to

fight

nosocomial

infections and

more money

allocated to it.

Rosenthal

insists that only

proper

departments

will fully

address the

Nosocomial-

problem.

Reduce

financial

constraints

Community

Relations

Lack of

teamwork and

communication

Enhance and

encourage

teamwork

and

cooperation

in the fight

against

nosocomial

infections

General

education on

nosocomial

infections

advises people

on the need to

work together

and involve

communication

in an attempt

to reduce

nosocomial

infections

Appoint a team

of 8 people to

clean the

surfaces and

conduct

communications

with the

ministry.

Enhance

general welfare

of the society

Possible Solutions to the Gap

In the book Prevention and Control of Nosocomial Infections, 4

Edition, Richard

talks about the ways through which nosocomial infections can be controlled and managed. He

ADVANCED PROFESSIONAL ROLES 9

argues that since they are transmitted from one person to another, through clearly defined

strategies, they can be used prevented and treated (Vega-Galvis, 2016). First, with the

adoption of copper surfaces, nosocomial infections will be reduced. The use of copper doors

and handles at California medical Health Centre saw a decrease of nosocomial infections by

50%. Second, adoption of the latest techniques, for example, the use of portable machines to

kill bacteria and virus that causes infections will help control infections. Third, printing of

flyers and placing them in all corners of hospitals will reduce the damages caused by

nosocomial infections. Four, while hospitals come up with new departments of fighting with

nosocomial infections and more money allocated to them, the fight against nosocomial

infections will be successful. The money may be used to buy necessary machines and

undertake necessary tests before transfusion and surgery. Five, teamwork may be enhanced

by appointing teams to clean surfaces. Communications with the ministry to ensure all

possible means are used to reduce nosocomial infections are also important strategies.

According to a famous American magazine, Health line, emphasizing on personal hygiene is

the most important aspect in controlling nosocomial infections (Vega-Galvis, 2016).

Recommendations

At Palmer Hospital, I recommend that new technology to be put in place to ensure

that healthcare related infections are reduced completely. Suganya insists that only the best

technology would curb nosocomial infections. He further states that with increased scanning

machines and surveillance, these infections could be reduced by 60% (Suganya, 2014).

Additional finances must be allocated towards this project. Education on the need for safety

and cleanliness may be given in order to enlighten people on the dangers of nosocomial

infections. According to Healthcare Times magazine, the introduction of bacteria scan

machines in New York Hospital decreased the rate of nosocomial infections by 72% (Ider et

al., 2016).

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However, although advancement in technology contributes significantly to reducing

nosocomial infections, it may be expensive. According to a statement by California medical

Health Centre, installing copper doors and surfaces increased the hospital’s expenditure by 1

million dollars (Vega-Galvis, 2016). Education to nurses and patients may be expensive and

at times, they may be ignorant towards personal hygiene. Nevertheless, adoption of these

measures and strategies will help reduce the number of deaths and increase the success of

Palmer Hospital.

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References

Ider, B et al. (2016). Multicenter study of device-associated infection rates in hospitals of

Mongolia: findings of the International Nosocomial Infection Control Consortium

(INICC). American journal of infection control, 44(3), 327-331.

Jeong, C. &. (2014). An integrative review of infection control research in Korean nursing

journals. Asian nursing research, 8(2), 128-134.

Mehta, Y et al. (2014). International Nosocomial Infection Control Consortium International

Nosocomial Infection Control Consortium (INICC) report, data summary of 43

countries for 2007-2012. Device-associated module. American Journal of Infection

Control, 42, 942-956.

Rosenthal et al. (2014). International Nosocomial Infection Control Consortium (INICC)

report, data summary of 43 countries for 2007-2012. Device-associated module.

American journal of infection control, 42(9), 942-956.

Suganya, M. V. (2014). Education on prevention of nosocomial infections among staff nurses

at neonatal intensive care unit in Sri Ramakrishna Hospital, Coimbatore. Naray Nurs

J, 3(3), 33-35.

Vega-Galvis, M. e. (2016). Multicenter study in Colombia: Impact of a multidimensional

International Nosocomial Infection ControlConsortium (INICC) approach on central

line–associated bloodstream infection rates. American journal of infection control,

44(11), 235-241.

Yepez, E. e. (2017). Device-associated infection rates, mortality, length of stay and bacterial

resistance in intensive care units in Ecuador: International Nosocomial Infection

Control Consortium’s findings. World journal of biological chemistry, 8(1), 95.

ADVANCED PROFESSIONAL ROLES 12

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