Essay on Nosocomial Infection Prevention Through Education and Awareness

Background Study

Complying with the various infection control measures is essential in preventing and controlling nosocomial infections. This can, however, be facilitated by providing education and raising awareness on the infection. Most patients visiting healthcare centers might not have the necessary knowledge of the hospital-acquired infection. Without such knowledge, it would be hard to take the necessary precautions. Education and awareness are not only necessary for the patients but for the medical staff too.

Poor hand hygiene on the part of health workers, for instance, is responsible for about 40% of nosocomial infections (Khan, Baig & Mehboob, 2017). Research indicates that these infections are minimal in hospitals where nurses have knowledge of various methods of alleviating hospital-acquired infections. In such centers, there is the presence of individual towels and tissues, automated sinks and hand hygiene agents. Even though all these resources may be available in the other health centers, they may not be utilized while observing the necessary precautions. Consequently, they may enhance the spread of infections.

Problem Statement

Patients under medical care are likely to acquire the nosocomial infection. Such infections are common across the world both in developed and developing countries. The world health organization (WHO) estimates that around 15% of the hospitalized patients suffer from nosocomial infection (Khan, Baig & Mehboob, 2017). During their stay in the hospital, patients are exposed to pathogens through the hospital staff, equipment, air droplets and bed linens. Increased infections lead to a prolonged hospital stay, social-economic disturbance, long-term disability and high mortality rate.

Research indicates that certain bloodstream and urinary tract infections can be attributed the hospital-acquired infections. The Extended Prevalence of Infection in Intensive Care estimates that approximately 51% of patients in Intensive Care Units (ICU) are infected (Khan, Baig & Mehboob, 2017). The infections are a source of worry for every nation in the world. There is a need for healthcare organizations to mitigate nosocomial infection through education and awareness to prevent complications associated with the possible illness and promote positive health outcomes throughout the world.

Purpose of the Change Proposal

The purpose of providing education and creating awareness is to prevent the spread of nosocomial infections and promote health at a personal level, as well as, on macro-levels. This knowledge will change the attitude of the patients and make them realize that they have a responsibility of ensuring that hospital workers take the necessary precautions when handling them. They, for instance, should step up and remind the hospital workers to wash their hands. The proposal aims at ensuring that all healthcare workers are made aware of patients, hospital staff, and the hospital environment as the possible causes of nosocomial infections.

PICOT

Does the creation of awareness and education among patients and health workers reduce hospital-acquired infections?

Literature Search Strategy Employed

I embarked on a literature search to find out whether the provision of education and creation of awareness among patients and healthcare workers is necessary to reduce hospital-acquired infections. I broke this question into specific subject areas to identify the most necessary keywords, synonyms, and spellings. I mostly used Boolean operators to combine my search terms as a way of either broadening or narrowing the scope of the results. Besides, I used search filters to limit the search results and align them with the research question. Such filters included publication dates, subject, and the article type.

I for instance used ‘or’ whenever I needed a broad search and ‘and’ when I needed narrower search results. To review the most relevant scientific literature available, I searched on some online bibliographic databases for the literature published after 2012 in the areas identified as necessary to the statement of task. I searched all the research materials published in the English Language. I consulted the third reviewer whenever I had doubts about the eligibility of any particular journal.

I mostly relied on the United States National Library of medicine in conducting the literature search. My aim was to find all the studies done regarding nosocomial infections, their causes, and prevalence, treatment and prevention measures. In searching for the relevant scholarly journals, I used keywords such as patients, healthcare workers, nosocomial infections and hospital-based infections. In cases where I could not find the expected results, I would rephrase my question while making sure that it did not lose the original meaning.

Evaluation of the Literature

Lack of education and awareness contributes significantly to the spread of hospital-based infections. According to Andersson et al. (2018), most people still have doubts that hand-hygiene practices are effective in preventing nosocomial infections. Andersson et al. (2018) recommend that nurses be enabled to think and talk differently about hand hygiene by creating platforms for learning. According to Haverstick et al. (2017), decreased infection rates and increased compliance with hand hygiene among healthcare providers and patients can be directly attributed to the implementation of education and awareness of hospital-based infections. The authors argue that for people to succeed in minimizing cases of hospital-based infections, patients education must be improved.

Hand hygiene is a simple task yet the single best method that can be used to prevent the spread of infection (Haverstick et al, 2017). These infections are frequently viewed as indicators of poor compliance with hand washing guidelines. Salama et al. (2013) recommend education programs for healthcare workers as a measure of improving hand hygiene compliance rate. These programs should include direct lectures to the nursing staff, workplace reminder posters with full instructions on the various techniques of hand sanitizer use, and hand washing.

In addition, the health facility’s management should consider introducing leaflets that explain why hand hygiene is necessary, how, and when it should be performed (Salama et al., 2013). Sahni et al. (2017) acknowledge that nursing staff are the backbone of any Intensive Care Unit and are more likely to come into contact with patients. As a result, they insist on the importance of education and thorough knowledge for these nurses to prevent secondary sepsis.

Mathur et al. (2015) observed health care workers who had undergone one-week training on hospital infection control, hand hygiene, and standard precautions. New nurses were offered weekly lectures for a period not less than three months. Compliance report was submitted to the administrative head at the end of every month. They found that there was a significant reduction in the rate of hospital-based infections. Mathur et al. (2015) acknowledge the importance of intensive training and sensitization on nosocomial infections.

More knowledge concerning the task intensity in relation to hand hygiene in the operating room is necessary (Megeus et al, 2015). Megeus et al. (2015) conducted a structured observation of hand hygiene during 94 surgical procedures. They recorded a total of 2,393 opportunities for hand hygiene. Lower compliance was observed during the induction phase. Considering the low adherence level observed, they recommended urgent effective improvement strategies to be implemented. According to them, these strategies should include education and practical training in terms of how to observe hand hygiene in the healthcare centers.

Ceballos, Waterman, Hulett, and Makic (2013) conducted a study to evaluate the current nursing practice and areas for improvement. Central line-associated bloodstream infection and ventilator-associated pneumonia bundles were developed and implemented on the basis of the best available evidence. Nurses’ leaders made sure that these bundles were well implemented and gave feedback on intervention compliance. They found out that sensitizing and empowering nurses to lead increases personal ownership and patient outcomes.

Nursing Theory Utilized

The journals used in this paper utilized the goal attainment theory by Imogene King. They all aim to reduce the spread of hospital-based infections. The articles emphasize the importance of specialized knowledge for nurses. These nurses are urged to communicate appropriate information to patients to achieve a mutual goal (“Nursing Theory,” n.d.). If the roles expectations and performances as perceived by the nurses and patients are congruent, efforts to reduce the cases of nosocomial infections will be successful. In addition, continuous adjustments to stressors in both the internal and external environment of the healthcare facility are emphasized.

Proposed Implementation Plan and Outcome Measures

Healthcare practitioners especially nurses should understand their roles in reducing the spread of hospital-based infections. A team of managers and directors should be appointed to guide, coordinate, and support the creation of awareness and provision of education concerning nosocomial infections. This team will lay the basis for addressing these infections and manage the change process in healthcare centers. Implementation team should introduce the proposed methods to the hospital staff. Such methods include washing hands, wearing gloves, and ensuring sufficient ventilation in the hospital buildings. After this, the implementation team should come up with a process of monitoring the progress and gather feedback. They should continue to engage senior managers and directors of the health centers to sustain their initial support for the improvement plan.

Potential Barriers

Implementing theory-driven knowledge translation program in a healthcare setting is not an easy process. Physicians’ knowledge and attitudes may hinder the efforts of implementing the change process in healthcare centers. This can be attributed to lack of awareness and familiarity with the proposed guidelines and recommendations. In addition, nurses’ attitudes can derail the progress of change implementation. Some of them may fail to agree with the proposals, others may lack the necessary skills while the rest fail due to lack of motivation. Moreover, organizational constraints can adversely affect the process of change implementation. This can be attributed to lack of sufficient resources and medical personnel in a health care center.

As highlighted above, nosocomial infections are common throughout the world in both the developed and developing countries. Most patients and some nurses lack the basic knowledge of hospital-based infections. This makes it hard to overcome and suppress the spread of these infections entirely. Various authors have cited the creation of awareness and provision of the relevant education as the necessary steps towards reducing nosocomial infections. Massive awareness will ensure that nurses are held accountable by patients and that patients can take any step required to alleviate the spread of hospital-based infections. In fighting the infection, some authors use Imogene King’s theory of goal attainment. The theory advocates for the provision of special knowledge to nurses and patients to achieve a common health goal. Managers in healthcare centers have a duty to reduce the prevalence of hospital-based infections by implementing the necessary steps that aim to reduce the spread of these infections. They, however, face some challenges such as lack of adequate resources, noncompliance by the clinic nurses, and lack of adequate awareness.

References

Andersson, A. E., Frödin, M., Dellenborg, L., Wallin, L., Hök, J., Gillespie, B. M., & Wikström, E. (2018). Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hand’s study. BMC Health Services Research, 18(2), 1-12. doi:10.1186/s12913-017-2783-1

Ceballos, K., Waterman, K., Hulett, T., & Makic, M. B. (2013). Nurse-Driven Quality Improvement Interventions to Reduce Hospital-Acquired Infection in the NICU. Advances in Neonatal Care, 13(3), 154-163. doi:10.1097/ANC.0b013e318285fe70

Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017, Jun). Patients’ Hand Washing and Reducing Hospital-Acquired Infection. Critical Care Nurse, 37(3), e1-e8. doi:10.4037/ccn2017694

Khan, H., Baig, F., & Mehboob, R. (2017). Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific Journal of Tropical Biomedicine, 7(5), 478-482. doi: 10.1016/j.apjtb.2017.01.019

Mathur, P., Tak, V., Gunjiyal, J., Nair, S. A., Lalwani, S., Kumar, S., . . . Misra, M. C. (2015). Device-associated infections at a level-1 trauma center of a developing Nation: Impact of automated surveillance, training, and feedbacks. Indian Journal of Medical Microbiology, 33(1), 51-62. doi:10.4103/0255-0857.148378

Megeus, V., Nilsson, K., Karlsson, J., Eriksson, B. I., & Andersson, A. E. (2015). Hand hygiene and aseptic techniques during routine anesthetic care – observations in the operating room. Antimicrobial Resistance and Infection Control, 4(5), 1-8. doi:10.1186/s13756-015-0042-y

Nursing Theory. (n.d.). Retrieved from http://www.nursing-theory.org/theories-and-models/king-theory-of-goal-attainment.php

Parisi, M., Gerovasili, V., Dimopoulos, S., Kampisiouli, E., Goga, C., Perivolioti, E., . . . Nanas, S. (2016). Use of Ventilator Bundle and Staff Education to Decrease Ventilator-Associated Pneumonia in Intensive Care Patient. Critical Care Nurse, 36(5), e1-e7. doi:http://dx.doi.org/10.4037/ccn2016520

Sahni, N., Biswal, M., Gandhi, K., Kaur, K., Saini, V., & Yaddanapudi, L. N. (2017). Effect of Intensive Education and Training of Nurses on Ventilator-associated Pneumonia and Central Line-associated Bloodstream Infection Incidence in Intensive Care Unit at a Tertiary Care Center in North India. Indian Journal of Critical Care, 21(11), 779-82. doi:10.4103/ijccm.IJCCM_259_17

Salama, M. F., Jamal, W. Y., Mousa, H. A., Al-AbdulGhani, K. A., & Rotimi, V. O. (2013). The effect of hand hygiene compliance on hospital-acquired infections in an ICU setting in a Kuwaiti teaching hospital. Journal of Infection and Public Health, 6, 27-34. doi:http://dx.doi.org/10.1016/j.jiph.2012.09.014