NURSE’S ROLE IN PREVENTING HOSPITAL ACQUIRED INFECTIONS

                  

Introduction:

Healthcare-associated infections (HAI) are a threat to patient safety. A nosocomial infection is contracted because of an infection or toxin that exists in a certain location, such as a hospital. The term nosocomial infections is interchangeably used with the terms health-care associated infections (HAIs) and hospital-acquired infections. For a HAI, the infection must not be present before someone has been under medical care.

Areas prone for HAI:

One of the most common wards where HAIs occur is the intensive care unit (ICU), where doctors treat serious diseases. About 1 in 10 of the people admitted to a hospital will contract a HAI. They are also associated with significant morbidity, mortality, and hospital costs.

Types of HAIs:

• CAUTI : Catheter Associated Urinary Tract Infection
• CLABSI: Central Line Associated Blood Stream Infection
• SSIs: Surgical Site Infections
• MRSA : Methicillin Resistant Staphylococcus Aureus Infections
• VAE : Ventilator Associated Events

Role of a Nurse :

Nurses play a pivotal role in preventing hospital-acquired infections (HAI), not only by ensuring that all aspects of their nursing practice is evidence based, but also through nursing research and patient education.

• Nurse as an Advocate : The nurses need to adopt Universal precautions. Universal precautions are designed to prevent the transmission of blood borne pathogens when providing first aid or healthcare. Nurses came across in contact with various body fluids  including blood, cerebrospinal fluid, amniotic fluids, semen and vaginal secretions, nasal secretions, sputum, saliva, sweat, tears, urine, feces or vomit . Under the universal precautions rule, nurses must wear personal protective equipment when coming into contact with the specified body fluids. This is helpful to prevent transmission to other patients or to self.

• Nurse as a Clinician : . Avoidance of urinary catheterization is recommended whenever possible. For patients who require long-term catheterization, supra-pubic catheters should be considered. Scrupulous hand washing and aseptic technique is vitally important in the insertion and care of urinary catheters, as well as accurate and precise documentation.Irrigating cutaneous wounds thoroughly between dressing changes, debriding necrotic material effectively and dressing a wound appropriately to absorb exudates, are all ways in which nurses can protect patients from HAIs

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• Nurse as a Care Provider : Neutropenic patients should receive frequent oral care, including teeth brushing and gentle flossing, or receive oral antimicrobial rinses when gingivitis or poor hygiene is noted. Intravenous therapy is a huge area of concern with HAIs. Nurses can make a huge contribution in this war against infection by using full barrier precautions (sterile field, caps, gowns, masks and gloves) when preparing for the insertion of central venous catheters. All catheters, regardless of site, should always be placed aseptically. A 2% chlorhexidine preparation is the preferred cleansing agent of catheter sites and injection ports and diaphragms of multidose vials should be cleansed with 70 percent alcohol prior to accessing . Catheters should be removed promptly when deemed unnecessary. Catheter dressings should be replaced immediately when damp, soiled or loosened. IV administration sets, extensions and secondary sets should be replaced every 72 hours, unless infection is suspected or documented.

• Nurse as Protector : Nurses can foster a safe environment for patients by creating an open, non-punitive environment where errors and near misses can be reported. This approach helps an organization determine how to improve the system and prevent future errors from occurring.Hand washing is another potent weapon in the nurse’s arsenal against infection, and is the single most important nursing intervention to prevent infection. Effective hand washing may be accomplished with antimicrobial soap and water, and specific guidelines for the use of alcohol-based hand rubs as acceptable substitutes.

General tips to be followed :

• ·   Adopt a safety-minded attitude. Safety is everybody’s job! Make prevention a part of your work habits. Focus on the task at hand.
• ·    When “noise” in your environment is distracting, you and others are at risk for accidents.
• ·   Noise” might include your own thoughts that are unrelated to the task at hand, an interesting conversation going on nearby, or anything that breaks your concentration.
• ·   Identify “noise” and take actions to limit the source.
• ·   Develop a personal list-making or note-taking system to keep your thoughts focused.

Conclusion :

Nurses in all roles and settings can demonstrate leadership in infection prevention and control by using their knowledge, skill and judgment to initiate appropriate and immediate infection control procedures. Practice diligently and keep your patient safe.