"Breaking the Chain of Hospital Associated Infection"

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DOME 1005

Foundations of Clinical Practice

“Breaking the Chain of Hospital Associated Infection”

09/01/2006

Breaking the Chain of Hospital Associated Infection

With the outbreak of antibiotic resistant infections, infection control is becoming a major concern for health organisations all over the world (DoH, 2003). Generally between 4 and 10 % of patients hospitalized in a more economically developed country, such as the USA, the UK or Australia, develop a hospital associated infection during their time in hospital (DoH, 2003). Currently an estimated one in ten NHS patients will contract a healthcare association infection whilst staying in an NHS hospital thus giving the UK one of the highest rates of healthcare associated infections in the western world (DoH, 2003). As well as significantly raising healthcare costs and lengthening hospital stays, it is estimated that hospital associated infections cause 25,000 patient deaths every year (Borton and McCleave, 2000).

 The Department of Heath (2003) recognises that the use of invasive medical devices is one of the strongest factors that increase the risk of contracting a Healthcare associated infection. This is supported by figures which suggest that 80% of healthcare associated urinary infections are caused by urinary catheters and 60% of healthcare associated infections of the blood can be traced to intravenous feeding lines and other such invasive devices (DoH, 2003). It also recognised that a patient’s age, underlying medical condition and the length of their hospitalisation also increases the risk of the patient contracting a hospital associated infection (Borton and McCleave, 2000).

Although these facts and figures may seem daunting, the situation can be improved by implementing a number of simple measures to break the chain of infection and prevent hospital associated infections occurring.

For a nosocomial (healthcare associated) infection to occur there must be a susceptible host, an infectious agent and a means of transmission from the source of the infectious agent to the susceptible host (Huband and Trigg, 2000). If any of these components are not present the chain of infection is broken and an infection can not occur (Mallik et al, 1997). The aim of this essay is to discuss the measures in place to break the chain of infection whilst evaluating the problems of implementing the various techniques in practice.

The susceptible host is perhaps the hardest part of the chain to control since patients are generally admitted to hospital as a result of an illness or injury which often leaves them more vulnerable to infection. As well as patients who are immunologically compromised because of illness or injury, there are also patients who are more vulnerable just because of their circumstances. The very young (children of a gestational age of less then 32 weeks) are at a high risk because their immune system is not yet fully developed (Huband and Trigg, 2000) and patients undergoing immunosuppressive treatment, or who have an immunosuppressive illness such as HIV, may struggle to fight off infections (Hockenberry et al, 2003). Although this means that there will almost always be a susceptible host present, there is still a lot healthcare professionals can do to protect vulnerable patients. Measures are in place to assess each patient individually to uncover their needs and equip nurses with the correct information to produce a protective care plan.

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During my time on placement I assisted with the care of a very premature baby who had contracted an infection whilst recovering from lengthy operation. A new care plan was produced which included a recommendation to move the infant into a side room, as recommended by the Leeds Teaching Hospitals Trust policy for infection control in suspected gastrointestinal infections (2000). Isolating the patient helps to prevent the transmission of the infectious organism to any of the other children whilst also providing an extra barrier to help to protect the patient against any other strains of infection that other children ...

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