Impact of Policy on Practice

A 3000 word analysis of a critical incident related interprofessional delivery of health and/or social care which demonstrates ability to set the situation in context.

Word Count: 2,846

Contents Page

Page 1---------------------------------------------------------------Title Page

Page 2---------------------------------------------------------------Contents Page

Page 3 - Page 10---------------------------------------------------Main Body

Page 11 - Page 14-------------------------------------------------References

Page 15--------------------------------------------------------------Appendix "A"

Page 16--------------------------------------------------------------Appendix "B"

Page 17--------------------------------------------------------------Appendix "C"

The following assignment will analyse an incident observed in a clinical setting it will relate the impact of local, national and international policies in relation to the given incident. The use of a PEST analysis tool as shown in Marketing Teacher (2008) (Appendix "A") will be used to analyse the incident and explore the particular factors which are political, economic, sociocultural and technological. The assignment will also show the impact of the incident to patients and professionals if it had been different. The legal issues have been addressed in this assignment as it will at all times adhere to the NMC code of professional conduct: standards for conduct, performance and ethics (2004, paragraph 5.1) which states that all information must be kept confidential, so therefore names and places have been changed to this affect and trust policies will be anonymised.

The incident described was observed within a placement area on a ward which shall be known as Hope ward, which is a day surgery unit within a hospital. A nurse who shall be referred to as Helen and the student were completing the Lewisham observation tool (LOT) as shown within National Patient Safety Agency (2007) (Appendix "B") which is a tool used to complete a hand washing and hand hygiene audit. During this audit Helen and student sat down for twenty minutes and observed the health professionals and other people in the room to see whether or not they used the opportunities available to wash their hands. Using the LOT the health professionals observed by Helen and the student within the clinical area used every given opportunity to wash or sanitise their hands using either soap and water or the alcohol gel. On the ward was a patient who shall be called Carol who was receiving Infliximab which is an intra-venous medication used to treat auto-immune disorders, Carol was receiving it for Crohn's Disease. Special care must be taken when treating any patients receiving Infliximab as they are extremely susceptible to infections. During the twenty minutes observation period a member of the public entered the clinical area and did not sanitise their hands the staff nurse on duty who shall be referred to as Sylvia saw this and asked them politely to use the alcohol gel provided at the end of the ward to clean their hands before they came into contact with Carol. At the end of the twenty minute time period the hand washing audit was completed with a perfect 100% compliance level.

Infection control is a very vast subject it incorporates many different factors from hospital cleanliness to hand hygiene. The aspect to be focused upon primarily within this assignment will be that of hand hygiene.

Political Factors

There are various international policies regarding infection control and hospital acquired infections (HAI). The World Health Organisation (WHO) (2006) produced a publication for guidelines on hand hygiene as part of the "Global Patient Safety Challenge 2005-2006: Clean care is safer care". Within the global consensus guidelines it is recognised that hand hygiene is a worldwide issue that needs to be addressed by each country through

"Staff education and motivation, adoption of an alcohol-based hand rub as the primary method for hand hygiene, use of performance indicators, and strong commitment by all stakeholders, such as front-line staff, managers and health care leaders, to improve hand hygiene."

(WHO, 2005)

The WHO (2008) have also produced a statement of aims in response to the prevention of infection in health care which sets out a list of objectives to subsequently assist all member states with assistance on fighting the infection epidemic. There has been a recent long term strategy developed for the surveillance of communicable diseases (European centre for disease prevention and control, 2008) which will endeavour to reduce the incidence and prevalence of communicable diseases in Europe.

The need for effective infection control within the National Health Service (NHS) at present derives from a number of different mediated incidents that have occurred in the NHS over the past few years. The main two infection incidents are the clostridium difficile (C.Diff) cases and deaths at Maidstone and Tunbridge Wells NHS Trust for which the investigation report (Healthcare Commission, 2007) document has been constructed and the outbreaks of Meticillin-resistant Staphylococcus aureus (MRSA) within the NHS. Through these incidents the pressure on the New Labour government has been immense with the public demanding for better infection control within the NHS to eradicate these potentially life threatening infections. The article (Mail Online, 2007) (Appendix "C") is an example of one of the many media reports on the infection control risks in the NHS hospitals. In response the government has introduced legislation the most recent of which is still under construction and introduced into parliament in 2007 the Health and Social Care Bill (Great Britain. Parliament. House of Lords, 2007) this bill aims to create one regulatory body for all health and social care called the "Care Quality Commission" which holds greater enforcement powers in infection control. The bill also updates the statute (Great Britain. Public Health (Control of Disease) Act 1984) with the aim of providing a more effective and proportionate response to infectious diseases. The statute (Great Britain. Health Act 2006) developed certain aspects of the law (Great Britain. Health and Social Care Act 2003) in regards to the previous inspection regulatory bodies. Within the statute (Great Britain. Health and Social Care Act 2003) a regulatory body known as the "Commission for health care audit and inspection" had been developed to oversee the general running of the NHS but did not incorporate any specifics about infection control. Whereas the law (Great Britain. Health Act 2006) specified on a code of practice relating to prevention and control of health care associated infections.
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With so much pressure placed on the government about the importance of infection control from an international level and that of the media and public, a new local policy Healthier people, excellent care: A Vision for South East Coast (South East Coast NHS, 2008) aims that by 2011 there will be no avoidable cases of MRSA and less than 2,000 cases of C.Diff. It is influenced by national policies such as Our NHS, Our future: NHS next stage review- Interim report (Great Britain. Department of Health, 2007) and the Health and Social Care Bill (Great Britain. Parliament. House ...

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