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The scholarly article that I chose is “Nosocomial infections in the ICU” by Stuart Edwardson and Chris Cairns. The article is about what are the major common infections that patients get during hospital staying period and the prevention methods. The major ones are ventilator-associated pneumonia (VAP), central line associated blood stream infection (CLABSI), urinary catheter related infection (CA-UTI), and surgical site infection. Due to all of these are invasive device procedures, they are highly likely to get nosocomial infections. Nosocomial infection means “all infections acquired between 48 hours after hospital admission and 3 days of hospital discharge.” (Edwardson and Cairns, 2018) The common resistant bacteria found in ICU are MRSA, VRE, and MDR gram negatives (Edwardson and Cairns, 2018). To prevent these infections, the most effective method is to do appropriate hand washing technique. The poor hand hygiene technique provides 40% of all hospital acquired infections, so just by washing hands properly would decrease the infection rates. In order to decrease the percentages of infection in the hospital, the care bundle is produced for the infections that are related to invasive procedures (Edwardson and Cairns, 2018).

            For the VAP, about 15% of patients in ICU gets infected. The risk factors are over 70 years old or more, lung disease, neurological deficit, and aspiration.( Edwardson and Cairns, 2018) The preventing care bundle steps are elevating the head of the bed 30-45 degrees, daily sedation holds, weaning plan, chlorhexidine oral care, stress ulcer prophylaxis, and venous thromboembolism prophylaxis. Other preventing methods are using non-invasive ventilation, endotracheal tubes, and selective decontamination of the digestive tract (SDD). For CLABSI, patients with burns, immunosuppression, malnutrition, and those receiving TPN are highly likely to get this. The bacteria can attach to the catheter due to its covered by plasma proteins including fibrin. If there is infection, then central line should be removed asap. The management should be focused on culture sensitivities such as broad-spectrum beta lactam, empirical fluconazole therapy, glycopeptide antibiotic, echocardiography. Also, watch out for asepsis would prevent CLABSI (Edwardson and Cairns, 2018). The care bundle for CLBSI are trained operator, written record of procedure, surgical scrub, maximal sterile barrier precautions (hat, gown, gloves, mask), aim to avoid femoral insertion site if possible, skin asepsis with 2% chlorhexidine in 70% isopropyl alcohol and allow this to dry prior to skin puncture, use a sterile, transparent, semi-permeable dressing to cover the catheter site(Edwardson and Cairns, 2018). For CA-UTI, the risk factors are for who show UTI symptoms with catheter in it or within the previous 48 hours (Edwardson and Cairns, 2018). To prevent the infection needs a strict asepsis for insertion, aseptic maintenance, regular review and prompt removal of catheters (Edwardson and Cairns, 2018).

            My thought on this prevention method is positive because I have always been wondering how we do not get infected from everything even when a little dust can cause infection. The invasive procedures are dangerous even though we do everything aseptic and trying not to touch any non-sterile fields. What I learned at school was that washing hands would be the first prevention method that would at least prevent any diseases to be transferred to people to people. If everyone follows the care bundle method for invasive procedures, then we could all decrease the infection rates at least in the hospital. There wouldn’t be any second infection happening. Overall, I really liked this article that at least there are method to decrease the infection for invasive procedures and that we can follow these procedures in the hospital for our safety and patients.

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Answer 1

The post in simple completely describes about the importance of hand washing in prevention of nosocomial infection like MRSA,VAP, CLABSI,CA-UTI. These infections occured after 48 hours of admission or after 3 days of discharge. The care bundle was introduced to reduce the rate of infections. Along with this the preventive methods and measures were initiated to reduce the VAP ,CLABSI in the patient who are admitted in hospital.