Question

iscuss the needed short-term and long-term goals needed to be achieved in order to accomplish lowering hospital acquired infections

Answer 1

Hospital Acquired Infections (HIA) or Nosocomial Infections are a great threat to patients undergoing treatments in hospitals. Getting infection from the hospital is the most dangerous situation in the health care industry. Unfortunately, many nosocomial infections are happening throughout the world. Microorganisms may enter into a patient's body via a surgical wound, a catheter, a ventilator, or during some invasive procedures. A medical device, a bed rail, a bandage or a caregiver’s hands etc. may be contaminated with pathogens and can act as a source of infection. Each health care personnel are responsible to prevent the occurrence of HIA.

Hospital Acquired Infections can be prevented by establishing short term and long term goals.

Long term goal:

The long term goal is the Zero - Incidence of Hospital Acquired Infection. The ultimate goal is to prevent all the occurrence of nosocomial infections and provide a risk-free environment for the patients. 100,000 Lives Campaign was the first campaign started in 2005 and then the 5 Million Lives Campaign has targeted for prevention and reduction of three HAIs; ventilator-associated pneumonia (VAP), central line-related bloodstream infection (CLRBI), and surgical site infection (SSI).

Short term Goals:

In order to achieve the long term goal, each health care institutions should make short term goals and should strictly adhere to it. The short term goals can be as follows;

1. Strict adherence with hand washing protocol. Follow the World Health Organization's five moments for hand hygiene. i.e: before touching a patient, before doing aseptic procedures, after body fluid exposure, after touching the patient and after touching the surroundings. Always perform the hand washing technique as per the guidelines. Wash with soap and warm water and then use antiseptic spray or solutions if there was exposure to any body fluids or contaminated surfaces.

2. Daily cleaning of all the medical equipment and devices including stethoscope with antiseptic solution or alcohol.

3. Follow aseptic technique for procedures like the insertion of I. V. canulas and other catheters. Thorough disinfection of skin shall be done before insertion.

4. Wear gloves, protective gowns, and masks whenever necessary. Hand washing should be done before and after wearing gloves also.

5. Identifying patients at risk of nosocomial infections like old aged people, newborns and pediatric patients, patients with burns, patients undergoing chemotherapy, patients on immunosuppressant drugs, Immunocompromised patients (Eg: HIV patients). Immunodeficient and Transplant recipients are at a higher risk of nosocomial infections. Recognizing higher risk patients will help to practice extreme caution while caring for them.

6. Isolation of the patient if necessary. Prevention of visitors having flu symptoms or other sickness is important. Those who are visiting should wear masks and hospital gowns. Instruct to wash hands before and after visiting the patient.

7. Organize an Infection Control Team in order to monitor the health care providers for their adherence with the infection control protocol and procedures.

8. Training of new employees and continuing education for the existing employees on infection control practices and guidelines.

9. Proper segregation of contaminated and noncontaminated wastes and proper disposal strategies.

10. Proper architectural layout like good room ventilation, tightly closing doors in isolation rooms etc.

11. Instructions to use antibiotic prophylaxis selectively in order to avoid drug-resistant organisms which may cause nosocomial outbreaks, like MRSA  (Methicillin Resistant Staphylococcal Aureus) outbreak. Close coordination among all the teams involved in the treatment is very essential.

12. Make a protocol to report any negligence from the employees in infection control, which shall be considered a serious violation necessitating disciplinary actions.

13. Prepare an action plan to handle any outbreaks, if occurred irrespective of all these measures.