Despite the advances made in Oncology care, infections from healthcare settings and the community settings are the primary cause for hospitalization and deaths among cancer patients receiving chemotherapy. Oncology patients are those who have or are suspected to be having cancer. These patients may contract transmissible infections due to the frequent contact with healthcare facilities where there are patients with other ailments. Similarly, cancer patients require intravascular devices such as implanted ports that are placed long-term to ease the chemotherapy infusion. However, these devices if not disinfected properly, they can predispose the patients to microorganisms that cause infections. Patients with cancer are usually immunosuppressed, and they are at the risk of contracting opportunistic and healthcare-related infections. These patients in most cases suffer from Neutropenia. It is a condition characterized by low white blood cells count. For this reason, a good infection preventive program should be put in place to reduce the risks of infections arising from the community or within the hospital. Evidence-based research, patient teaching, and practice have indicated that nurses have a significant role in addressing the risks of infection and managing the infections contracted by individuals living with cancer. Careful attention and proper infection measures should be put in place to minimize the chances of cancer patients from contracting diseases. This research paper seeks to discuss the measures of preventing infection contracted by cancer patients, healthcare practitioners and visitors to the patients.
Strategic Plan in the prevention of oncological infections
Healthcare care centers as well as clinicians should contact a contact a SWOT analysis before choosing a change of action (Baden et al., 2016). For example, they should ascertain their capability of handling cancer patients by evaluating the infrastructure as well as personal they have. Furthermore, before adapting a course of action, they need to also evaluate the strength of the solutions they come up with. This change model will also help healthcare providers to identify their weakness and come to a conclusion of weather their institutional weaknesses can affect their line of duty. Consequently, given that the wish of all healthcare givers is treating their patients, SWOT analysis is significant to clinicians in that it does not only raise the status of their facility as the best hospital for treating cancer but also, they shall be able to select the most effective strategies for treating cancer patients. Lastly, before implementing a course of action when treating the cancer patients, health practitioners need to ascertain the threats they pose to their cancer patients, clinicians and the society at large. Below are the strategies used in preventing infections by oncological patients.
Delegate your assignment to our experts and they will do the rest.
Hygiene
Proper hygiene is critical in the prevention of adventitious infections among cancer patients, especially patients with immunosuppression. Healthcare givers should conduct a regular skin inspection exercise to sites with high risks of infections such as perineum and intravascular catheters. The expert recommendation includes avoiding used tampon by the recipients of hematopoietic as well as avoiding rectal thermometers, digital rectal examinations, suppositories, and enemas to prevent a mucosal breakdown during neutropenia. It is recommended that patients, especially those who are critically ill should use chlorhexidine for bathing to control the multidrug-resistant organisms that cause infections (Sandherr et al., 2015).
Secondly, given that the mouth is an essential target for pathogenic bacteria, proper oral hygiene is recommended. Intense oral examinations accompanied by treatment should be carried out before the treatment of neck and head cancers as well as high-dose chemotherapy, and other cancers that cause immunosuppression (Baden et al., 2016). Regular oral hygiene is recommended for healing of microsites and minimizing infections such as pneumonia. Neutropenia patients should use normal saline or sterile water 4-5 times per day for performing oral rinses. Patients ought to be brushing their teeth regularly to minimize gingival trauma.
Furthermore, hand hygiene has also been cited as an effective method of preventing the transmission of infections. Though it has been mentioned as a practical measure, medical practitioners often forget to wash their hands before and after coming into contact with cancer patients. Furthermore, given that some of the oncology patients are outpatient, nurses should educate them about the need for maintaining hand hygiene not only for themselves but also for their close contacts (Sandherr et al., 2015).
Low Microbial Diet
In an effort of preventing infections among cancer patients, they are also required to take low microbial diets. During the periods of neutropenia, many cancer centers prescribe hematologic malignancies to their patients. Minimizing the exposure to microbes in foods such as raw fruits and vegetables, undercooked meat and unpasteurized beverages, during neutropenia decreases the chances for adventitious infections. Patients should also choose to drink bottled water as it is free from Cryptosporidium (Baden et al., 2016).
Device-Associated Infections
Given the unique requirements of patients with cancer, intravascular catheters, especially the implantable or tunneled catheters are used regularly for controlling infections. It is useful given that it provides continuous access for regular blood infusion, draws of blood products and chemotherapy. For this reason, these patients are prone to infections as well as catheter-related complications (Bailey et al., 2016). The use of non-tunneled central catheters is the common cause of Catheter-related infections. However, no Catheters are without risks. Though not often feasible, the best way of preventing catheter-related infections is by minimizing the use of the catheter. Though there is limited information about the frequency of using catheters for urinary tract related infections by cancer patients, it is of great help for patients with requiring urinary catheterization. Precautionary measures of this technique should be followed keenly. For instance, it should be removed when not needed, and aseptic technique should only be used during insertion.
Central Venous Catheter Care
Central Venous Catheter (CVC) refers to the infections of the bloodstream that are more prevalent among patients with cancer. The meticulous intervention of CDC can help in preventing related infections. Before contacting CDC care, nurses are required to observe hand hygiene. They should put on sterile gloves or clean their hands before changing the CVC dressing. The treatment site ought to be disinfected with 2% of chlorhexidine. Consequently, an iodophor, the tincture of iodine should be used in an occasion where there is the contraindication of chlorhexidine. Either a semipermeable or a sterile, dressing can be used for covering a site for catheter (Sandherr et al., 2015).
Sutureless securement devices are used for reducing infections in peripheral inserted catheters cases. In situations where patients are diaphonic or if the site for the catheter is oozing, a transparent or semipermeable dressing may be preferred. It should be noted that a dressing that becomes loose or soiled should be changed. Given that the Catheter is not supposed to get in contact with water, patients should be protecting the impermeable CVS site when they shower. Notably, also, administration sets are not to be replaced more regularly than 72-96 hrs. It is advisable that they are used for up to 7 days. However, tubing used in the administration of blood, blood products, and lipids should be replaced daily (Baden et al., 2016).
Education and Training
All staff in health centers should receive appropriate education and training relating to the reduction of infections in cancer patients. Education should be given during the orientation of new employees and also when new policies are introduced. Also important to note, competency evaluation should be contacted regularly to assess the competency of nurses and other health workers in the prevention of infections (Levine et al., 2017).
Standard Precautions
All staff in healthcare facilities should adhere to precautionary measures such as; observing hand hygiene, using protective gear, coughing etiquette, disinfecting contaminated equipment and safe injection practices. Precautions for preventing infection in the healthcare facilities are stated in the BICAPP. For example triaging patients as they enter the facility should be adhered to, especially in situations where there is an increase in the community respiratory virus (Baden et al., 2016).
Control of Respiratory Viruses
Common community respiratory viruses can cause disease, morbidity and even mortality among the cancer patients. Given that viruses can spread fast, significant efforts should be put into place to control the spread of infections in healthcare facilities and even households. Respiratory infections are commonly caused by influenza viruses, syncytial viruses, parainfluenza viruses, human metapneumoviruses, rhinoviruses, and adenoviruses. Studies have indicated that nearly half of patients with cancer are infected with the community respiratory viruses which put them at the risk of contracting pneumonia which contributes to 50% of deaths recorded by patients with cancer (Al-Niaimi et al., 2015). Given that most of the viruses cannot be adequately treated, prevention is therefore essential. Vaccination can also be used for preventing infections. Frequent hospital surveillance should also be carried out to diagnose and implement preventive measures before the spread of infections. Notably, patients exhibiting acute respiratory infections during the winter season should be placed on droplet and contact precautionary measures until when a diagnosis has been made.
Immunizing Healthcare Practitioners
Health practitioners are in great danger of contracting infections because they are exposed to risk factors. Some of the infections they are exposed to are vaccine-preventable diseases. For this reason, live-attenuated vaccines are used for the health workers who come into contact with immunosuppressed patients. In some cases also, frequent guests of the patients should also be vaccinated to protect them from contracting infections as they interact with patients with cancer (Baden et al., 2016).
Conclusion
In summary, we have laid focus on the infection measures that are applicable to the healthcare personnel, visitors at the Cancer Centre and more importantly the patients, highlighting the vital issue of surveillance and implementation of preventive remedies to reduce the risk of exposing more patients to bacteria, community respiratory viruses, fungi, and infectious pathogens. However, healthcare providers should contact a SWOT analysis before they come up with workable solutions for preventing infections among cancer patients. By doing so, they need to evaluate the strengths of their facility by evaluating if it has adequate infrastructure and personnel to handle the treatment of cancer. Consequently, they shall be able to assess the failures and opportunities of every solution to the facility as well as the patient. Lastly, before implementing the preventive strategies, nurses will be in position to ascertain the dangers associated with their choices.
References
Al-Niaimi, A. N., Ahmed, M., Burish, N., Chackmakchy, S. A., Seo, S., Rose, S., ... & Connor, J. (2015). Absolute postoperative glucose control reduces the surgical site infection rates in gynecologic oncology patients. Gynecologic oncology, 136(1), 71- 76.
Baden, L. R., Swaminathan, S., Angarone, M., Blouin, G., Camins, B. C., Casper, C., ... & Greene, J. N. (2016). Prevention and treatment of cancer-related infections, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network, 14(7), 882-913.
Bailey, H. H., Chuang, L. T., DuPont, N. C., Eng, C., Foxhall, L. E., Merrill, J. K., ... & Blanke, C. D. (2016). American Society of Clinical Oncology statement: human papillomavirus vaccination for cancer prevention. Journal of Clinical Oncology, 34(15), 1803-1812.
DiSaia, P. J., Creasman, W. T., Mannel, R. S., McMeekin, D. S., & Mutch, D. G. (2017). SPEC-Clinical Gynecologic Oncology. Elsevier Health Sciences.
Levine, D. R., Mandrell, B. N., Sykes, A., Pritchard, M., Gibson, D., Symons, H. J., ... & Baker, J. N. (2017). Patients' and parents' needs, attitudes, and perceptions about early palliative care integration in pediatric oncology. JAMA oncology, 3(9), 1214- 1220.
Sandherr, M., Hentrich, M., von Lilienfeld-Toal, M., Massenkeil, G., Neumann, S., Penack, O., ... & Cornely, O. A. (2015). Antiviral prophylaxis in patients with solid tumors and hematological malignancies—update of the Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO). Annals of Hematology, 94(9), 1441-1450.
