Prevention of nosocomial infection is an intervention developed and implemented to curb the spread of infections in a hospital setting. The intervention was formulated in the early 1950s, and hospitals recognized and implemented it in the early 1960s. The main aim of this program was to focus on healthcare-associated infections, introduce basics, and expound on the risk factors. However, the outcomes of the program was not felt since it was organized and managed by private academic settings instead of public agencies. In the 20 th century through policy changes, more emphasis was placed on the condition. The main purpose of the revitalized program was to prevent and minimize the risk of contracting infections in the hospital. Prevention and reduction could be achieved by implementing isolation, surveillance, management of outbreaks, a clean environment, educating the patients, and implementing the policies of infection prevention.
The primary focus of the infection prevention program is to prevent and stop the transfer of infections depending on the micro-organism involved. On that note, Mehta et al. (2019) developed precautions based on the condition of the patient. For general patient care, hand washing, personal protection, cleaning and disinfecting equipment used on the patient, injecting safely, and disposing of needles and other sharp instruments are precautions that should be considered. For patients who have conditions that can be transmitted through contact, it is essential to consider standard precautions. The spread can be contained by limiting the movements of the patient, using disposable equipment, and exhaustive cleaning and disinfecting equipment. Also, patients who have or are suspected of having conditions that can be disseminated via air droplets through coughing, sneezing, or talking can be controlled by providing the patient with a facial mask and limiting movements of clients. Finally, patients with conditions that can be transmitted by air should be isolated as well as maintaining the other standard precaution measures.
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Mehta et al. (2019) also point out that a hospital must have essential materials to implement the infection control precautions for every patient in their facility. The primary precaution of preventing the transfer of infection is hand washing. To achieve this, soap and warm water must be provided or alcohol or non-alcoholic hand sanitizer. Gloves are also necessary equipment in preventing hospital-based infections. Currently, the safety standards require that gloves are used on a single patient. Other necessary equipment include facial masks and wearing gowns while entering the patient’s room. Regular disinfection of the floors and proper handling of a patient’s linen is necessary to control hospital-based infections.
According to Gilbert & Kerridge (2019), health care facility should also have a well-structured committee that develops and ensure implementation of an infection control program. The committee should include infection prevention experts, epidemiology personnel, and a committee. An epidemiologist is a physician who has specialized in infectious disease. His/her role is to meet with the administrators and head of departments and discuss their responsibilities in infection prevention, what is expected, and how available resources should be utilized. An infection prevention expert is a registered nurse who has an overview of the nursing practices, epidemiology, and basic knowledge of microbiology. The infection control committee is vital in formulating and facilitating the implementation and maintenance of infection prevention policies.
Storr et al. (2017) explain that a successful infection prevention program should address areas such as surveillance, isolation, investigating, managing outbreaks, continuous education, environmental hygiene, and antimicrobial resistance. According to Storr et al. (2017), surveillance is the process of assessing the rate of infection in the hospital. At this point, the hospital target areas where infections can be transmitted easily. These include surgical units, intensive care units, and oncology centers. However, public health authorities have made it necessary to survey the whole hospital. The hospitals took up this change due to the extensive use of technology in the health care system. The electronics help the service providers to identify patients who are at a higher risk of contracting nosocomial infections.
Isolation is the act of separating a patient who is suffering from a contagious disease from the general patient population (Storr et al., 2017). The isolation process is tailored to prevent the spread of micro-organisms from infected patients. The process is expensive and consumes much time, and it is only used when there is a need. Assessing the need and the type of isolation required by the patient is essential. The standard precautions provided by the Healthcare Infection Control Practice Advisory Committee encompass handwashing, safe needle disposal, and personal protection (Storr et al., 2017). These precautions are essential in preventing the transfer of diseases from one patient to another.
Investigating and managing an outbreak is also an essential area in the infection control program. An outbreak can be identified during the surveillance process. Cluster infections reported by lab technicians should be further probed to confirm if indeed there is an outbreak. The leading cause of an outbreak is direct or indirect contact with multi-drug resistant micro-organism (Storr et al., 2017). Therefore, investigations are critical in preventing the spread of a contagious ailment.
Educating healthcare providers is essential to improving disease prevention knowledge. This can be done through workshops and seminars to increase medical practitioners’ understanding of the prevention of nosocomial infections. On the other hand, the hospital can appoint healthcare personnel who will be tasked with the mandate to disseminating information to all workers of the facility about the prevention of infection transmission.
Wang et al. (2019) posit that antimicrobials are widely used medications in both inpatient and outpatient settings. A facility should develop and implement an anti-microbial stewardship program to reduce antibiotic resistance, improve the quality of healthcare delivered, and at a cheaper cost. The program should assess the susceptibility of an antibiotic to help in evaluating the resistance patterns of the new antibiotics. An active antibiotic stewardship program includes restricting prescriptions while a passive program involves the provision of susceptibility reports, education, and guidelines.
According to Dekker et al. (2019), a ll inpatients are susceptible to contracting a hospital-based infection. Therefore, cleaning the environment is emphasized. Traditional methods of decontamination are inadequate. Thus, steaming, sterilization, disinfection, and using automatic disposal systems are effective in reducing the dissemination of infections. Implementing this requires the combined efforts of healthcare professionals, public health personnel, architectures, and engineers.
Wholesomely, infection control can be understood as the process of minimizing the spread of nosocomial infections. Nurses play an essential role in identifying and preventing hospital-based infections. Their role is to recognize and isolate ill patients, practice prevention strategies such as hand hygiene and safety needle disposal, collect and analyze data on the incidence of the healthcare-associated infections, assess the impact of a prevention strategy, and also serve as educators to the community about nosocomial infections, tuberculosis, and HIV/AIDS. The hospitals should also provide adequate equipment required to control the spread of infections. Clinical-based results show that an effective infection control program results in minimum infection rates and a lower risk of multi-resistant drug microbes developing. The articles were helpful, and therefore utilizing the information daily will help to control the spread of hospital-based infections in healthcare facilities. In this regard, the information provided in this literature review contribute to the already existing body of research.
References
Dekker, M., Jongerden, I. P., van Mansfeld, R., Ket, J., van der Werff, S. D., Vandenbroucke-Grauls, C., & de Bruijne, M. C. (2019). Infection control link nurses in acute care hospitals: a scoping review. Antimicrobial resistance and infection control , 8 , 20. https://doi.org/10.1186/s13756-019-0476-8
Gilbert, G. L., & Kerridge, I. (2019). The politics and ethics of hospital infection prevention and control: a qualitative case study of senior clinicians' perceptions of professional and cultural factors that influence doctors' attitudes and practices in a large Australian hospital. BMC health services research , 19 (1), 212. https://doi.org/10.1186/s12913-019-4044-y
Mehta, Y., Gupta, A., Todi, S., Myatra, S., Samaddar, D. P., Patil, V., Bhattacharya, P. K., & Ramasubban, S. (2017). Guidelines for prevention of hospital acquired infections. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine , 18 (3), 149–163. https://doi.org/10.4103/0972-5229.128705
Storr, J., Twyman, A., Zingg, W., Damani, N., Kilpatrick, C., Reilly, J., Price, L., Egger, M., Grayson, M. L., Kelley, E., Allegranzi, B., & WHO Guidelines Development Group (2017). Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations. Antimicrobial resistance and infection control , 6 , 6. https://doi.org/10.1186/s13756-016-0149-9
Wang, J., Liu, F., Tan, J., Harbarth, S., Pittet, D., & Zingg, W. (2019). Implementation of infection prevention and control in acute care hospitals in Mainland China - a systematic review. Antimicrobial resistance and infection control , 8 , 32. https://doi.org/10.1186/s13756-019-0481-y
