Summary
Preventing nosocomial infections proves to be a challenge, especially for health practitioners, due to the issue of them developing later after admission. Nosocomial infections are not present when a patient is admitted. The threat of these infections, which makes it essential to implement the right preventative strategies, is the development of severe health complications and even death in patients with only mild symptoms. The recommended prevention approach relies on the effective preparedness of the medical staff (Edwardson & Cairns, 2019). The main aim of preventing nosocomial infections is to implement a standard institutional procedure employed by all departments in the facility. The following are the objectives that will help guide the proposal:
- To identify the risk of nosocomial infections in patients acquiring severe health complications that may lead to death.
- To identify the high-risk groups at risk of nosocomial infections to develop interventions meeting their specific characteristics.
- To identify the personnel at the frontline of introducing nosocomial infections and develop strategies preventing them from being predictors of these infections.
The healthcare facility is responsible for developing or regulating infection control measures to reduce endogenous and exogenous transmission of nosocomial infections. Exogenous transmissions occur in interactions involving two or more people (Rahman et al., 2019). This may be the patient and the doctor or between two or more patients. As a result, environmental cross-contamination occurs. Such interactions occur daily in healthcare facilities, meaning many patients are at risk of contracting nosocomial infections. Therefore, preventions need to identify this risk and address it effectively. Implementing an effective hand hygiene policy is an excellent way to start. Pathogen transmission is standard during such interactions, and introducing hand hygiene policies across all departments, personnel, and patients using the facility can help limit their spread.
The second approach should consider the threat of a disease or condition an admitted patient is diagnosed with. This step helps the facility embrace the use of personal protective equipment. As mentioned earlier, the goal is to limit the spread of a pathogen from an infected patient to another patient. Since doctors and other practitioners may interact with patients frequently, such pathogens spreading are very high. However, if the practitioners use PPEs frequently, these probabilities are limited. Therefore, the third step would require the implementation of mandatory isolation for patients with severe and contagious complications (Kaur et al., 2020). Interaction should also be limited only to key personnel equipped with the right gear. Finally, implementing proper aseptic or sterile handling techniques while inserting or maintaining indwelling devices, such as disinfection and waste management, can be implemented later. The following table illustrates the timeline for completing these interventions.
Table 1 Interventions for the prevention of exogenous nosocomial infections with their risk levels and timeframe
The subsequent interventions are meant to prevent endogenous nosocomial infections. These infections arise from improper or excessive use of spectrum antibodies, leading to the development or growth of other infections (Rahman et al., 2019). The chances of these infections occurring are very limited. However, it is essential to implement an effective intervention to prevent the onset of nosocomial infection. For instance, if a patient is given vancomycin in excessive doses, they are likely to contribute to a change in the patient’s average bacterial flora balance, resulting in overgrowth in a given bacteria. Such infections are nosocomial since they can transfer from one part of the body to another or through the patient’s immune system in light of current events like chemotherapy and malnourishment. The appropriate intervention, in this case, would be the use of the correct antimicrobials with the suitable duration, dosage, and agent. The risk of such infections is also high, and the intervention needs to be implemented three or four days after a patient’s admission.
These interventions need to be implemented in the specified order and adherence to the timeframe. Follow-up strategies around identifying whether the hospital has succeeded in reducing the prevalence of nosocomial infections on a larger scale should be carried out. For instance, the facility can check whether regular surface disinfection, staff restriction, and minimized movement of sterile objects are embraced in surgical sites. This observation can compare the current nosocomial infections with previous infections. If the numbers are low, it would mean that the interventions were effective. However, this would only be possible if team members have a typical inclination to achieve the goals. The roles and responsibilities of the team would include overseeing whether other personnel are following the same procedures, ensuring that all equipment is properly sterilized and stored, and following up with surgeons to ensure that surgical techniques are effective.
Measurable Indicators and Change Factor
The measurable indicators promoting the success of the proposed interventions include reduced death rates due to reduced nosocomial infections, increased life expectancy, and reduced infant and maternal mortality rates. These indicators identify the high-risk groups and provide measures to assess the efficacy of an intervention. For instance, practitioners need to evaluate how patient outcomes have been influenced once the recommended interventions are used. Suppose a hospital recorded increased infant or maternal mortality rates before introducing an intervention. When calculating the new rates, the same factor should be considered and illustrate whether it has reduced or increased. This strategy will also act as the change factor to illustrate improvement. For instance, if there are reduced infant and maternal mortality rates before an intervention is introduced, the facility can record an improvement. The change, in this case, will be the implementation of the proposed interventions.
References
Edwardson, S., & Cairns, C. (2019). Nosocomial infections in the ICU. Anaesthesia & Intensive Care Medicine, 20(1), 14-18.
Kaur, R., Weiss, T. T., Perez, A., Fink, J. B., Chen, R., Luo, F., Liang, Z., Mirza, S., & Li, J. (2020). Practical strategies to reduce nosocomial transmission to healthcare professionals providing respiratory care to patients with COVID-19. Critical Care, 24(1), 1-13.
Kollef, M. H., Torres, A., Shorr, A. F., Martin-Loeches, I., & Micek, S. T. (2021). Nosocomial infection. Critical Care Medicine, 49(2), 169-187.
Rahman, M. R., Perisetti, A., Coman, R., Bansal, P., Chhabra, R., & Goyal, H. (2019). Duodenoscope-associated infections: Update on an emerging problem. Digestive Diseases and Sciences, 64(6), 1409-1418.