Infection Prevention and Control Management: Standard healthcare precautions
Elderly people are particularly more vulnerable to getting sick from infection, therefore, it is important for healthcare staff to work in compliance to organization and government policy to ensure patient safety, in present, hospital-acquired infection is a big concern for healthcare providers as it is increasing cases of morbidity and mobility. Considering the present situation where Covid-19 issue has affected the world it is been identified that organization needs more effective policy and procedure to prevent and control the infection to certify patient safety. Especially, in aged care staff ethical responsibility to work according to prevention and control of infection on community aged care guidelines published by government to prevent the infection in aged care. Staff should have effective knowledge and skills to identify risk and take appropriate action to mitigate those risks, in order to understand this better in this essay we are going to discuss the infection prevention and control practise procedure and policy, and importance of infection control knowledge, safety and cost effectiveness, and how it is significant to respect cultural value and promote diversity. In end, a conclusion relevant to the infection prevention in aged care facilities will be given.
In healthcare, infection control prevent the spread of infection in the organization and in order to do so staff must have knowledge and overview how the infection spread and what are the risk factors to ensure safety of patients and employees. It vital for employer to educate all the staff about procedure and use effective communication skills to monitor staff compliance to the policy. The focus on reducing healthcare associated infection affecting patient’s health is continuous throughout Australia. Government guidelines are identified in relation to patient’s pathway and define practice to ensure safety.
Working in aged care flu and other infections disease are potentially dangerous as the flu can be spread by droplet and coughing and considering Covid-19 disease it is more crucial to take all safety measure to stop the spread of the disease in aged care. in aged care home, outbreak of flu or gastro can start spreading even if only 2-3 people residents in the care get sick therefore its responsibility of employee to act fast to control the spread of infection. The staff must know how to notify the state health department to control the spread of infection and also have efficient knowledge to take safety measures to control infection.
Why the infection management is important
Elderly people with multiple comorbidities living in social care services are at higher risk of acquiring infection because of low immunity and close living proximity within residents and staff (Biswal et ., 2017). In aged care, The Aged Care Quality Standards help in recognising the necessity of minimising the infection related risk to residents, staff and the community through adopting standard and transmission based precaution measure to prevent and control the spread of the infection. Employees in social care must be trained to promote and practice antibiotic prescribing and use to support the optimal care in order to minimise the resistance to antibiotic (Tennant et al., 2020). Antimicrobial stewardship is vital for prevention and control program.
Infection Prevention and control practise procedure and policy.
Prevention and control practice procedure involve following procedure include early detection of infection and taking immediate action to prevent transmission to other people in the care, as soon as infection is suspected it is vital that diagnosis is been sought, and clinical data is been collected to confirm the presence and type of infection. The physical examination should be carried out to collect the vital sign and it is important to use therapeutic skills such as effective communication and active listening skills to ask the resident about their symptoms, reviewing medical history of resident’s previous infection, vaccination status, medicines and predisposing illness can be helpful in early recognition and prevention of the infection.
Considering non-infective causes and observing for new infection sign and symptoms can is helpful as in case of increasing sign and symptoms of infection is been identified diagnostic testing can be carried out to follow up the results immediately and appropriate treatment ca be provided. In many cases there is no typical sign or symptoms of infection in that case there is no need of microbiology and other tests but documentation and communication is important for assessment for sign and symptoms. Aged Care Quality and Safety Commission 2018 and Aged Care Quality Standards provide guidelines and support to aged care employees to ensure quality and safety standards as per these standard hygiene is the most effective means to avoid infection transmission in the resident care research supported by Word Health Organisation the fact that hand hygiene is important and should be performed by staff at right moments to ensure safety, for example, when staff touch a resident or done procedure such as changing a drainage bag or personal care it vital to perform the hand hygiene to stop the transmission of infection. In many cases there are unplanned or incidental contact for instance, hugging, shaking hands, etc. which occur regularly in aged care homes therefore WHO and other government guidelines includes strict implementation of hand hygiene where in homes is not always considered realistic (Mitchell et al., 2019). Core elements of hand hygiene must include a provision of alcohol based sanitizer educating staff, colleagues, visitors, and residents.
Intervention for preventing the infection include number of strategies such as minimising the risk factors of infection and take transmission based precautions, elderly who are at higher risk of having an infection should be identified. There are different risk factors why elderly are more susceptible to have infection such as compromised immune system, multiple hospitalisations, immunosuppression due to medications and health conditions, past exposure to antimicrobials, immobility, UTI, social and lifestyle factors such as stress, depression, eating unhealthy food, using toxic substances, etc. The organisation risk factors that can increase the risk of infection transmission are-
- Inadequate infection prevention and control policy
- Untrained staff or staffing deficits, for example, difference in number of resident and staff available to take care (inadequate staff)
- Poor or limited hand hygiene
- Non-compliance to government and organization policies
It is vital that staff practice standard precautions such as –
- Personal hygiene practice
- Hand hygiene, informing residents about the importance of hand hygiene
- Using personal protective equipment
- Safe handling and disposal of sharps
- Ensuring the environment is clean, disinfecting and sterilisation of instrument used in cleaning
- Respiratory hygiene and non-touch technique
- Safe handling waste and transmission based precautions as per standard implemented
There are different ways to minimise the resident exposure to the infection such as recognising care-based contacts and occupant risk factors that escalate the chances of infection transmission (Inns et al., 2018). Reduceand remove the use of intrusive devices where probable such as urinary catheters when no longer needed. It vital that staff work in compliance with standard precautions to improve aged care occupant ability to take part in own hygiene and resist infections. Encouraging and recommending immunisation for elderly such as seasonal influenza, pneumococcal, etc. it is been identified that social and lifestyle factors also play crucial role in managing the infection such as UTI which is very common in elderly, thus, educating employees the nutritional status and fluid intake is right, also, managing stress is vital to ensure healthy mental wellbeing that can be done through involving elderly in community events, using therapeutic skills and active listening skills so that residents can share their concerns more comfortably with staff so that fast action can be taken to ensure wellbeing of residents. Encouraging mobility and moderate level physical exercise can also help in improving immunity and ensuring health and wellbeing.
The most common outbreaks in the aged care setting are respiratory illness, UTI and gastroenteritis therefore it is vital for employees in the setting to access public health guidelines to certifysuitable management of infection transmission (Sluggett et al., 2020). Respiratory disease and gastroenteritis infection transmission can be managed through initiating when unit or facility where resident who are symptomatic can stay for 3-4 days to avoid the risk of transmission to other residents, and visitors. Also, this management strategies should be swiftly instigated, early identification and reporting of the data of residents who are unwell and follow the facility procedure to control the infection consulting with the authorities alerting visitors and starting the transmission based provisions in addition to standard safety measures. Depending on the patients’ health staff can make different referral to general practitioner, microbiologist, pharmacist, public health authority, etc.
Infection control knowledge, safety and cost effectiveness
In aged care the prevention strategies that is been followed are to ensure exemplary practice of standard and transmission based precautions. When controlling the infection there are different ways when staff can identified the risk of infection, as mentioned earlier sometimes the symptoms are visible but in many case there are slow onset of symptoms. In these case monitoring and active listening skills help the workers to identify if the resident has suffering from any type of infection, for instance, fever with lethargy, and fever in absence of any other symptoms, confusion, behaviour change, sadness, stress, falls and functional decline, loss of appetite, constipation, etc. if there are visible signs and symptoms the diagnostic testing should be carried out to identify bacterial or viral infection is suspected or not, also before antimicrobial test the test should be done in timely manner to maintain specimen quality, it is rthe esponsibility of the staff to talk laboratories provider about the handling and storage of the specimens (Houghton et al., 2020), than following up with diagnostic results on time as treatment given will be depending on these results. Also, it is important to ensure in case patient UTI diagnosis there should be typical clinical presentation, and urinary dipstick testing only required when there is typical clinical presentation of UTI (Storr et al., 2017). Documenting the data and communicating the assessment finding is vital to treat the infection in timely and effective manner and ensure the data is been documented in aged care residents health record to prevent and control the infection in future. In case of patient with infection it vital to communicate infection control professionals such as infection disease physician, wound consultant, etc.
Evaluation and reassessment
As mentioned above, in order to effectively prevent and control the transmission of infection it is vital to work in compliance to organization and government policy to ensure hygiene and safety. The effectiveness of the strategies implemented can be evaluated through-
- Monitoring that staff and worker compliance to recommended interventions.
- Observing sign and symptoms and evidence of new infection in the individual resident.
- Effective communication and listening skills to understand resident health and wellbeing
- Monitoring staff for continuing compliance with the organisation’s infection prevention and control policy and procedures (Sari &Sjaaf, 2017).
- Monitoring and reporting factors that might increase the risk of infection for elderly in care
- Ensuring regular documentation of progress in the notes, such as signs and symptoms of infection.
- Resident contributionby ensuring residents are been educated about the spread of infection, how it can affect the health and prevention strategies and encouraging hand hygiene as the easiest and safest way to avoid the infection.
- Workforce knowledge and education is vital when a team member of the clinical team holds the portfolio for infection prevention and control with appropriate training.
- Educating staff and colleague about the importance of controlling infection is vital feedback, formal and informal communication about recognising signs and symptoms of infection and how the team can act appropriately on possible infection outbreak situation.
- Implementation and use of risk assessment is helpful for to team in prevent and control intervention through accurate and descriptive documentation.
How can monitoring be used effectively within infection prevention and control programs?
An effective infection avoidance and control program comprises the effective collection, assembling, examinationand reporting of procedure and consequence data associated with infections. Procedurescomprise, for example, practise of hand hygiene and vaccination compliance. Results may comprisesubstantial organism infections that are unaffected to antibiotics such as vancomycin resistance enterococcus bacteria. Significantly, a observing or surveillance program permitsuseful and timely data that can be shared with other staff and residents in the care, formal and informal communication and regular feedback empowers the stakeholders to be more attentive toward the necessity of preventing the infection and manage their infection more appropriately through interventions that include policies and procedure, education for residents, visitors and workers. Aged care organisation can take part in state wide surveillance program and key data that will be collected and submitted to control infection can be practiced in organisation. The Victorian Healthcare Associated Infection Surveillance Coordinating Centre provides data that comprise information about influenza, zoster, pneumococcal, etc. Vaccinationprocess and compliance among residents, staff, also it provide information about the antimicrobial suggesting practices and referrals process. It is recommended to-
- Increase standardised monitoring modules
- Increasing secure information technology infrastructure
- Collecting, evaluating and reporting scrutiny data in a timely manner
- Setting goals and prompts for change to certify early detection of possible opportunities for enhanced performance of the team
- Providing as essentialskilled infection control and infectious diseases training and assistance.
It’s a ethical responsibility of organization employer to provide in house training for eliminating risk from organization to ensure safety and wellbeing of employee, in regular meeting employer can inform educate about organization policy and how employees can also utilise important resources online that can provide aged care to develop protocols that effective to prevent and control infection, for example, National Health and Medical Research Council 2010 Australian guidelines for the prevention and control of infection in healthcare and Australian Commission on Safety and Quality in Health Care 2018, Australian Aged Care Quality Agency 2018 are some vital resources to support employees to certify safe environment for residents.
The need of respecting the cultural value
It is important to respect cultural values as it helps in reducing health disparities and improving quality of life. It is vital to ensure the organization has diverse staff to meet the need of diverse residents with different beliefs and values. Especially when caring for indigenous community people who don’t like to talk to people outside their community or may hesitate in communicating their needs due to language barrier therefore it's important for aged care workers to use effective communication skills (verbal and non-verbal) and active listening skills as we know much time health-related concern can be identified through communication if the symptom is not visible. Encouraging staff to use therapeutic skills not only helps in educating and encouraging staff about hygiene practice but also encourage them to adopt a healthy lifestyle which can improve their mental and physical wellbeing.
Describe how you will implement and evaluate these changes and take appropriate action
Documentation of data regularly is the best ways to ensure the effectiveness of infection prevention and control measures are done accurately. Direct observation, feedback sharing, reviewing health data, and formal and informal communication is effective in ensuring that the changes are implemented effectively.
Healthcare-acquired infection are a big concern, especially for people who are elderly it is very important that organization has the effective policy and procedure to prevent the transmission of infection among residents and staff by working in compliance to precautions stand all the time. Encouraging hand hygiene, using personal protective equipment, healthy diet, physical activity, respiratory hygiene, environment hygiene, mediation, social distancing, and separating wards for people having flu or infection to ensure safety is vital. In healthcare, it is vital to review patient medical history if anyone is suspected to be at higher risk of infection or have the infection should be encouraged to follow the procedure to maintain well-being but in many cases, the patient is unable to care for themselves such as forgetting to use sanitizer or change cloth, thus, it became vital for staff to monitor residents, use therapeutic skills so that patient feels comfortable to share their concern with them. Using risk assessment is helpful to identify the possible infection risk, consequences, and procedures to mitigate risk, monitoring is helpful in identifying early signs and symptoms and making referrals for tests as soon as the result taking appropriate action, using positive verbal and non-verbal communication skills to comfort the patient, and taking all safety measure to avoid the transmission of the infection. It's the ethical responsibility of organization employees to ensure the facility is safe for residents, visitors and staff.
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