Hospital Infections

Hospital InfectionsTotal Quality ManagementANEST 401 ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ Name: Albatool Ali Aladinan ID: 2180005269 Jeelan Sajer Alenazi ID: 2180003391 Rana Amer Alzeggaf ID: 2180001500 Aldanah Hamad Almarri ID: 2170000638 Instructor: Dr. Bashar Alzghoul Date of submission: 1-12-2019 ContentsIntroduction 3Case study 4Causes of hospital infections1- Patient factor 52- Equipment factors 63- Environment factors74- Staff factor 7 5- Financial factors 86- Practice factors 9SolutionsSolutions for Patient factor 9Solutions for Equipment factorsSolutions for Environment factors: 10Solutions for Staff factorSolutions for Practice factors 11Conclusions 12References 13Introduction Hospital infections are the main source of morbidity and mortality in the hospital environment, and they do not have a link with the original illness that causes the patients to come to the hospital. The infection caused by micro-organisms such as bacteria, viruses, fungi or parasites. In addition, Infection is spread to the patient in the clinical environment in different ways mainly through person-to-person contact. This includes unclean hands, air droplets. Medical instruments such as catheters, lung machines and medical equipment that use from patient to another patient without sterilization providing a way for pathogens. There are many types of hospital infractions and the most common types are bloodstream infection, urinary tract infection, wound infection, pneumonia (lung infection). Another thing, hospitals housing a huge amount of people who are sick and already have weak immune systems so that will increase the rate of infection if the hospital does not have proper infection control procedures and policies. Furthermore, hospital infections increase the period of stay in the hospital, antibiotic-resistant, health care costs, and unnecessary deaths. Hospital-acquired infection (HAI), also known as a nosocomial infection, is an infection that is acquired in a hospital or other health care facility. [1] Infection is spread to the patients in the clinical setting by various means such as health care staff, equipment, environment, and patients. They spread infections by transmission in various ways. First of all, contact transmission, which is divided into two subgroups: direct-contact transmission and indirect-contact transmission. Direct contact transmission occurs when there is physical contact between an infected person and a healthy person. Indirect contact transmission occurs when there is no direct human-to-human contact, transmitted by mites, fleas, ticks, rodents or dogs. [2] Secondly, droplet transmissions, such as coughing, sneezing, talking and during the performance of specific operations, like bronchoscopy. Additionally, airborne transmission, transmit microorganisms include Legionella, Mycobacterium tuberculosis, the rubeola, and varicella viruses. As well, common vehicle transmission such as food, water, medications, devices, and equipment. Also, Vector born transmission, for examples, mosquitoes, flies, rats, and other vermin transmit microorganisms.A study was done by Madani (2002) in King Abdulaziz University Hospital in Jeddah, Saudi Arabia to research MRSA commonness during the time of 1998. Staphylococcus aureus was distinguished secludes from patients in around 292 examples; out of them 111 examples were MRSA (38%). About 74.8% of these secludes were from nosocomial contaminations cases. Additionally, from all the clinic regions, the most noteworthy was the therapeutic ward (27%), at that point 20.7% was for both medicinal and careful wards for pediatrics. At that point, different zones were as pursue; 18% for outpatient division, 17.1% for grown-up careful ward, 17.1% escalated care units. The past outcomes recommend that MRSA contamination is expanding in the emergency clinic as the staying scene, so the requirement for control measures for MRSA spread counteractive action must be set up and actualized.A forthcoming report done in Taif, Saudi Arabia during the time of 2004, at the Al Hada Armed Forces Hospital which analyzed all medical clinic patients; demonstrated that the quantity of patients who created contaminations in the emergency clinic was 1382 patient. Nosocomial disease represented 668 of the cases with a level of 48.3%, while the rest of the cases 714 (51.7%) represented network obtained contamination. In this way, the pace of nosocomial contaminations was about 4.98%. MRSA was found to have the most elevated rate (31.8%), proposing it as the commonest nosocomial pathogen. Another partner study done in the emergency unit neonates in Abha General Hospital in 2010 centered in estimating nosocomial contamination event and the hazard factors. From the 401 neonates which stayed in the unit for 48 hours, 77 neonates created diseases. The principle three diseases were; pneumonia (50.0%), essential circulation system (40.9%) and skin and delicate tissues (6.5%). Nosocomial contamination expanded the danger of neonates biting the dust multiple times than neonates free on disease.The nasal carriage of MRSA among the human services laborers still speaks to an issue that must be managed and tended to. The most endemic regions inside the clinics incorporate; nursery, maternity, pediatric, restorative, medical procedure, serious consideration units. Studies are done to examine the level of nasal carriage among the social insurance laborers in emergency clinics and from patients’ injuries and consumes since 1990 till now. Causes of hospital infectionsHospital infections are a major cause of mortality and morbidity. Infection prevention start with identifying the causes then solving them, Measures of infection control include patient, equipment, staff, and environment, practice, and finance factors. Identifying the possible causes will help detecting and control them.1- Patient factor Risk of infection can be contributed by patient factors, immunity, length of stay, age, and hygiene, can determine the patients risk of infections.1.1 poor hygienePoor hygiene practices can be largely responsible for transmitting infection, Poor personal hygiene practices can help the transmission of disease. Transmission could be directly by person contact. Or indirectly by the contact with infected people food, or belongings 1.2 low immunityThe frequency and the intensity of an infection depends particularly on the patient immune system, infection or illness of low immune system patient might be harder to treat. Weak immune system Infections usually involve pneumonia, meningitis, bronchitis, and skin infections.1.3 being near infected personViruses and infection can spread between people through close contact. Or through droplets expelled into the air through coughing or sneezing.1.4 ageAging declines immunity which increase vulnerability to infection, especially infections of certain organ systems such as lung infection.2- Equipment factorsInfection of high touch Equipment is one of the main reasons of transmitting pathogens in the hospital setting.2.1 Catheter InfectionsIn most surgeries a catheter is placed in the patient’s bladder as an outlet for urine during a procedure. The catheter increases the risk of urinary tract infection (UTA) which is the most common type of HAIs.2.2 hospital policyHospital policies differ from one another. Some guidance leaves it up to the hospital how frequently Medical Equipment should be cleaned. But without a present of a process that guarantee the performance of the policies, workers may neglect cleaning.2.3 Not cleaning equipmentNot cleaning equipment between settings in the needed frequency can be a major cause of infections.2.4 cleaning dutiesSetting the responsibilities for cleaning can be a problem, but everyone should be held accountable for cleaning the equipment they took into the room.3- Environment factors:Hospitals environment is a significant source of healthcare-associated infections. Exposures to environmental pathogens promote developing infections with significant morbidity and mortality.3.1 Environmental Surfaces in Patient Care AreasHigh touch surfaces in the hospital environment, such as bed or carts, are constantly exposed to pathogens. If not cleaned appropriately, pathogens can stay active for months, increasing the risk of transmitting infections to patients.3.2 Airborne microorganismsAirborne bacteria and virus can be produced by not only people but also environmental sources. Hospital air system can assist the spread of infection throughout the hospital.3.3 Waterborne MicroorganismsHospital water system can be a microorganism reservoir. Such as Pseudomonas aeruginosa, and Legionella pneumophila, which are common healthcare associated infections. [3]3.4 Lack of standards and guidanceSuch as inadequate ventilation in operating rooms, and poor water quality in dialysis. Can result in harmful outcomes in the patient.4- Staff factorIn addition to polluted equipment, outside environment, and infected patient, Health care providers can also spread infection.4.1 poor trainingMany healthcare providers receive little or no training for what they are supposed to be doing, including poor cleaning practices, or misuse of equipment.4.2 lack of Personal Protective Equipment useRegardless of the many suggestion in various guidelines, healthcare workers still display weak PPE use. Lack of Personal Protective Equipment can be due to:Not enough timeSpeculation that the usage of PPE conflicts with performing the job.Physical discomfortUnavailability or inaccessibility of PPE 4.3 unawarenessThe unawareness of the staff about how their hands, clothes, and equipment, can be polluted with pathogens that eventually get transmitted to the patients.5- Financial factorsThe hospital finance can determine the quality of healthcare, length of stay, and providing proper equipment to improve patient safety.5.1 Not enough equipmentPatient’s life is put in jeopardy when the hospital is lacking essential medical equipment for crucial cases.5.2 poor quality performanceGood Payment will improve patient outcomes. While underpaying workers can be a reason for poor performance.5.3 lack of workersStaff shortages in healthcare is a huge problem that makes providing patient care a very exhausting task. Unfilled job positions can contribute in increasing the risk of hospital infection.6- Practice factors6.1 improper use of antibioticsSome microorganism that previously reacted quickly and positively to antibiotics, have developed a resistance against them. Due to improper usage of antibiotics. This can lead to even more serious infections such as pneumonia, which is the most common hospital acquired infection.6.2 poor infection controlInfection control is a fundamental aspect in health care. In newly evolving countries like India, it is under recognized and under supported in most hospitals. Which put health care providers as well as patients at risk of infection. [4]6.3 Poor managementNot establishing infection control guidelines or neglecting the enforcement of policies and not holing workers accountable for their poor performance.Solutions1- Patient factor 1.1 poor hygiene One of the most important way to prevent the spread of infection is by practicing good hygiene, including washing hands regularly, especially after contact with an infected person, or high touch surfaces.1.2 low immunity Some precautions for People with weak immune system to minimize their chances of developing infections is to avoid close contact with ill people, and get the recommended vaccine and stay informed with their vaccinations.1.3 being near infected personAvoid being too close to infected or ill person to prevent contagion until the illness cure. 2- Equipment factors2.1 Catheter InfectionsFor prevention, urinary catheter should only be used when necessary and immediately removed when not required, and Perform a good hygiene before contact with the catheter.2.2 hospital policyProcess that guarantee the performance of the policies should be present and applied, to restrain workers from neglecting cleaning.2.3 Not cleaning equipmentSetting guidelines for cleaning in the needed areas and frequency, to Ensure Equipment Cleanliness, in addition to Education, and training of the staff.2.4 cleaning dutiesSetting the responsibilities and holding people accountable for cleaning the equipment they took into the room.3- Environment factors:3.1 Environmental Surfaces in Patient Care AreasHigh touch surfaces in the hospital should be cleaned appropriately between each setting.3.2 Airborne microorganismsUnder some conditions the patient should be transferred to an isolation room that has a negative pressure and contain airborne within the room, to prevent spread of infection to other people.3.4 Lack of standards and guidanceEstablishing standards and following guidelines in ventilation, lighting, water quality, and other process throughout the hospital.4- Staff factor4.1 poor trainingProvide training to healthcare workers and direct them on what they are supposed to do, and provide instruction for proper equipment use.4.2 lack of Personal Protective Equipment useFollowing guidelines for PPE application including respiratory, Head, Eye, Skin, Hand, and Foot protection, and training employees to establish proper use of PPE, and ensuring availability of all Protective Equipment.5- Practice factors5.1 improper use of antibioticsAntibiotics should only be used when prescribed by a doctor. And should be taken in the required dosage and time. And not quitting antibiotic treatment before completing the course to prevent antibiotic resistance.5.2 poor infection controlSupporting the Infection control aspect to prevent the spread of infections within the hospital settings. And provide Training courses to educate workers about their responsibility for infection prevention.ConclusionsIn conclusions, Hospital infections are a major cause of mortality and morbidity. To detect and control the Hospital infections we should Identifying the possible causes. In addition, Hospital infections occur due to many causes such as Patient factor, Equipment factors, Environment factors, Staff factor, financial factors and Practice factors. Risk of infection can be contributed by patient factors, immunity, length of stay, age, and hygiene, can determine the patients risk of infections. Equipment factors is one of the main reasons of transmitting pathogens in the hospital setting and the possible cause are Catheter Infections, hospital policy, Not cleaning equipment. Environment factors is a significant source of healthcare-associated infections. Exposures to environmental pathogens promote developing infections with significant morbidity and mortality. In addition to polluted equipment, outside environment, and infected patient, Health care providers can also spread infection by poor training, lack of Personal Protective Equipment use, unawareness. Financial factors the hospital finance can determine the quality of healthcare, length of stay, and providing proper equipment to improve patient safety. Practice factors such as improper use of antibiotics, poor infection control, and Poor management. For instance, to avoid Hospital infections we should find solution for every factor. The possible solutions for patient factors is to practice good hygiene, including washing hands regularly, especially after contact with an infected person, or high touch surfaces. Equipment factors for prevention, urinary catheter should only be used when necessary and immediately removed when not required, and perform a good hygiene before contact with the catheter. Policies should be present and applied, to restrain workers from neglecting cleaning. Setting guidelines for cleaning in the needed areas and frequency, to Ensure Equipment Cleanliness, in addition to Education, and training of the staff. Also the possible solution for Environment factors is by Establishing standards and following guidelines in ventilation, lighting, water quality, and other process throughout the hospital. High touch surfaces in the hospital should be cleaned appropriately between each setting. And Supporting the Infection control aspect to prevent the spread of infections within the hospital settings.Reference1- Centers for Disease Control and Prevention. (2016). HAI data and statistics. Healthcare-associated infections. CDC.2- Mossong, J., Hens, N., Jit, M., Beutels, P., Auranen, K., Mikolajczyk, Heijne, J. (2008). Social contacts and mixing patterns relevant to the spread of infectious diseases.PLoS medicine, 5(3), e74.3- U.S. Department of Health and Human Services Centers for Disease Control and Prevention (CDC). (2003). Guidelines for Environmental Infection Control in Health-Care Facilities. Retrieved from: https://www.cdc.gov/infectioncontrol/pdf/guidelines/environmental-guidelines-P.pdf4- Minhas, S., Kotwal, A., & Singh, M. (2011). Infection Control in Health Care Facilities. Medical Journal Armed Forces India, 67(1), 7–8. https://doi.org/10.1016/s0377-1237(11)80003-1

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