Literature Review: Infection Prevention and Control in Health Care

Literature Review: Infection Prevention and Control in Health Care 1. Introduction There are a number of measures used to control and prevent infections in the health care sector. Infections associated with the provision of medical care are caused by bacteria, viruses, and fungi and can occur anywhere, but in medical institutions they are a more serious problem. One of the most urgent tasks in modern hospitals is the prevention of hospital-acquired infections, which are also called nosocomial infections. nosocomial infections. The specific focus for prevention of nosocomial infections are measures that identify immunodeficiency states, their adequate correction, and the use of prophylactic specific serums, toxoids, and bacteriophages. The rationale for conducting this literature review is to critically analyse the existing literature regarding the control and prevention of infectious diseases in health care settings. This literature review is aimed at synthesising the findings from previous research and providing current evidence on the research problem. The strategic goal of health care settings worldwide is to ensure the quality of medical care and create a safe hospital environment by preventing and controlling the spread of infections. Three themes have been identified for this critical evaluation: surgical site infections, preventive measures for nosocomial infections, and infection control for health care workers. The first theme presents the common pathogens of nosocomial infections, evaluation of time trends in the rates of surgical site infection, and the evidence of the effectiveness of showering or preoperative bathing with antiseptic formulations for preventing surgical site infections. The second theme highlights the potential health concerns that affect the mortality, morbidity, and quality of life of the individuals, and the ways to examine recent procedures for monitoring cleanliness, disinfection, and methods of cleaning. Finally, the third theme discusses infection control procedures for health care workers, as they are at an increased risk of developing nosocomial infections. 2. Critical Analysis of the Literature Surgical Site Infections Modern nosocomial or hospital‐acquired infections in surgical settings are caused by microorganisms such as Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Proteus, Escherichia coli, Klebsiella, and Candida. Worth, Bull, Spelman, Brett, and Richards (2015) conducted research in Australia that evaluated time trends in the rates of surgical site infection (SSI), along with the SSI pathogens. The researchers performed an observational cohort prospective multicentre study of 81 health care facilities located in Australia that were involved in the Victorian Healthcare Associated Infection Surveillance System (VICNISS). Approximately 5123 SSIs were reported by the monitoring of 183,625 procedures. In this research, the most widely found pathogen was S. aureus, while ceftriaxone-resistant Escherichia coli was found to be the leading cause of SSI in surgical settings. Conversely, Webster and Osborne (2015) researched the effectiveness of showering or preoperative bathing with antiseptic formulations for preventing surgical site infections. They used randomised controlled trials to compare the use of different antiseptic formulations in preoperative showering and full‐body bathing with non‐antiseptic preparations in patients intended for surgical procedures. The study did not find a significant difference between the two types of formulations used in the pre-operative procedures. For instance, compared to other wash products, chlorhexidine was not found to provide significant results in reducing the surgical site infection. Similar research by Berríos-Torres et al. (2017) highlighted the practice of bathing and showering with antiseptic agents. These authors found that a common practice in most surgical settings is for patients to be bathed or showered with the antiseptic agents or with anti-microbial or non-antimicrobial soaps prior to operation day. However, Berríos-Torres et al. (2017) stressed that the anti-microbial prophylaxis must be administered if indicated according to the published clinical practice guideline. The researchers did not recommend the application of topical antimicrobial agents in the surgical incisions. Nonetheless, there are further studies that do not recommend the practice of bathing and showering with antiseptic or antimicrobial agents. For instance, Noto et al. (2015) affirmed that daily showering with topical antimicrobial agent broad-spectrum chlorhexidine for critically ill patients is generally conducted to reduce hospital-acquired infections; however, their trial with the use of chlorhexidine was not found to reduce the incidence of hospital-acquired infections, including C. difficile. Therefore, they recommended that daily bathing with chlorhexidine for critically ill patients is not required. Preventive Measures for Nosocomial Infections Nosocomial infections are infectious diseases received by patients in medical institutions. These infections in the hospital may be caused by transmission mechanisms that are traditional for epidemiology, mainly through contact with the patient or through objects used by the patient, foodstuffs, and water into which infectious agents could have previously entered from the patient. Moreover, hospital waste is considered a potential way to increase hospital-acquired infections. In this regard, Khan, Baig, and Mehboob (2017) indicated that about 15 per cent of total hospitalised patients suffer from nosocomial infections. These infections account for about 10 per cent of the infections in developing countries, and 7 per cent in developed countries. The researchers further mentioned that a potential source of nosocomial pathogen is hospital waste, as 20 to 25 per cent of the hospital wastes has been found to be hazardous. Nosocomial infections can also occur through airborne droplets, for example, during viral infections such as measles, rubella, and chicken pox. Other methods of infection are associated with the treatment and diagnostic processes in hospitals. A common example is an infection through blood transfusions, such as HIV, viral hepatitis B, viral hepatitis C, viral hepatitis D, and malaria. Khan, Baig, and Mehboob (2017) recommended that these types of infections may be prevented by implementing an infection control program, adopting a policy for anti-biotic control, and keeping a check on the use and resistance of antimicrobial use. General cleaning of the premises of the ward offices and other functional rooms and offices should be carried out according to the approved schedule at least once per month with thorough washing and disinfection of walls, floors, and all equipment, as well as wiping furniture fixtures and security louvres. Storr et al. (2017) reported that health care-associated infections (HAI) are potential health concerns that affect the mortality, morbidity, and quality of life of both the patients and health care workers. The researchers emphasised the local burdens of HAI and the patterns of transmission involved. In order to prevent HAIs and other intra-hospital infections, all medical products that involve violation of the integrity of the skin and mucous membranes or are in contact with the surface of mucous membranes must be subjected to pre-sterilisation processing and disinfection. These disinfection and sterilisation measures are aimed at the destruction of nosocomial pathogens in the nosocomial environment. Disinfection is the destruction of pathogenic and conditionally pathogenic microorganisms from the potential surfaces. One of the most important criteria for the quality of medical care is the infectious safety of the treatment and diagnostic processes. Infections associated with the provision of medical care are the most important component of this problem due to the global nature of the distribution, and the negative consequences for the health of patients and the economy of the state (Wozniak, Bailey, & Graves, 2019)(reference). Modernisation of health care dictates the need to integrate the system of control over the nosocomial infections in the management system to ensure the quality of medical care in medical organisations (Hall, Halton, Macbeth, Gardner, & Mitchell, 2015)(...