Fundamentals of Infection Risk Management-Free-Samples for Students

Quetion: Write an Essay on Fundamentals of infection risk management. Answer: The essay aims to discuss the four common microorganisms responsible for the hospital acquired infection and highlight the prevalence rate in health care settings. The essay further evaluates the rate and impact of these infections on the staff, facility and the patient. It also critically analyses the national and international guidelines to combat infection due to one of the microorganisms. The critical analysis also includes the state of current infection, control and prevention for one of the organism. The essay then provides review on how the current infection and control practices have historically developed and improved the current practices. Various organisms have been found to be the contributing factor of the hospital acquired infection. The four microorganisms that are dealt in the essay areMethicillin resistant Staphylococcus aureus (MRSA), E.coli, Klebsiella pneumonia and Pseudomonas aeruginosa. According to CDC (Centre of disease control) these are the most common pathogens causing the hospital acquired infections (Ehagroup.com, 2017). In New Zealand or NZ the highest reported hospital acquired infection is due to Staphylococcus aureus and the incidence is due to strain of methicillin-resistantS. aureus that caused the epidemic spread. It mainly causes soft tissue and skin infection, gastrointestinal, nosocomial, and systemic infections. The prevalence of infection due to this pathogen is high in New Zealand than in any developed country. Studies and reports from the period 2000-2001 revealed that S. aureusbacteraemiawas 4 times more likely among the Pacific Peoples and two times more likely among the Maori patients. It occurs at rate of 25/100000 population (Williamson et al., 2017). It is confined to affecting children. Only one specific aspect of disease is commonly reported in NZ that is MRSA infection. MRSA is also known as multidrug-resistant Staphylococcus aureus and oxacillin-resistant Staphylococcus aureus (McMullan et al., 2016). Pseudomonas aeruginosa is responsible for 11% of all the hospital acquired i nfections. The fatality rate of the infection caused by this micro-organism is 50%. It is resistant to most commonly used antibiotics. It is highly diagnosed in patients with AIDS, and Cancer. It mainly causes urinary tract infections. In blood stream infection cases, 96% were found to be noscomial (Pfaller, Bassetti, Duncan, Castanheira, 2017). Hospital acquired pneumonia caused by Klebsiella pneumonia is the second most commonly reported hospital acquired infection. This infection comprises of 15-20% of total hospital acquired infections. It occurs at the rate of more than 15 cases/ hospital admissions (Pitout, Nordmann, Poirel, 2015). The E.coli strain that is dangerous and contributor of most hospital acquired infections is E. coli O157: H7. Children and older adults are highly susceptible to this infection. This pathogen is highly prevalent in bloodstream infections and occurs at rate of 35/100000 population (Martelius et al., 2016). These infections have adverse effect on ov erall health system. These infections are increasing the cost of the health care. Each year 100 million procedures are performed in NZ hospitals. These infections are increasing the litigation nationwide. There is high chance of the acquisition of infection in other hospitals, rehabilitation centres and nursing home. The group of patients who are highly susceptible to these infections are young children and older adults and immunocompromised patients (Khan, Ahmad, Mehboob, 2015). After admission to the hospital, around 5-10% of the patients acquire an infection. It is difficult to measure the exact cost. The annual cost was found to be in excess of NZ$50 million for medical admissions and $85 millionfor surgical admissions. The additional cost is due to diagnosis and treatment of hospital acquired infection (Moura, Baylina, Moreira, 2017). It leads to added burden on the health care staff due to work overload and job stress. Even the staffs acquire these infections which lead to attrition and poor qual ity of care. Extended length of stay in hospital adds to anxiety and stress in patients (Williamson et al., 2014). Hospital acquired infections were investigated over several years and was concluded to be caused by unclean and non-sterile environmental surfaces, breach of infection control procedures and practices (Ehagroup.com, 2017). Based on this evidence several strategies were developed to control the hospital acquired infection due to these micro-organisms. One of the above identified micro-organism for which the current infection, control and prevention and the national and international guidelines will be discussed is MRSA. To control MRSA various prevention and control guidelines were developed. However, the implementation does not seem to be serious enough as there is still a prevalence of MRSA infection. The surveillance of MRSA and the methodology is provided by CDC. There is a large gap between the existence of guidelines and the actual implementation (Cdc.gov, 2017). The prevention and control guidelines for MRSA in many countries are similar. The fundamental recommendation in every guideline is screening and early detection, patient isolation, hand hygiene, and decolonization. In low prevalence countries these guidelines were found to keep the health care facilities MRSA free and prevent the infection. Failure to adhere to the national guidelines makes countries like NZ MRSA-endemic that has high prevalence rate (Williamson Heffernan, 2014). The National Clinical Guideline developed by the RCPI Clinical Advisory Group on HCAI - Subgroup MRSA Guideline Committee is based on series of recommendations. The guidelines reflect the best international practice. It is disseminated through the HSE networks and is effective in many facilities in combating infection (HPSC, 2017). The subject of debate is Antibiotic stewardship. It is effective to use local antibiotic susceptibility data for effective results (Guharoy et al., 2016). As per the Ministry of Health, NZ, guidelines developed should be used for formulating own MRSA policy. It also states that the key infection controlling procedure includes hygiene practices being rigorously followed in hospitals. In NZ these procedures and guidelines along with comprehensive MRSA surveillance has helped in defining the mostly transmitted MRSA strains. It aided in extra stringent infection control (Ministry of Health NZ, 2017). However, some strains are highly transmissible and were foun d to be difficult to control. Prudent antibiotic use was found effective. According to EHA (Environmental and public health consultants), MRSA is most susceptible to beta-lactamase resistant penicillins. Vancomycin is the highly preferred drug for MRSA infections (Guardabassi, 2017). The above mentioned guidelines and recommendations were made based on changing epidemiology of MRSA in NZ and other countries. These guidelines were made based on old and new literature, previous guidelines, local and epidemiological data. International guidelines were made based on epidemiological data from different countries and putting various draft guidelines for consultation. NZ MRSA surveillance was started ever since first reported case in 1975. ESR (Institute of Environmental Science and Research Limited) conducts annual surveys in laboratories of NZ every year. These surveys monitor changes and help develop new prevention strategies (ESR, 2017). This helped in identifying the infection pattern and epidemiology which gave birth to national and international guidelines mainly in period 2000-2011 (Williamson et al., 2014). Owing to these efforts there has been stable rate and prevalence of MRSA infection in NZ since last three years. In conclusion, health care facilities are the places that may turn dangerous due to Hospital acquired infections also called as nosocomial infections. Various organisms have been found to be the contributing factor of the hospital acquired infection. Four of them have been discussed in this essay. MRSA is discussed in details as it is highly prevalent infection in NZ and in other countries. Stringent guidelines, surveillance, adherence and antibiotic stewardship are key factors to prevent and control MRSA. References Cdc.gov. (2017).Methicillin-Resistant Staphylococcus aureus (MRSA).Cdc.gov. Retrieved 11 December 2017, from https://www.cdc.gov/mrsa/community/index.html Ehagroup.com. (2017).Nosocomial Infections and Hospital-Acquired Illness.Ehagroup.com. Retrieved 12 December 2017, from https://www.ehagroup.com/epidemiology/nosocomial-infections ESR. 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