What Are Healthcare Associated Infections?

IntroductionEffective infection prevention and control is central to providing high quality healthcare for patients and a safe working environment for those that work in healthcare setting.Healthcare associated infections (HAIs) are infections acquired as a direct or indirect result of healthcare (Horan, Andres & Durdeck, 2008). International evidence suggestsa considerable infection burden exists among long-term care residents however, there are few published studies on the rate of infection in Australia (WHO, 2016). Australian acute healthcare facilities, have approximately 165,000 HAIs each year (Mitchell, Shaban, Macbeth, Wood &Russo,2017).HAIs are the most common complication effecting patients in hospital. In addition tounnecessary pain and suffering for patients and their families, adverse events can prolong hospital stays and are costly to the health system. Approximately 7% of hospitalised patients will acquire a HAI, with an estimated increase to the cost of a patient’s admission of 8.6% (IHPA, 2017).The problem not onlyeffect patients and workers in hospitals -HAIs can occur in any healthcare setting. These including office-based practices(such asgeneral practice clinics, dental clinicsand community health facilities), paramedic pre-hospital work settings and long-term care facilities.Any person working in or entering a healthcare facility is at risk. However, healthcare associated infection is a potentially preventable adverse event rather than an unpredictable complication. It is possible to significantly reduce the rate of HAIs through effective infection prevention and control.TargetAudienceand RationaleforResourceThis document can be used by Third Year Undergraduate Nursing Students and New Graduate Registered Nurses.Inassisting healthcare workers to improve the quality of the care they deliver;best practice principles aim to promote and facilitate the overall goal of infection prevention and control:the creation of safe healthcare environments through the implementation of evidence-based practices that minimise the risk of transmission of infectious agents.(Australian Government, 2020)Outcomesand LearningObjectivesThis resource has the following four objectives:•Understandingthe purpose of Infection Prevention andControl;•Understand who is responsible for Infection Prevention and Control in the healthcaresetting;•UnderstandingStandard Precautions and when to usethem;•The identification ofthe 5 Moments of HandHygiene.
Why Infection Prevention and ControlInfection prevention and control practices canminimise the risk ofInfectiontransmission occurringbetween patients. HealthcareWorkers and other people in the healthcare environmentand are anEssential component of safe quality healthcare (Australian Guidelines for the Prevention and Control of Infection in Healthcare, 2019)(WHO, 2020)The NSQHS Standards The National Safety and Quality Health Service Standards[NSQHS], (2020)aims toprovide a nationally consistent statement and standardhealth care that allthe nation can expect from all healthcare organisations.The Federal Government in collaboration with all AustralianStates and Territories funded the NSQHS. There are 8 standards that all healthcare organisationsand health care workers must uphold, to ensure, patient wellbeing, quality cod value, quality and safety,finally to support health professionals to provide safe and high quality careas seen in the diagram below.(NSQHS, 2020)..(NSQHS, 2020)Standard3 Preventing and Controlling Healthcare-associated Infections (HAI’s)the focus of this education booklet.
What Are Healthcare Associated Infections?Healthcare associated infections are infections that are acquiredas a direct or indirect result of healthcare (Webster, Faogali &Cartwright, 2014). HAI’s can occur as a result of the provision of healthcare in any setting. Whilethe specific risks may differ, the basic principles of infection prevention and control apply regardless of the setting.In order to prevent HIA’s it is important to understand how infections occur in the healthcare setting and then institute ways to prevent them. If effectively implemented, the two-tiered approach of standard and transmission-based precautions recommended for best practice provides high-level protection to patients, healthcare workers and other people in the healthcare setting.(NSQHS, 2020)Infection Prevention is Everyone’s Business!This responsibility applies to everybody working in and visiting a healthcare facility, including administrators, staff, patients and carer (Australian Guideline for the Prevention and Control of Infections in Healthcare, 2019). Infection prevention and control is integral to clinical care and often requires a range of strategies to be successful. It should not be considered as an additional set of practices but as part of standard care.Successful approaches for preventing and reducing harms arising from HAIs involve applying a risk-management framework to manage the ‘human’ and ‘system’ factors associated with the transmission of infectious agents. This approach ensures that common (such as gastrointestinal viruses) or evolving infectious agents(such as influenza, CoVID or multi-resistant organisms) can be managed effectively.Involving patients and their carers is essentialin successful infection prevention and control in clinical care. Patients and families that are sufficiently informed have a fundamental role in managing the risks of infection and the reducing the risk of transmission of infectious agents.
Contracting a HAIMost infectiousagentsare microorganisms. These exist naturally everywhere in the environment and not ALL microorganisms cause infection. Transmission of infectious agents within a healthcare setting requires all the followingelements:•Causative agent(pathogen)•Reservoir•Portal ofExit•Means of Transmission•Portal ofEntry•ASusceptible Host(Australian Guideline forthePrevention and Control ofInfections in Healthcare, 2019)What Are Standard Precautionsand When Should They Be Used?Standard precautions refer to those work practices that are applied to everyone, regardless of their perceived or confirmed infectious status and ensure a basic level of infection prevention and control (Australia Guidelines for the Prevention and Control of Infection in Healthcare, 2019).Everyone has the potential to harbour infectious agents. The implementation of standard precautions is a first line approach to infection prevention and control in the healthcare environment. The implementation of standard precautions minimises the risk of transmission of infectious agents from person to personwithin the variety of healthcare settings in Australia.(AustralianGuideline for the Prevention and Control of Infections in Healthcare,
How Are Standard Precautions Implemented? •Personal hygiene practices, particularly hand hygiene, aims to reduce the risk of contact transmission of infectious agents (WHO,2019)•Appropriate use of personal protective equipment (PPE), includesgloves, gowns, plastic aprons, mask/ face shields and eyeprotection. Theaim of PPE is to prevent exposure of the healthcare worker and patients to infectious agents (WHO,2019)•The safe handlingand disposal of sharps assists in preventing transmission of blood-borne diseases to healthcare workers (WHO,2019)•Environmental controls, including cleaning and spills management, assist in preventing transmission of infectious agents from the environment to patients (WHO,2019)•Practicing respiratory hygiene and cough etiquette reduces the risk of transmission of infections (WHO,2019).(AHPRA,2020)Hand Hygiene and Best Practice Effective hand hygieneis the single most important strategy in preventing healthcare associated infections (WHO, 2019). Ease of access to hand washing facilities (soap and water) and alcohol-based hand rubs can influence the transmission of HIA’s. Washing hands with soap and water is required if hands are visibly soiled while either product can be used if hands are visibly clean (WHO, 2019).It is recommended that routine hand hygiene is performed:•Before touching apatient•Before a procedure•After a procedure or body substance exposurerisk•After touching apatient•After touching a patient’ssurroundingsHand hygiene must also be performed before putting on gloves and after the removal of gloves.(Australian Commission on Safety and Quality in Healthcare, 2018)AQuestion?How often do you use the Five Moments in your clinical practice?

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