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What Nurses can do to Prevent Hospital-Associated Infections

Higher Education Articles August 19, 2013

The public health actions brought on by the CDC and other partners in healthcare has helped reduce nurse hospital infection rates and improve medical procedures, clinical practice and continued development of evidence-based guidance on infection control and successful prevention of infection. However, nurses must continue to do their part to reduce the incidence of these infections as much as possible.

Healthcare-Associated Infections (HAI) Threaten Patient Safety

The Center for Disease Control (CDC) protects patient safety by overseeing the nation’s surveillance, laboratory research, outbreak investigations and prevention of infections associated with healthcare. The CDC uses the knowledge it gains from these activities to identify infections and develop strategies to prevent them.

A nurse plays a key role in preventing the spread of hospital-acquired infections (HAI). She must ensure that all facets of her nursing practice are based on the evidence, research and education highlighted by the CDC. A nurse is essentially a patient advocate, which puts her in a unique position. It gives her the ability to create change by improving her own patient care standards. There are many tools available to a nurse interested in creating a safe environment for her and her patients. Some of these tools are detailed below.

Universal Precautions

Universal precautions are the foundation of environments that are free of infection. The CDC states that, when providing health care or first aid, universal precautions are intended to assist in the avoidance of transmission of blood borne pathogens. For example, the universal precautions require that nurses wear protective equipment when they encounter certain body fluids, such as:

•Amniotic Fluid
•Cerebrospinal Fluid
•Blood
•Sputum
•Vaginal Secretions
•Semen

Unless blood is visibly present, these precautions do not apply to:

•Sputum
•Sweat
•Saliva
•Tears
•Nasal Secretions
•Feces
•Vomit
•Urine

Hand Washing

Another extremely important weapon that nurses can use to fight infection is hand washing. In fact, this is the single most important thing a nurse can do to prevent the spread of infection. A nurse should use antimicrobial soap and water whenever she washes her hands. The CDC has also set forth specific guidelines concerning the use of alcohol-based hand rubs as a substitute to traditional hand washing techniques.

In addition, any patient that has neutropenia must receive oral antimicrobial rinses, especially if poor hygiene or gingivitis is seen. Neutropenic patients should also receive oral care frequently, which includes gentle flossing in conjunction with teeth brushing.

Thorough Irrigation of Cutaneous Wounds

A nurse should irrigate all skin wounds thoroughly prior to redressing them. It is important to effectively remove the dead tissue and then dress the wound properly in order to absorb fluids that may seep from the wound.

Intermittent Catheterization

Nurses should avoid giving patients catheters whenever possible. If catheterization cannot be avoided, intermittent catheterization is recommended. For patients’ requiring long-term catheterization, the supra-pubic catheter should be taken into consideration. When caring for a catheter, meticulous hand washing and a sterile technique are essential. Precise documentation is also a must.

Intravenous Therapy (IV) Concerns

An enormous area of concern in relation to HAIs is intravenous therapy. When inserting catheters and IVs, nurses have the ability to make a massive contribution to the war against infection. By using full barrier precautions when inserting central venous catheters, the possibility of infection is decreased. These precautions include creating a sterile field and using gowns, masks, caps and gloves. Regardless of the site in which the catheter is being placed, the catheter must be placed aseptically.

The preferred cleansing agent for catheter sites is a 2% chlorhexidine preparation. Diaphragms and injection ports of multi-dose vials also need to be cleaned using 70% alcohol before they are accessed. When a catheter is no longer deemed necessary, it needs to be removed safely and without delay.

Healthcare-associated infections can be extremely serious. For this reason, nurses should be vigilant at all times when caring for their patients. By following the procedures listed here and staying up-to-date on the latest recommended procedures from the CDC, nurses can greatly reduce the incidence of healthcare-associated infections among their patients.

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