Introduction
The risk of infection while operating in any healthcare facility is a challenge to the basic tenets of such an institution in terms of ensuring the wellbeing of people in all nations. In Canada, Zoutman, Ford, Bryce, and Gourdeau (2010) estimate that above 200,000 people contract HAI (Healthcare-Associated Infections). According to their report, 8000 of the infected people die annually. However, the problem equally attracts the attention of healthcare professionals even in other parts of the world apart from Canada. For instance, World Health Organization (2011) reveals that HAIs constitute a universal challenge in all nations. Prevention of HAIs requires cooperation among patients, families, and healthcare staff members while at the same time utilizing the right equipment to manage them effectively. Perhaps, this approach involves mitigating and/or responding to HAIs, which form the fundamental strategies of risk management. This paper discusses how healthcare facilities can utilize the concept of risk management to curb infections in healthcare settings.
Transmission of Infection in Health Settings
Prescription of appropriate strategies of managing the risk of infection in healthcare settings requires an understanding of the mechanisms through which infections are transmitted (Cruickshank & Ferguson, 2012). Infections involve three aspects, namely origin, manner of spreading, and the existence of a predisposed host (National Health and Medical Research Council, 2013). In healthcare settings, sources of infection include infected patients, their friends, family members, or any other person who interacts with other people within the facilities. Contact, airborne elements, or droplets constitute the three possible modes of transmission of any infection (National Health and Medical Research Council, 2013).
Contact transmission takes place in the form of direct or indirect transmission. Direct spread takes place through the transfer of germs that cause diseases from a contaminated person to a susceptible target. Indirect transmission entails the transfer of disease-causing microorganisms via an intermediary formite and/or object. Such objects may include bed tables, toilet door handles, bath tabs, hospital instruments, and bed railings among various environmental surfaces. Droplet transmission takes place whenever respiratory droplets that are associated with sneezing and coughing are exposed to a vulnerable host’s mucosal surfaces (National Health and Medical Research Council, 2013). In some situations, this process may involve any contact with environmental surfaces that contain microorganisms followed by contact with mucosal surfaces of susceptible hosts. Since respiratory droplets do not remain in air for prolonged time akin to their high weight, their dispersal takes place only within limited distances.
Airborne infection occurs through the transfer of a nuclei droplet using air as the medium from infected persons to susceptible hosts. In this case, microorganisms have the ability to survive for an extended period in the air while also outside the body of an infectious agent (National Health and Medical Research Council, 2013). Considering the modes of transfer of microorganisms that cause infections through the three main approaches, healthcare facilities can develop and implement appropriate standard practices for reducing infection rates. Such mechanisms include the use of protective equipment, observing general hygiene, proper waste management, and sterilization of equipment before sharing them.
Risk Management in Healthcare Settings
Risk management involves clearly defined phases, which have to be followed sequentially to create a better analysis and synthesis of risks and the associated implications in the effort to enhance decision-making processes (Cruickshank & Ferguson, 2012). Risks include dangerous or potentially dangerous conditions, which may increase incidents of HAIs. In business settings, adopting appropriate strategies for risk management helps in increasing business performance, quality, and safety standards in the future. Derivation of proper risk management practices requires learning from historical experiences with risks, which affect an organization negatively. Upon applying this concept in healthcare settings, it implies that the current data on the risk of infections within healthcare setting can form an important starting point in the development of risk management strategies for new infections.
All healthcare facilities should have the ability to identify potential risks and then derive strategies for managing them effectively by creating Safety systems. Indeed, National Health and Medical Research Council (2013) confirms that they need to consider risk avoidance by first identifying, analyzing, and then treating them after conducting thorough evaluations. This plan suggests that healthcare facilities have a responsibility creating performance standards, implementing patient safety initiatives, and conducting frequent assessments for preventing the spreading of infections. Cruickshank and Ferguson (2012) add that these risk management approaches also require healthcare professionals to design comprehensive protocols together with processes of enhancing prevention and control of infections within their local settings. In some cases, although it is impractical to conduct a complete assessment of risks, especially when conducting routine performance evaluations, identification followed by analysis of the risk of transmission should constitute the daily activity of a healthcare facility.
Risks Identification
Risk identification is important in helping derive strategies of risk prevention. This strategy involves defining the causative agent, its mode of transmission, and potential susceptible hosts. After risk definition, strategies for its avoidance can be deployed. For instance, it is important to decide on whether interventions are necessary to avoid exposure to the identified risks. Healthcare professionals also need to respond to the interrogative of whether there exist alternative procedures, which can lower the probability of exposure of susceptible hosts to infectious agents (Youngberg, 2011). This move may include devising alternative mechanisms of administering antibiotics.
Avoiding or Prevention of Infection Risks
Prevention of risks is the best strategy of managing them. Many of the cases of HAIs (about 70%) are preventable (Cruickshank & Ferguson, 2012). Infection control precautions demand precise compliance with control and HAI prevention approaches. Monitoring, prevention, and HAI tracking aid in the reduction of instances of the spreading of infections. For instance, in Canada, hospital and other healthcare facilities engage in surveillance activities to ensure reduction of infections such as central line infections and catheter-related and surgical sites infections that spread within their facilities (Zoutman, Ford, Bryce & Gourdeau, 2010). The surveillance targets specific units within a facility. It can be implemented from the broad-based approach. Research evidences that not all programs of monitoring the effectiveness of surveillance enhance the prevention of infections in healthcare facilities. For instance, CDC conducted a study in the US on the efficacy of various SENIC (Noncomial Infection Control) programs in an attempt to single out the most effective infection control, prevention, and surveillance target programs (Cruickshank & Ferguson, 2012). The study found that not all hospitals implemented such programs in accordance with recommendations by CDC.
In Canada, a study was conducted on 80 beds to determine the extent of compliance with the best practices for infection control guidelines and/or surveillance guidelines. It found that only 68% of the hospitals followed SENIC practices while only 64% complied with the best practices of infection surveillance. This finding suggests that for effective infection control, mandatory compliance with the set national patient safety goals, monitoring standards, control, and surveillance are necessary.
Risk Analysis
Risk analysis requires healthcare professionals to consider various decision constructs. The first issue of consideration involves why a risk can occur (Youngberg, 2011). This issue calls for determination of the elements of tasks or activities within healthcare facilities, which can enhance the transmission or spreading of infections (National Health and Medical Research Council, 2013). The next stage demands the evaluation and determination of the available best practices for minimizing potential risks.
Before determining the possible repercussions of the risk of spreading of infections with a healthcare facility, it is important to determine the degree of possibility of occurrence of the infections. According to Centers for Disease Control and Prevention (2014), it is advisable for healthcare professionals to exercise vigilance when to eliminate any chances of pitiable antibiotic recommendations, which have exposed many patients to the threat of fatal infections. A probable consequence may entail the correlation of mortality or even morbidity rates for HAIs with a period of people’s stay within a healthcare facility. During analysis, it is also incredibly important to determine factors that lead to the escalation or minimization of risks. This strategy involves examining factors that have the ability to change the repercussions of the risk of spreading of infections such as the existence of the necessary equipment for limiting the probability of direct personal contact, expertise, and experiences of the medical staff member who deals with the challenges of spreading of infections (National Health and Medical Research Council, 2013).
Risk Evaluation
Risk evaluation involves conducting an in-depth assessment of the level of the risk of spreading of infections. Several considerations help in terms of arriving at a decision on the permissibility of risks. For instance, determining the threshold of the risk (low or high) can help in terms of deducing whether it constitutes a problem that requires urgent intervention (National Health and Medical Research Council, 2013). Health professionals also need to consider whether the need or purpose of conducting a certain intervention outweighs the possibility of spreading infections. For example, persons who are diagnosed with MRSA may be required to attend gym sessions as part of therapeutic interventions. This strategy implies that the task can be conducted on condition that the equipment is thoroughly cleaned after use. Other factors to consider in the evaluation stage of managing the risk of spreading of infection in healthcare facilities comprise aspects such as interventions that are necessary for eliminating or minimizing and mitigating multi-drug resistant organisms spread whilst showing how such steps apply to a specific scenario.
Treating Risks
Risk treatment comprises the last stage of managing risks based on the theoretical construct that has been deployed in this paper. In this stage, information that is generated via the analysis and evaluation phases with reference to the risk of spreading of infections in healthcare facilities becomes integrated with the objective of selecting the best decision from a set of viable options (Cruickshank & Ferguson, 2012). An important strategy for selecting the best decision entails scrutinizing how thresholds of risks are influenced by the suggested mitigation approaches. This strategy yields a variety of possible choices.
The first option can entail developing a plan of avoiding any risk. This step calls for selecting an alternative low-risk activity. A healthcare practitioner may choose to minimize the threshold of a risk through the adoption of preventive strategies and/or utilizing the available system of risk control and monitoring. This plan mainly encompasses evidence-based guidelines and policies on the best practices for executing a certain task in a manner that minimizes the threshold of any risk (Zoutman, Ford, Bryce & Gourdeau, 2010). Risk transfer and patient education encompass yet other possible alternatives, which entail seeking aid to execute a task from peers who are well equipped, trained, and experienced in terms of executing risk transfer in a less precarious manner.
Reference List
Centers for Disease Control and Prevention. (2014). How Poor Antibiotic Prescribing Puts Patients at Risk for Deadly Infections. Web.
Cruickshank, M., & Ferguson, J. (2012). Reducing Harm to patients from Health care Associated Infection: The Role of Surveillance. Australia: Australian Commission for Safety and Quality in Health Care.
National Health and Medical Research Council. (2013). Clinical Educators Guide For the Prevention and Control of Infection in Healthcare. Sydney: Author.
World Health Organization. (2011). Report on the Burden of Endemic Healthcare-Associated Infection Worldwide. Geneva: Author.
Youngberg, B. (2011). Principles of Risk Management and Patient Safety. Sudbury, MA: Jones & Bartlett Learning.
Zoutman, E., Ford, D., Bryce, E., & Gourdeau, M. (2010). The state of infection surveillance and control in Canadian acute care hospitals. American Journal of Infection Control, 31(5), 266-273.