The Issue of Nosocomial Infection Management Term Paper

Introduction

The issue of nosocomial infection management is rather serious across the healthcare projects and programs implemented in the USA. In this respect, the rates of mortality and morbidity from such a kind of infection are very high (Wisplinghoff et al., 2004). The whole body of Medicare in the US should pay more attention to this aspect of direct danger for patients. To say more, the concept of nursing is under revision today. As the closest to patients, nurses should get through a sort of procedures to verify, for instance, general hygiene, sterilization of all appliances, etc. Unfortunately, nosocomial infections still take place within the healthcare system of the United States. It means that people are not guaranteed to be healed after intensive treatment and care in a hospital. It reflects on the medical insurance-related conflicts. In turn, it affects the national economical stability across the country.

Moreover, the problem should be resolved from the inside out. It means that the survey touches upon the specific gram‐negative bacilli, nosocomial bloodstream, and intravascular catheter-related infections. Based on these three areas of infection the discussion follows up the outcomes of the nosocomial infection in its four main types, namely:

• Pneumonia;
• Surgical site infection (SSI);
• Urinary tract infection (UTI);
• Bloodstream infection (BSI) (Gaynes et al., 2005).

Hence, this term paper considers clinical resources, effective methods to cure the outcomes of nosocomial infection, and health promotion resources. The danger of infection can be formidably reduced when applying prophylactic measures and effective approaches in treating patients timely.

Body paragraphs

A hospital-acquired infection is the result of gram-negative organisms. Nurses are at risk to cause trouble to a patient using a neglectful attitude to duties. It means that clinical nursing issue of checking up appliances to work with and conditions for patients’ care. In this respect, the growth of bacilli in the organism will debilitate on top of that weakened immunity of a patient. The result is that gram-negative aerobes and pathogens attack the life-supporting systems of the human organism (Gaynes et al., 2005). Hence, nurses should be aware of the ways for nosocomial infection to affect patients.

Gram-negative pathogens are more associated with the emergence of nosocomial pneumonia, SSI, and UTI. In this respect, medics need to pay more attention to the peculiarities of the locality where a definite hospital is situated. Thus, nosocomial pneumonia is caused by aerobes (Acinetobacter species), UTI is caused by Pseudomonas aeruginosa, SSI is caused mainly by Enterobacter, and Acinetobacter (Gaynes et al., 2005). Taking this into account, medical staff should be aware of the sources for these microorganisms and their delimitation. Moreover, nursing might be supported by innovative methods for processing departments and premises adjacent to the hospital.

Nosocomial bloodstream infections (BSIs) are stated as one of the main reasons for mortality in the United States. This outrageous fact gives reasons to suppose that the healthcare system does not meet the standards of the profession, meaning nursing. Thus, the medical verification among nurses should be provided in terms of certification and improvement of qualification as well. The study reported by Wisplinghoff et al. (2004) outlines that BSI’s proportion increases in ratio to other common nosocomial infections and diseases owing to antibiotic-resistant microorganisms. This idea gains approval in different studies on infection management. Thereupon, Gaynes et al. (2005) researched the rates of nosocomial infections in hospitals across the US and state their dramatic growth. The awareness of patients, however, does not include an idea of aggravating health by going through the cure. This paradox should not be in evidence throughout Medicare. Thus, BSIs are another reason for still growing nosocomial risk in hospitals.

Gram-negative, gram-positive organisms, and fungi are considered to be the three main infectious microstructures to affect the circulatory system. This assumption is no longer a theoretical approach. Wisplinghoff et al. (2004) remark that BSIs are caused by gram-positive organisms (65% of cases), gram-negative organisms (25% of cases), and fungi (9,5% of cases) (309). It means that nurses must be educated and trained to meet the main requirements of public health regulations. Nevertheless, the staff needs to be careful in assisting patients when administering medicines. Touching upon the appliances, medical staff should be aware of how to sterilize them. On the other hand, nonrecoverable appliances after being utilized should be thrown away into special tanks for used medical things. It is rational to follow this piece of advice, especially in the intensive care unit. The question is that in this very unit patients are at risk to have an infection from coagulase-negative staphylococci (CoNS), Enterobacter species, Serratia species, and some other species (Wisplinghoff et al., 2004).

Another source for morbidity and mortality in the United States is intravascular catheter-related infections. Studies reported by Mermel et al. (2001) outline that peripheral and non-tunneled central venous catheters (CVCs) can be easily infected by CoNS along with “S aureus, different species of aerobic gram-negative bacilli, and C albicans” (223). In this respect, nurses need to have more information on contemporary procedures for injecting peripheral and non-tunneled catheters after abiding by rules of hygienic processing of hub and lumen within CVC. This rule is paramount having to do with catheter-related implications. To prevent nosocomial infections, an up-and-coming nurse should follow the steps of utilizing appliances before, during, and after the procedure to be taken. Epidemiology and pathogenesis appear in cases when the nursing unit within medical staff does not get through appropriate verifications on local and national levels.

Current practice states that since the National Nosocomial Infections Surveillance (NNIS) system (Gaynes et al., 2005) along with the Infectious Diseases Society of America (IDSA) (Merel et al., 2001) keep on working, Nosocomial infections can be delimitated. The Healthcare system should function as a whole organism. Thus, experts might help resolve the problem with nosocomial infections and their prevention. It finds more prospects when concerning the fact that within the period between 1970 and 2003 the rates of nosocomial infection decreased significantly due to the work of aforementioned instances (Gaynes et al., 2005). To say more, unless there is a strict order in controlling such a human-directed or life-directed, so to speak, field of activities, the quality of cure in hospital will fall dramatically.

Antimicrobial‐pathogen combinations should be included more intensively to work out the problem. It means that nurses should be capable of implementing antibiotics to decrease the growth of the infection in the initial stage. Antimicrobial resistance and its rate, particularly, are especially seen in the example of Acinetobacter species and P. aeruginosa (Gaynes et al., 2005). It drives the healthcare system and nurses, in particular, to cooperate with physiologists and pharmacists. The most effective antibiotics should be tested shortly to help medics resist the national rate of nosocomial infections.

Nurses should take care of patients when in hospital and after intensive treatment until a definite time. This suggestion result from the study reported by Wisplinghoff et al. (2004). The researchers admit that in terms of BSIs the mean intervals (from admission to infection) vary according to the type of bacteria species. Thereupon, Escherichia coli has 13 days interval, S. aureus 16 days, for Candida species and Klebsiella species this period is 22 days, enterococci are 23 days, finally, Acinetobacter species take 26 days (Wisplinghoff et al., 2004, p. 1093). Furthermore, nurses should be accurate in administering blood-related appliances, so that a patient’s epithelium and circular system keep functioning well. Merel et al. (2001) insist that the cure for nosocomial infections lies in using “antibiotic lock technique in addition to standard parenteral therapy for patients with hemodialysis catheter-related infection” (235). Hence, BSIs can be reduced in their flow considerably by forcing them with new combinations of antibiotic-related medicines.

Conclusion

Getting through the studies and problems observed, it is necessary to state that the nursing department in hospitals is quite significant in preventing patients from nosocomial infections. These staff members, as I feel it, should be conscientious about their work. Otherwise, they need to follow the ways to improve their qualification in bacteria knowledge and in methods to eliminate the source of infections (negative-gram, positive-gram microorganisms, fungi, etc.). By exercising entire measures on prophylactics, the nursing unit guarantees the quality of medicine and the usefulness of medical insurance at large.

Reference

Gaynes, R., Edwards, J. R. & the National Nosocomial Infections Surveillance System. (2005). Overview of Nosocomial Infections Caused by Gram‐Negative Bacilli. Clinical Infectious Diseases. 41:848–854.

Mermel, L. A., Farr, B. M., Sherertz, R. J., Raad, I. I., O’Grady, N., Harris, J. S. & Craven, D. E. (2001). Guidelines for the Management of Intravascular Catheter‐Related Infections. Infection Control and Hospital Epidemiology. 22:222–242.

Wisplinghoff, H., Bischoff, T., Tallent, S. M., Seifert, H., Wenzel, R. P. & Edmond, M. B. (2004). Nosocomial Bloodstream Infections in US Hospitals: Analysis of 24,179 Cases from a Prospective Nationwide Surveillance Study. Clinical Infectious Diseases. 39:309–317.