Evidence from comprehensive investigations of healthcare-related infections indicate that certain hospital procedures have to be modified in order to control further spreading of an outbreak and to prevent new morbidity cases to arise. It has been observed that there are certain disparities that exist between what is known as medical practice and actual hospital or bedside care. Almost half of the patients in the United States have been determined not to have received the expected medical care.Such imbalanced medical practices have been studied by healthcare administrators for some time, as they also identify consequences of these discrepancies, including the effect on the health and safety of patients as well as healthcare personnel. There is also a huge effort in designing schemes that would improve clinic protocols.
It is crucial to know why certain healthcare personnel follow stringent examination procedures on their patients, when other personnel do otherwise. Review and observation of clinical practices have shown that specific actions in the clinic result in healthcare-associated problems.These issues can only be resolved through modification or addition of procedures that all healthcare personnel should understand and follow. It is important that the rationale behind such change be explained to healthcare personnel in order for them to fully follow the new rules. In order to determine whether change is necessary, the characteristics of healthcare personnel and the characteristics of the healthcare system should be assessed. Healthcare personnel have different ways of thinking, learning, perception and motivation that a healthcare administration should consider.
In addition, the healthcare system should be well-structured to promote control, professionalism and quality management (Cameron et al. 2006; Collignon et al. , 2006). One good example is the relationship that shows the importance of evidence and safe practice in medicine is the correlation between hand washing and nosocomial infections. Healthcare-associated or nosocomial infections are bacterial infections acquired during a patient’s stay in a healthcare institution. It imposes a huge burden on healthcare institutions, costing billions of dollars for additional care costs as well as a significant fraction of lost lives.
In 2004, the World Health Assembly had instituted a global program to improve patient safety measures by inclusion of safety guidelines in hospital policies (Donaldson and Fletcher, 2006). In Australia, approximately 7,000 patients are infected with Staphylococcus aureus in the blood stream each year, of which half of the cases are acquired through a healthcare-related route (Collignon et al. , 2005). In order to control the increase in number of healthcare-associated infections, key factors that make healthcare institutions susceptible to such outbreaks had to be identified.New healthcare system guidelines called for hospitals to thoroughly clean and disinfect environmental medical equipment surfaces on a regular basis.
However, while the efficacy of hand hygiene is well accepted, it is also well known that healthcare workers frequently fail to abide by adequate hand hygiene practices mainly due to lack of reinforcement, social norms, conrol and leadership (Grol and Wensing, 2004). In fact, research has shown that adherence rates to hand hygiene guidelines are lowest in ICUs, where to the frequency of patient care contact, multiple opportunities for hand hygiene exist on a hourly basis.Any direct patient-care contact, which includes contact with gloves and/or contact with objects in the immediate patient vicinity, should be considered as an opportunity for appropriate hand hygiene. In order to determine the extent of exposure to a healthcare-related infection, contact tracing is usually performed in the healthcare facility (Spearing et al. 2002). Such tracing will involve the patients, the immediate family members of the patient and healthcare personnel including physicians, nurses and laboratory technicians.
All individuals that have been in close contact with the patient are tested for the pathogen.Once an outbreak is established, the healthcare system will immediately take measure to resolve this issue. Intervention through changes in healthcare practice involved asking healthcare employees to participate in a survey that examines how closely hand hygiene protocols are followed and, if they are not followed, why not. It may be that the activity level of ICUs is so great that the practitioners feel that they cannot take sufficient time to do adequate hand hygiene. If this is the case, alternative methods of hand hygiene to that institution's traditional policy have to be investigated.
It may be possible that non-compliance was influenced by tremendous workload, resulting in personnel rushing back and forth and definitely lacked time to stop and wash hands. It may be, therefore, expeditious for hospitals and other healthcare organizations to look into hiring additional personnel to aid with cleaning/disinfecting tasks. It may also prove necessary, to cope with factors of time and efficiency, to train cleaning personnel to take a systematic approach to patient room cleaning that includes all high touch areas.Holding in-service training for housekeepers was an effective component of their overall strategy in lowering healthcare-related infections. This process could be facilitated by a checklist approach or by periodically reevaluating rooms. Given these detailed accounts of healthcare-associated infections in hospitals as correlated with hand washing methods, it is of significant importance that the sensitivity and response rate of health personnel be identified in order to know if there are any discrepancies and gaps in the standard hospital protocols that foster the expansion of microbials in hospitals.
