Infection Control

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The aim of this essay is to discuss and analyse the fundamental issues of infection control which underpins Adult Nursing. The topic for discussion is infection control/nosocomial infections in particular Methicillin-resistant Staphylococcus aureus (MRSA). There are varying degrees of the strain Staphylococcus aureus (S. aureus) and some strains are classed as MRSA (National Health Service (NHS) Plus, 2005). Not all strains of the bacterium will cause an epidemic. Epidemic causing MRSA is classified as EMRSA, most notably EMRSA-15 and EMRSA-16, which can be more difficult to control (Department of Health (DH), 2004). However, for the purpose of this essay, the author will focus on MRSA in an acute setting, which has become a major problem around the world, causing hospital acquired infections and, more recently, infections in the community (Ayliffe et al, 2000). Applying current research, the essay will indicate that there is an increase of the transient infection and look at its modes of transmission throughout a hospital ward. This essay will also draw attention to the implications MRSA has towards patients and staff, plus what precautions can be established to prevent or to contain the spread of this particular infection. Due to word limit of this essay, good use will be made of appendices.

MRSA is deserving of its second name the ‘super bug’, as it has been shown to survive four months in dry conditions (Duckworth & Jordens, 1990, cited by Wiseman, 2004). With pathogens being able to survive under such basic conditions, many implications for patients’ basic health care are raised in a hospital or a primary care setting. It appears that for MRSA to live in a human body there must be a susceptible host with a compromised or depressed immune system (Cohen et al, 2000). MRSA is classified as an opportunistic infection, because, it takes hold of host whom has been weakened (Cohen et al, 2000).

Further indicating patients who are debilitated and have devices which puncture the skin, such as intravenous and intra-arterial lines, the unusual ability of this organism to spread, colonise and infect the recipient, meaning it can gain entry to the bloodstream and cause septicaemia which is rapidly fatal (MacKenzie et al, 1997). Patients in hospital under the care of all health professional, especially nurses, whom have more personal contact with patients, close attention must be given to methods in which micro-organisms can be transmitted, whether it is through direct or indirect contact. Therefore, the role of the nurse should always be aware of and practice universal precautions (See Appendix 1) and aseptic technique (See Appendix 2) where necessary to assure the well being of their patients.

Modes of transmission can be from a simple skin to skin contact, for example a handshake, to sexual intercourse, to a patient lying in a hospital bed with a surgical wound while hospital cleaning staff clean another hospital bed 4 feet away (Cohen et al, 2000) (See Appendix 3).

Consequently, the nurse’s role of using the process of assessing, planning, implementing and evaluating patients must be an ongoing procedure in order to always have an insight into how a patient is progressing and to deem their level of susceptibility. Also, using the Roper-Logan-Tierney Activities of Living (AL’s) as a tool will ensure the patient’s basic health care needs are met.

Nevertheless, the nurse must look at their portal of entry and exits, micro-organisms may enter the body via the skin post surgery or through the respiratory tract, the digestive system and the urinary and reproductive systems (Heath, 2003 & Cohen et al, 2000), especially if mobility is compromised and nutrition intake is poor. Control of infectious disease involves breaking the ‘chain of infection’, therefore, the nurse should take a swabbing of the nose, throat, eyes and wound as a tool to detect if the patient has been or is exposed to MRSA and send to...
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