Section 1: Infections in Healthcare Settings Essay.
Nosocomial infections, hospital acquired infections, are an on-going concern to healthcare professionals. These infections are one of the major causes of death in hospitalised patients and are a significant burden on not only the patient’s and the public’s health (as organisms causing nosocomial infections can be transmitted to the community through discharged patients, staff and visitors) but also the economy. A nosocomial infection is an infection acquired at least 72 hours after being admitted into hospital for any reason other than the infection or one which develops amongst hospital staff. Infections are also identified as nosocomial if they appear in a patient within 30 days after their discharge from hospital. Non nosocomial infections, community acquired infections, are infections acquired anywhere other than the hospital. The most common places where non nosocomial infections occur are schools, day care centres and sports facilities. They are spread through skin to skin contact, cuts and grazes, overcrowding and poor hygiene. The illnesses or infections can be the same, for example, pneumonia or gastroenteritis but it is the setting that they are contracted in which differentiate the two infections.
Nosocomial infections occur worldwide and affect both wealthy, developed countries as well as the poorer ones with scarce resources. A survey conducted by the World Health Organisation in 55 hospitals across Europe, the Eastern Mediterranean, South East Asia and the Western Pacific shows an average of 8.7% of hospital patients have a nosocomial infection. At any one time, over 1.4million people have a hospital acquired infection. According to a report published by The National Audit Office in the United Kingdom, there are at least 100,000 hospital acquired infections per year at a cost to the NHS of hundreds of millions of pounds. The result of acquiring an infection could be an extended stay in hospital, increased use of drugs for further treatment as well as the possibility of isolation and additional laboratory or other diagnostic studies. This all adds to the imbalance between resource allocation for primary and secondary healthcare by diverting scarce funds to the management of potentially preventable conditions. Figures in 2011 from the NHS Information Centre show that the number of patients picking up life threatening infections has doubled over 2 years. Poor hygiene on wards is thought to be responsible for this increase. Infection experts warn that some of the most serious nosocomial infections are becoming ‘hyper resistant’ to antibiotics.
A large majority of hospital patients are treated with antimicrobial drugs and this promotes the emergence of multi drug resistant strains of bacteria. Antibiotics are becoming less effective because of this resistance. As they are more commonly used, bacteria resistant to the treatments emerge. Many strains of pneumococcal, staphylococci and tuberculosis are currently resistant to almost all antibiotics which were once effective. Multi resistant Klebsiella, which causes pneumonia and meningitis and pseudomonas aeruginosa, which can cause severe tissue damage or septic shock, are now extremely prevalent in many hospitals. Some people are more susceptible to hospital acquired infections due to various reasons. The elderly are frailer already because of their age and impaired immune functions due to anatomic changes as they get older. Old age is associated with a decreased immune system, this is known as immunosenescence. Michelle Mitchell, charity director of Age UK, reports that people over the age of 60 are 88% more likely to pick up a hospital acquired infection. People receiving chemotherapy are at an increased risk when their white blood cell count is low. White blood cells are the body’s main defence against infection so when they are at a low level, patients are immunocompromised and more susceptible to...
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