Abstract
Nursing professionals, owing to their close interactions and the time they spend with patients in the provision of care, have an instrumental role in the prevention of healthcare associated infections (HAIs). The present paper demonstrates that the nursing roles include: wearing of personal protective equipment under the universal precautions, hand washing and consistent hand hygiene practices, cleaning and disinfecting medical devices/equipment and environmental surfaces, internalizing hospital policies and practices on infection control and prevention, engaging in patient education and empowerment, as well as taking extra protective measures when inserting/removing invasive devices.
Introduction
In contemporary healthcare settings, nursing professionals have a fundamental role in the prevention of healthcare associated infections (HAIs), not only by utilizing the skills and knowledge in evidence-based nursing practice (Benson & Powers, 2011), but also through nursing research, patient education and empowerment (Grant, 2004). Although practitioners have for the last several decades focused much attention on the prevention of HAIs, incidence rates and associated complications continue to soar at an upsetting rate in many health institutions (Collins, 2008). The present paper discusses some of the roles that nurses can actively undertake in the prevention of HAIs.
A Critical Discussion of the Nursing Roles
Extant literature demonstrates that HAIs refer to unanticipated infections that are acquired in the continuum of settings where patients obtain health care, and that not only result in substantial patient morbidity and mortality, but also extend the duration of hospital stays and impose added diagnostic and treatment interventions, hence causing extra costs to those already incurred by the patient in treating the principal ailment (Collins, 2008). Such a predisposition reinforces the need for nurses to become active players in the prevention of HAIs.
As patient advocates, nursing professionals are in a pivotal position to use the many processes and practices at their disposal to create a safe environment for patients as well as enhance care standards. For example, nurses should always wear personal protective equipment under the universal precautions to prevent the transmission of fluid-borne pathogens upon coming into contact with specific body fluids, including blood, cerebrospinal fluid, amniotic fluids as well as semen and vaginal discharges (Vandijck et al., 2010).
Available literature demonstrates that hand washing is the single most important intervention that could be effectively used by nurses to curtail the spread of HAIs, not only from one patient to the other but also within the healthcare environment (Benson & Powers, 2011). In this respect, nurses should always ensure they wash their hands thoroughly using antimicrobial soap, antiseptics or alcohol-based hand rubs to prevent the spread of HAIs from one patient to another.
Indeed, nurses should follow a strict and consistent hand hygiene practice before and after making contact with a patient, after making contact with environmental surfaces and medical equipment, and also before and after donning gloves (Dekker, 2011). But even more significant, nurses should always ensure they keep their fingernails short and desist from the use of artificial fingernails and other nail decorations as these provide a fertile breeding ground for pathogens that normally cause HAIs.
It is common practice for nurses and other medical professionals to use medical devices/equipment on more than one patient (Benson & Powers, 2011), and a strand of extant literature (e.g., Collins, 2008; Vandijck et al., 2010) shows that these devices serve as conduits to transmit pathogens from one patient to another, resulting in undesirable spread of HAIs. Indeed, according to Benson and Powers (2011), “there’s research reporting evidence of hardy pathogens remaining for weeks on environmental surfaces in the healthcare environment” (p. 38). Consequently, nurses have a fundamental role to clean and disinfect these devices/equipment and environmental surfaces to prevent them from becoming potential vectors for transmission of infection within hospital settings, but also to foster a safe environment for patients.
To effectively play their pivotal role in the prevention of HAIs, nurses should also familiarize themselves with hospital policies, practices and processes on infection control and prevention, as well as protocols that govern the approaches taken to quarantine patients suspected of having developed dangerous communicable diseases within care settings (Collins, 2008).
It should be remembered that nursing professionals are often the first of the healthcare team to develop close relationships with patients going by the amount of time they spend with them in the provision of care, implying that they are most often the first to notice and learn about anticipated patient symptoms that obliges the use of policies and strategies to curtail the spread of contagious pathogens. Accordingly, it is imperative for nurses to equip themselves with adequate knowledge on the policies and strategies as reinforced by evidence-based nursing practices, with the view to preventing the spread of infections from one patient to the other within the hospital context (Benson & Powers, 2011; Vandijck et al., 2010).
Moving on, it is clear that nurses should engage in patient and family education so that patients not only become more knowledgeable about their illnesses and disease pathways, but also understand why they are often advised to use particular strategies and treatment regimens (Benson & Powers, 2011). A more educated and empowered patient population, according to Grant (2004), is better able to take personal hygiene practices to ensure disease-causing pathogens are not spread to other patients during their course of stay in the health facility.
Nurses are also instrumental in using education to explain to patients the rationale for taking their medications on time and, if the situation warrants, the rationale for placing certain patients under contact isolation. Lastly, it should be the role of nurses to reinforce teaching and empower patients together with their families not only to expect healthcare professionals to undertake hand hygiene practices before and after coming into contact with patients, but also to remind them whenever they fail to undertake routine hand hygiene practices (Benson & Powers, 2011; Dekker, 2011).
Finally, nurses should take extra protective measures when removing unnecessary invasive devices from patients who have already responded well to treatment. Indeed, extant literature demonstrates that devices such as urinary catheters, central lines and peripheral intravenous lines provide an enabling environment for transmission of disease-causing pathogens if necessary measures are not put in place (Benson & Powers, 2011).
To prevent the spread of HAIs from one patient to another while inserting or removing invasive devices, nurses should wash their hands using antiseptic soap and also undertake aseptic technique to guarantee the elimination of all pathogens (Collins, 2008). Intravenous therapy, in particular, has been identified as an enormous area of concern for HAIs, prompting health facilities to develop and implement policy frameworks and strategies that ensure nurses use full-barrier precautions (e.g., sterile field, caps, gowns, masks and gloves) when inserting or removing the intravenous lines (Vandijck et al., 2010).
Conclusion
Flowing from this discussion, it is evident that the roles that nursing professionals should take to ensure the prevention of HAIs are undoubtedly endless. Nurses should strive to make a difference by ensuring they work within the stated requirements to guarantee successful prevention of healthcare associated infections.
References
Benson, S., & Powers, J. (2011). Your role in infection prevention. Nursing Made Incredibly Easy, 9(3), 36-41.
Collins, A.S. (2008). Preventing health care-associated infections. Rockville, MD: Agency for Healthcare Research & Quality.
Dekker, S. (2011). Patient safety: A human factors perspective. Boca Raton, FL: CRC Press.
Grant, P.S. (2004). Making the most of your infection control professional. Nursing, 34(3), 17-17.
Vandijck, D.M., Labeau, S.O., Vogelaers, D.P., & Blot, S.I. (2010). Prevention of nosocomial infections in intensive care patients. Nursing in Critical Care, 15(5), 251-256.