Critical Evaluation of Standard Precautions Practice in Aged Care Setting

This article provides a critical evaluation of standard precautions practice in aged care setting, focusing on hand hygiene and proper donning and doffing. It discusses the challenges and barriers to adherence, strategies to overcome them, and the importance of leadership in infection prevention and control.

A critical evaluation of standard
precautions practice in aged care
setting
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Contents
INTRODUCTION...........................................................................................................................1
BACKGROUND AND CONTEXT................................................................................................1
Strategy............................................................................................................................................3
Evaluation........................................................................................................................................5
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8
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INTRODUCTION
Standard precautions were intended to minimize the risk of blood borne transmission as well
as other diseases from sources known as well as unrecognized. They are also the reasonable
process of protection for infection prevention. These all should be used, at the very least, in the
treatment of all with patients. All people (including workers and caregivers) should cooperate
regarding infection prevention procedures in health-care facilities, in contrast to processes
carried out along with health professionals when delivering care. In order to prevent
dissemination, regulation of the presence of diseases from either the source is important.
Circulatory, among source control interventions, as routine clinical precautions, sanitation
etiquette, established and during epidemic of serious respiratory distress syndrome (SARS), is
now regarded. In this project, the main issue faced by the aged care people which is related with
non-hygienic condition behaviour and activity of staff members. The main aim of this project is
to provide proper improvement plan and strategy which help to reduce the chances of getting
infected by any disease which can be harmful for aged people.
BACKGROUND AND CONTEXT
The main aim of this project is to provide a detailed and suitable strategy which can be used
to make staff member aware regarding hand hygiene and also make proper donning and doffing.
Hand hygiene is indeed a key element of routine measures and among the most important ways
of avoiding health care-related transmission of infection. Through use of basic hygiene, in
contrast to infection control, is risk evaluation and the level of anticipated interaction with
contaminated needles, or diseases, should direct safety gear. Growing use of such standard
safeguards globally will minimize needless health care-related hazards. The development of an
institutional environment of safety aims to promote compliance with the prescribed measures
which steps and possible risk mitigation. The availability of free personnel and equipment, along
with the management and training of health employees, patients and tourists, is essential for a
health improvement atmosphere in terms of reliability. Carry out hygiene practices by hand
washing or personal hygiene, conduct sanitizing wipes using soap and water if the hands are
clearly soiled or if there is sensitivity to spore-forming species are confirmed or strongly
demonstrated. believed, or after bathroom use and anything else, if allowed by resources,
conduct hands trying to rub with a treatment centred on alcohol. Ensure that hand-washing
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services with safe clean water are available. The prices of products for hand hygiene (clean
drinking water, shampoo, smooth sheets for individual use, hand rub dependent on alcohol). A
handle dependent on alcohol ideally, rubs must be free at the time of Care. Handle instruments
that are soiled through blood, mucous membranes, toxins and waste products in a way that
avoids damage to skin or mucous membranes, clothing contamination and also the transmission
of diseases to many other clinicians and to other patients about the climate. Prior to use with
some other patient, wash, clean, and recycle efficient approach properly. At just the start of
employment, the techniques they adopted when drama etc. diseases, as well as prevention and
treatment education were given to the number of hospices. As the instructions are given with
regards towards hygiene that should really be taken inside a facility wherein the percentage of
clients must not be compromised by the employees because of disease. Members must maintain
sufficient distance for each client and for each decision they make, use hand sprays. They were
also provided with training to recognize the severity of the safety actions taken by staff members
to safeguard them as well as the employees of the staff. Those that are with them. According to
research, owing to this introduction of od strategy, the planning succeeded and enabled the
majority of patients who recover as well as rebound again from disease and also the frequency of
infections was greatly reduced.
However, there are some factors that affect the adherence to the practices of hand hygiene
by Health Care professionals. The risk factors for ineffective or poor hand hygiene adherence
includes physician status, wearing gowns, working during the week, automatic sink, nursing
assistant status. Apart from this, the self-reported factors related to poor adherence with hand
hygiene involves lack of paper towels and soaps, under staffing/ overcrowding, the patient
required to take priority, hand washing agents cause dryness and irritation, no role model from
superiors or colleagues, disagreement with recommendations, often too busy/ insufficient time
etc. In addition to this, there are some perceived barriers to hand hygiene including lack of
institutional priority towards hand hygiene, lack of active participation in promotion of hand
hygiene at institutional or individual level, lack of institutional safety climate, lack of
management sanction of rewarding compilers/ non compilers. In order to overcome these
barriers, it is very necessary to provide employees with proper education regarding hand hygiene
and culture of adherence along with the feedback on performance. In addition to this, providing
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easy access to the materials of hand hygiene is also an another way that help in overcoming the
issues associated with hand hygiene.
Strategy
The instantiation of the best strategy to reduce the change of getting the aged of old people
infected from any disease because of unusual practice of staff member. It can be suggested that
has the biggest purpose of avoiding the triggers of contamination in aged people since the
immune mechanism s considered fragile and has little capacity to counteract the consequences of
infections. The most important devices are known to have the underlying resistance to infection.
The specific rates which possibilities of infection diagnosis in aged people at the first level could
be debited with this accompanying instrument, which can also assist in the elderly as well as the
majority of the individuals can be handled with both the prescription and the right guidance
issued by them to remain alert in relation to diseases. As a result of this policy, the techniques
debiting the primary goal of minimising the burden of disease in a palliative care wherein the
infant is capitalized are strongly regarded. Since all age ranges have a poor immune system and
may be similarly affected in the future. The approximate statistics show that the reduction rate
including its disease referred to as low as well as the disease that further leads a person to relapse
and flu infections in a care home is reduced to 30%. It also revealed that other defense steps were
also undertaken to remove the entire incidence of pathogens by way of regulation acceptance that
is safe and keeps the age clean.
 Hand washing (40-60 seconds): clean hands of soap; scrub all surface areas; vigorously
scrub palms with clean with such a fresh sheet; use a wash cloth to switch off the faucet.
 Hand rub (20-30 sec): spread ample material to reach all hands regions; rub palms
completely dry.
 Before after each and every prior communication with the patient, and if gloves were
required or not, amongst patients.
 Application before treating an invasive item and after the gloves have been discarded.
 Body oils, secretions, excrement, – anti clothing, and infected objects after handling
blood, even though safeguards are provided.
 During health treatment, as the patient transfers from a polluted location to a clean body.
 During the relative vicinity of the user, following contact towards physical objects.
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An element of standard precautions, personal protective equipment is one of a hierarchy
of controls which aims at eliminating or removing hazards to healthcare personnel from the
exposure of infectious disease. The hierarchy is provided below -
1. Training and administrative controls
2. Work practice controls
3. Engineering controls
4. Personal protective equipment
In the Donning, the general CDC recommendations for proper utilization of personal
protective equipment includes -
Don personal protective equipment prior to contact from patient and before entering into
the room of patient. Once it is on, utilize personal protective equipment carefully in order to
avoid contamination and follow the safe work practices involving work from clean to dirty,
keep hands away from face, limit the surfaces touched and change personal protective
equipment when heavily contaminated. As per the guidelines, the recommended donning
sequence is provided below -
1. To don a gown -
2. Choose appropriate size and type of gown
3. With back opening, secure the gown at waist and neck
4. If the gown is small for complete coverage, utilize two gowns.
To don a mask -
1. Place the mask over nose, chin and mouth.
2. After that, fit flexible nosepiece on bridge of nose.
3. Secure the mask on head with elastic and adjust it to fit.
To don face shield and goggles -
1. Wear the goggles over eyes and then secure to head utilizing ear piece.
2. Place the facial over face, secure on brow and adjust for comfort.
To don gloves -
1. In the personal protective equipment kit, gloves are the last component to be applied.
For wearing the gloves, extend hand into gloves and to cover the wrist of isolation
gown.
2. Tuck cuffs of gown properly under each glove and adjust it for comfort.
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The removal basics associated with personal protective equipment includes –
When the care tasks of patients are complete, it is important to carefully remove the personal
protective equipment and discard it properly. After that, immediately performing the hand
hygiene is when necessary. At the time of removal of personal protective equipment, the main
goal is to eliminate contamination of self and environment. To remove the gown, the steps to be
followed includes unfasten the ties, peel gown away from shoulder and neck, turn the
contaminated side inside, role the gown and discard it properly.
Proper donning as well as removal of personal protective equipment is a very basic step in
safety culture. It is the work environment where shared commitment to safety exist between
management and employees. Proper adherence to safe work practices will help in reducing the
exposure of infectious fluids and blood. Developing a strong safety culture help in improving
infection prevention program.
Evaluation
Standard precautions are the directives or guidelines that were developed in order to break
the chain of infection as well as decline the risk of transmission of pathogen within health care
settings. The standard precautions are applying to body fluids and blood, secretions and
exertions, mucous membranes and non-intact skin. The standard precautions not only protect the
patient from infection, but they protect Health Care workers also. As per the view point of Charis
E. Patterson, 2015, in preventing the spread of infection, hand hygiene is the best weapon and
involves hand washing with water and soap and alcohol based hand rubs. The alcohol based hand
rubs contains around 60% to 95% of alcohol and is the preferred method for decontaminate the
hands, except when an individual has infectious diarrhea or when hands are visibly soiled. It is
very important that prior and after contact with patient, hand hygiene must be performed. Apart
from this, immediately after touching non intact skin, blood, body fluids, contaminated items or
mucous membranes and after removing the gloves, hand hygiene must be conduct (Basic
principles of infection control, 2015). For maintaining the strict hand hygiene practices in
hospitals and clinics, the patients as well as their family members must be taught regarding
significance of washing hands. Scrubbing the hands for 20 minutes at least by utilizing soap and
water and paying attention to the areas like back of hands, between fingers, thumbs and
underneath fingernails is also important.
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According to the opinions presented by Josephine Hegarty & et. al., (2019), acquisition of
health care associated infection is one among the frequent harmful events that threatens the
safety of patient and affecting around 5% to 10% of individuals admitted to hospital. It is a major
burden on people, their families as well as health care services which leads to rising mortality
rates, high cost of treatment and extended stay in hospital. In such situations, successful
execution of clinical guidelines can help in decline the prevelence of such infections which in
turn leads to reduce the incidence of hospital stay. Although, the clinical guidelines facilitated
evidence based practice as well as enhance the health outcomes for patient, the availability of
written guidelines doesn't make sure successful prevention and control of infection (Leadership
perspective on the implementation of guidelines on healthcare-associated infections, 2019). The
uneven execution of evidence-based guidelines is recognized widely as continuing challenge.
One among the suitable way to overcome this challenge or issue is adapting guideline
recommendations in this context. This adaptation must acknowledge the local context as well as
engage stakeholders to maximize and sustain compliance in more effective way. The senior
leaders can facilitate adaptive approach, execute guidance as well as motivating people to engage
in day to day infection prevention and control duties.
A study reiterates that execution of guideline recommendations needs training and education
as part of the multimodal interventions, where leadership has been determined as core element of
success. The leaders play a vital role in strengthening infection prevention and control culture,
through depicting tangible support to teams, make sure that needed resources as well as health
care practitioner time exist to undertake the activities associated with infection prevention and
control. In this, leadership is essential with supportive claims that at all levels, it mixed with
clear National strategy as well as local structural capacity to deliver the guidelines. Leadership
also play a significant role in infection prevention and control execution when regional or
National strategies have unintended consequence like inadequate engagement, lack of local
ownership. In such case, the leaders facilitate execution of clinical standards by mixture of
strategic approaches with bottom-up collaborative working principles. By the execution of
guidelines, successful leaders can contribute to the actions of prevention of infection.
Understanding the perspectives of healthcare leaders help in study of execution of guidelines on
health care associated infections.
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From the above discussion, it has been evaluated that the particular issues pertaining to
execution of guidelines can be addressed by leadership, like limited collaboration between senior
management and frontline staff as well as the consequent lack of shared ownership of execution
of healthcare associated infection. In order to overcome the issues, leaders are encouraged so that
they promote collaborative execution strategies developed by managers, senior clinicians,
frontline staff, service users and infection prevention practitioners. The co-produce execution
plans in infection prevention and control can benefit from the leader's collaborative leadership
style where they are enable to share their opinions as well as participate in decision making,
instead of more hierarchical style of leadership. The mixture of insights and information from
frontline staff members and senior leaders can be appropriate to determine the opportunities and
priorities for realistic enhancements in practice. Effective leadership style has strong influence
on the outcomes of patient. Transformational leadership adopts long-term approach developed
around common relationship as well as understanding. On the other hand, the transactional
leadership is more emphasized on short-term rewards.
In the disposal of waste in aged care settings, it is the responsibility of management that the
staff must be trained appropriately infection control practices as well as manual handling. Apart
from this, it is the responsibility of staff members who generate the waste, to dispose the waste
appropriately and standard precautions must be followed while handling the infectious waste in
aged care settings. According to the health and safety infection control policy, it is necessary to
make sure effective risk management, governance and encouraging a safe culture. The
management has the responsibility to ensure commitment and proper budget allocations for
controlling the infections.
CONCLUSION
As per the above mentioned report, it has been concluded that in the aged care settings, it is
very important to take appropriate infection control measures so that a safe environment can be
developed for the old aged people and the risks related to health and safety can be eliminated.
Ensuring proper hand hygiene is one of the most appropriate strategy that helps in controlling the
infection. It is very necessary for the staff members to make sure that hand hygiene is performed
immediately after contacting the patient. Apart from that, it is also very important to make sure
that exposure to body fluids and blood is avoided as this increases the risk of spread of infection.
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Proper donning off personal protective equipment and performing hand hygiene are the
appropriate strategies to control the risk of healthcare associated infection.
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REFERENCES
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