Acquired Infection

This article discusses the incidence and prevalence of MRSA, risk factors, hand hygiene, standard precautions, transmission based precautions, and multi-disciplinary team support for care of patients with MRSA infections.

Running head: ACQUIRED INFECTION
ACQUIRED INFECTION
Name of the student:
Name of the university:
Author note:

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Introduction:
Methillin resistant staphylococcus Aureus or the MRSA is one of the types of bacterium
that are responsible for causing infections in different parts of the body. This organism is very
difficult to treat as they are resistant to a large number of antibiotics. These organisms are mainly
seen to cause various types of problems as it ranges from skin infections and sepsis to that of
bloodstream infections and pneumonia (Haysom et al. 2018). Therefore, nursing professionals
who provide wound care treatment to different patients need to be very careful regarding their
hygiene maintenance so that the patients do not get vulnerable to such disorders (Zingg et al.
2015). The assignments will mainly show the incidence and prevalence of the infectious
organisms, differences between the two types of infections, care habits that professionals need to
uptake and multi-disciplinary team support that would provide care to the patients.
Incidence and prevalence of MRSA:
Staphylococcus Aureaus is considered to be one of the major bacterial pathogen that
remains intricately associated with the considerable mortality and morbidity of not only patents
in the healthcare centres but also in the communities that have the infections of the organism.
Manifestations of this form of pathogen are seen to take place in the form of occurrence of
infections that may range from mild to that of moderate skin (Banach et al. 2015). In many cases,
studies have also shown that such pathogens may also cause soft tissue infections such as
impetigo and furunculosis and may result in invasive as well as life threatening infections like
osteomyletis. Necrotitis pneumonia and infective cardititis are also seen to occur. Other disorder
that may also take pace is called the bacteraemia. In the present generation, not only in the nation
of Australia but also in the rest of the world, antimicrobial resistance in the pathogen can be

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described as the major impediment for effective treatment. Researchers have stated that most of
the hospital strains are not only resistant to methicillin but also to other multiple antimicrobials.
From the studies conducted in the year 2014, it is known that about 27 institutions around the
nation of Australia had participated in the Australian Staphylococcal Sepsis Outcome
Programme (ASSOP) (Huang et al. 2016). It was found that 18.8% of the 2206 Staphylococcus
aureus bacteraemia (SAB) isolates were found to be methicillin resistant. This was significantly
higher than the other European countries. They had also found that the 30day all cause mortality
associated with MRSA infection was 23.4% and this is significantly higher than the 14.4%
mortality associated with the methicillin sensitive strains.
People who are receiving medical care in the healthcare centres can get serious infections
from these pathogens which is called the healthcare associated infections or the HAIS. This has
the capability to cause death in individuals besides tremendous suffering. Different hospitals are
seen to report various kinds of infections like the infections caused by C. difficile, infections that
follow surgery and even infections that may occur following the placement of a tube in the
bladder or a large vein. Researchers are of the opinion that HAIs are mainly caused by antibiotic
resistant bacteria that may lead to sepsis or death and MRSA is one of the such deadly strains
that result in increasing the sufferings of patients mainly affecting wound management and many
others (Ji 2016). On the other hand it is seen that when people in the community settings acquire
such pathogens they are called the community acquired MRSA. However, the level of incidence
in the community is much smaller than that of the healthcare settings. However, researchers are
of the opinion that people are more prone to get community-acquired MRSA when they have
skin trauma, skin tattoos or body piercing, previous infection with MRSA, sharing equipments or
supplies that are not cleaned or laundered and many others. People living in the communities like

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those in prisons, people in military or people in athletic teams are also prone to development of
such disorders (Lee et al. 2015).
Risk factors:
Many risk factors expose individuals to development of infections by MRSA.
Researchers are of the opinion that mainly three types of risk factors result in the infection of
MRSA among different individuals. The first one risk factor is being hospitalised. It is seen that
those individuals who have been hospitalised become more vulnerable to the occurrence of this
infection. Studies conducted over the years have shown that older adults, children and those who
have weakened immune systems are more vulnerable to the disorders. Another risk factor is
witnessed when patients are provided with invasive medical device (Salge et al. 2017).
Researchers conducted over the years have shown that medical tubing like in cases of the
intravenous lines as well as urinary catheters also act as a pathway for MRSA for travelling in
the body. Another risk factor is that individuals who live for long-term facility in healthcare
centres are also highly vulnerable to acquire the infection. They may be also carrier where they
might not be affected themselves but they may make others sick. In the case study provided, it
was seen that Mrs. Jenkins had also been exposed to the environment of the healthcare when she
had faced a fall. She had been admitted to emergency centre for her treatment of the wounds and
this might have been the situation when she had acquired the infection (Vaidya et al. 2015). The
healthcare environments or the nursing professionals may not have maintained proper hygiene
for which she might have been exposed to the infection (Ventola et al. 2015). Moreover, as she is
old she is also vulnerable to the disorder, as researchers have mentioned that old patients are
more vulnerable to this infection.

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Hand hygiene:
Hand Hygiene is considered one of the most important primary measures that have the
capability of preventing healthcare associated infections. Researchers have found out that hand
of healthcare workers are the most common route of transitions for microorganisms like that
MRSA during delivering of care and therefore, proper cleanliness of the hands should be ensured
before treating patients. Hand hygiene is therefore considered to be one of the most important
part of the standard and isolation precautions and are at the core of multi-faceted strategies for
prevention of different types of infection like that of surgical site, wound handling, ventilator-
associated pneumonia and vascular catheter- and urinary catheter-related infections (Magil et al.
2014). Every healthcare professional should maintain the key principles that are required for
maintaining hand hygiene while handling vulnerable patients. It is of high chance that the
healthcare professionals who attended Ms. Jenkins had not maintained the key principle of hand
hygiene. Hand hygiene should be performed at the appropriate time and along with the correct
technique. Moreover, professionals also need to be careful that that whether they are following
hand hygiene in five key moments or not that reduce the risk of pathogen transmission. These are
before touching the patient, before taking up the aseptic procedures or cleaning procedures, after
body fluid exposure, after touching the patient, after touching surroundings (Slayton et al. 2015).
All these might to have been properly done when Mrs. Jenkins was treated that might have
exposed her to the disorder.

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Standard precautions:
There are ten important standard precautions that every healthcare professionals need to
take so that the spread of infection does not take place. The first one is maintaining of proper
hand hygiene and use of gloves in the correct moments and the correct ways. Professionals
should do facial protection of eyes, nose and mouth when they visit patients with MRSA
(Septimus & Schweizer 2016). It might have happened that professional who treated the patient
did not take these precautions on meeting MRSA positive patients before attending her.
Therefore, Mrs. Jenkins might have been affected by the disorder. Besides, wearing of proper
safety gowns, proper prevention of needle stick and injuries from other sharp instruments should
also e handled with care. The professionals should maintain respiratory hygiene and cough
etiquettes. Environmental cleaning should also be ensured. Handling of the linen should be done
in ways by which skin and mucous membrane exposure does not take place (Kelly et al. 2016).
Waste disposals should be done responsibly and patient care equipment should be sterilised and
handles with care so that transmission of the pathogen does not take through them. The
healthcare professionals of Mr. Jenkins might have failed to maintain these standard precautions
where providing care for the patient and hence her wound was exposed to the pathogens
resulting her to suffer.
Transmission based precautions:
Transmission based precautions are considered to be the second tire of basic infection
control and are needed to be followed in addition to that of the standard precautions. There are
mainly three areas of Transmission based precautions. One of them is the contact precaution,
droplet precaution as well as airborne precautions. Professionals need to ensure proper patient

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placement so that they remain free from chances of getting the infection from another patient,
properly use personal protective equipments like gloves, limiting patient’s movements and
transportations. Proper disposable or dedicated patient care equipments should be ensured and
cleaning and disinfection of the rooms should be prioritised. Using of masks, gloves and other
protective materials can prevent transmission of the germs (Yao et al. 2015). All these guidelines
were not followed by the professionals in case of Mrs. Jenkins and therefore, she might have
been exposed to these infection.
Multi-disciplinary teamwork:
The patient who would be discharged home would be highly vulnerable to lead poor
quality lives if proper care is not taken. Her wound was affected by MRSA and proper antibiotics
have been given to her. If the proper course of medication and wound management is not done,
the degree of infection might also develop and this might affect healing of the wound. Therefore,
the community registered nurse who would be attending her at home has a large number of
responsibilities to care for. Besides conducting proper wound management of the skin tear that
had been infected by MRSA and providing her the correct dose of medication of antibiotics at
the right time through the proper routes, she also have to conduct many other activities that
would help in developing a MRSA-pathogen free environment. She should participate in normal
domestic cleaning assuring that the environment is clean (Tilahun et al. 2015). Surfaces and
floors should be vacuumed and cleaned regularly. Moreover, she should also take care of the
clothing, bedding and many others ensuring that they are washed properly. Rubbish should
properly disposed. Moreover, they should also educate the patient and her family members about
how to maintain hygiene while handling the patient or while attending her needs. This would
ensure prevention of the spread of infection to other members. The occupational therapist should

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put his focus on the rehabilitation that is related to her skin tear in the lower extremity of her
right leg. As the wound is not healing for long time, she might not be able to mobilise properly
and would be spending most of her time is supine position. Therefore, occupational therapist
would make sure that he evaluates’ the psychosocial as well as the emotional needs of the
patient, thereby modify the treatment approach to facilitate her compliance with the
rehabilitation program. He would be providing a holistic and client centred approach helping her
to develop mobility in gradual ways and keep her empowered throughout her treatment (Kelly et
al. 2016).
Conclusion:
From the entire discussion, it becomes quite clear that the professionals who were
appointed in the emergency department to treat Mrs. Jenkins did not follow the proper measures
requiterred to prevent MRSA. It is one of the strains of Staphylococcus aureuas that have
become resistant to a number of antibiotics and are therefore called methicillin resistant.
Treatment of such infections is important as that may expose the patient to several other
disorders like pneumonia and others. Therefore, it is expected of the professionals to undertake
proper hand hygiene, standard precautions and transmission based precautions so that they can
provide high quality care service. Hospital acquired infections results in suffering of patients that
are easily avoidable. Hence, it has become one of the main priorities of every healthcare centres
to ensure safe and high quality care. This would prevent hospital readmissions, longer stays of
hospitals and unavoidable deaths.

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