Leadership in Preventing Nosocomial Infection

Running head: LEADERSHIP
Leadership
Name of the student:
Name of the University:
Author’s note

1LEADERSHIP
Nosocomial infection or health care associated infection (HCAI) is the
transmission of pathogens like Staphylococcus aureus,
Klebsiella and Escherichia coli through direct contact with contaminated
environment or health care staffs resulting in increased hospital stay, high rate of
morbidity and mortality and increased health care cost for patient and health care
facilities. Nosocomial infection affects millions of people globally and it severely
threatens patient safety (Yallew, Kumie & Yehuala, 2017). As nosocomial infection
occurs due to lack of appropriate implementation of hygiene protocols to prevent
transmission of infection, the role of clinical leaders is paramount to influence
change in hospital setting. Leadership plays a role in promoting effective
governance and bringing system wide changes to achieve and sustain improvements
to care quality and patient safety. The main purpose of this essay is to provide an
overview of the issue of nosocomial infection in hospital setting and critically
analyse the need for change in health care practice. In response to the change
required for preventing nosocomial infection in clinical setting, the essay discusses
about key leadership attributes and skills required to change the process. The thesis
for the essay is that leaders have the capability to transform the hospital culture and
prevent eliminate environmental factors contributing to nosocomial infection.
Nosocomial infecton or HCAI is a type of infection that is transmitted to
patients or health care staffs during the process of care. It results in increase in
occupational infection among staffs as well as adverse event and prolonged hospital
stay for patient (World Health Organization, 2018). There are multiple causes
behind the transmission of such infection in hospital setting. Firstly, the hospital

2LEADERSHIP
environment is itself the cause behind risk of nosocomial infection. Infections can
be transmitted through three routes such air, water and surface and this is seen
particularly in mechanically ventilated patients and those requiring invasive device
for treatment. Malfunction and ventilation system results in accumulation of dust
and moisture within the system resulting in increased risk of spread of
environmental fungi and bacteria (Beggs et al., 2015). Apart from environmental
factors, the most crucial factor that lead to nosocomial infection includes lack of
hand hygiene and poor compliance to hand hygiene among nurses and other staffs.
This is said because majority of nosocomial infections are transferred through hands
of care personnels and hand is the first method for prophylaxis (Sharif et al., 2015).
However, research evidence shows poor compliance to hand hygiene practices and
use of alcohol based disinfectants by nurses. Hence, as hand hygiene is directly
linked to nosocomial infection, poor compliance to hand hygiene justifies the need
for leadership role in bringing changes to practice.
Effective clinical leadership is vital to bring change in health care system and
engage in implementation of steps to promote improvements in quality of care. As
nosocomial infection has influence on the quality and reputation of hospital
performance, leadership skill is crucial for influencing group activities and
eliminating barriers during the change process (Daly et al., 2014). Based on analysis
of the cause behind HCAI in hospital setting, both environmental factors as well as
staff related factors have been identified as the cause behind burden of HCAI. The
lack of compliance to hand hygiene particularly demonstrates lack of
implementation of appropriate protocol or culture to promote hand hygiene. Hence,

3LEADERSHIP
as per the leadership vision, it is necessary to identify the barriers that result in poor
hand hygiene cultured and increased risk of HCAI. As this issue particularly suggest
the need to bring major change within the hospital setting, the transactional
leadership style is considered important to bring changes in the system. This
leadership is relevant for the problem because transactional leaders act as the
manager of change and they engage in appropriate exchange with employees and
other stakeholders to improve performance and production (Sfantoo et al., 2017).
Therefore, identifying barriers to change process is crucial to make effective plans
for reduction in HCAI incidence.
To achieve the goal of high quality care, the main role of a leader is to instill a
culture of safety among health care staffs. The significance of this strategy is that it
supports creating environment for safer care. In the context of HCAI, proper hand
hygiene technique and education of staffs regarding hand hygiene is regarded as
crucial to achieve the quality improvement goals. However, criticial analysis of the
cause behind non compliance to hand hygiene is critical to implement effective
change. Firstly, for patients admitted to hospitals, compliance to hand hygiene is
affected by barriers like critical illness, lack of access to hand sanitizers, presence of
morbidity like confusion and delirium. After patient, the health care staffs like nurse
are important source of pathogens by direct contact during care of patient. However,
health care workers also increase the likelihood of infection transmission due to lack
of awareness regarding outcome of poor hand hygiene, poor attitude towards hand
hygiene and lack of appropriate hand hygiene protocol (Fox et al., 2015). Teker et
al. (2015) argues that lack of appropriate safety culture, excessive workload and