Perioperative Nursing Care in Infection Control

This report focuses on how to deliver safe health care, risk management in infection control and the role of health care practitioners in delivering a safe health care. Perioperative nurses have the duty of providing care services to all patients during the perioperative period, before and immediately following an intervention procedure and/or surgery.

Running head: PERIOPERATIVE NURSING CARE IN INFECTION CONTROL
Perioperative Nursing Care in Infection Control
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Controlling and minimizing spread of disease and health care associated diseases is
among the core functions of any health care institution. The environment in the health care
facility contains potential elements to facilitate growth and spread of infectious diseases. The
people, air in the environment and everything else can act as microorganism carriers
(Centrak, 2018). According to the WHO (2018), injections are among the most widely used
procedure in the health care institutions. Approximately 16 billion injections are administered
to people per year with almost 90 percent given in curative care. In other countries, about 70
percent of the injections are administered by reusing syringes and needles and others
administered unnecessarily. This could transmit airborne diseases. The WHO came up with a
campaign (Get the point, make smart injection choice), whose aim is to make the injection
practice safer for every stakeholder.
There are almost 200,000 cases of healthcare associated infections (HAIs) reported in
Australia every year (Patterson, 2015). This is therefore, considered as the most commonly
occurring complication for the patients, that makes them suffer along with their families.
According to the Australian government, there have been almost 724 cases of healthcare
associated bloodstream infections recorded in 2016 (Poggio, 2013). Out of the 724 cases,
13.4% occurred in non-inpatient patients, majority of which was related to hematology or
oncology patients (Poggio, 2013). The rate of healthcare associated bloodstream infections in
hospitals was 4.5 per 10,000 bed-days in 2016 (Patterson, 2015). Such adverse situations
prolong the period of stay in the hospitals and thereby increase the cost of care as well.
In developing countries, surgical suite infections are more frequently contracted
during health care delivery (Patterson, 2015). Poor hand hygiene leads to transmission of
germs causing diseases, even the germs resistant to antibiotics. This exposes a patient to risks
of contracting healthcare associated infections. Surgical site infections are the common health
care associated infections and the bacteria causing them are in most cases resistant to

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commonly used antibiotics. Effective infection prevention and control is a fundamental
aspect in delivering an effective, safe and high quality health care (WHO, 2018). This report
focuses on how to deliver safe health care, risk management in infection control and the role
of health care practitioners in delivering a safe health care.
According to Connors (2015), it is very devastating for a patient to contract
infections in the health centre. He further makes it clear that it should be understood that
infection control in hospitals should not be solely nurses and doctors responsibility. This is
why health care managers and regulatory agencies are joining hands with infection control
personnel to ensure improvement in infection control in health care facilities. Aspergillus
infection causes 5000 deaths every year. Transplant patients who suffer from this fungi have
a 74 to 92 percent likelihood of passing away. Legionella bacteria acquired in the hospitals
has more than 40 percent mortality rate and is twice as deadly as that acquired outside the
hospital. Therefore, it is of great importance that the concerned stakeholders work together
for a vigilant infection control and prevention. This shed light on what should be done to
prevent these infections.
Perioperative nurses have the duty of providing care services to all patients during the
perioperative period, before and immediately following an intervention procedure and/or
surgery. Perioperative nursing requires the nursing staff to adorn a range of specialty roles
that commonly encompass circulating, holding bay, anaesthetic administration, use of
instrument. They are also needed in the recovery rooms. Some other roles of nurses include
evaluation of the patient and their education on the different infection control practices
(Quick, 2013). There is mounting evidence that have establish high rates of hospital acquired
infections (HAIs) with perioperative settings. These infections are commonly defined as
those that occur during the course of providing care to a patient (Lewis et al., 2013). Without
the presence of a clean environment or appropriate infection control measures that commonly

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comprise of decontamination procedure and/or hand hygiene, the nurses are not able to
prevent the onset of infections in perioperative settings.
The patients being operated in theatres are considered as a potential source of
contamination. Thu, perioperative nurses have the duty of putting on appropriate surgical
attire, such as, PPE and scrub suits as the first step of infection prevention. Apart from hand
hygiene practices, they are also responsible for preventing surgical site infection by
accurately removing the hair from perioperative patients during their surgery and full
washing of the patient body, with the use of antiseptics (Poggio, 2013). Some of the major
issues related to priority safety are namely, pressure injuries, medication error, retaining
surgical instruments, wrong site surgery, surgical fire and perioperative hypothermia
(Steelman, Graling & Perkhounkova, 2013). Furthermore, putting on specific shoes, masks,
and clothing in the operation theatre also helps the perioperative nurses to prevent the
transmission of potentially dangerous pathogens in the controlled environment. Thus, the
efforts that are usually taken by these nurses in preventing the onset of HAIs include skin
antisepsis, prophylactic antibiotics, hand hygiene techniques, wound protectors, hair removal
and normothermia prevention.
According to Mehta et al. (2014), nosocomial infections are a major concern to
clinicians and patients as well. While considering the mortality, cost, duration of stay in the
hospital and morbidity, efforts should be made to prevent these infections. In management of
these infections guidelines have been set to guide the health care personnel. The principle of
grading systems is used to access quality of care. Germs transmission is in most cases done
through hands. Maintaining hand hygiene it the most effective means of controlling
horizontal infection transmission in hospitals (Zorrilla-Vaca & Escandon-Vargas, 2017). This
should be done before and after attending a patient, before aseptic procedures, after exposure
to body fluids and after coming into contact with the patients’ environment. Some practices

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previously practiced during pre-surgical preparation, such as re-using a syringe to administer
drugs for different patients, posed a great risk in disease transmission. This had to be dropped
in the effort to managing the health care acquired infections. According to the University of
Essex (2018), stated that prevention of these infection is much far better that treating them.
Most health care facilities prevent through cleaning, sterilization, outbreak investigation and
disinfection. It is also advisable to follow standard precautions regardless of the infection
status of the patient. Wearing of sterile gloves, gown, mask, face shield or eye protection,
shoes and head coverings are important precautions. Other than the standard precautions,
transmission base precautions such as airborne, contact and droplet precautions should be
observed (Nazeer, 2017).
Connors (2018) thinks that a thorough and a clear understanding of the risk factors is
prominent to the nurses. He thinks that they should also be aware of the role played by the
physical environment in ensuring patients’ safety. AMN health care (2018) claims that nurses
play a vital role in preventing the transmission and spread of heath care acquired infections
through research, educating the patients and ensuring that their practice is evidence based.
Nurses are the patients’ advocates and have the full potential and are in a unique position to
improve patients care standards, build and maintain a safe environment for the patients
through the tools available to them (nurses). Universal precaution is fundamental in
maintaining a safe health care environment. It is designed to prevent blood borne pathogens
transmission during health care practices. Sandra (2011) thinks that it is the duty of nurses
and health care practitioners to practice and promote hand hygiene. It is in fact a leading
measure to prevent infection spread in health care facilities, although most nurses’
compliance is low in most hospitals. Nurses should develop a habit of routine hand hygiene
before performing any patient care services. Nurses should consistently apply antiseptic
techniques so as to control pathogen contaminations.

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According to Dancer (2009), nurses often use medical instruments for different
patients. It is therefore there duty to clean and disinfect these devices and instruments before
using them to the next patient. They should also make the environmental services aware of
the cleaning and disinfecting expectations regarding computers and patient monitoring
devices. Other very vital roles of nurses in ensuring infection control in health care facilities
include: patient assessment and additional precautions, whereby the nurse would be able to
tell any unexpected signs and symptoms on the patient; use of standard precautions; patient
education whereby the nurse explains to the patient and their family about treatment progress
and the rationale for treatment and strategies; use of safety devices and removal of
unnecessary invasive devices (Rao, 2013).
Perioperative nurses work along with the clinical practitioners, surgeons,
technologists or anaesthesiologists to ensure complete safety of the patients being operated or
going through any invasive procedures. To effectively manage the risks, the nurses must
make sure that the patients are given the antibiotics as prescribed, their wounds are properly
cleaned and regularly treated with medications, and most importantly, the nurses or any care
providers who would attend to the patient, must go through the general procedure of hand
hygiene maintenance to ensure patient safety and reduce any chance of infection through the
wound. A few infection control principles must be strictly followed by the perioperative
nurses for effective control of any chances of infection and further management of risks to
the patients. These include: cleaning and disinfecting the wounds of the patients, practicing
safe injection procedures and maintaining a good hand hygiene, always adhering to using
sterilized needles and wound care instruments and proper disposal of the waste materials.
It is therefore clear that everything in the environment can act as a microorganism
carrier and potential agents to facilitate growth and spread of diseases. It is a great shame to
health care delivery bodies for patients contracting infections at their look and therefore

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health care infection control is a fundamental aspect in preventing patients’ infection. Nurses
should maintain high levels of cleanliness, both of themselves and the environment. They
should also take frequent and close examinations on the patients so that they are aware when
the patients show unexpected changes. This would reduce disease transmissions in health
centres and also reduce deaths.

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References
AMN Health care. (2015). The Nurse’s Role in Preventing Hospital Acquired Infections.
Retrieved from: https://www.rn.com/nursing-news/nurses-role-in-preventing-hospital-
acquired-infections/
Centrak. (2018). Infection Control. Retrieved from: https://www.centrak.com/infection-
control/
Connors, B. (2018). The Importance of Hospitality Infection Control and What Facility
managers Need to Do About it. Retrieved from:
https://www.eheinc.com/blog/hospital-infection-control-and-what-facilities-
managers-need-to-do/
Dancer, S. J. (2009). The role of environmental cleaning in the control of hospital-acquired
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Lewis, S. S., Moehring, R. W., Chen, L. F., Sexton, D. J., & Anderson, D. J. (2013).
Assessing the relative burden of hospital-acquired infections in a network of
community hospitals. Infection Control & Hospital Epidemiology, 34(11), 1229-1230.
https://doi.org/10.1086/673443
Mehta, Y., Gupta, A., Todi, S., Myatra, S., Samaddar, D. P., Patil, V., … Ramasubban, S.
(2014). Guidelines for prevention of hospital acquired infections. Indian Journal of
Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of
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Nazeer, Z. B. (2017). The Importance of Infection Control Risk Management in Health Care
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Zorrila-Vaca, A. and Escandon-Vargas. (2017). The Importance of Infection Control and
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