Perioperative Nursing: Strategies for Infection Control

This essay explores the strategies undertaken by perioperative nursing professionals to control infections that might result due to mismanagement of operative strategies. It delves deeper into exploring relevant scientific literatures and evaluates effective control strategies that can be undertaken.

Running head: PERIOPERATIVE NURSING
PERIOPERATIVE NURSING
Name of the Student:
Name of the University:
Author Note:

1PERIOPERATIVE NURSING
Introduction:
Perioperative nursing can be defined as a nursing practice that involves catering to
patients who have undergone a surgery or some other kind of minimal invasive procedure.
Nursing professionals who are involved in perioperative nursing techniques work in close
association with anaesthesiologist, surgeons, nurse practitioners and surgical technologists
(Blomberg, Bisholt, Nilsson, & Lindwall, 2015,p. 365). Perioperative nursing professionals
deal with a wide range of functions that concern preoperative, intraoperative and post-
operative care within the operation theatre (Blomberg, Bisholt, Nilsson, & Lindwall, 2015,p.
367,368). There are many vital components of pre-operative nursing which are stringently
managed by the nursing professionals. This essay would focus on strategies undertaken by
perioperative nursing professionals to control infections that might result due to
mismanagement of operative strategies. This essay would delve deeper into exploring
relevant scientific literatures and evaluate effective control strategies that can be undertaken.
Further the essay would formulate an effective summary from the literatures reviewed and
develop improvised interventions to monitor stringent infective control policies.
Discussion:
Peri-operative nursing care has been categorised as an important aspect in rendering
safe healthcare services to individuals. It should be noted that patients who visit the hospital,
do so with a certain level of expectations. The expectation level is to receive the best
healthcare facilities without any possibility of developing an infection and also attain
complete cure. Research studies have revealed that on an average there are 2 billion people
who do not have access to proper health care facilities (Barnes, Spencer, Graham & Johnson,
2014,p. 525). Studies have further stated that on an average, a million deaths occur every year
due to the observance inadequate and insufficient infection control strategies in the hospital
settings. Studies have also stated that the time period for the possible development of

2PERIOPERATIVE NURSING
infection due to casualty or negligence observed in the procedure of surgery can last from a
period of 2 weeks to almost a month (Barnes, Spencer, Graham & Johnson, 2014,p. 528) .
Major incidences of infection have been categorised as formation of blood clots in
different organs of the body, development of infection in the lungs, kidney and liver.
Probable incidences of developing post operative fever and ‘strokes’ have also been reported
in research studies (Berend et al., 2013, p. 515). It has been found that most of the infection
cases have resulted on account of critical complications arising after a difficult operation.
Mortality rates have been reported to be roughly three times higher in developing countries
than in developed countries primarily because of a major lacuna in managing risk factors and
infection control strategies in a proper manner (Berrios-Torres et al., 2017,p.790).
Mortality rates have been reported to be higher in procedures involving surgical
intervention. Moreover it has been found that mortality rate is lower in terms of developing
infections due to improper anaesthetic management (Berrios-Torres et al., 2017,p.790).
However, there have been several reports that have predicted the prevalence of mortality rates
arising due to improper administration of anaesthesia, causing an overdose. The overdose of
anaesthesia has led to the development of several complications such as pulmonary infection
and development of infection in the respiratory tract (Kwon et al., 2013, p. 8). Deaths have
been reported on account of blockage in the respiratory pathway. It has been reported that
catheter associated infection is the most common form of infection that affects patients
undergoing surgery in an ICU setting (Kwon et al.,2013, p.8,9) . Typically, it has been found
that catheter related infection development around the urinary tract develops on account of
manhandling or problems associated with the correct placement of the catheter in patients.
Research studies have also suggested that catheter infections can also arise on account of
infections caused by hospital pathogens (Poultsides et al., 2013,p. 387).

3PERIOPERATIVE NURSING
As stated by Carol and Sanjay (2013), hospitals must effectively imply stringent rules
that would help in monitoring the infection standards at a typical hospital setting. In this
regard, it has further been said that, effective hospital leadership, development of
collaborative and dispensing effective interventions can help in minimising the development
rate of infections. Evidences provided by statistical data reveals that approximately every
year, 40% of peri-operative infections are primarily linked to the urinary tract infections
across hospitals globally. Approximately, 23% infection cases reported at the Intensive Care
Unit have also been reported in context of infection in the urinary tract (Lowbury et al., 2013,
p. 111). Risk factors associated with development of infection on account of improper
hygiene has also been reported in hospitals of developing countries. There have also been
numerous instances when rapid infections have spread and caused major illness in infants due
to improper sanitisation and maintenance of hand hygiene. Infection related to the
development of sepsis-shock has also been reported in patients worldwide. In addition it
should further be stated that there have been instances where drug over dose and improper
handling of surgical instruments has led to fatal consequences in patients.
Fatal consequences such as deaths have also been recorded in scientific literatures.
Therefore, it is important to note here that, a number of death cases have taken place across
the world primarily due to negligence in observing proper risk management procedures to
control infection at a peri-operative setting (Rosenthal et al., 2014, p. 945). It is important to
evaluate that patients dealing with major health complications visit the health care
organizations and expect to be treated in a safe manner. It is primarily the duty of nursing
professionals involved in peri-operative care to make sure that patients are being subjected to
a medically safe treatment procedure that is free from the presence of any infection. Inability
to dispense safe medical treatment can give rise to fatal consequences that might even take
away the life of a patient. Numerous health care strategies that involve cheap and effective

4PERIOPERATIVE NURSING
strategies to combat issues related to peri-operative care must be undertaken by healthcare
organizations all over the world to ensure that patients can receive quality in terms of
facilities and recover without the development of fatal infections. It is extremely important
for the peri-operative nurses to be spontaneous, alert and at the same time efficient in order to
reduce any risks or possibilities of medical error that could prove to be detrimental for the
patients.
Peri-operative nursing professionals assisting in operation theatres can either be a
scrub nurse or a circulating nurse. The prime responsibility of a scrub- nurse is to handover
and passes the surgical instruments that surgeons would be using during an operation
procedure the duty of the circulating nurse is to maintain a safe and hygienic environment
inside the operation theatre based at a hospital setting (Talbot et al., 2013, p.632). It can
hence be said in this regard that the nursing professionals working for the peri-operative
department work in close association with the surgeons and other medical experts who are
required during an operation in a hospital unit. It is extremely important that the duties are
performed with accurate precision because a minor error such as a slight overdose of
anaesthesia could lead to the manifestation of severe infections in the respiratory tract and
could even prove to be fatal in some cases.
Argument and Evidence:
On thoroughly evaluating the evidences furnished by the research studies, it can be
said that a major role of conducting a safe operation procedure depends upon the peri-
operative nursing professionals. In order to avoid the occurrence of medical errors it is
essential that the nursing staffs are adequately trained and are aware of the infection control
guidelines as per the medical standards.

5PERIOPERATIVE NURSING
Researchers have suggested that in order to ensure a safe surgical procedure it is
extremely important to ensure that the nursing professionals involved in the peri-operative
care are able to coordinate with the entire surgical team (Wood et al.,2014, p. 140). Effective
team-work and maintenance of coordination plays a key role in observing a safe surgery that
reduces the possibility of any risks related to infection disorder. It is important to employ a
multidisciplinary team that would appropriately comprise of professionals belonging from
diverse medical specialization to proceed with the surgery in a smooth manner and avoid the
prevalence of any discrepancy or haphazardness. At the same time it is important for medical
organizations to have a proper action plan ready in order to address all the risk factors
associated with infection in an effective manner.
Further, research studies have revealed that it is important to undertake steps and
ensure that a proper flow of communication operatives between the team undertaking the
extensive procedure of surgery. At every step it is important to intimidate the information to
the surgeons in case any abnormality is observed. Moreover, it is also important to be alert
and convey the minimal changes that are hallmarks of risk developments and might lead to an
infection in patients. It is also the prime responsibility of the nursing professionals to
maintain a calm atmosphere within the hospital operation theatre (Wood et al., 2014,p. 138).
Unnecessary crowding in the hospital or immediate family members of other patients who
come and visit the hospital often talk loudly or grieve loudly in case of the demise of a family
member. Evidences have also reported instances where visitors are careless with the eatables
that they consume and often end up littering unnecessary that leads to contamination and
transmission of infectious agents. It has been suggested that healthcare organizations must
have stringent measures in order to control and eradicate these risk factors. Infectious agents
have also been reported to enter operation rooms through the constant entry of stretchers that
might comprise of patients who have open cuts and contaminated wounds. A secure method

6PERIOPERATIVE NURSING
could possibly include immediate dressing of the wound or stringent monitoring through an
intercom system that would effectively predict the safe time to bring in stretchers inside the
operation room. It is also important for the nurses to ensure a quality check on the
equipments being used in the surgery procedure so as to ensure that there are no possibilities
of risk associated with the use of equipments. Infection control strategies also involve double
assurance and cross checking of all steps undertaken during the ongoing surgery.
The nursing professionals also need to maintain a balance between the safety of the
patients and the surgeons. Many instances have been reported where the family members of
the patients often indulge in violent actions if the patient is deprived of appropriate medical
care or could not be saved despite a successful operation. In order to tackle these situations it
is important to incorporate effective means of conveying the treatment or surgical procedure
to the family members of the patient and make them clearly aware about the expected
outcomes. Infection control strategies primarily comprise of efficiently preparing the patient
about to undergo the surgery for the process (Wood et al., 2014, p. 139). It is crucial to note
here that in most of the cases infections arise from the endogenous contamination, therefore it
is important to effectively reduce the microbial load prior to the surgical procedure in order to
proceed with a safe surgery. Interventions such as showering the patient with an antiseptic
and administering efficient antimicrobial prophylaxis can help in the reduction of the
microbiological load from the genital tract, respiratory tract or the patient’s skin. Exogenous
infections are extremely common in cases that proceed with the placement of implants such
as total hip prostheses. Increasing possibility of air-borne bacterial contamination has been
reported in scientific literatures. In order to prevent the risk, effective strategies such as
undertaking a safe and clean surgical procedure is recommended.
Transmission of infectious agents through the skin and individuals of professionals
working inside the operation theatre is common. In order to prevent the same, precautionary

7PERIOPERATIVE NURSING
measures such as wearing of surgical gloves, gowns, caps and masks is highly recommended.
In addition, stringent compliance with the infection control standard is maintained and the
quality of environment inside the operation theatre with respect to the rate of air exchange
and cleaning process is thoroughly supervised (Rosenthal et al., 2014, p. 945). Regular
cleaning and sterilization of the equipments, ensuring laminar air flow, ultraviolet lighting,
using surgical gowning to treat exposed wounds, maintaining positive pressure and ensuring
non-turbulent germ free air envelope has been reported to be effective strategies to control
infection that spread through air (Rosenthal et al.,2014, p. 947).
Conclusion:
Therefore, to conclude it should be stated that maintenance of stringent infection
control norms in peri-operative setting by nursing professionals can help in reducing the
morbidity and mortality rate tightly linked to post-surgical infections. Healthcare
organizations across the world must ensure stringent measures to comply with the infection
control strategies and incorporate effective training to professionals in order to avoid medical
errors and patient deaths. Improvement in infrastructure and inclusion of effective
contamination control strategies can help in providing safe surgical interventions and
ultimately yield positive patient outcomes.

8PERIOPERATIVE NURSING
References:
Barnes, S., Spencer, M., Graham, D., & Johnson, H. B. (2014). Surgical wound irrigation: a
call for evidence-based standardization of practice. American journal of infection
control, 42(5), 525-529.
Berend, K. R., Lombardi, A. V., Morris, M. J., Bergeson, A. G., Adams, J. B., & Sneller, M.
A. (2013). Two-stage treatment of hip periprosthetic joint infection is associated with
a high rate of infection control but high mortality. Clinical Orthopaedics and Related
Research®, 471(2), 510-518.
Berríos-Torres, S. I., Umscheid, C. A., Bratzler, D. W., Leas, B., Stone, E. C., Kelz, R. R., ...
& Dellinger, E. P. (2017). Centers for disease control and prevention guideline for the
prevention of surgical site infection, 2017. JAMA surgery, 152(8), 784-791.
Blomberg, A. C., Bisholt, B., Nilsson, J., & Lindwall, L. (2015). Making the invisible
visible–operating theatre nurses’ perceptions of caring in perioperative
practice. Scandinavian journal of caring sciences, 29(2), 361-368.
Kwon, S., Thompson, R., Dellinger, P., Yanez, D., Farrohki, E., & Flum, D. (2013).
Importance of perioperative glycemic control in general surgery: a report from the
Surgical Care and Outcomes Assessment Program. Annals of surgery, 257(1), 8.
Lówbúrý, É. J. L., Ayliffe, G. A. J., Geddes, A. M., & Williams, J. D. (2013). Control of
hospital infection: a practical handbook. Springer, pp. 111.
Poultsides, L. A., Ma, Y., Della Valle, A. G., Chiu, Y. L., Sculco, T. P., & Memtsoudis, S. G.
(2013). In-hospital surgical site infections after primary hip and knee arthroplasty—
incidence and risk factors. The Journal of arthroplasty, 28(3), 385-389.

9PERIOPERATIVE NURSING
Rosenthal, V. D., Maki, D. G., Mehta, Y., Leblebicioglu, H., Memish, Z. A., Al-Mousa, H.
H., ... & Apisarnthanarak, A. (2014). International Nosocomial Infection Control
Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-
associated module. American journal of infection control, 42(9), 942-956.
Talbot, T. R., Bratzler, D. W., Carrico, R. M., Diekema, D. J., Hayden, M. K., Huang, S.
S., ... & Fishman, N. O. (2013). Public reporting of health care–associated
surveillance data: recommendations from the Healthcare Infection Control Practices
Advisory Committee. Annals of internal medicine, 159(9), 631-635.
Wood, A. M., Moss, C., Keenan, A., Reed, M. R., & Leaper, D. J. (2014). Infection control
hazards associated with the use of forced-air warming in operating theatres. Journal
of Hospital Infection, 88(3), 132-140.