Clinical Audit and Health Infection Risk Management Report

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This report provides a detailed analysis of clinical audits in health infection risk management. It emphasizes the significance of clinical audits as a tool to assess healthcare facilities' compliance with established standards, focusing on identifying and managing infection risks. The report highlights the importance of professional growth and improved patient safety through clinical audits, emphasizing the examination of clinician performance and the implementation of safety measures. Key areas of focus include shared clinical equipment, clinical waste management, and hand washing practices, as well as a critical analysis of policies regarding personal protective equipment (PPE), gloves, aprons, covers, bibs, and eye and face protection. The report also underscores the need for respiratory protective gear to prevent airborne infections. It concludes by summarizing the role of clinical audits in enhancing healthcare quality and ensuring patient safety by identifying and addressing potential risks. References to relevant literature are included to support the findings and recommendations.
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Health infection risk management
Student’s Name
Institution Affiliation
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Health infection risk management
Introduction
Clinical audit is an essential tool in infection risk management. Clinical audit is the assessment
of the healthcare facility to determine whether the services being provided comply with the set
standards. The aim of clinical audit is to check on the compliance to safety standards by the
healthcare providers. In this case, the audit identifies areas prone to infections and providing an
audit report, which details on the measures that can be taken to manage the risks. In addition,
clinical audit identifies mistake and errors in the nature of healthcare delivery like the non-
compliance to hand washing guidelines, therefore, ensuring that proper steps are taken to
enhance patient outcome. Therefore, the focus of clinical audit is to evaluate on the performance
of clinicians in order to provide an assurance report that the services given by the health facility
are in line with the guiding standards.
Importance of Clinical Audit
Professional Growth
One of the benefits of clinical audit is that, it promotes professional growth. For instance, it gives
clinicians the opportunity to engage in peer reviews from where they gain confidence in their
clinical activities thus enabling positive patient outcome. Additionally, in the case where the
audit presents a patient case study, professional come together, thus enhancing professional
growth (Siebenaler, Czech & Roach, 2017). Through the clinical audit, clinicians are able to
benefit from peer-pear reviews, which enhance self-confidence. In this case, through the peer
reviews, clinicians are able to identify their strengths and weaknesses, which is imperative in
healthcare delivery. Clinicians should be aware of the performance and their practice so that
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appropriate adjustments can be made to enhance professional growth and improve the healthcare
services. Thus, clinical audit enables clinicians to be aware of what is expected of them and the
adjustments needed in their profession to ensure patient safety.
Improved Patient Safety
A clinical audit is a systematic examination of the performance of team, individual, or
organization’s clinical work. The process entails the measurement of clinical outcome to provide
quality services; the outcome of the audit is interpreted through peer review and consultation.
Further, the audit focuses on the performance of clinicians in terms of quality of services where
the audit examines and gather evidence on the clinical actions, which is then, interpreted using
patient outcome parameters, clinical performances, and the regulating standards in order to
determine the areas that need improvement in order to enhance patient safely (Weiss, Simon,
Graf & Linsler, 2017).
Improvement of the management
Clinical audit is key to an improved management (Sinha, Murthy, Nath, Morris & Millar, 2016).
A good clinical audit gives the management the opportunity to report accurately on their
outcome with the potential of comparing and analyzing patient outcome, perform peer review,
and to reduce patient healthcare cost. Further, clinical audit gives the management an
opportunity to assess the organization processes in relation to the clinical practice, this is
important as it helps in the identification of problematic areas or weakness in management so
that appropriate changes can be made to ensure patient safety. Therefore, through clinical audit,
the management acquires knowledge on the areas within the organization that need improvement
(Wilson, Bak & Loveday, 2017).
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High Risk Areas that should be audited
Shared Clinical equipments
Sharing clinical equipments can lead to the spread of infections as it acts as a media between
which infections can be transferred from one patient to the other (Solomkin, 2015). Some of the
shared equipments that can spread infections include x- ray machines, haemodialyis machines,
and dental instruments. Therefore, it is important for the auditors to examine whether proper
mechanisms are used to prevent the contamination of equipment and surfaces as per the
regulating standard. Further, the auditors will assess on whether surface barriers like sheets,
tubings, and other instruments are cleaned between patients to prevent the spread of infections
(Wick, Siebenaler, Czech & Roach, 2017).
Clinical Waste
Clinical waste if not properly management can be a source of infections. Clinical waste
management is essential in the prevention of infections (Zimmerman, Gilbert, Brown & Shaban,
2016). Clinical waste is anything that can endanger the life of both the clinician and the patient;
this includes wound dressings, used needles, and many other substances like gloves or aprons
which might contain human blood or body substances. In this case, clinical waste should be
properly disposed or managed. Clinical waste can be managed starting from the source of
production where the clinical wastes is collected using special tools and taken to a special room
where segregation is done. From this point, the waste that is of value recycled while the harmful
one can be gotten rid by burring deep into the earth’s surface to avoid injury to both human
beings and the environment. In this case, the auditor should ensure that the clinical waste
management procedures are followed as per the organizational policies. Clinical waste audit is
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imperative as it ensure proper disposal or recovery of clinical waste. Therefore, clinical audit
plays a vital role in ensuring that clinical waste is properly treated or incinerated to avoid injury
to human beings and the environment and the failure to conduct will add up to the failure of the
duty of care the organization owes third parties.
Hand Washing
Hand washing is one of the most effective ways of reducing the spread of infections. Hand
washing can be done using water and soap or alcohol based disinfectant. According to Zingg,
Holmes, Dettenkofer, & Pittet (2015), when properly done, hand washing can get rid of about
99% of disease causing infections. It is for this reason that clinicians should adopt proper hand
hygiene in order to avoid transmitting infections to the patients (Solomkin, 2015). It is the duty
of clinicians to adopt good hand washing practices in order to safeguard safety of the patients.
During the clinical practice, clinicians should develop a practical voice in the support of hand
washing in order to manage the spread of infections. Montgomery & Cummings (2017) explains
that, knowledge and power assist in the implementation of strategies that aim at preventing
infections and improving patient outcome. Therefore, clinicians should use education, written
materials, and performance feedback in order to yield a positive feedback in hand washing
practices within the organization (Duff, O'Sullivan, Ainle & Buckley, 2017). Further, nurses
should be encouraged to advance their levels of education, which will enable them assume
leadership position that will enable them to foster a culture of hand washing. In relation to this,
the auditor has the responsibility of ensuring proper hand washing practices are done to avoid the
spread of infections. In this case, the auditor should examine on whether the healthcare providers
wash their hands before and after handling patients (Iqbal, Ponniah, Long, Rath & Kent, 2017).
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Critical Analysis
1. Policy
In regards to PPE, the audit will review the compliance to PPE standards; this includes
examination of whether the organization has implemented policies and procedures, which relate
to Personal Protective Equipment. For instance, the audit will verify on whether face masks,
gloves, and aprons are available for use in all the departments especially the high risk areas.
2. Gloves
Gloves are essential in the prevention of infections especially when the clinician comes into
contact with the patient’s blood. Gloves can either be sterile, non- sterile, or rubber latex. Sterile
gloves are used during surgical procedures. Non-sterile gloves are used when it is highly possible
that the clinician will be in contact with body fluids like blood while rubber latex is used when
the healthcare provider or clinician is allergic.
In this case, the audit will assess whether the gloves are conventional to the European
Community Standards and are available and fit to be used by the healthcare providers.
Additionally, the audit will also examine whether a different glove is worn for each patient and
whether hands are disinfected on removal to avoid the spread of infection from patient to patient
and from patient to clinician (Greene & Kaye, 2014).
3. Aprons
Gowns and aprons are used to prevent contact with body fluids and tissues. Aprons are essential
in the prevention of infection from patients to the clinician. In this case, the audit will determine
whether plastic aprons are disposed off when detected to contain body fluids like blood or when
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it becomes wet, this is very important as aprons can act as a media for the spread of infections,
which might affect the safety of patient and clinicians alike.
4. Covers and bibs
Covers and bibs are used in the prevention of infections through direct contact. They are used to
break the chain of infection. The audit will determine whether covers and bibs are used properly
as a single- use to prevent further spread of infections.
5. Eye and Face protection
Eye protection equipments should be used when there is a high risk of infection likes theatre
rooms where splashing of body blood and other body substances is highly probable. Eye
protection equipment are essential in the prevention of infection from reaching he clinician.
Therefore, the audit should determine whether a complete set of eye equipments are available for
use in all operating and theatre rooms.
6. Respiratory protective gear
Respiratory protective gears are used to prevent clinician from inhaling infected air in the case
where there is a risk of airborne infections. These equipments are used when handling patients
with or diagnosed with diseases (Lawes, Lozano & Gould, 2017).
Conclusion
Audit refers to the examination and assessment of process to determine whether they comply
with the organizations set standards. In the health sector, audit is conducted in order to determine
the quality of healthcare services. Clinical audit is a continuous process that focuses on specific
aspects of healthcare. The audit are meant to assess on whether the healthcare services being
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provided comply to the organization goals, which is patient safety. One of the areas of focus is in
infection risk management, where the auditor examines patient outcome and the clinical process
against the set standard. In risk management, the audit should determine whether safety
precautions like hand washing, clinical waste management, and sterilization of shared
equipments are put in place in order to ensure patient safety. Therefore, with clinical audit, risky
areas prone to infection within the organization can be identified and appropriate action taken to
ensure patient safety.
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References
Lawes, T., Lopez-Lozano & Gould, I. M. (2017). Effect of a national 4C antibiotic stewardship
intervention on the clinical and molecular epidemiology of Clostridium difficile
infections in a region of Scotland: a non-linear time-series analysis. The Lancet Infectious
Diseases, 17(2), 194-206.
Gould, D. J., Creedon, S., Jeanes, & Moralejo, D. (2017). Impact of observing hand hygiene in
practice and research: a methodological reconsideration. Journal of Hospital
Infection, 95(2), 169-174.
Greene & Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care
hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S66-S88.
Gruendler, J. (2017). Clinical Staff Ownership is Associated with Decreased Incidents of
Hospital Acquired Infections. American Journal of Infection Control, 45(6), S95-S96.
Iqbal, H. J., Ponniah, N., Long, S., Rath, N., & Kent, M. (2017). Review of MRSA screening and
antibiotics prophylaxis in orthopaedic trauma patients; The risk of surgical site infection
with inadequate antibiotic prophylaxis in patients colonized with MRSA. Injury. 2(4)67-
78
Duff, C., O'Sullivan, C., Ni Ainle, F., & Buckley, R. (2017, June). A clinical audit of Venous
Thromboembolism Risk Assessment and Prophylaxis in the acute hospital setting, in the
context of a national improvement collaborative. In IRISH JOURNAL OF MEDICAL
SCIENCE (Vol. 186, pp. S271-S271). 236.
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Montgomery, & Cummings, M. J. (2017). Measuring Infection Prevention Capacity in Long-
Term Care Facilities (LTCF). American Journal of Infection Control, 45(6), S19-S20.
RABIAIS, I. C. M., VIVEIROS, A. M., & FREITAS, C. M. R. (2016). Prevention and Control
of Infection: An Advanced Nursing Practice. International Journal of Nursing, 3(1), 81-
88.
Ross, P., Hubert, J., & Wong, W. L. (2017). Reducing the blame culture through clinical audit in
nuclear medicine: a mixed methods study. JRSM open, 8(2), 2054270416681433.
Sinha, A. K., Murthy, V., Nath, P., Morris, J. K., & Millar, M. (2016). Prevention of late onset
sepsis and central-line associated blood stream infection in preterm infants. The Pediatric
infectious disease journal, 35(4), 401-406.
Solomkin, J. (2015). Clean care is safer care: Surgical site infection. Journal of Microbiology,
Immunology and Infection, 48(2), S1.
Siebenaler, R., Czech, C., Craig, J., & Roach, J. (2017). Central Line-associated Blood Stream
Infection Reduction in an Intensive Care Unit Utilizing a Maintenance Bundle Audit
Tool. American Journal of Infection Control, 45(6), S95.
Weiss, K., Simon, A., Graf, & Linsler, S. (2017). Clinical practice audit concerning
antimicrobial prophylaxis in paediatric neurosurgery: results from a German paediatric
oncology unit. Child's Nervous System, 33(1), 159-169.
Wilson, J., Bak, A., & Loveday, H. P. (2017). Applying human factors and ergonomics to the
misuse of nonsterile clinical gloves in acute care. American Journal of Infection Control.
45(4) 56- 67
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Wick, K., Siebenaler, R., Czech, C., Craig, J., & Roach, J. (2017). Central Line-associated Blood
Stream Infection Reduction in an Intensive Care Unit Utilizing a Maintenance Bundle
Audit Tool. American Journal of Infection Control, 45(6), S95.
Zimmerman, P. A., Gilbert, J., Brown, L., & Shaban, R. Z. (2016). Infection prevention and
control learning and practice in pre-registration undergraduate nursing: The sociological
influences of the clinical environment. Infection, Disease & Health, 21(3), 131-132.
Zingg, W., Holmes, A., Dettenkofer, & Pittet, D. (2015). Hospital organisation, management,
and structure for prevention of health-care-associated infection: a systematic review and
expert consensus. The Lancet Infectious Diseases, 15(2), 212-224.
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