Nursing Essay: NSQHS Standards for Infection and Falls

This essay examines the application of the National Safety and Quality Health Service (NSQHS) Standards, specifically Standard 3 (Preventing and Controlling Healthcare Associated Infections) and Standard 10 (Preventing Falls and Harm from Falls), in the context of a 61-year-old patient, Mrs. Brown, receiving Hospital in the Home (HITH) care following a Lap Cholecystectomy. The essay explores the patient's risk factors, including T2DM, OA, and toe amputation, and details the nursing interventions required to mitigate infection risks at the PICC and wound sites, as well as strategies to prevent falls in both home and hospital environments. The essay emphasizes the importance of hand hygiene, sterile precautions, and environmental modifications for fall prevention, highlighting the differences in applying these standards between a hospital and a home setting. The conclusion reinforces the role of NSQHS standards in ensuring quality care and patient safety.

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Nursing
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The National Safety and Quality Health Service (NSQHS) Standards is a widely
accepted Standard Guidelines which is the brainchild of the Australian Commission on Safety
and Quality in Health Care (ACSQHC). Partnership and consultation with technical
professionals, jurisdictions and stakeholders have led to the NSQHS standrads that include
patients and healthcare professionals alike (Daly et al., 2017). The aim of these standards is
the protection of the patients from potential harm and improvement of the quality of health
care services provided. The present essay is based on the application of two of the ten
NSQHS standards, “Standard 3- Preventing and Controlling Healthcare Associated
Infections” and “Standard 10- Preventing Falls and Harm from Falls”, to a presented case
study and the comparison of the application in the home as compared to hospital
environment. The patient in question is 61-year-old Mrs Brown who has been referred to a
Hospital in the Home (HITH) service after a Lap Cholecystectomy. The medical
complications include T2DM, OA and toe amputation. The ongoing care needs include
administration of IVAB’s via a PICC line, monitoring wound area vital sign assessment and
general education.
The standard 3 of NSQHS standards states that clinical professionals must implement
accurate systems for the prevention and management of healthcare associated infections and
impart knowledge of the same to others for achievement of desired outcomes. The intention
is to safeguard patients from suffering infections while receiving care
(safetyandquality.gov.au, 2012). Mrs Brown is at risk of developing an infection at the PICC
site as well as the wound site, leading to the requirement of adhering to practices associated
with infection prevention. Hand hygiene has been indicated to be the most prominent and
effective practice to eliminate infection chances. At hospitals, nurses are to use alcohol-based
gels or antiseptic-containing detergents or soaps for this purpose. At home, the same practice
is to be adhered to. Since the patient is been given care at her home, it is advisable that the

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nurse uses sterile barrier precautions such as gloves and mask while coming in contact with
the patient. In addition, chlorohexidine can be used for skin antisepsis (Shaban et al. 2016).
Since in the present case the care is given at home, the nurse has the additional responsibility
of managing the patient related supplies on the basis of the supposed cleanliness of the
patient’s house. A home appearing to be clean in an apparent manner might be contaminated
with a number of pathogens, usually drug-resistant (Qian et al., 2016).
The standard 10 of NSQHS standards states that clinical professionals are to
implement robust systems that are useful for preventing patient falls and reducing harm from
such falls. The intention is to avoid any additional health complications arising due to patient
falls (safetyandquality.gov.au, 2012). The patient under scrutiny has suffered a toe
amputation, implying that functional deficit is suffered by the patient. The patient is therefore
at risk of suffering fall. The nursing care provided as a preventive strategy for falls needs to
be advanced as chances of suffering falls at home are more as compared to that at a
healthcare setting. At a health care setting, prevention of falls can be achieved by
implementing guarding rails at beds, keeping provision for bed switch for the light and
maintaining clean and neat environment (Li et al., 2016). In contrast, fall prevention practices
are more detailed at home care setting. The patient needs to be familiarised with the setting,
and the personal possessions of the patient are to be kept within reach of the patient. Sturdy
handrails are to be placed at hallway, room and bathrooms. It is also advisable to keep the
bed brakes locked. Comfortable and well-fitting footwear and clothes are to be worn by the
patient. Keeping the care areas of the patient uncluttered is also a duty of the nurse. Lastly,
safe patient handling practices are to be followed by the nurse (DiCenso et al. 2014).
From the above discussion, it is to be concluded that the NSQHS standards provide a
mechanism for a quality guarantee that aids in examining the effectiveness of relevant care
systems as reflected by maintaining minimum standards of quality and safety. The NSQHS

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standards 3 and 10 guides the standards of care practice within the domiciliary care
environment as well as the hospital system. While standard 3 deals with prevention of
healthcare associated infections, standard 10 involves prevention of patient falls. The patient
Mrs Brown had been under risk of developing an infection at the wound site and PICC line
used for IVAB administration. In addition, there is an increased chance for the patient to
suffer a fall since she had undergone a toe amputation in the recent past. It is the
responsibility of the nurse to adhere to the standards as outlined to ensure that quality care is
provided in Hospital in the Home environment.

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Reference
Daly, J., Speedy, S., & Jackson, D. (2017). Contexts of nursing: An introduction. Elsevier
Health Sciences.DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based
Nursing-E-Book: A Guide to Clinical Practice. Elsevier Health Sciences.
Li, E., Clark, M., Heesch, K., & Vallmuur, K. (2016). 94 Falls in middle-aged adults
presenting to emergency departments in Queensland, Australia: risk factor
exploration.
National Safety and Quality Health Service Standards (2012). safetyandquality.gov.au.
Retrieved 4 September 2017, from
https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-
Standards-Sept-2012.pdf
Qian, S., Yu, P., Hailey, D. M., & Wang, N. (2016). Factors influencing nursing time spent
on administration of medication in an Australian residential aged care home. Journal
of nursing management, 24(3), 427-434.
Shaban, R. Z., Macbeth, D., Vause, N., & Simon, G. (2016). Documentation, composition
and organisation of infection control programs and plans in Australian healthcare
systems: A pilot study. Infection, Disease & Health, 21(2), 51-61.