Two types of microorganisms nursing essay

In 2009 a hospital in Canada , with multi health care workers finalized in their study that hand washing has a significant effect in removing Clostridium difficile , as it must be done over the use of alcohol rubs ( Oughton ; Loo ; Dendukuri ; Fenn ; Libman, 2009). Hand antisepsis means to get rid of and destruction of transient microorganisms without the use of soap and water. It requires use of antiseptic products such as alcohol-based liquids, thick gels and foams. Alcohol liquids doesn’t remove soil or dirt with organic material; however, it does produce antisepsis action when the hands are obviously clean. Alcohol rubs, when used for a minimum of 5 seconds, removes 99% of microorganisms of the hands including gram-positive and negative bacteria, multi drug resistant pathogens fungi, and viruses. Because alcohol formulation have a brief rather than sustained antiseptic effect; however, nurses must repeat their use over the course of a day (Wolke , 2009). A group of health care workers from the Hospital of Saint Raphael, performed a study regarding the relationships between the incidence of Clostridium difficile –associated disease (CDAD) and the use of alcohol hands rubs during a 3 years periods. The study was conducted because it was assumed by an infection control workers that the increase rates of Clostridium difficile –associated diseases is due to the higher use of the alcohol hand rubs. The findings showed a slight reduction or no change in the incidence of Clostridium difficile –associated diseases (Boyce, Ligi, Kohan, Dumigan, Havill, 2006). A study was conducted to compare the compliance between hands washing versus alcoholic rub, with 12 healthcare professionals working in intensive care unit, who takes around 40-80 seconds for hand washing. In the other side 20 seconds are spent in using alcohol rubs. Compliance is more for alcohol rubs as it’s easily available in patient’s bedsides, requires less time than washing the hands . In addition it allows more quality of patient’s care without interfering. Another reason for low compliance with hand washing is that it causes skin dryness, especially in summers, and that alcohol rubs decreases skin irritation after hand washing according to a study performed in 15 volunteers (Barash, Cullen, Stoelting, Cahalan, Stock, 2009). Preventing ventilator-associated pneumoniaAs per the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) there are four essential elements of Ventilator care bundle (VCB) which are elevation head of bed, daily sedation score assessment and possibility of weaning, gastric ulcer prevention and deep vein thrombosis prevention. Many researches showed that there are other bundles which need to be added, and these bundles are related to employees. The VCBs implemented by Papadimos et. al.(2008) was a main part of the FASTHUG , which involved enteral feeding assessment , sedation , analgesia, thromoembolitic prophylaxis , head of bed elevation , ulcer prevention , and capillary blood glucose level . These elements are not based on patients research as a result , they might not be appropriate as (VCB) elements. Rather , they are better suited as extra to an everyday  patient checklist , where the VCB is also an element ( DuBose et al., 2008 ; Khorfan , 2008 ). Adding to the VCB components in many of the researches , that is supported by strong evidence was oral hygiene (Berriel-Cass et al., 2006 , Hatler et al ., 2006 ; Khorfan , 2008) . As per Barriel-Cass et al. (2006) point of view washing hands is important to prevent infections therefore , he added it in the VCBs. However, handwashing is difficult to be compliant with and audit . Therefore , they created peer , and charge nurse observations , and sign in sheets , to follow up hands-washing , yet it is still difficult to be observed. In different studies there were different strategies implemented that included participation of multidisciplinary teams to follow up patients with ventilator , daily assessments , staff communication and education with provided printed written materials , visual reminders , and compliance audits . VCB protocol guidelines defined by Institute of Healthcare Improvement (IHI) were mostly used by the studies. Audits and feedback were considered in five studies as part of their implementation policy. Two other studies used pictures , posters and other description for weekly evaluation. (Hampton et al., 2005; Hatler et al., 2006) . Another two studies gave feedback every month (Crunden et al., 2005; Barriel-Cass et al., 2006). Although Khorfan (2008) described sharing results , but specified little details on how it was applied. Crunden et al. (2005) said that monthly reports is essential to give the staff feedbacks regarding their accountability and responsibility to be be more focus on the intervention. Guidelines for Infection ControlAccording to CDC’s report (part II) in 2009 by the National Center for Infectious Diseases and the Healthcare Infection Control Practices Advisory Committee (HICPAC) outlines the controls for the prevention of infections acquired during the stay in hospitals. These include; establishment of a team to overlook the matters of patients’ health and safety, which is mandatory. The authority over the procedures and implications of control provides a check and balance and keeps the things upbeat. The team conducts researches for new techniques and strategies or modifications for the existing ones. The guideline also highlights the importance of the usage of procedures which minimize the transmission of infections through dust particles using environmental controls.