HNB3219 Perioperative Nursing

Perioperative care calls for the provision of better conditions for patients at the period or before operation and thereafter. According to statistics, approximately one out of 25 patients around the world acquires infection during the course of stay under hospital care (CDC, 2018). Despite the benefits of advancement in therapeutic and diagnostic possibilities, the perioperative scenario in hospitals still exposes patients to significant risks and harm during the process of stay. Patient safety at this stage is essential towards preventing and controlling disease spread among patients. Patient safety refers to the prevention, avoidance, and caution against outcomes and injuries emanating from the process of healthcare. Nurses play a critical role in safeguarding patients prior, during and after an operation thus remain at the centre of infection control through effective strategies towards prevention of risks and spread.

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Hospitals are areas for treatment and wellness and thus ought to prevent and not promote the spread of diseases. It is of extreme importance for nurses and other caregivers to remain aware of the risks and factors pointing towards patient safety and enhance the practices within their health facilities. As such, continuous improvement ought to be conducted to guide and create a culture of safety within organization as the knowledge enhances the field of infection control and prevention of catastrophic events during patient handling. Risk management in the clinical setup is an important regard towards patient safety and risk free engagement. 

Communication

The first essence of risk management can be enhanced through proper communication channels among staff in the preoperative stage in the clinical world. In most cases, patients land on wrong drugs that may damage their wellbeing and thus deny or prolong the process of healing. As such, roper communication comes in handy to ensure a seamless process that aids individuals towards success. Nurses ought to follow the right communication channels and pass information whenever finishing shifts to ensure adequate care on patients. Improper communication allows for assumption of roles and accomplishment of risk management measures among the nurses. Consequently, the fact affects the likelihood of infection control as everyone works with their own assumption and guideline as opposed to following the right channel of communication. Nurses must create and follow an open communication system where information can be accessed and utilized towards minimizing and controlling infection. 

Safety culture

Culture refers to the way of doing things and living where people carry out daily activities based on the practices established. Nurses working in the perioperative stations need to create a culture of safety through the use of safety protocols and procedures aimed at preventing infection spread. Change in culture begins with the nurse’s role of proactively safeguarding oneself as well as the patients in a facility. The practice can be done through use of safety equipments such as gloves whenever handling patients of different concerns. Following such measures can assist nurses in preventing disease spread not only to the patients but also to themselves.

Training

Infection control is a proactive role towards combating communicable and non-communicable disease spread. Training in risk management is essential for the nurses and the patients in understanding their roles in providing safety to themselves. Nurses as care providers have to be given training on the safety handling of patients and preventing themselves from affecting and being affected by infections (Makary & Daniel,2016). Training impacts knowledge essential in preventing pathogen transfer from one place to the other. On the other hand, patients can benefit from training activities on safety and risk management in the preoperative setting essential in following laid down procedures towards infection control. Patients with the knowledge would always take precautionary measures thus remaining healthy and in line for the operation awaiting. 

Practice and Promotion of Hand hygiene

Hand hygiene is an effective means towards the prevention of infection transmission. Nurses and other healthcare workers are the most probable agents for the transmission of healthcare related pathogens from one patient to the other. As such, nurses are required in the spirit of infection control to exercise hand hygiene after handling one patient to prevent the spread of antimicrobial resistance. At the same time, nurses are required to keep their nails short and avoid the use of artificial nails as they may be dens for carrying infections from one patient to the other (Makary & Daniel, 2016). Studies in the infection control in medical care indicates that nearly everything in the healthcare setting ranging from healthcare worker’s hands to medical equipment can serve as reservoir for pathogenic organisms. As such, it is essential for nurses to remain aware of the case and prevent the infection control from causing disastrous pandemics. Therefore, it is important for health workers to remain keen and exercise caution towards preventing infection spread from one patient to the other.      

Staying home when Ill

Health workers are instrumental in the process of delivering service to patients. However, the care givers can be of negative effect to patients whenever ill or affected by contagious infections. In this respect, nurses have to take an off and seek further treatment before returning to work and handling patients. In any case a nurse carries on with the duties, the risks of spreading the infection to several other patients remains high. Consequently such an act amounts to an outbreak as one nurse may handle several patients in the process of dispensing their duties. Nurses have the responsibility of seeking for medical leave to cater for their health concerns until recovery prior to returning on duty. Healthcare organizations are responsible for the provision of resources to aid in recovery of their workers at no charge and thus nurses have to take chance of the situation and seek treatment.   

Cleaning

Patient safety begins with a clean environment that supports an ample environment. Unclean or non-dry floors can lead to accidents from falling patients which further complicate the safety situation. The fatality rate in Sub-Saharan African countries is 21/100, 000 workers and the accident rate is 16,000/100,000 workers. In Sub-Saharan African countries about 54,000 fatal and approximately 42 million occupational accidents happen annually that results at least 3 days absence from work of every workers (Jilcha & Kitaw, 2016). As such, nurses ought to communicate with the cleaning team to ensure it is done on time and perfect enough to guarantee minimal accidents resulting from slippery floors.

At the same time, cleanliness assists in preventing infection as the harboring locations would have been reduced by a clean environment. Nurses often use medical devices on more than one patient and thus have the responsibility to clean and disinfect the devices whenever shifting to other patients (Zingg, Holmes, Dettenkofer, Goetting, Secci, Clack & Pittet, 2015). Housekeeping staff often fear to clean devices for the purpose of avoiding interference and thus leave them at the hands of the nurses who might at times assume and avoid cleaning. Cleaning working apparatus as well as tools for medication ensures accurate results and less interference on quality standards. Nurses ought to ensure clean working environment as a measure towards risk management. 

Isolation for Airborne Prevention

Patients with highly communicable diseases have to be separated and isolated for the safety of themselves and those of others. Isolation of patients assists in offering specialized care among patients of similar disease while preventing re-infection for the recuperating patients. The lack of isolation leads to new infections on patients thus complicating the process of treatment. Nurses have to always remain alert to prevent and isolate patients with highly communicable diseases for specialized care and proper handling while awaiting further medication (Vincent & Amalberti, 2016). The measure goes in line with the safety procedures in occupational areas. 

Occupation safety and health administration

Safety procedures in organizations are well laid out in line with controlling and preventing risks. Nurses ought to dress properly and have themselves protected from droplets and airborne diseases. All these point towards precautionary measures in line with health and occupational safety. Besides, work environment must be conducive for work as per laid standards and have safety gadgets installed and functional in case of emergencies and hazardous situations (Vincent & Amalberti, 2016). Nurses have to acquaint themselves with the policies and safety operations to be of help to patients and keeping themselves out of danger.

Use of Aseptic Technique

Aseptic techniques refer to procedures and practices carried out under controlled conditions in order to minimize contamination by pathogens. Maintaining the absence of pathogenic organisms is essential in the clinical setting as it protects patients from new infections and at the same time prevents the spread of pathogens. Nurses are at the centre stage of ensuring good health among patients and thus have to take measures to ensure total aseptic condition to keep patients out of risk in a clinical setting (Makary & Daniel, 2016). Such measures include hand washing practices which reduce the possibility of harboring pathogens. At the same time, following the right protocols and avoiding shortcuts in medication helps in reducing risks and ensuring a safe working environment. 

Patient Assessment and Additional Precautions

Proactive measures are essential in the treatment process and aid towards infection control. However, some measures fail to mature and take effect thus calling for reactive measures to curb situations. Healthcare-acquired infections also come with a financial price, costing $9.8 billion a year, according to research published in 2013 in JAMA Internal Medicine.18 The U.S. Department of Health and Human Services, which has made the reduction of these infections one of its top priorities, has put the added financial burden due to HAIs at $28 billion to $33 billion a year (Doherty & Carino, 2015). Nurses have to assess patients periodically to determine the nature of their health and recommend for additional measures to aid the process of recovery. Additional precautions come in the case of developed disease and infection spread from one patient to the other thus raising the need for isolated care in patient handling (Veenema, 2018). Nurses have to identify new developments in patients and plan for precautionary measures to help in the clinical setting. As such, continuous assessment and precaution have to be factored in and implemented to the latter.   

Patient Education

Family and patient education is essential towards risk management in a clinical setting as it helps provide care to patients and their families. Patients ought to be educated by nurses on their healthcare patterns, precautions, and reactions related to their illness. As such, the strategies and rationale for treatment have to be determined and made known to the patient before further treatment (Makary & Daniel, 2016). Cases where patient consent has to be sought have to be factored in to ensure patient consent is sought. Patients have to receive explanation on the need for isolation and any other measure that might raise concern to remain free from doubts and feeling of neglect. The nurse has to deliver the information and find interpreters in cases where language barrier arises (van Rosse, de Bruijne, Suurmond, Essink-Bot & Wagner, 2016).

Use of safety devices

Safety devices are a requirement in clinical settings and have to be used all the time. Educating the patients and nurses on the use of safety device and the benefits therein assists in risk management. Fire equipments and sterilization apparatus have to placed in strategic locations and used frequently whenever situations arise. Nurses have to ensure a smooth use and adoption to the standard procedures of working in making the patients safe and ready for further treatment. At the same time, nurses have the responsibility of removing unnecessary devices such as catheters whenever patients want to visit the restroom to avoid infection and damages (Potter+, Perry, Stockert & Hall, 2016). UTIs (30–40% of HAIs), which are mainly due to indwelling catheters, but which may also occur in the absence of invasive procedures in the elderly and in pregnant women. Despite their moderate rates of morbidity per se, UTIs affect the overall condition of patients and extend the length of hospital stay (Schulte, Duster, Warrack, Valentine, Jorenby, Shirley & Safdar, 2016).  Moreover, nurses are to inform patients and doctors of the removal of IV being used for hydration whenever a patient’s appetite increases (Meddings, Rogers, Krein, Fakih, Olmsted & Saint, 2014).      

Infections remain a threat to the global healthcare system and must be factored in. Nurses remain core persons in patient handling during the treatment process. Risk management is therefore essential in handling patients and preventing further infection spread from one to the other. Nurses have a huge role in ensuring proper measures in place that support good recovery and preparation for further medical procedures. Administration and hospital management have to facilitate a proper environment according to occupational health and safety procedures in use of standardized procedures and engage workers in training activities for equipping purposes. Setting up preventive measures towards risk reduction remains essential in infection control especially for re-infection cases that emanate from improper patient safety practices.

References

Doherty, D., & Carino, R. (2015). Critical risks facing the healthcare industry. Philadelphia: ACE Group.

Jilcha, K., & Kitaw, D. (2016). A literature review on global occupational safety and health practice & accidents severity. International Journal for Quality Research, 10(2).

Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. Bmj, 353, i2139.

Meddings, J., Rogers, M. A., Krein, S. L., Fakih, M. G., Olmsted, R. N., & Saint, S. (2014). Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual saf, 23(4), 277-289.

Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2016). Fundamentals of Nursing-E-Book. Elsevier Health Sciences.

Schulte, D. M., Duster, M., Warrack, S., Valentine, S., Jorenby, D., Shirley, D., … & Safdar, N. (2016). Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients. Substance abuse treatment, prevention, and policy, 11(1), 15.

van Rosse, F., de Bruijne, M., Suurmond, J., Essink-Bot, M. L., & Wagner, C. (2016). Language barriers and patient safety risks in hospital care. A mixed methods study. International journal of nursing studies, 54, 45-53.

Veenema, T. G. (Ed.). (2018). Disaster nursing and emergency preparedness. Springer Publishing Company.

Vincent, C., & Amalberti, R. (2016). Safety strategies in hospitals. In Safer Healthcare (pp. 73-91). Springer, Cham.

Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L., … & 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.