• Subject Code : POLY20057
  • Subject Name : Policy review essay

Policy Review Essay: Perioperative Role (Infection Control Policy)

Purpose of infection control policy

The purpose of infection control policy is to outline the main principles and framework for the control of infection in Western Sydney Local Health District (WSLHD). The aim of this policy is to provide the guidelines to various Western Sydney Local Health District for the effective prevention, management, and control of healthcare-associated infections.  The policy aims towards the reduction of adverse effects on the health of patients who would get treatment in the healthcare facilities and to reduce the burden of infections.  The instructions of the policy outline the mandatory requirements for the prevention and control of the infection from the healthcare organizations of Western Sydney. These instructions and directives provided by the policy are applicable to all WSLDH employees, visitors, patients, and other stakeholders. Another purpose of the policy is that all the patients, visitors and employees of WSLDH will be protected from the infections as much as possible so that the detection, prediction, and prevention of the infections could be possible within the scope of current practices available resources.  In addition to it, the purpose of the policy is to develop and implement infection control strategies which can reduce the risk of infections which are preventable in nature for the delivery of safe and cost-effective healthcare services.

The content of the policy:

There are mainly eight topics which have been defined in the policy for the effective prevention and control of infections.  These eight policy statements are antimicrobial resistance organisms, management of outbreaks of infectious diseases, deceased bodies, notifications for notifiable infectious diseases, signs for the precautions of additional transmission, control of tuberculosis infection in healthcare settings, remanufacturing of single-use medical devices (SUDs) and non-occupational exposures.  All the statements have been divided into four main categories namely, desired outcome of the proposed statement, the scope of the statement, the directives of the policy and the references which evident the issue described in the statement and the support the policy guidelines for the particular policy.  The statement on antimicrobial resistance organisms has focused on the spreading of microorganisms like MRSA, VRE and many others which can cause significant risks to the people.  The aim of the statement of the deceased body is to minimize the infections which may occur due to dead bodies which have recently done in the healthcare settings. Another aim of this statement is to identify the requirements of additional transmission-based precautions.  The statement of infectious disease outbreak management is to manage the response of infectious outbreaks in WSLDH with the help of coordination among different healthcare facilities (HCFAC). Notification of notifiable infectious diseases is to notify all the infectious diseases under the NSW Public Health Act 1991. The statement for tuberculosis infectious control is to ensure the isolation in a separate room and treatment of all the patients who showed a positive smear test for Mycobacterium Tuberculosis. Transmission-based precautions system has formulated to ensure the requirement and communication of additional transmission-based precautions to prevent the transmission of the pathogenic microorganism to the patients and visitors in healthcare settings.   The remanufacturing of SUDs has aimed towards eradication of the instances for the invasion of medical products.  The non-occupational exposure statement has aimed towards the prevention and treatment of non-occupational transmission of blood-borne or sexually transmitted diseases to the patients.

Analyzation of the contribution of the Infection Control Policy:

Maintaining every day a new policy and procedures is a challenge in the perioperative unit for any healthcare organization. These standards are necessary for the perioperative nurses since they deal with the patients before and after the surgical procedures and during their recovery period. They also continue with the patients until the patients resume to their daily activities. Usually, the period of surgery encompasses three phases: 1. Pre-operative 2. Intra-operative and lastly 3. Post-operative and the word perioperative consist all the three phases. 

Earlier perioperative nursing referred to the operating room nursing, but later this nursing profession was recognized by defining various policies, standards, and procedures. An organization called Association of Operating Room Nurses (AORN) represents the perioperative nursing area now called the Association of the Peri-operative registered nurse that deals with a large number of the patients. 

NSW has committed to a large number of healthcare policies and thus ensures the safety of the patients in combination with the visitors. The commitment arises for designing and adopting the infection control healthcare policies will minimize the risk they can acquire as an occupational infection or the hospital-acquired infection (NHMRC, 2010). However, developing policies alone will not achieve the target itself until this is followed by several infection control programs performed within each healthcare organization. 

Infection Control Process: The two-tier approach that is used to control the infections are called infection control precautions and these are the standard precautions. The first tier-approach is designed for caring all those patients who have infections either by their own or are hospital-acquired regardless of their diagnosis parameters or presumes infection status. Second-tier of the process includes the precautions used for caring those who are presented with specified care and therefore are called as additional or transmission-based precautions. In this regard, it can be analysed here that this policy is very useful and effective. 

Tier 1: Standard Precautions

Standard precautions are followed for all those patients who have infections either by their own or are hospital acquired. The policies designed however does not rely completely on their diagnosis process or presumed infection status. Standards precautions or infection control policies are generally applied for: 

  • Blood or blood products 

  • Other body secretions such as excretory products 

  • Body linings or mucous membranes 

  • Non-intact skin

The policy recommends the guidelines that are designed with the perspectives to reduce the transmission of an infection through micro-organisms from both the sources i.e., known or unknown or unrecognized sources. Tier-1 also includes the standard precautionary guideline for safe and protective practices that will provide a barrier towards further transmission of infection. This includes: 

  1. Hygiene maintained during hand processes 

  2. Use of gloves, masks, gown, and aprons

  3. Use of facial protecting devices

  4. Appropriate handling of the device  

  5. Incorporation of the respiratory hygiene and cough etiquettes and 

  6. Appropriate handling of the laundry

These are illustrated as followed:

  1. Hygiene maintained during hand processes: Hand hygiene is the most important during then surgical processes and is considered as a useful tool for reducing transmission of the infection and infectious agents.

  2. Use of gloves, masks, gown, and aprons

Wearing gloves, masks, and other precautionary items will resist the bacterial infections from overspreading and thus provides the protection against viral and bacterial contamination that generally spreads during handling the patients and the other visitors. Gloves are used to protect especially in that case where the healthcare practitioners or other healthcare experts are directly in contact with blood or blood products/ body products.

  1. Use of facial protecting devices

Masks are the part of standard precautions that provide the face a shield so that while handling the patients, the likelihood of infection transfer is reduced. For the surgeries related to the processes such dental care processes or any invasive process, fluid resistant surgical masks are important and therefore must be worn. 

  1. Appropriate handling of the device  

Equipment must be taken care of appropriately in a manner, such that the healthcare worker must be prevented by the exposure of their skin and mucous membrane contact.

The nurses working in the perioperative department must wear gloves while dealing the surgical processes in the operation theatres. This will help the nurses to care for the patient in a better way and also reflects their area of practice with special standards. 

Tier 2: Additional (transmission based) precautions

In the Infection control policies, the precautions which are referred to as the additional precautions are those developed for the patients with any region of suspected infections. These patients are those usually presented with a small number of pathogens, that may get developed more by adapting the surrounding environment. Therefore, it is necessary for the nurse to interrupt in the final process of the treatment in order to limit the transmission of the pathogens that will cause infections. There are three types of additional precautions that must be taken care while dealing with the patients:

  • Airborne infection control 

  • Droplet control 

  • Contact infection control 

If the above factors get combined with each other they may be responsible for more infectious diseases. They may get entered into the body through multiple routes of transmission and for a nurse and another healthcare professional it may get much more complicated to be handled (NHMRC, 2010). Therefore, the nurses must be able to utilize these policies in case. For immune compromised patients, it is very important that the nurses must design their treatment and their other related processes by recommending these infection control policies. 

Airborne Precautions:

Airborne precautions are taken care of where patients are suspected to be infected with such pathogenic infections that can transmit via the airborne route. Therefore, the treatment is designed to reduce the risk for the patients and thus helped them with better health care. Droplet nuclei are the major one that accounts for the airborne infections, where the pathogens remain suspended in the air or environment and cause infection to the patients. Therefore, it is necessary for the nurses to take care of these patients and if possible the patients must be taken care in a negative pressure room. 

Compare and Contrast:

If we contrast healthcare infection control policies in their description of treatment options and management of the issues, it is noticed that Healthcare-associated infections (HIAs) can occur during and after the treatment of the patient in any healthcare settings (NHMRC, 2010). Specific risks and basic principles of the policies may differ in their roles depending upon the individual and on the assessment performed by the healthcare professional. There is no difference in the policies that are followed by the other healthcare organization. They use the same approach for handling the patients presented in the department with any infectious disease. Also, it brings into the notice that the patients and caregivers involved in the process of overall treatment, and decision making about the care to be provided to the patients are sufficiently involved in the management of risks caused by the transmission of infectious agents (NHMRC, 2010). Same as in the case of the droplet precautions it is applied to those patients who are suspected of having the infections through droplet route but are designed to decrease the risk of the droplet transmission. Respiratory droplets are generated during the sneezes and cough of the patient, therefore, the nurses are in requirement of the policies so that they can care for these patients well. Nurses itself can get the infections by communicating to the patients or treating them so by maintaining the hand hygiene, and keeping the doors closed in case of the airborne precautions they can reduce the risk of getting infections. Also, they can use and wear single masks and other precautionary items (NSW, 2017). 

An alert is required to be generated since the infectious patients during their cohorting process, and they must be reported with the separation of patients with a minimum of distance one meter. The visitors are required to put with two fluid resistant masks and the protective eye wears. Patients on the oxygen therapy ate required to change up with their nasal prongs. Therefore, the nurses are required to take care of certain things as illustrated above. While working in the recovery unit it was noticed that the patients having their surgical processes afterward got the infections which may be related to the hospital environment or any other lacking reason. But it is important for the nurses and the healthcare professionals to provide care to these patients at the first so that they may not get any further complication during their treatments. There are no other modifications requi9red in the document for meeting the needs of contemporary clinical needs. All the guidelines are documented well in the policies. Some point, however, could be added as educational interventions that will promote the good hygiene and introduction of the aseptic techniques can also be incorporated for providing the patients with sustainable treatment. This will also create an impact on the total outcome and will promote evidence-based care (NSW, 2017). 

References:

Infection Control Policy. (n.d). Retrieved from https://www1.health.nsw.gov.au/pds/ArchivePDSDocuments/PD2007_036.pdf

Infection Prevention and Control Policy. (2017). NSW: Health procedures. Retrieved from https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2017_013.pdf

NHMRC, (2010). Retrieved from https://nhmrc.gov.au/about-us/publications/australian-guidelines-prevention-and-control-infection-healthcare-2010#a1__infection_prevention_and_control_in_the_healthcare_setting

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