Which is the Most Effective Nursing Action for Preventing and Controlling the Spread of Infection?

Infection Control in Healthcare and Nursing Action

Infection control is the practice of preventing the spread of infections throughout healthcare settings as microbes are almost present on each surface. 

However, differentiating between harmful and beneficial ones is crucial. A hospital serves as the safest place for ill patients but equally risky place due to the presence of germs. 

From patient beds, counters, and moist places to indwelling devices, germs are frequently found in these areas. Transmissions in such settings are very common through physical contact with these surfaces, inhalation of droplets through coughing and sneezing, and when skins are exposed through injuries. 

Due to these circumstances about 1 in 31 patients have healthcare-associated infections (HAIs). Patients become more susceptible to infections when their immunity is compromised due to the presence of disease, they are on medications, or their body gets exposed to microbes during surgeries or tubes like catheters. 

Effective infection prevention in healthcare is necessary for patient safety and nurses play a pivotal role in preventing infection spread by determining the infection risks, crafting Infection control policies in healthcare, and guiding the healthcare team and patients regarding safety measures.

This blog aims to explore Infection control in nursing and focuses on the most effective nursing actions to prevent infection. 

Understanding the Chain of Infection

Understanding the chain of infection can assist in implementing infection prevention strategies in nursing. 

The Six Links of Infection

The six steps of the infection process include.

• Infectious agent that causes disease. This can be a virus, bacteria, or fungi. 
• The Reservoir is where the infectious agent spends its lifecycle. This can be a human host, any natural habitat, or any common object. 
• Through the portal of exit, the infectious agent moves out of the host. (e.g. respiratory droplets or body secretions)
• The mode of transmission serves as a pathway for the transmission to another host. 
• Through the portal of entry, the disease-causing agent enters the new host. e.g.) exposed skin or other sources.
• A susceptible host, who has a weakened immune system, allows the pathogen to easily invade their body. 

For Effective infection prevention in healthcare, nurses can intervene at each stage to break the chain of infection.

Common Pathogens in Healthcare Settings

Healthcare-associated infections are either highly resistant easily transmittable or both. Common pathogens that nurses need to guard against, include MRSA, C. difficile, tuberculosis, influenza, and others.

A few Infection control protocols related to these pathogens include proper handwashing,  the frequent use of Personal Protective Equipment, the use of disinfectants, and isolating the infected patients. 

Core Nursing Actions in Infection Prevention

Hand Hygiene

Hand washing is an Evidence-based infection prevention technique in healthcare. WHO states that most Healthcare-associated infections can be prevented by washing hands at the right moment. Moreover, the WHO also provides a detailed guideline on hand washing techniques. 

The 11-step handwashing technique given by WHO includes.

• Wet your hands.
• Apply Soap.
• Rub both palms together.
• Put the right palm over the left dorsum with interlaced fingers and vice versa.
• Join both palms in the interlaced position.
• Join the back of the palm with opposing fingers and interlock them.
• Rub both the thumbs turn-wise.
• Rotate clasped fingers to clean the palm of each hand. 
• Rinse your hands.
• Dry with a towel.
• Use a towel to stop the water flow.
• You have safe hands now! 

The timing and frequency of handwashing in Nursing practices to control infections include washing hands before patient care, after contact with bodily fluids, and after contact with the patient and their surrounding. 

Frequent handwashing can break the chain of infection and promote a safe healthcare environment. 

Personal Protective Equipment (PPE)

PPE plays an essential role in preventing Infection in nursing

Different types of PPE (gloves, gowns, masks, eye protection) provide physical protection to the hospital staff, decreasing the chances of infection exposure. 

Guidelines for PPE Usage

While using PPE Nursing practices to control infections include proper donning and doffing procedures to avoid cross-contamination. The medical staff should carefully don, which means to wear PPE by starting with cleaning their hands and wearing the items according to the situation at a clean germ-free place.

During Doffing,  the nurses should start by removing gloves from the inside area as the front of the gloves will be contaminated. Then clean their hands and wrists subsequently after each removal. The PPE should then be discarded immediately in the assigned bins.

Specific Recommendations for Nurses

To prevent infection in nursing, nurses can use gloves when in contact with blood or bodily fluids, wear surgical masks or respirators during aerosol-generating procedures, and wear gowns when chances of splashes are present. 

Sterilization and Disinfection

The Role of Sterilization

Sterilization of medical equipment through various methods like autoclaving kills all forms of microbes and eliminates their spores to end their lifecycle.  

Maintaining sterile environments is important for  Infection control in nursing due to its role in ensuring that medical and surgical instruments are free of pathogens and do not transmit them to humans. 

Cleaning and Disinfecting Patient Spaces

Cleaning patient areas is essential for preventing Healthcare-associated infections. High-touch surfaces such as patient beds and call buttons along with the equipment that is shared between patients should be thoroughly cleaned. 

Environmental Hygiene

Cleanliness and Infection Prevention

Environmental practices through regular cleaning of hospitals commonly touched areas such as patient room doors, their light switches, and side tables.

The airborne pathogens present in a room full of patients should not be spreading and proper ventilation along with HEPA filters can ensure the passage of only purified air through these rooms preventing cross-contamination.

Waste Management

Proper disposal of waste and handling of contaminated materials can prevent the spread of infection. 

The use of biohazard bags and sharp bins ensures that this waste is differentiated from the local waste and incinerated according to the safety protocols. In this way, the microbes present are eliminated before disposal and the environment remains safe from their spread. 

Isolation Precautions in Infection Control

It is essential to understand the types of Isolation Precautions for Nursing actions to prevent infection:

Standard Precautions

These are universal precautions for every patient, regardless of infection status. These include hand washing before and after interacting with the patient, use of PPE when exposed to body substances, and disinfecting the medical tools.

They form the foundation for the prevention of Healthcare-associated infections.

Transmission-Based Precautions: 

These are used along with the standard precautions when the patient’s infection is determined. 

Methicillin-resistant Staphylococcus aureus, a highly resistant bacteria from common antibiotics requires contact precautions such as gloves and gowns. 

COVID-19, a respiratory disease, demands airborne precautions such as the N-95 mask and isolating the patient. 

Droplet precautions are used in conditions such as influenza, where a surgical mask is necessary. 

How Nurses Implement Isolation

Nursing practices to control infections and manage isolation protocols effectively while caring for patients include the use of PPE, educating the patient regarding their condition, and reducing their traveling from one room to another. 

The Role of Nurses in Monitoring and Surveillance

Patient Surveillance for Infection Symptoms

Nursing actions to prevent infection start with monitoring the patients for signs of infection (e.g., fever, redness, swelling, discharge).

Reporting Infections

Identify any symptoms associated with outbreaks or unusual infection patterns and report them to the healthcare authorities immediately. 

Infection Control Audits

Regular audits can ensure adherence to infection control practices such as the right use of PPE, following the hand washing techniques, and improved hospital standards.

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Educating Patients and Families

The Importance of Patient Education

Effective infection prevention in healthcare is not limited to the hospital staff but can also be done by educating patients in layman’s language on infection prevention techniques, including hygiene practices, vaccination, and antibiotic stewardship.

Engaging Families in Infection Control:

Involving family members in infection prevention, particularly in long-term care settings can reduce the chances of Healthcare-associated infections. 

Offering detailed tutorials regarding the use of PPE and handwashing before and after meeting the patient and promoting the cleaning of common living spaces can also serve as infection control strategies. 

Addressing Challenges in Infection Prevention

Preventing infection in nursing comes with certain challenges. Here is how nurses can break these barriers and ensure Effective infection prevention in healthcare. 

• Resource Limitations: Understaffing, and insufficient access to PPE, or cleaning supplies can restrict the nurses from working according to the Infection control policies in healthcare. 

However, to manage the situations, nurses can work within these constraints by reusing PPE as per guidelines and demanding the production of more of these for continuing patient care without risks. 

• Patient Non-Compliance: In situations where patients refuse to comply with infection control measures (e.g., isolation, hand hygiene) the nurses should educate them regarding the impact of  Healthcare-associated infections along with including the family members for extra understanding and cooperation. 
• Cultural and Behavioral Barriers: Cultural attitudes toward healthcare may impact infection control efforts. 

However, nurses can navigate these barriers by demonstrating their understanding of cultural competence along with highlighting the negative consequences that can occur with infection spread throughout the healthcare setting. 

Evidence-Based Nursing Practices for Infection Control

Research and Data on Infection Control

A study finds that Nursing practices to control infections through hand hygiene techniques results in significant reduction of hospital-acquired infections. 

WHO has stated detailed hand-washing techniques along with emphasis how the use of gloves does not replace the need for washing hands. 

Another study suggests that specific PPE usage along with the proper dining and doffing techniques can protect medical workers from Healthcare-associated infections.

Adapting Evidence-Based Guidelines

Nurses should remain updated regarding any new health care policies and their practices should evolve based on the latest research and clinical guidelines from trusted health organizations like the CDC and WHO.

Case Studies and Real-world Examples

Case Study 1: Controlling a Flu Outbreak

During an influenza flu outbreak, nursing interventions in controlling the situation included:

Isolating the patients with flu-like symptoms. 

Checking the medical history and vaccinating the individuals who were not vaccinated before.

Increased use of disinfectants to clean the common areas of use.

Offering detailed guidance to the patients and their family members regarding effective infection prevention in healthcare.

As a result, the outbreak was controlled within 8 days, along with only 2 new cases and no mortalities. 

Case Study 2: Preventing MRSA Spread in the ICU

A rapid spread of MRSA was observed among 6 ICU patients. Upon further searches, the health care staff discovered that this was due to cross-contamination by the same equipment use and poor hand washing techniques.

Nursing actions to prevent infection in such a scenario include

Initiating a collaborative approach to perform a root cause analysis. 

Encouraged strict adherence to MRSA Infection control policies in healthcare such as the use of PPE during contact with these patients and assigning specific stethoscopes and blood pressure monitors for each patient. 

Added more hand sanitizing stations and encouraged the patients and health care staff to implement the WHO guidelines for hand hygiene.

Focused more on using various disinfectants in the patient’s room, especially on the frequently touched surfaces. 

Raised voice for the need for staff compliance audits to ensure the staff’s adherence practices that are necessary for Effective infection prevention in healthcare. 

As a result of these Nursing actions to prevent infection, MRSA transmissions were stopped within 1 month and audit reports demonstrated a noticeable improvement in effective hand hygiene practices from 63% to 94%. 

Final word

The key Nursing actions to prevent infection include hand hygiene after every step they take in patient care, the right use of PPE based on the kind of exposure to the infectious material, and environmental cleaning practices especially on the high touch surfaces.

For Effective infection prevention in healthcare, nurses should regularly collaborate with the infection control teams and stay updated on the latest infection control protocols. 

 Moreover, through continuing education and certifications, nurses should adopt and continually practice these essential infection control measures in their daily routines to protect both themselves and their patients and to ensure Evidence-based infection prevention in healthcare.

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Frequently Asked Questions (FAQs)

What is the single most important action for preventing infection in healthcare settings?

The single most important action for preventing Healthcare-associated infections is the hand hygiene practice of washing hands properly with soap and water following the recommended steps. In case of their absence, use hand sanitizer with a minimum of 60% alcohol. 

How often should nurses wash their hands?

Before and after touching a patient, after exposure to the patient’s body fluids, before performing aseptic procedures, after their presence in the patient’s surroundings, and after taking off gloves. 

When should nurses use PPE, and how do they ensure its proper usage?

Nurses should use PPE depending on the risk and mode of transmission they are dealing with. Proper usage is based on knowing the right technique of donning, doffing and disposing of them in their respective bags. 

What should be done if a nurse notices a healthcare-associated infection outbreak?

Nursing actions to prevent infection in such a scenario include reporting the outbreak, isolating the patients, following effective PPE, hand hygeine and cleaning practices along with educating the patients and health workers regarding the strategeies to prevent Healthcare-associated infections.