Free Paper with a Case Study on Surgical Site Infections

Learning Objective 1

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To develop a deeper understanding of sources, causes, prevention and management of surgical site infections.

Care for patients in the pre, peri and post-operative setting Case Study

Pre-operative is conducted before an elective surgical procedure is carried out. It meant to make sure that the patient can undergo surgery and same time identifying the issues which need to be addressed by the surgical team. The post-operative procedure involves the healthcare professional, and it requires continuous monitoring and clinical assessments that are repeated to ensure that the patient does not face any complications, and if any, they are recognized and addressed. The preoperative management takes place during the surgery process. The surgeons and the anesthetic team has to make sure that the process is taking place smoothly, they are careful with the way the patient is handled, the vital signs are checked continuously. All these methods are supposed to ensure that the patient does not go into a coma or bleed excessively. In pre-operative, the patient is required to undergo various tests, and the medical history examined to establish whether they had undergone another surgery.

Justification

To determine possible ways of improving care and managing infected surgical sites.

Self-reflection

After the study I conducted, I was able to establish that peri-operative care can be affected by different factors. Some of these illnesses are congestive cardiac failure, diabetes mellitus, heart disease, renal dysfunction and chronic respiratory disease. It is necessary for chest pain, palpitations, ankle swelling and dyspnoea tests to be carried out since anesthetic drugs are known to have adverse effects on the respiratory and cardiovascular diseases. The patients who have long-term steroids problem need more cover of intra-operatively as a way of avoiding a hypotensive crisis. Smoking history is also necessary since there is a significant relationship between anesthesia and smoking.

The post-operative care involves mainly selective monitoring, regular assessment and timely documentation of the patient performance. The major body systems that are involved in this care are renal, respiratory and cardiovascular systems. They help in monitoring the performance of the vital signs and establish the performance of the patient. In monitoring the rate of the pulse is taken, urine output, temperature, pain scores, blood pressure and peripheral oxygen saturation.

Timeline

Two hours

Barriers and Bridges to Infection Prevention and Control

Effective infection control and prevention is hindered various factors in the working environments it starts with lack of adequate education on how to effectively control and prevent infections. Some of the patients and healthcare providers are not aware of the methods they should apply in effective controlling of infections. They end up spreading them. Lack of awareness of the importance of disease control is another issue faced in healthcare where people do not know that simple practices such as hand washing may be used in controlling infections. Justification

Observing the working environment and analyzing the obstacles which are faced during prevention and control of infections

Self-reflection

After the study I conducted, I was able to establish that controlling and preventing infections is a combined effort. The patients and the providers should work as a team in reducing infections spread primarily in the hospital environment. The patients should be educated continuously on how they can stop infections and provided with the required measures such as alcohol-based detergents and clean water necessary for infection prevention. The providers should also be trained on how to sterilize the equipment they will be using in the hospital to make sure that they are ready for use without spreading any illnesses.

Timeline

One hour

Conceptual Map of Infection from One Person to Another

When an individual has been infected with an illness, they can transfer it directly or indirectly to another person. Directly, the infected person comes into contact with the uninfected individuals and leaves the disease-causing organism with them. Indirectly, a sick person will move and leave the contamination on a certain surface which is the reservoir, and it escapes which may be through air or water and finds entry to the susceptible person through breathing or drinking.

Justification

To provide an evidence-based understanding of practices that put patients at risk of infection to adopt a preventive approach rather than awaiting acquisition of infection.

Concept Map

Disease organism (agent)mode of transfer reservoir

Susceptible organism mode of entry mode of escape

Learning Objective 2

To increase an understanding of infection control responsibility Infection Control proponent

Clarification of tasks and role of infection control in hospital conceptual map

Justification

Determination of how prevention and control of illnesses can be carried out.

Postoperative Risk Factors for Central Venous Catheter-Related Infections in a Neonatal Population Literature Review

The care procedures that are applied to the newborns in intensive care units need the application of advanced technology. One of the invasive procedures is the use of the central venous catheter. The line has to be inserted in the correct position to make sure that it will allow effective administration of the medications and solutions. The newborns have a higher risk of infections in comparison to other patients. It is because of the immature immune system. There are low levels of complement factors thus making the neonates unable to fight infection. Bacteria can find its way through during the administration of the medication. It is necessary to make sure that sterilization of the items used in this case is done.

Justification

To examine and summarise current evidence-based research on postoperative risk factors for central venous catheter-related infections in a neonatal population.

Annotated Bibliography

Gleason, CA 2011. Avery's Diseases of the Newborn E-Book. London: Elsevier Health Sciences

According to Gleason (2011), neonatal population, the commonly used intravascular devices which are used are peripheral intravascular catheters (PIVs), surgically placed central venous catheters (CVCs), umbilical catheters, and peripherally inserted central catheters (PICCs) and percutaneous arterial catheters. However, the rate of infections linked with catheter directly depends on the member of days which the catheters are in place while on the other hand it is inversely related to the birth weight of the patients and the gestational age. Infants having less than one-kilogram birth weight have a higher nosocomial infection than children weighing more than one kilogram (Gleason 2011). The fundamental pathogen that is associated with catheter linked bloodstream infections is Coagulase-negative Staphylococcus (CONS).

In neonatal population, PIVs are frequently used for vascular access (Gleason 2011). Every device that is used has its varying rate of infection hence rate of infection escalates with the type of invasive device that is used. Different methods have diverse periods during which they can be used, and therefore this has varying levels of exposure of the neonatal population. The risk thus increases with the length of exposure. The neonatal community has a higher risk of catheter-associated bloodstream infections and lesser risk of ventilator-related as well as urinary tract related infections.

Lengthy periods of mechanical ventilation are the core risk factor for the growth in pneumonia which is acquired in hospitals by the neonatal population (Gleason 2011). Moreover, using intravenous lipid emulsion such as intralipid increases the infection rates in the neonatal population. When lipid emulsion is used, the rate of flow through the intravenous catheter is decreased which therefore makes it possible for the growth and proliferation of microorganisms (Gleason 2011). Lipid emulsion enhances the growth of CONS bacteria in neonatal population which increases the risk of contracting the nosocomial infection.

Sachdeva A. and Dutta AK 2012. Advances in pediatrics. Japan: JP Medical Limited

According to Sachdeva and Dutta (2012), there are high mortality and morbidity rates associated with nosocomial infections in the neonatal population. The rates of healthcare associated infections (HAI) significantly differ in various people, but neonatal intensive care units and pediatric intensive care units record the highest level of diseases. The healthcare-related infections in the neonatal population are majorly caused by exogenous factors such as microorganisms (Sachdeva and Dutta 2012). Endogenous infections, on the contrary, are as a result of insertions of vascular catheters, surgical process, and indwelling devices.

Endogenous factor-infections are usually caused by colonization, and consequent infection by pathogens in the hospital surrounding caused by immunosuppression or flora changed through antimicrobial therapy (Sachdeva and Dutta 2012). In addition, 8.5% of the hospital-acquired infections are caused by Hemolytic streptococci which is very dominant in the neonatal population (Sachdeva and Dutta 2012). There is a high rate of enterococcal infections in infants and people between the ages of 13 and 65 years (Sachdeva and Dutta 2012).

Despite mechanical ventilation being the main cause of Ventilator-associated pneumonia (VAP), reintubation, use of neuromuscular blockade agents, the presence of genetic syndrome and immunosuppression are other risk factors of VAP in neonatal population (Sachdeva and Dutta 2012).

DeLoughery TG 2014, Homeostasis and Thrombosis. New York: Springer Publishing

According to DeLoughery(2014), in North America, 25% of neonatal strokes is recorded which is seen in 1 out of 3500 live births. Some of the risk factors which can be the leading causes of neonatal strokes include placental thrombosis, maternal fever, long periods of the membranes rupturing, neonatal sepsis and neonatal congenital heart disease. Besides, Varicella zoster (chickenpox) infection which is prevalent among the newborn population is linked with acquired antibody to protein S and angiopathy which cause strong in this populationDeLoughery (2014). Besides, other infections such as meningitis and encephalitis are also leading causes of inflammation which ultimately leads to stroke in the neonatal population.

Islam S 2016 Thrombosis and embolism: From research to clinical practice, volume 1. New York: Springer publishers

According to (Islam (2016), 90% of neonatal thrombosis cases are attributed to central venous catheter placement. The level of fragility of the germinal matrix in infants and more in premature babies pose them to be at risk of intraventricular hemorrhages. High cases of venous thromboembolism (VTE) infection is recorded from percutaneously inserted catheters (Islam (2016). The location of the central lines anatomically and their size have key significance in causing infection in that high risk of VTE infection is caused by larger catheters than smaller ones (Islam (2016). Additionally, a neonatal population with complicated health conditions which involve the use of certain chemotherapy such as L-asparaginase therapy for acute lymphoblastic leukemia similarly have a higher risk of contracting catheter VTE infection (Islam (2016). Likewise, inherited thrombophilias also escalates the risk of the neonatal population getting infected with CVC related thrombosis such as cerebral venous thrombosis (Islam (2016).