The author has chosen to base this assignment on the transmission of infection and implications in clinical practice. This will has been attempted by discussing infection, its causes and the ways it is transmitted. Followed by an investigation of the immune system, its' response to infection and who is most at risk. Implications in clinical practise were investigated, and then related to an incident in clinical practice.
This assignment was a good opportunity to gain a better understanding of infections and the methods of control. The clinical experience the author will focus upon was an elderly female who is fully mobile but slightly confused. In accordance with the NMC code of conduct (2002), the client’s actual name and placement setting will not be disclosed in order to maintain confidentiality. The client has been named Ann. Ann was experiencing symptoms of the Varicella Zoster Virus when admitted to the ward.
Ayliffe, Fraise, Geddes and Mitchell (2000, p1) state that the term infection is generally used to refer to the deposition and multiplication of bacteria, and other micro-organisms in tissue or on surfaces of the body with an associated tissue reaction. The four types of micro-organisms are protozoa, bacteria, viruses and fungi. "The world around us contains an assortment of viruses, bacteria, fungi and parasites capable of not only surviving but thriving in our bodies - and potentially causing us great harm" Martini (2001, p129). Micro-organisms are living creatures that can only be seen under a microscope and are called pathogens. Hinchliff and Schober and Norman (1998, p365) also includes that many are essential for our survival but a small amount cause disease by invading and damaging tissue.
"To cause an infection a pathogen must have a way to enter the body - a portal of entry" Wilson (2001, p33). Also stated is that after gaining entry the micro-organisms may spread to other tissues and be expelled by the same or different route. To transmit to another person it must leave the body. According to Hinchliff et al. (1998, p369) the main ways of transmission of pathogens are hands, airborne particles, inanimate objects, blood borne, insects, food and water. Although all of these are important, one of the main routes is from hands.
"Infection control affects every aspect of healthcare and every nurse, irrespective of the setting in which they work, should ensure that their practice incorporates a sound knowledge and understanding of basic principles" May (2000, p5).
According to Wilson (2001, p35) hands should be washed between examination of all patients. Microbes on hands are acquired through contact with excretions, secretion or infected lesions and are easily transferred through touch. "Pathogens on hands will not survive long", Wilson (2001, p34) but as our hands are constantly touching the transmission rate will be high. This simple but essential skill is very important but is often overlooked or not performed with enough care. Mallet and Balley (1996, p41) supports that hand washing is the most important procedures for preventing infections. Either a lack of knowledge or time could be to blame for this. Also that wearing rings increases that number of micro-organisms on the hands.
All patients with known or suspected infections should be isolated until test results prove there is no infection according to Hinchliff et al. (1998, p386). The patient needs to be in a separate room with both washing and toilet facilities. If a single room is not available then patients with the same infection may be situated together. Not only is it the staff which must be clearly informed but also the visitors according to Wilson (2001, p359). They are just as likely to spread the infection and staff must ensure they understand the importance of correct behaviour. Patients must remain in their room as much as possible and only leave for essential purposes.