Infection Control - Essay Example

INFECTION CONTROL Infection usually is a scare for people who dwell in untidy atmosphere or whose life is associated with activities that are prone for dangerous microorganisms to attack easily on. (e.g., public health servants) The effects of infection on various parts of our human physique vary depending upon the microorganisms that attack on and the state of resistivity of the immune system. Infection generally is fought with antibiotics. Antibodies produced by antibiotics easily manage bacterial infection. Viral infection is quite virulent that antibiotic treatment is not sufficient. According to Hans C J Gram, a Danish bacteriologist in 1800's many bacterial infections are grouped either as G+ or G - depending on the type of bacteria that caused them. The bacteria in each group have certain characteristics that help determine the sensitivity of these microorganisms to antibiotics. A common Gram-negative bacterium in intestines is approximately 1 to 2 micrometers in length and 0.5 to 1.0 micrometers in width.these cells are growing by binary fission. The surface of the cells is covered with a fuzzy material composed of lipopolysacchride, which protect the cells as armor. Spiral-shaped Campylobacter is a Gram-negative bacterium an important intestinal pathogen.1 Dr.yi ZM od South Central University of China conducted investigations with patients of chronic obstructive disease combined with pneumonia and found that bacteria in the patients at respiratory ICU are mainly made up of G- bacillus and secondarily of G+ which are sensitive to certain antibiotics like amikacin , ceftazidime and vanomycin. ( Yi ZM, 2003) We shall now talk about infection that takes place during the course of medical treatment itself. Aids, the global scare made many medical professionals to use sterilized needles during their process of treatment. (Slide.1) Single-puncture syringe that cannot puncture the skin once it is used is the best form of administering equipment for anesthetic and other medications. The profession is to go miles before attaining complete protective treatment. One of the most dreads that now posed by the ultrasound treatment is the use of gels. When an object or human body part is exposed to ultrasonic waves, density differences inside the object or the body parts cause some waves to reflect at the point of interface. This reflection is built into an image of the internal part of the body and its structure on the monitor screen. A gel or jelly is normally used to transmit the acoustic waves through the transducers-a device that contains a crystal, which converts alternating electric currents into vibrations-to the object or the internal part of the body. Experiments show that a high-energy ultra sound emitter inserted through an angioplastic catheter can effectively break up the blocks and restore normal blood circulation. In many patients bacteremia is a result of an intravascular focus, such as contaminated catheter or prosthetic device. (Abraham I Braude, 1981) Contamination of the gel at the manufacturing facility and improper use of the gel at clinical settings are the sources of many cases of bacteremia and septicaemia. Non-sterile gels meant for external use, when used for invasive procedures like biopsies, put most of the patients under the risk of infection. Some precautionary measures can be followed to reduce the risk of infection. Separate individual procedures for sterile and non-sterile gels are postulated by Canadian Health Authorities. They are: - Sterile gels: - 1. Sterile gels must be used for all invasive procedures especially on babies in neonatal I C U. 2. Bacteriostatic gels should be considered for intact mucous membrane operations like oesophagal, rectal and vaginal areas. 3. Sterile packages must be used for one time use only. Non-sterile gels: - 1. Single use containers are the best for non-sterile gels. 2. In the situations of the use of reusable containers, the containers must invariably be cleaned thoroughly by using hospital-grade disinfectants. The very bad practice of "topping up" must be dispensed with. It should be seen that no crack is found in the reusable bottles. 3. Only the non-expired contents of gel should be transferred to the refills. 4. Dispensing devices in the large containers must be used for refilling. The refillable bottles themselves should not be used to aspirate the gels from the bulk container. 5. Proximity of the bottle and the container must be very close during refilling of the gel. 6. Gels should not be used after one month from the date of opening. 7. Dispensing nozzles or the tips of the bottles should not be brought into bodily contact with patient or staff. 8. Small and single-use packs of gels are the best for infrequent operations. 9. Direct use of bulk containers must strongly be discouraged for use on patients. Since improper use at clinics also cause problem, certain instructions for them are advisable. Warming of gel: Gel warmers should be cleaned weekly using approved disinfectants. Bottles must be immediately removed from warmer after warming and dried. Necessity of the use of warmed gels must be judged properly. Storage of gels and Ultrasound appliances: Ultrasound products and gels should be protected from contamination by moisture, insects, dust and rodents. (Slide.2) Products suspected to have been contaminated must be discarded. (Chica-Canada Position statement on Medical gels, 2005) Bottles are generally used for the storage, and dispensing, of ultrasound gel. When bottles are exposed to body fluids, they can become contaminated with a wide range of microorganisms, which can be transmitted to another patient during a subsequent procedure. Simple wiping of the bottles before refilling from a bulk container is not sufficient. The interior and exterior surfaces and leftover gel may not be contaminant free. Small disposable bottles are expensive and the process of using them is laborious and time consuming. The most thorough disinfection protocol can only address the exterior of the gel bottle. (medi-inn) During the performance of ultrasound techniques on patients certain extra precaustions are necessarily to be made. Disposable cover like condom is advisable to use in the vaginal or endocavitary examinations. Transducers used on the skin surface should be cleaned with soap and water or low-level disinfectant sprays. Closed flush and waste containments systems must be used in angiography. Glass containers should be separately handled from regular waste to reduce injury to service staff. Patients may enter the room of radiographic investigations with identified or unidentified microorganisms. Bacteria like Mycobacterium tuberculosis spread via air borne route. Such patients with communicable diseases must wear surgical or isolation mask in the radiology room to reduce the probability of spreading the microorganisms to patients without such attack. Negative-pressure isolation room is well suggested for those patients. (Candace Friedman, Kathleen H Peterson,2004) CONCLUSION Although all infections do not carry with them the risk of causing diseases, care must necessarily be taken to prevent them. Clinical procedures when carried out in improper way causes infection. This can effectively be overcome by following strictly the instructions stipulated by the manufacturers of many of the medical equipments and pharmaceutical products. Reference list--- -- Abraham I Braude, 1981, " Medical Microbiologyand Infectious Diseases" Vol II, pp1395, W.B Saunders Company -- Candace Friedman, Kathleen H Peterson,2004, "Infection Control in AmbulatoryCare", pp126, 127, Jones and Bartlett Publishers -- Chica-Canada Position statement on Medical gels, 2005 (http://72.14.203.104/searchq=cache:JhRKR1_XKNsJ:www.chica.org/pdf/medgels.pdf+infection+control+ultrasound&hl=en) --http://www.medi-inn.com/geldisp.htm -- Dr.Yi ZM, Yang H, Xiang XD, 2003, "Characteristics of bacteriology and drug sensitivity in patients with COPD combined with pneumonia", Department of Respiration, Second Xiangya Hospital, Central South University, Changsha 410011, China. Revision sent on 26.01.2006 @1200 hrs Read More