Terminology and the Critique

Terminology and the Critique



Terminology and the Critique

Introduction

Hospital acquired infections are a serious problem in patient care and adversely affect the mortality and morbidity. Mainly the affected areas are ICU and acute wards where the patients are critical and immuno compromised. Nosocomial infections complicate the primary disease process and create problems like septicaemia and ARDS. They remain endemic in critical care wards and lead to epidemic out breaks. In the ICU, the accumulation of a number of immuno compromised patients and their nursing and invasive procedures provide a favourable environment to the growth and transmission of nosocomial Infections. MRSA is common isolate and is responsible for nearly 10% of nosocomial infections recognised as a significant hospital acquired pathogen in acute and long term patient areas worldwide. In contrast, the rate of infection increased by 18% among hospitals with minimal or poor infection control practices. Nosocomial infection control contribute to good patient care. (Richard 1991)

Review of Literature

Material and methods

All the new infections that occurred after 48 hours of admission, and were not present or incubating at the time of admission and not responsible for the primary disease process were regarded as nosocomial or hospital acquired infections. In the absence of clinical evidence of infection, the demonstration of bacterial colonies of more than 20 in the screening samples, were regarded sufficient to label such patients as infected and necessary treatment was advised. Only those patients qualified for the study who showed evidence of acquiring nosocomial infection during the stay in ICU. All infected and septicemic patients were excluded from the study and segregated on admission in different cubicles to prevent cross infection to other patients. (Haley 1995)

The study was spread over two phases of six months each. In the phase I of our study ie, during the first six months, the regular ward routine of nursing patients were not disturbed and no new specialized nursing protocol was introduced. The nursing staff continued to attend to their patients in their army uniforms and followed the same routine of infection control measures and other practices which were existing earlier. The barrier nursing precautions were resorted to only while nursing infected and septicemic patients. Ward disinfection routine continued as before and waste disposal drill was carried out as per the standard policy of the hospital. (Myfield 2000)

Hand washing facilities were improved by providing running warm water and liquid soft soap near the central nursing station. The staff were explained the importance of repeated hand washing immediately before and after every episode of patient contact or nursing activity in prevention of cross infection. They were instructed to wash hands immediately before and after handling each patient in specific with unwashed areas of hands. The results obtained in both phases for each category were finally compared as percentage and further statistically analysed for any significant change, by using Chi square test and P values as test of significance. Attempt was also made to link the difference in observations in both phases to the financial implications ...