Infection Control
A vital tool in the healthcare armory against infection
In the wake of the coronavirus pandemic, the general public has been faced with a barrage of information on pathogens, aseptic techniques and measures for hygiene which has forced the threat of infection into the collective consciousness. To those of us who work in or recruit for healthcare settings though, this is business as usual – and there’s far more than just viruses to worry about. One of the major parts of many healthcare jobs is not just treating sick patients, but preventing the spread of viruses, bacteria, bodily fluids and even yeasts and fungi to other, non-infected patients. There is also the constant threat of infection to the health of the nurses, carers and doctors in these settings, and aseptic techniques are among some of the most important roles in the entirety of healthcare practice. This begs the questions; what measures are there, why do they matter and who do the measures protect?
Although there are set guidelines, an RCN poll found a large disparity in nurses understanding between what is included in aseptic techniques, and how they relate to infection control. Infection control, as defined by the Centre for Disease Control, is ‘the prevention of spread of infection in healthcare settings’. The phenomena of infection control are perhaps not as ancient as one may think, as merely 150 years ago the concept of minute organisms living in a scab or lingering in the air were stuff of heresy. Now though, the bad omens of weather and spirit are no longer to blame for infections, and utmost importance is placed on maintaining good self and patient hygiene. Indeed, alongside the phenomena of increased capacity for cleaning, medicines and agents to counter infection, many bacteria have adapted to circumvent these measures. In 1960, a novel bacterium of the genus Staphylococcus was discovered after infections were persisting after treatment with a new class of secondary antibiotics. This bacterium was eventually coined as ‘Methicillin-resistant Staphylococcus Aureus’, and MRSA continues to plague hospitals and care settings to this day. To this end, many of the infection control settings are in place to reduce the chances of antimicrobial resistance and to prolong the efficacy of current treatments, if needed.
Some of the measures most often put into practice are:
- Hand hygiene – regular hand washing with antibacterial agents, alcohol rubs and liquid soap are all used in different contexts, particularly in between seeing different patients, as in pre-surgical preparation.
- Personal protective equipment (PPE) – something we are all now acquainted with, this is used when there are risks to the provider of coming into contact with potentially infectious material. These include gloves, goggles, masks, visors and even suits.
- Safe handling of sharps – the placement of sharps such as needles and sampling equipment into specific bins is crucial to prevent the spread of bloodborne infections like HIV, hepatitis and other infections. These infections occur when needles and syringes are not disposed of properly i.e. when tying a bin bag, the sharps protrude and penetrate the skin of the person concerned.
- Spillage – nurses and doctors are trained to identify certain types of spillage and have the correct neutralising/sanitising chemicals on hand.
- Decontamination – the appropriate cleaning, sterilisation and disinfection of certain equipment used in procedures i.e. operating tools, scalpels, scopes etc
This list is by no means comprehensive but gives an idea of the scale of the task that is keeping an environment infection free. Inevitably, accidental infections do occur, particularly in skin abrasion and the use of indwelling devices like catheters. Any devices which do have these susceptibilities require an even more stringent pursuit of the infection control guidelines to maximise the chance of an infection free procedure/operation. Although this training is provided in general to healthcare providers, there is regular training and updates on best practice, especially in the wake of the COVID-19 outbreaks. This virus, in particular, has shaken up the procedural guidelines and use of PPE because of the communicable nature of transmission, and, in a positive light, has highlighted the importance of infection control beyond the realm and responsibility of healthcare providers.