This reflective essay is based upon my experience working alongside the Infection Prevention and Control Support Nurses at the general hospital. As part of my learning experience as a 2nd year student nurse is to accompany the infection control nurses when visiting the wards The role of the IPCSN involved teaching, educating and advising all disciplines across the Trust, monitoring outbreaks and daily surveillance.
I will structure this essay using Gibbs Model of Reflection (Gibbs 1988).
Reflective learning helps practitioners analyse their experiences and how they think and feel about them before deciding whether they would approach the situation in a different way next time. In order to maintain confidentiality at all times for the patient and of any staff members I will adhere to the NMC Code of Professional Conduct (NMC 2008).
Therefore any names used in this essay are fictional.
The Health Act states: ‘Effective prevention and control of Health Care Associated Infections (HCAIs) have to be embedded into everyday practice and applied consistently by everyone’ (Department of Health [DH], 2006).
Hospitals and other care providers are legally required to implement this code of practice within their organisations. Most common infections occur as a result of people taking various antibiotics and being in close contact with each other, such as hospitals and nursing homes (NHS 2010).
Attention to good hand hygiene measures should be observed during outbreaks. It is very important that staff and patients wash their hands with soap and water Health Protection Agency (2010).
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Compliance with hand hygiene is only maintained by constantly reminding staff of it and monitoring their performance. The ayliffe technique is recommended for nursing staff especially after direct contact with patients who are ill (Ayliffe 2000) and the use of wearing protective clothing of disposable apron and gloves making sure they are changed and hands washed between patients.
The infection prevention and control protocol’s include the use of protective clothing, environmental cleaning and decontamination and disposal guidelines for items that have been in contact with the patient. Risk assessment is also important (Coia et al 2006).
The infection prevention and control team (IPCT) was informed by a medical ward that several patients had had episodes of diarrhoea and vomiting. Norovirus is a common form of viral gastroenteritis that occurs during winter month’s and is highly infectious (NHS 2010).
The symptoms of norovirus include nausea, vomiting, diarrhoea and high fever (NHS 2010).
This alerted the IPCT therefore there was a need to investigate and assess the situation fully and a ward visit was required. I went along to the affected ward to observe the assessment with my mentor Helen, where two patients there may have developed norovirus the symptoms they present with diarrhoea and vomiting which has escalated during the last six hours, the IPCSN asked the staff nurse if samples had been obtained for collection of the suspected patient’s faeces and vomit the nurse was not aware of the policy.
Patients with norovirus are usually isolated in a single room as they are classed as contagious the incubation period is 24-48 hours. Patients need to remain isolated for 72 hours after symptoms have subsided. Hense, in this case there were no single rooms available therefore the suspected patient’s are nursed in the affected bay and a caution is put on that bay to any new admissions NHS (2010).
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Following the next episode of diarrhoea and/or vomiting samples are required to detect Norovirus and once collected they must immediately be sent to the virology laboratory for investigation.
Helen gave the nurse a norovirus resource pack put together by the IPCT which contains an outbreak action plan and checklist to be implemented and for other staff to read which will advise staff of the isolation precaution and give guidance on managing the infection and the affected patients were given information leaflets about the illness. Staff were advised to encourage fluids especially with the patient’s suspected with nurovirus and commence them on a Bristol stool chart in order to monitor the diarrhoea a food chart and fluid balance chart to keep a record of the input and output.
By documenting the information correctly enables nurses adhere to the NMC code for good record keeping (NMC 2009) who recommend that stating the date, time, signing and printing alongside is good practice. On reflection I have learned by being with the IPCT the importance of sending samples off when the first episode of diarrhoea and vomiting occurs leasing with team members. The IPCT emphasises prompt screening of suspecting patients for a norovirus as early detection of the signs can prevent an outbreak on the ward.
I have become aware that the mode of transmission of norovirus means it is not always possible to avoid becoming infected (Nursing Times 2011).
The trust provides mandatory training to inform nursing staff on the most recent infection control measures in practice. Hence, good hygiene and the isolation of infected individuals can limit the spread. Good communication is important with all visitors and staff, including cleaners. However, everybody who has contact with the patient or the environment is entitled to relevant information that will enable them to reduce the risks of transmission to themselves or others.
I can now see that this situation could have been avoided if samples had been sent for screening earlier. However, the results of screening tests take some time becoming available on the database and failure in communication can prevent the results reaching the wards promptly. During my nurse training I have learned about the common hospital acquired infections (HCAI) meticillin-resistant staphylococcus aureaus (MRSA), clostridium ifficile (c-diff) and norovirus, but now I know that there are many more micro-organisms that the IPCT have to record and monitor when arise at times the IPCT have to report the situation to the department of health. I have gained a lot of experience from this placement regarding Infection control and I now have a broad range of knowledge of which I will pass on to future colleagues and junior staff.
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