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Guides to Good Nursing Practice Infection ControJ Preamble The field of hospital infection control stmied in the middle of the 1800s when Semmelweis and Nightingale introduced sanitation and hygienic practices into hospital. Modern 'infection control' as practised today , was initiated when a series of hospital outbreaks of Staphylococcus aureus infection in the 1950s occurred in United States and United Kingdom (Lin, Ching & Seto, 2004). Infection control has becotne a fonnal discipline in Hong Kong since 1nid 1980s because of the Methicillin Resistant Staphylococcus Aureus (MRSA) outbreak publicity. The emergence of life-threatening infection during the outbreak of Severe Acute Respiratory Syndr01ne (SARS) in March 2003 has highlighted the need for efficient infection control programmes in all health care settings and capacity building for health care workers (World Health Organization, 2003 ). Healthcare-associated infections (HAI), whether acquired during home, ambulatory, institutional or hospital care, constitute one of the greatest challenges of modern medicine. HAl have shown to be expensive. They extend clients) stay and increase mortality (Dawson, 2003). The prevention and control of infection is fundan1ental to the provision of a safe enviromnent for clients and forms an integral part of the practice of any health care workers in the clinical settings. Nurses , as front-line care givers, are ideally placed to practise infection control which is an integral part of quality client care. Definition Infection control refers to policies and procedures used to minimize the risk of spreading infections, especially in hospitals and health care facilities (Jones & Frey, 2004). Principles In implementing infection control, the nurse needs to consider the following: I. Re1nove source of infection by treating infections, decontamination procedures and enviromnent clem1ing. 2. Prevent transfer of infections with good hand hygiene practice, aseptic procedures a11d appropriate precautionary measures. 3. Enhance body resistance with good nutrition, appropriate antibiotic prophylaxis or vaccination. Responsibilities of the nurse I. The nurse assesses the situations for potential or actual transn1ission of infectious disease during care delivery in all settings. 2. The nurse ensures necessary action(s) is/are taken to reduce the risk of developing HAl in clients, self and others . 3. The nurse applies measures to prevent and control transn1ission of micro-organisms that are likely to cause infection. These include : a) Keeping updated record of immunization status of self. b) Adopting appropriate precautions during caring practices. c) Adhering to appropriate hand hygiene guidelines/protocols. I Developed by the Professional Development Committee of the Nursing Council of Hong Kong d) e) 4. 5. 6. 7. 8. 9. 10. Using appropriate personal protective equiptnent. Reporting, intervening and providing appropriate care when an infectious risk of exposure has occurred to client(s), self or others. The nurse monitors the compliance of infection control policies and practices. The nurse ensures that timely and appropriate investigations, treatment and care are provided to the client with infection. The nurse reports the abnorn1al clustering of sy1npt01ns other than infectious diseases in accordance with the prevailing reporting system. The nurse collaborates in surveillance with regard to prevention and control of infections. The nurse educates client and family with regard to personal and environ1nental hygiene, prevention and control of infections. The nurse proactively identifies appropriate resources to upkeep the standards of infection control practices and infectious diseases management. The nurse updates self knowledge and practices of infection control. Bibliography Ayliffe G.A.J., Fraise A.P., Geddes A.M. & Mitchell K. (2000). Control ofHospital infection -a practical handbook (4 1h ed.). London: Arnold. College of Nurses of Ontario. (2004). Prachce Standards: Infection Prevention and Control. [On-line]. www. cno. org/pubs/publist.html. Curran, E. (2001 ). Reducing the risk of healthcare-acquired infection. Nursing Standard. 16, (1 ), Septe1nber. 45-52. Dawson S.J. (2003). The role of the infection control link nurse. Journal of Hospital Infection. 54 ) 251-257. Jones, C.L.A. and Frey R.J. (April 2004). Infection Control. [On-line]. wvvw.healthatoz.com /healthatoz/ AtoZ/encylinfection_ control.jsp. Lin M.L., Ching T.Y and Seto W.H. (2004). A Handbook ofinfection Control for the Asian Healthcare Worker. (2nd ed) . Hong Kong: Elsevier (Singapore) Pte Ltd. Nursing Council of Hong Kong (NCHK). (2002). Code ofProfessional Conduct and Code of Ethics for Nurses jn Hong Kong. Hong Kong: NCHK. NCHK. (Dece1nber 2004). Core-Competencies for Registered Nurses (General) [On-line]. WVv'VV . nchk .org.hk. World Health Organization, Western Pacific Region. (December 2003) . Practical Guidelines for Infection Control in Health Care Facilities. [On-line]. www.wpro.who.int/SARS. 2 Developed by the Professional Development Committee of the Nursing Council of Hong Kong Useful Web-sites in Hong Kong Webpage on Infectious Diseases & www. ha. home/visitor. Infection Control, Hospital Authority Intranet: Infectious Disease Control Training Centre: ww\v.ha.org.hk/idctc. Centre for Health Protection: www.chp.gov.hk. Working Group Members Convenor: Ms Patricia CHING, Queen Mary Hospital Adviser: Ms Helena LI, Shatin Hospital Me1nbers: Ms Regina CHAN, Prince of Wales Hospital Ms Elizabeth CHEUNG, Hong Kong Sanatorium & Hospital Mr . KAN Chun-hoi, Tuen Mun Hospital Ms LAM Hung-suet, Yan Chai Hospital Ms LAM Siu-sheung, Princess Margaret Hospital Ms LEE Suet-yi, Queen Elizabeth Hospital Ms Annie LEUNG, Caritas Medical Centre Ms Agnes OR, Kowloon Hospital Ms A1ny SIT, Tai Po Hospital Mr. TSOI Wai-lun, United Christian Hospital Ms Isadora WONG, The Duchess of Kent Children's Hospital Ms Ida YIP, Pan1ela Youde Nethersole Eastern Hospital Mr. YU Man-kit, Queen Elizabeth Hospital Printed in Dece1nber 2007 3 Developed by the Professional Development Committee of the Nursing Council of Hong Kong