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Infextion Control

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INDENTIFY ONE EPISODE OF CARE WHICH INVOLVES MEETING A PATIENTS INFECTION CONTROL NEEDS.

This essay will discuss an episode of care given by myself under the supervision of a registered nurse. I will be discussing a clinical procedure that I have become competent in practising, however I will be focusing on the infection control needs around the procedure as well as the professional and ethical practice of infection control. The patient I shall be referring to shall be known as Patient A, this is to meet the nursing and midwifery code of conduct to protect the patient’s identity and to maintain confidentiality (NMC 2008). (LO 1.8)

Patient A is an elderly gentleman living within a residential home, doctors are unable to resolve his underlying medical conditions of Chronic Obstructive Pulmonary Disease (CoPD), Heart Failure and Malignancy, which together resulted in him suffering from recurrent Pleural effusion. A Pleural Effusion is an accumulation of fluid in the chest cavity (Rocket 2012) this area normally contains a small amount of Pleural fluid and aids for optimal function of the lungs during respiration (rocket, 2012). However, Patients A’s conditions interfere with the body’s natural ability to reabsorb the fluid, which results in a larger amount of fluid building up, which in turn made the patient have serve breathing difficulties. Doctors decided rather than submitting Patient A for repeated procedures they inserted an Indwelling Pleural Catheter (IPC) into his chest, which allowed medical staff to drain off excess Pleural fluid and eliminate his respiratory symptoms (Rocket 2012).

As part of the Nursing Process (KYN107) my mentor, a registered nurse assessed that patient A was able to have his Pleural Catheter drained , it was also assessed that due to the high risk of infection (Wilson, 2006), because of his age and Medical conditions that this procedure needed to be performed under aseptic non-touch technique(ANTT) (Rocket 2012). Aseptic technique ensures that only uncontaminated sterile equipment and fluids come into contact with the susceptible body sites. It should be used in any procedure that bypasses the body’s natural defences. Using this procedure reduces the risk of spreading organisms from one person to another (Sharp, C 2011, National institute for clinical excellence, NICE, 2012). (LO 1.3, 1.4)

After gaining consent from Patient A (NMC, 2008) and under my mentors supervision, I planned and implement then procedure of draining patient A’s pleural catheter. Whilst I was preparing the equipment I noticed that the patient had a desk top fan in use, so I explained to him that the procedure needed to be done as sterile as possible and that the fan would blow dust particles onto the sterile work surface, so with his permission I turned off the fan. I cleaned the nursing trolley with detergent wipes as per local policy, I then went on to follow the hand hygiene guidelines (Cartmel V, 2012) in hand washing, after which I proceeded to prepare my work station by opening my sterile dressing pack and placing all the equipment I needed into the center of the sterile set (Rocket, 2012) this is to ensure that equipment does not touch any area that is unsterile. Once I was sure that everything was ready I then washed my hands again and proceeded to put on my sterile protective garments (gloves and apron). I asked the patient if he was comfortable and happy with me to proceed (NMC 2008.) With his consent and under the supervision of my mentor I went on to complete the procedure using ANTT. Throughout the procedure I asked patient A if he felt any signs or pain or breathlessness. Had the patient shown any sign of these I would have immediately stopped and reported my concerns. Once I had completed the procedure and covered the patients IPC with a dressing I cleaned away all my equipment by disposing of it in a clinical waste bag, I also removed my protective garments safely following local guidelines I then went on to re wash my hands. The clinical waste bag was then disposed of in the designated area by the residential home. The residential home arrange for a private company to then collect the waste and dispose of it by incineration as part of the Environment Protection Act (EPA, 1990) this act imposes a duty to dispose of waste correctly. Afterwards I then completed the relevant documentation of all events in the nursing notes in accordance with the policy. Throughout the procedure I followed the guidelines for infection control in compliance with the NMC’s code of practice on preventing and controlling infection (NMC, 2008). (LO 1.5)

Nursing has been found to be one of the most trusted professions (Royal College of Nursing, 2002) and as nurses we have an ethical obligation to meet that trust. Patients trust us to aid in the prevention of infection, this could be as simple as protecting ourselves and others from infection by following good hand hygiene. Hand washing is a basic principle and still the most effective way in preventing infection (Sharpe, 2011). The aim of hand washing is to remove physical dirt and reduce the number of bacteria on our hands to an amount below what is needed to cause infection (Mallik M, 2009).Nurses also have a professional obligation to keep themselves up to date with the principles of infection prevention (Ludwick R, 2006) and to follow policies and guidelines that are in place to assist in this. Registered and student nurses that do not follow procedures may be in breach of the NMC’s code of professional conduct (NMC, 2008), nurses also have a professional and ethical obligation to safe guard the health and well-being of their patients, this includes protecting them from the risk of infection (NMC, 2008).(LO 1.1, 1.7)

In conclusion to this nursing activity, like many others associated with a high risk of infection, it is essential that everyone involved makes sure they keep the risk of infection as low as possible, ways to reduce the risk is by following good hand hygiene and infection prevention procedures.

As part of my pre-registration and the NMC code on reflecting on practice I feel that I am currently working towards a Bondy level two within my course. I have a good understanding of the practical nursing tasks performed by myself under the supervision of my mentor and I am now also starting to understand the under-pinning knowledge behind why we perform this tasks. I feel more confident when answering questions from my mentor and have researched many scenarios to ensure my knowledge is based upon best practice as well as gaining confidence with my skills, which will help me in my development within my nurse training. I am able to evidence in my portfolio this level by reflective accounts on my practise, witness testimonies and course material. (LO 2.1)

(LO 2.2, 2.4, 3.1, 4.1, 4.2, 4.4)

Word count 1125

References

Rocket medical. (2012). rocket medical. Available: http://www.rocketmedical.com/Product_pages/Chest_Drain/Product_rocket_IPC_drainage_set.htm. Last accessed 02 august 2012.

NMC (2008a) The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives. Nursing and Midwifery Council, London. www.nmc-uk.org/aDisplayDocument.aspx?documentID=5982.

NURSING & MIDWIFERY COUNVIL (2008) THE CODE, LONDON, NURSING & MIDWIFERY COUNCIL

The Open University (2009) KYN107 introducing professional practice and knowledge block 1, resource 29 “practicing and the nursing process”, Milton Keynes, The Open University.

Sharp, C (2012). Infection Prevention and Control Manual. Peterborough: Peterborough Community Services. p1-106.

Cartmel, V (2012). Hand Hygiene Policy. Peterborough: Peterborough Community Services. p1-16.
Environmental Protection Act. (1990). Environmental Protection Act.Available: http://www.legislation.gov.uk/ukpga/1990/43/contents. Last accessed 13/09/2012.

Ludwick Ruth. (2006). Ethics: What Would You Do? Ethics and Infection Control. Available: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Ethics/EthicsandInfectionControl.html. Last accessed 15/09/2012.

Nice, (2012) Infection: Prevention and control of healthcare-associated infections in primary and community care, www.publications.nice.org.uk/infection-cg139 accessed on 30/07/2012

Wilson J. (2006), Infection Control in Clinical Practice 2nd Edition, Bailliere Tindall, London.

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