Allied Health - Standard Precaution Measures to Prevent and Control Infections - Nursing Assessment Answer

February 12, 2019
Author : Andy Johnson

Solution Code: 1EIGB

Question: Standard Precaution Measures to Prevent and Control Infections

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Health care systems remain the most discussed topics over the recent years. Physicians and clinical practitioners are everyday working and researching to enrich the field of healthcare with the necessary and required precautionary measures that will ensure the prevention and control of infection in healthcare systems. It is important to note that, infected population spends more time in hospitals and clinics increasing the dependency ratio and consequently leading to low socioeconomic growth and development.

By analyzing and implementing the necessary standard precautionary measures, practitioners are able to prevent and control the infectious agents in the environment. This paper seeks to illuminate or elucidate on the environmental controls, which in this case include; cleaning and spills management. Notably, environmental controls or cleaning would include activities or practices such as routine cleaning services, cleaning shared clinical equipment, using surface barriers to protect clinical surface, site decontamination after spills of blood or other infectious materials. Also of importance to note are the transmission-based precautions. The paper will further seek to establish and discuss the transmission measures including; contact, droplet, and airborne precautions, how to respond to risks of infections, for instance, in case where a potentially infectious substance or agents spills on the floor, and also explain how such cases would put workers at risks and the actions or measures to be taken. Lastly, personal protective equipment is discussed in details when to use and how to clean the environment.

1.1.1 Environmental Controls

The standard precaution in this case is environmental control. This entails all prevention measures, which can be implemented from the environment in which the infection transmission agents are. For implantation of this precaution, routine cleaning should be done frequently on those surfaces that have minimal hand contact such as ceilings and floors. The most frequent handled surfaces should undergo through cleaning more preferably with detergents or disinfectant. I would also encourage that this cleaning is done effectively using warm water and allowing the entire cleaned or washed surface to completely dry to avoid chances of contamination. Because clinical equipment can be transmission agents, it is fundamental to ensure that all shared equipment are cleaned. Most of the equipment such as X-ray should be washed on the handles. Other equipment such as computers and syringes should be changed and cleaned before use on different patients. This would control and reduce by high margins levels of infections that occur within the environment. In case of spillage (as of blood or any other infectious fluid) on carpets, corridors or other external objects cleaning would also serve to prevent any infection. I would also be careful enough to use gloves and gumboots while attending to such exercises in the healthcare (Maltezou, 2010).

1.1.2 Transmission-Based Precautions

In addition to standard precautions, transmission-based precautions are pursued in cases where the suspected or confirmed availability or presence of infectious agents represents an increased risk of transmission. It is useful in containing multi-resistant organisms (MROs) and in outbreak disaster precaution and management. It's true that, the medical and fluid handling procedure increases risks of transmission of infectious agents, and hence effective practices to reduce the risks of transmissions requires considerations to a specific situation. In this case, therefore, appropriate use of personal protective equipment including gloves, aprons or gowns, surgical masks, protective eyewear, and P2 respirators are considered. To reduce the risk of transmission I would put on both gowns and gloves upon entering the patient care areas, especially in a situation implicated in transmission through the environment. To prevent contact transmission, the clinicians and health professional are required to perform hand hygiene, ensure that skin and clothing do not come into contact with potentially contaminated environmental surfaces. Also of importance would be to remove gloves and gowns and perform a general hygiene before leaving the patient care areas (Perçin, 2016).

1.1.3 Case Study Example (Management)

From the case, it is clear that, spillage of clinical waste on a busy corridor or pavement within the environment of healthcare is very dangerous. It should be noted that pieces of sharp objects can accidentally cut or pierce the passers-by leading to infection of diseases. In case of blood bandages, people may contact infection through bacteria which may be present in the blood spilled on the pavement. In case of an outbreak of a communicable disease such as measles or whooping cough, the spillage of clinical waste containers on a busy corridor or walkway is very dangerous. To respond to this emergence, I would inform people within the facility to be aware of the situation and so take personal preventive practices. I would also create barriers to prevent people from using the affected part till thorough cleaning with detergent and disinfectant is done and the corridor let to dry. All the contents of the containers should be collected carefully and properly disposed to reduce chances of the aforementioned risks. It would also be important to create notices and internal memos to inform all the people within the health about the issue and so opt for other walkways instead. I would improvise some posters to direct the clinicians and patients around to on which pavements to use to give enough time for the mess to be attended to (Liyanage & Egbu, 2005).

1.1.4 How Case Example Would Put Workers at Risk

The case example, may put workers at risk of contracting infections, especially through the air by inhaling infectious gases from the sites of breakage. There is also a risk of being cut or pierced by sharp objects such as glass and syringes. All this would endanger the health of other workers in the healthcare facility. I would ensure that there is enough awareness of the emergent situation through circulars and internal memos, placing a sign near the place of spillage and other directional posters. All this would serve to protect workers while at the same time cleaning of the corridor or floor is underway. When necessary, immunization can be administered to minimize chances of outbreak of infections among clinicians and other staff members in the healthcare systems ("PREVENTION AND TREATMENT OF INFLUENZA", 2001).

1.1.5 Key points in cleaning the Health Care Work Environment

Cleaning of the healthcare work environment is very critical to ensure maintaining high standards of hygiene. It is important to always put on personal preventive equipment, especially in case of accidental spillage of blood, vomit and other waste materials. Cleaning is done using solutions of neutral PH to reduce chances of adverse reactions. The cleaning is done manually must be accompanied by wearing PPE. Automated cleaning is done with special equipment and precautions should be taken on cleaning equipment. Normal detergents are appropriate when using equipment and instruments depending on the type of cleaning required. Still on this PPE should be worn to prevent splashes or accidental penetration of sharp objects into the skin. On the hand, disinfectant is most appropriate for equipment that is repetitively used in a healthcare facility. It is important to note that, disinfection of items should be done after thorough cleaning. Disinfection can either be thermal or chemical and therefore should only be done on plastic items that are not subject to corrosion. Sterilization is important to destroy all micro-organisms present on the outer surfaces of instruments and devices to prevent or control transmission of diseases. It can be done through the use of heat resistant items and or recycling heat and other moisture sensitive equipment ("Improving Healthcare through Built Environment Infrastructure2013 01 Edited by Mike Kagioglou and Patricia Tzortzopoulos Improving Healthcare through Built Environment Infrastructure Wiley-Blackwell 2010 272 pp. 978-1-4051-5865-7 £69.99", 2013). This should be done using low temperatures or other relevant technologies. All sterilization should be documented for safety before the equipment is stored for future use. Storing sterilized equipment should be done in such a way that the level of reprocessing is maintained. The items and devices should be kept in a cool, clean, and dry place to prevent contamination. It is also important to ensure that sharp objects cannot damage the package.

1.1.6 When use of PPE is required and how regularly, it should be changed

Personal preventive equipment (PPE) is designed to be used in a specified environment. They are issued to the relevant staff and clinicians to cover or protect themselves, and should only be worn within the working area not outside. The use of PPE is usually required when working with a bacteria-prone place within the healthcare facility to protect the attendants from contracting infectious viruses or bacteria. For instance, when handling equipment and material that can be contaminated, one is recommended to put on protective gloves. In addition, PPE should be worn when close contact with patients and other infectious objects is inevitable. When handling non-sterile equipment, personal preventive equipment is important to avoid direct contact with infected devices that may consequently lead to disease infection. It is important, noting that, mucous membranes, especially of the nose, mouth and eyes are at high risk of infection, and therefore, when working in places prone to splashes, sprays, blood and other body substances, it is important to put on face and eye protection devices.

The frequency to which PPE should be changed is dictated by the environment or task an individual is undertaking. Some equipment such as gloves are removed or changed after attending to patients and the necessary hand hygiene is done thereafter. Aprons, gowns and other cats should be changed after work is done or change of the area of work within the healthcare facility. Personal preventive equipment should be changed frequently and is primarily dependent on the extent of exposure to infectious agents or the activity at hand.

1.1.7 A process to be followed in the management of clinical and other wastes

Some of the personal preventive equipment that can be used in the healthcare include the aprons, gowns, and eye and face protection devices. In addition, surgical masks are also used to cover the mouth and nose. Further, gloves, uniforms, footwear such as gunboats are other PPE used in the healthcare facility.

Color coding of waste containers is a very important measure in waste management. Wastes should therefore be collected in appropriate containers and color coded to distinguish different waste containers more easily. This technique ensures that, disposal of wastes is done accordingly with regard to the waste management practices of the healthcare facility and the international standards. Color coding distinguishes different types of wastes to facilitate and ensure correct handling of the containers.

It is also important to note that, storage of clinical wastes as well as precautions in identifying the storage place should be considered to ensure that prevention is done exemplarily well. Thus, clinical waste should be stored in an isolated place, far from reach of unauthorized persons. Selection of a waste storage place should be done after a critical decision formulated from visual checking, benchmarking or other relevant investigations. This sampling of the environment to determine the space to store wastes is very important and recommendable.

Clinical wastes can be properly handled and processed through proper disposal and sterilization of equipment if need be. Frequent cleaning with soap, detergent, and warm water should also be advocated in handling clinical wastes.

1.1.8 Purpose of a clean zone

A clean zone is a specified area in the healthcare facility where all non-contaminated equipment is placed. Clean zones are very important in maintaining a clean treatment facility for both patients and clinicians. Some of the items maintained in clean zones include medical records, documents, clean linen, supply stores, and sterile instruments.

1.1.9 Purpose of a contaminated zone

A contaminated zone is also useful to a health care facility in that, it hosts all objects, devices and wastes which ought to sterilize, decontaminated or disposed in the near future. For instance, used linen is kept in the contaminated zone waiting to be taken to the laundry for decontamination. In this zone, health professionals are required to mark it as no go zone since it is highly contaminated.

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