Free Statement Of The Problem Research Paper Example

Capstone Project Milestone #1

My clinical problem is about infection control and how the role of sterilization and disinfection are crucial for ensuring that surgical and medical instruments do not transmit infectious pathogens to patients. In my practice, I have noticed that conventional medical instruments, such as stethoscopes, are regularly used for patients without adequate disinfection. This topic of interest to me because infection control is a visible issue in every sector of health care and must be addressed to maintain patient safety. Improper sterilization of hands and stethoscopes can result in the transmission of harmful micro-organisms. Non-compliance is most often reported as a lack of time or supplies.
It is required that all medical instruments, whether critical or non-critical, be thoroughly disinfected or sterilized. Failure to do that leads to a possibility of transmission of pathogens.
Dr. Robert Weinstein estimated that about 20-40% of disease-causing micro-organisms were as a result of cross-infection through the hands of health-care workers and another 20-25% as a result of contaminated surfaces (Weinstein, 1991). Scientific evidence shows that contaminated equipment and surfaces in hospitals play a fundamental role in the transmission of nosocomial infections. Some of these pathogens are known to persist for a long period (Weber and Rutala, 2009). They thus colonize the hospital surfaces and hands of hospital personnel making it possible for the staff to transmit them while handling patients. Environmental and non-critical equipment surfaces frequently touched by hand (e.g. stethoscopes, bed rails, tables) could result in secondary transmission. It happens through contamination of the health-care workers hands or by contacting medical equipment that subsequently contacts patients( CDC, 2008). Dr Jonathan Otter notes that the modes of transmission of nosocomial pathogens majorly include hands of health care workers, contaminated surfaces and equipment. He says that in order to combat the transmission, medical personnel need to adhere to strict hand hygiene practice and disinfection of surfaces and equipment (Otter, 2012).
The use of alcohol-based hand foam sanitizers to disinfect medical equipment and surfaces is advantageous overuse of gels and wipes. Although gels are cheaper and easy to use, they tend be sticky. Wipes, on the other hand, fail to cover the entire surface of the hand. Foams provide better coverage because they cling to the hand reducing spillage and waste, and are not likely to miss the surface to be disinfected.
My practice area is clinical. Here, I have made such observation, and I am going to discuss this problem henceforth.

Practice issues

In my clinical practice, I noted laxity in observation of the safety and risk management guidelines. The practice has clearly stipulated concerns that need to be followed in every process or procedure. You could easily notice personnel using the one stethoscope for all patients in the room without disinfecting it. Disinfection takes time. The health workers, tasked with many duties, could easily avoid this procedure in the pretext that it is time-consuming. It is also worth noting that the staff can avoid disinfection since they lack specific guidelines and regulation on the same. In my practice, I have observed lack of these guidelines in a number of facilities.

Scope of the problem

Whereas problems arising from attendant's failure to disinfect equipment affect individuals in particular and the population in general, the problem is limited to the institution or system. It is in the hospital or facility where individuals contract the infections. Failure to have right regulations and standard guidelines touch on the entire health system.

The PICO question

a) Definition of PICO question
Does hand and equipment sanitization significantly reduce the transmission of harmful organisms, in an in-patient setting what is the effect of using alcohol-based hand foam sanitizers to simultaneously sterilize the hands and a stethoscope compared to merely cleansing with alcohol (wipes)?
b) Elements of PICO question

P- (Patient, population, or problem): Contaminated medical equipment

I- (Intervention): Use of alcohol-based hand foam sanitizers to disinfect medical equipment.
C- (Comparison with other treatment/current practice): There are no standard regulations or guidelines in place to inform the process of disinfection
O- (Desired outcome): Rates of nosocomial infection will decrease during the hospital stay

Sources of evidence

I intend to do a thorough literature search especially in researched articles. I will make reference to guidelines provided to inform the procedure in health facilities. I will consult standards provided by regulating bodies, professional regulations in the medical field as well as institutions and communities.
Search terms, databases to search, and search strategies
i) Search Terms
Medical equipment, contaminated medical equipment, disinfection and sterilization, hand-washing, cleaning, cleansing, alcohol-based hand foams, stethoscope, infection control, cross contamination, nosocomial infections, health care setting, reduce bacteria transmission, compliance to medical guidelines, interventions to spread of bacteria
ii) Databases to search
I will make a check to these databases because they contain useful information for this inquiry: Center for Disease Control and Prevention, Journal of Family Practice, CINAHL, PubMed and Google Scholar
iii) Search strategies
I will limit myself to the keywords and phrases that are relevant to my research. I will review the findings and pick the ones that are useful to my inquiry and use them to obtain information. I will ignore links that are not medically related and those that do not relate to health care setting.
References
http://thcu.ac.jp/faculty/journal/pdf/vol5_n2/111_JonathanAOtter
http://www.cdc.gov/hicpac/Disinfection_Sterilization/2_approach.html
Weinstein RA.(1991). “ Epidemiology and control of nosocomial infections in adult intensive care units."Am J Med.
Rutala WA & Weber DJ. (2009). “Cleaning, disinfection, and sterilization.” In: Carrico R, ed. APIC Text of Infection Control and Epidemiology. 3rd ed. Washington, DC: Association for Professionals in Infection Control and Epidemiology.
References/ Evidence appraisal
http://thcu.ac.jp/faculty/journal/pdf/vol5_n2/111_JonathanAOtter
Dr. Jonathan Otter’s Journal of Healthcare-associated infections 2012, is an excellent source of information on discussions of or related to nosocomial infections. Dr. Otter, Ph.D., discusses solutions old and new of problems associated with such diseases. As a Healthcare Director, Research Fellow and Visiting Professor on matters health, one can rely on knowledge and experience of Dr. Otter in raising practical solutions to such problem.
http://www.cdc.gov/hicpac/Disinfection_Sterilization/2_approach.html
Centre for Disease Control and Prevention (CDC) is a US government agency with the mandate to protect public by preventing and controlling diseases. It provides necessary education to citizens as well as drawing policies and guidelines in the public health sector. This 2008 publication provides crucial insights into the process of disinfection and sterilization including importance, procedure and guideline framework. As an authority in disease prevention and control, its publication can only be rated highly.
Weinstein RA.(1991). “ Epidemiology and control of nosocomial infections in adult intensive care units."Am J Med.
This source is useful in the provision of relevant information and statistics related to nosocomial infections especially in adult intensive care units. Although the information majorly relates to adult ICU, it can be very useful in making a few generalizations on the same matter. The solutions provided by Dr. Weinstein on this issue cannot be overemphasized.
Rutala WA & Weber DJ. (2009). “Cleaning, disinfection, and sterilization.” In: Carrico R, ed. APIC Text of Infection Control and Epidemiology. 3rd ed. Washington, DC: Association for Professionals in Infection Control and Epidemiology.
The renowned doctors make attempts to help the medical personnel gain deeper understanding in preventing transmission of healthcare-associated pathogens resulting from contact with contaminated surfaces. This resource is highly beneficial as it provides knowledge needed for this inquiry. They discussed methods of the pathogen spread and colonization of surfaces. They discuss albeit in summary, methods that can be used in cleaning, disinfection, and sterilization.