Running head: REFLECTIVE LOG 1

Mushtaq Ahmad

BN: 505886

Post RN BScN Year 1

Faculty: Zohra Kurji, Jacqueline Dias & Amina Aijaz

361: Teaching & Learning : Principles & Practices

The Aga Khan University School of Nursing and Midwifery

Date: 02/03/2014
REFLECTIVE LOG 2

I was working in the Neuro-medicine unit as a nurse team leader. I was the only nurse

in the unit with my subordinate medical technicians. Most of the time, I observed that they

were not following aseptic techniques while doing procedures or attending patients. One of

the admitted patients was with history of stroke. He developed hospital acquired infection

(nosocomial infection) within three days. He was suffering from high grade fever,

tachycardia, shivering and pain. I discussed that patient’s status with the doctor and we

shifted him to the High Dependency Unit for critical management. Patient’s family members

were very upset regarding his condition. They complained that their patient had nothing and

now his condition is deteriorating due to hospital acquired infection.

I felt remorseful that the patient came with another complain and now has develop

some microorganisms given by us. As I have mentioned my subordinates were not following

aseptic techniques which made patient’s stay longer, gave stress to the family and increased

financial burden on them. I got opportunity to identify the reason for nosocomial infection at

the time, which helped me to manage him before his condition became worse.

I analyzed that health care professionals must be able to follow aseptic technique

while doing any procedure and attending the patients. Due to our carelessness, patients

develop hospital acquired infections. In the hospital, there are patients with different diseases

and infections. If staff attends them without following aseptic techniques or proper hand

washing, infection transfers from patients to patients as the situation has happened in the case

of this patient who makes us ponder over it. Hands of health care provider are considered to

be the most common sources for the transmission of infection from one patient to another.

According to Allegranzi & Pittet (2009), health care worker’s hands are the most common

vehicle for the transmission of pathogens from patient to patient within the health care

environment. Hand hygiene is one of the best ways to prevent the spread of microorganisms
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and reducing health care-associated infections. There are different types of pathogens found

through which patients get different infections.

According to Berekt et al., (2012), “large numbers of microorganisms are responsible

for hospital acquired infections and any microbe may have the capacity to cause an infection

in the hospitalized patients. 90 % of the nosocomial infections are caused by bacteria”.

Patients get different type of infections during their stay in hospital, but the most common

types of nosocomial infections that could occur in a hospital set up are surgical wound and

other soft tissue infections, urinary tract infections, respiratory infections and bloodstream

infection. According to study by Mulu W.et al., (2012), “the nosocomial pathogens that cause

infections can come either from endogenous or exogenous sources. Animate and inanimate

sources of exogenous infections include hospital staff, other patients, visitors, food, water,

fomites, urinary catheter, intravenous devices, respiratory equipment and other procedures”.

I realized that there was a need to educate the health care staff to prevent and control

hospital acquired infection. Staff education is very important to decrease the rate of

nosocomial infection. We should continue to arrange regular sessions for the staff regarding

infection control practices so as to keep our staff more efficient and updated. Moreover, I

collaborated with infection control department in order to improve hand hygiene and use of

aseptic procedures in different units and monitoring the rate of nosocomial infections

occurring.

This situation teaches us a lesson that being health professionals we should follow the

aseptic technique while doing any procedure on the patient and prevent patient from

nosocomial infection. So there will be no burden on the patient, family and the stay of

patients in the hospital will be minimized. This upholds the principle of non-maleficence, i.e.

doing no harm to the patient.

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First, I will try to prevent this situation from happening again in my unit. For this

purpose, I will train my staff and will teach them how to follow aseptic technique, maintain

hygiene and prevent transmission of infection. Also, staff will have sufficient knowledge and

will be trained regarding hospital acquired infections. Projects will be run in the unit to

improve hand hygiene compliance. The physical environment of the hospital must be clean

and free from pathogens; management should focus to maintain the cleanliness of wards and

hospital. In hospital setting, sanitizers should be easily accessible for hand hygiene. There

should be a system available to isolate patients having communicable diseases. The

administration department should provide resources for maintenance, proper hygiene, and

more cleaning staff to keep the physical environment cleans of the hospital.
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References:

Mulu, W., Kibru, G., Beyene, G., & Damtie, M. (2012). Postoperative nosocomial infection

and antimicrobial resistance pattern of bacteria isolates among patients admitted at Felege

Hiwot Referral Hospital, Bahirdar, Ethiopia.Ethiopian journal of health sciences, 22(1), 7-18.

Retrived from http://www.ajol.info/index.php/ejhs/article/view/77672#

Bereket, W., Hemalatha, K., Getenet, B., Wondwossen, T., Solomon, A., Zeynudin, A., &

Kannan, S. (2012). Update on bacterial nosocomial infections. Eur Rev Med Pharmacol Sci,

16(8), 1039-1044.

Retrievedfrom:http://www.europeanreview.org/wp/wp-content/uploads/1249.pdf

Allegranzi, B., & Pittet, D. (2009) .Role of hand hygiene in healthcare associated

infection prevention. Journal of Hospital Infection, 73(4), 305-315.

Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/19720430