The pandemic has blurred understanding of guidance, so it’s time we were clear on the basics
Compliance is critical to patient safety, but monitoring it is far from straightforward
Urinary tract infections (UTIs) are common in hospital and community settings. The major risk factor for developing a UTI is having a urethral catheter in situ . The longer the catheter remains in place, the higher the risk of infection. The consensus in guidelines is that indwelling urethral catheters should not be used unless necessary and should be removed within 24 hours if possible. The care of patients and nursing home residents who are catheterised for long periods could be improved if guidelines were implemented fully.
Measles is one of the most contagious of all infectious diseases and less than 15 minutes’ exposure can result in infection for individuals who have not been fully vaccinated or who lack natural immunity. It is spread by minute aerosol droplets. Complications occur frequently and range from mild to life threatening. The prevention and control of measles is taken seriously by the World Health Organization and public health authorities in the UK. Public Health professionals should have a high level of awareness of measles and its risks, to help identify new cases and implement measures to prevent and control spread.
The varicella zoster virus causes two infections: varicella, also known as chickenpox occurring mostly in childhood, and herpes zoster, also known as shingles affecting mainly older people. Varicella usually occurs in children under ten years of age. It is generally a mild infection and in the UK vaccination is not offered as part of the routine immunisation programme. However, adults who develop varicella are at risk of developing complications and the infection is likely to be more severe. Serious complications are a particular risk for pregnant women, unborn children, neonates and those who are immunocompromised. Nurses whose work brings them into contact with those at risk have a vital role in providing information about the importance of avoiding varicella. After the acute infection, the varicella zoster virus gains access to the ganglia in the sensory nervous system where it can remain dormant for years. Reactivation results in herpes zoster, a common and unpleasant illness. A vaccine for herpes zoster was introduced for people aged 70-79 in the UK in September 2013.
Outbreaks of infection are managed by specialist practitioners in public health and infection control. However, the occurrence of an outbreak impinges on the work of other nurses employed in the affected service. In most cases the effects will be self-limiting and although inconvenient at the time, are not far-reaching. However, media reports have fuelled concerns about outbreaks of infection among health workers as well as the public. The aim of this article is to provide an understanding of outbreaks of infection and the implications of outbreak situations for nurses employed in community settings, drawing on the lessons learned from a wide range of outbreaks past and present.
Most fungi live harmlessly in the environment, but some species can cause disease in the human host. Nurses working in primary care are likely to see patients with superficial fungal infections and are well placed to offer advice about treatment and measures to prevent the spread of infection in the home.
Superficial surgical site infection (SSI) usually resolves quickly causing only short-term discomfort. However, SSI involving deeper tissues is a leading cause of morbidity and mortality and increases the overall cost of care. Although SSI commonly originates in the operating theatre, signs and symptoms of infection often do not appear until patients have been discharged from hospital. Nurses in a range of clinical settings are involved in the care of patients who either develop or are at risk of developing SSI and therefore need to know how to advise and manage these patients.
Many patients receiving inpatient care or admitted as day cases undergo invasive procedures that place them at potential risk of healthcare-associated infection. Human skin is populated with microorganisms most of which are harmless, however some have pathogenic potential. This article outlines the protective function of intact skin and describes its resident and transient microbial flora. The role and limitations of antiseptics in reducing the risk of infection are discussed.
Influenza is an acute, highly infectious viral infection. Seasonal outbreaks occur annually across the world, presenting a major public health challenge. Older people and those with chronic conditions are most at risk and for these groups secondary infection and complications can be severe. Implementing infection prevention and control measures is not straightforward because of the types of settings where many older people receive care, the special needs of frail older people likely to be most seriously affected, and because little is known about the mode of transmission of the virus.
Escherichia coli ( E.coli ) is a normal inhabitant of the human gastrointestinal tract able to cause a range of infections in the human host. It is the organism most frequently responsible for urinary tract infections that occur in the community and it is the bacterium most often causing diarrhoea in people travelling overseas. In recent years a strain called E.coli O157 has gained notoriety for causing foodborne infection which can have severe health consequences. This article describes the range of different infections caused by E.coli in primary care settings and clarifies the characteristics of the different strains of the bacteria that explain variations in their pathogenicity.
Most fungi live harmlessly in the environment, but some species can cause disease in the human host. Nurses working in primary care are likely to see patients with superficial fungal infections and are well placed to offer advice about treatment and measures to prevent the spread of infection in the home. Patients with weakened immune function admitted to hospital are at high risk of developing serious, invasive fungal infections. Systemic fungal infections are a major problem among critically ill patients in acute care settings and are responsible for an increasing proportion of healthcare-associated infections.