Running head: The Giving Nurse

The Giving 1

The Giving Nurse

Hana Scully
Nursing 101
Kapiolani Community College

June 24, 2014

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Imagine you were admitted into the Intensive Care Unit due to a wound infection
in your leg, your wound was cleaned, you received IV fluid, and medication. After 48
hours of being in the hospital you got a surgical wound infection. Turns out you received
more than just wound care; you also received a nosocomial infection. A nosocomial
infection is a hospital-acquired infection, meaning a patient caught an infection during
their stay in the hospital. Patients are exposed to a variety of microorganisms while in a
hospital, and there are multiple ways a patient can acquire these organisms. A few
examples are from one patient to another, nurse to patient, poor hospital conditions and
contaminated equipment (Timby, 2013). Creating a less stressful environment for nurses,
using proper standard precaution procedures, and a clean and organized hospital, can
significantly reduce the two millions hospital acquired infections that occur in the United
States every year (nosocomialinfectections.org, 2014).
Hospitals are a playground for infectious microorganisms, many which cause
people to become sick. Many patients in hospitals already have weakened immune
systems and become a susceptible host and an ideal place for microbes to spread,
reproduce, and grow (Timby, 2013, p.144). Therefore, it is very important for nurses to
always follow infection control procedures to prevent exposing clients to contagious
microorganisms.
A nurse has physical contact with multiple patients during one shift. Therefore, it
is very important a nurse performs proper hand washing techniques. Hand hygiene is the
single most effective way to prevent infections. Research has proven that, approximately
36% to 50% of health care workers comply with the minimum requirements for hand

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washing as recommended by The Center for Disease Control and Prevention (Timby,
2013, p.146). For example, if a nurse did a physical assessment on a patient that had strep
throat and then performed poor hand washing before assessing her next patient she has put
the second patient at risk for acquiring strep throat. When a nurse performs poor hand
washing they are providing poor nursing care and can create additional health issues for a
patient.
However, poor hand washing is not the only way nosocomial infections are
acquired; unsanitary working conditions, contaminated equipment, and nursing units
being short staffed are all factors that contribute to hospital acquired infections. Hospitals
are overflowing with infectious microorganism from the floor to light switches and
everything in between therefore, it is crucial hospitals are kept sanitary to limit the spread
of contagious diseases. (Timby, 2013, p.145) However, this does not always happen,
some examples are poor housekeeping, overcrowded facility, improper care of invasive
devices, and improper disposable of contaminated equipment (Berket et al., 2012).
Nursing care can also be negatively impacted when nurses are under the stress of being
short staffed, due to an increased workload nurses may feel rushed and stressed and it can
have a negative influence on they way they perform care (Duffield et al., 2011).
Staff shortages and the resulting increased workload have led to concerns about
the quality of health care provided to patients. It was found that when nursing
demand/supply levels exceeded 80%, the number of negative outcomes increased
not only for patients but also for nurses and hospitals (Duffield, 2011).
There are many nursing care factors that can contribute to nosocomial infections.

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Nosocomial infections are increasing in intensive care patients; multiple nursing
care factors contribute to this rise in number. Primary bloodstream infections,
pneumonia, and urinary tract infections associated with invasive devices made up the
great majority of nosocomial infections (Richards, 1999). Wound sites where invasive
devices are inserted are an ideal reservoir for microorganisms to grow reproduce and
eventually cause the patient to acquire an infection and become ill (Timby, 2013).
Patients in intensive care units are already at extreme risk for nosocomial infections due
to weakened immune system, open wounds, and other factors (Richard, 1999). Proper
wound care by a nurse is very important in preventing nosocomial infections. However, a
nurse may be in a rush and fail to use sterile techniques when performing wound care and
expose the patient to infection (Timby, 2013). An example would be a nurse performing
wound care on a Gastronomy site and using expired saline, going over the same area
twice and re-contaminating the area, or having other patients to care for and neglecting to
perform wound care before each feeding and whenever necessary (Timby, 2013). Nurses
are constantly in physical contact with the wound site where the invasive device is
located therefore, wearing gloves and hand hygiene is vital because wound sites are ideal
portals of entry for microorganisms (Timby, 2013, p.144).
Nosocomial infectious have been an issue since the introduction of hospitals and
unfortunately dont have any sign of decreasing in the near future. The increasing rate of
hospital acquired infections may effect nursing care in the future by hospitals having
mandatory infection control classes and implementing them more frequently, decreasing
patient- to- nurse ratios, surveillance cameras, and hospitals being checked more

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frequently for sanitary working environments. It is unrealistic to think nosocomial
infections will one day not be an issue however, it is possible to reduce the amount of
health acquired infections significantly by enforcing the recommendations for Center of
Control and Disease and prevention.
Its hard to believe a 20 second procedure if done correctly can reduce the number
of nosocomial infections tremendously. Hand hygiene compliance increased
significantly from 41% to 87% during the initiative, and improved further to 91% (the
following year. Nurses achieved higher hand hygiene compliance (93%) than physicians
(78%). There was a significant, sustained decline in the healthcare-associated infection
rate from 4.8 to 3.3 per 1000 inpatient days (Kirland, 2012). Hand hygiene is the
number one way to expose or prevent a patient from acquiring a health-acquired
infection.
Correct hand hygiene plays a vital role in lowering the amount of acquired
infections. However, there are other factors of nursing care that can be done to reduce
nosocomial infections. For example, knowing how to perform proper wound care,
optimal invasive device care, using non-contaminated equipment, having a sanitary or
sterile work field, cleaning your stethoscope, creating a positive working environment,
and not attending work if you are feeling ill (Timby, 2013). Nurses are always caring and
giving unfortunately not everything they give is good.

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References
Barbara, T. (2013). Fundamental Nursing Skills and Concepts (10 ed., pp 144,145,146).
Lippincott Williams & Winkins.
Berket, W., Hemalatha,K., Getenet, B., Wondwosse T.,Solomon, A., Zeynudin A., &
Kannan, S. (2012). Update on bacterial nosocomial infections. European Review
for Medical Pharmacological Sciences, 16. Retrieved from
http://www.europeanreview.org/wp/wp-content/uploads/1249.pdf
Duffield, C., Diers, D., O'Brien-Pallas, L., Aisbett, C., Roche, M., King, M., & Aisbett,
K. (2011). Nursing staffing, nursing workload, the work environment and patient
outcomes. Applied Nursing Research, 24(4). Retrieved from
http://www.sciencedirect.com.ezproxy.library.kapiolani.hawaii.edu:8080/science/a
rticle/pii/S0897189709001311?np=y
Kirkland, K., Homa, K., Lasky, R., Ptak, J., Taylor, E., & Splaine, M. (2012). Impact on
hospital-wide hand hygiene initiative on healthcare-associated infections: results
of an interrupted time series. BMJ Quality & Safety, 21, 1019-1026. doi:
10.1136/bmjqs-2012-000800
Richards, M., Edwards, J., Culver, D., & Gaynes, R. (n.d.). Pub Med.gov. Nosocomial
infections in medical intensive care units in the United States. National
Nosocomial Infections Surveillance System.. Retrieved June 2014, from http://
www.ncbi.nlm.nih.gov/pubmed/10362409
Vandijck, D., Labeau, S., Vogelaers, D., & Blot, S. (2010). Prevention of nosocomial
infections in intensive care patients. Nursing In Critical Care, 15(5), 251-256.
doi:10.1111/j.1478-5153.2010.00409.x

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(2014, ). Nosocomial Infections | Hospital-Acquired Infections. A Serious Health Care
Problem. Retrieved June 20, 2014, from http://www.nosocomialinfections.org/