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Practices
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Hygiene and nutrition control are of the paramount importance
in health care organizations, especially health care organizations
with older inpatients. In fact, aged people are more susceptible
to the negative impact of their environment, various infectious
diseases and other health care problems, which can be provoked
by poor nutrition or hygiene. In such a situation, one of
the major goals of nurses and health care professionals working
with elderly people is to provide them with safe environment,
prevent the risk of catching an infectious disease or development
of some health problems, because these people can suffer from
complications, which may lead to the lethal outcome in the
most severe cases. At the same time, the creation of the safe
environment means the provision of elderly people with good
nutrition, regular cleaning, etc. However, in addition to
the work of nurses and medical staff on the creation of safe
environment, it is also necessary to inform elderly people
on basic rules and hygienic norms in order to minimize the
risk of the development of serious health problems. In this
respect, it is also important to remember about the necessity
of control over the medical staff and patients since without
an effective system of control, all the efforts of health
care professionals, including nurses may be inefficient.
At this point, it is possible to refer to the problem Maria
Schwarzkoph has faced. Obviously, this problem is very serious
since such symptoms as stomach cramps and diarrhea can be
symptoms of an infectious disease, which may affect not only
Maria Scharzkoph, but also other patients. On the other hand,
such symptoms clearly indicate to the fact that Maria Schwarzkoph
has got her health problems because of the poor hygiene or
probably malnutrition. Consequently, it is necessary to pay
more attention to hygiene in the facilities and nutrition
of patients.
First of all, it is necessary to start with the strengthening
the infection control in order to minimize and prevent all
possible risks of the development of some disorders or infectious
disease. In fact, the personnel working with patients, as
well as all people who contact with patients, for instance,
visitors who call on patients, including friends or relatives,
should be informed on the existing risks to the health of
the patients. In all probability, visitors and people who
do not have a medical education will need instructions from
the part of the personnel in order to teach them the basic
hygienic norms and rules. Being informed about possible risks
to the health of patients, people will be more aware of the
possible effects of their actions or inactions leading to
the violation of basic hygienic norms within the facility.
At this point, the effective system of the infection control
should rely on the checking system which can prove that all
the visitors and the personnel are informed about basic hygienic
and anti-infectious norms and rules. What is meant here is
the fact that it is necessary to introduce special instructions
where all basic hygienic norms are listed. A visitor or a
health care professional, or any other person, who enters
the facility, should carefully read the instructions and,
if necessary, get additional information from the health care
professional, a nurse, for instance, who is responsible for
the spread of these instructions. On getting all the information
a visitor, health care professional, or any other person,
should sign the instructions which will prove that he is informed
and conscious of possible effects of the violation of the
basic hygienic norms. It is important to make a person responsible
for his actions and while signing the instructions he read,
a visitor or health care professional agrees with his responsibilities.
Consequently, if he violates the hygienic norms certain actions
can be undertaken in his regard. For instance, a professional
working in the facility can be transferred to another facility,
where he can perform less responsible work or even fired if
his actions led to very negative effects, such as the spread
of an infection within the facility involving many patients.
As for visitors, such as relatives of patients they can be
limited in their access to the facility.
In addition, it is necessary to pay more attention to the
hygiene and infection control within the facility that may
need more efforts from the part of the personnel working within
the facility. To put it more precisely, it is necessary to
establish a strict control over the personnel who have access
to the dirty utility. In fact, it is necessary to ensure that
they will have an opportunity to protect patients from the
spread of any infection which may be spread from the dirty
utility. In practice, this means that people will need to
wash their hands and ensure that their clothes is absolutely
clean or, if necessary the clothes can be changed, in a special
room, next to the dirty facility.
Furthermore, the personnel as well as patient should focus
on the maintenance of hygiene in WCs, which are next to rooms.
It proves beyond a doubt that the ignorance of basic hygienic
norms and unclean WCs can be the major source of infectious
diseases and health disorders, leading to stomach cramps or
diarrhea. Consequently, the personnel should ensure that WCs
are perfectly clean and absolutely safe for inpatients. Naturally,
all other rooms and areas within the facility should be in
perfect order and clean too. This is particularly important
in relation to the dining room since it is another place where
the risk of catching an infectious disease or other health
problems is particularly high. At this point, it is worth
changing the dining room and providing each patient and each
person attending the dining with a separate table in order
to minimize the risk of spreading an infection.
In addition, the ward and staff should work with patients
in order to strengthen control over hygiene and infection
prevention. What is meant here is the fact that elderly people
often have problems with adequate following the established
rules, including rules related to hygiene. Often they do it
unconsciously because of poor memory abilities, for instance,
which naturally expose elderly patients to the risk of catching
an infectious disease or other health problem because they
fail to follow basic hygienic norms and rules. To inform inpatients
on these norms and rules and to maintain hygiene in the facility,
it is necessary to provide patients with instructions concerning
the basic principles of their behavior in the facility (Miller,
2003). In fact, the personnel, including nurses, should constantly
inform patients and remind them about the importance of hygiene
and about the necessity to follow the established rules strictly.
At this point, it is possible to develop special reminders
for elderly patients. For instance, it is possible to place
special leaflets or posters where the basic rules and norms
of hygiene are written or printed in a clear and comprehensible
way, including simple pictures or signs, which inform patients
how they should behave and what they should do.
Along with the strict observance of basic hygienic norms and
rules, nutrition is another important factor that can facilitate
infection control and prevention of various health problems
or, in contrast, deteriorate the health of patients. Also,
it is necessary to remember that the personnel is also exposed
to the risk of catching an infectious disease, especially
nurses who contact regularly with patients (Longstreth, et
al, 2006). On analyzing the nutrition of patients, it is important
that the nutrition was balanced. In other words, patient should
receive a sufficient amount of vitamins, microelements, minerals
and other elements essential for the normal functioning of
human body. In fact, the balanced nutrition, rich in vitamins,
strengthens the immune system of patients and, therefore,
decreases the risk of the development of various health problems.
On the other hand, patients should not over-consume vitamins,
which are mainly concentrated in fruit and vegetables. It
is very important to develop an individual diet for each patient.
The diet for either patient should be carefully prepared and
a nutritionist developing the diet should take into consideration
not only the age of patients but also their health problems,
peculiarities of their constitution since either patient has
unique needs.
Furthermore, the technology of cooking is also of the utmost
importance. It proves beyond a doubt that if terms of storage
of products or their cooking are not followed, the dishes
consumed by patients are likely to bear dangerous elements,
bacteria which may cause such disorders as diarrhea as well
as serious infectious diseases, such as salmonellosis (Ryan
and Ray, 2004). As a result, the health of patients can deteriorate
consistently.
The problem of Marie Schwarzkoph reveal the existence of the
problem of poor hygiene since stomach cramps and diarrhea
are likely provoked by some bacteria which may lead to the
development of an infectious disease. In order to decrease
the risk of the further development of infection it is necessary
to identify clearly what the problem actually is. This means
that it is necessary to examine Marie Schwarzkoph in order
to diagnose whether she has an infectious disease or not.
After that it is possible to start treatment depending on
the outcomes of the examination. In order to ease her sufferings
at the moment, it is possible to use diazepam to decrease
stomach cramps. In addition, it is necessary to replace fluid
lost because of diarrhea. The medicaments that can be used
are loperamide and bismuth subsalicylate (Alam and Ashraf,
2003). Anyway, it is highly recommended to isolate Marie Schwarzkoph
for the moment.
Thus, taking into account all above mentioned, it is possible
to conclude that hygiene and infection control are extremely
important in health care organizations, especially if they
deal with elderly patients. The high susceptibility of these
patients to various diseases implies more efforts from the
part of the personnel to maintain hygiene in the health care
organization. At the same time, it is not only health care
professionals who should observe the basic hygienic norms
and rules, but it is also patients and all people who enter
the facility.
References:
Alam N.H. and Ashraf, H. (2003). "Treatment of infectious
diarrhea in children". Paediatr Drugs 5 (3): 151–65.
Kasper, D.L., et al. Harrison's Principles of Internal Medicine.
New York: McGraw-Hill, 2005. ISBN 0-07-139140-1.
Longstreth, G.F. et al. (2006). "Functional bowel disorders".
Gastroenterology 130 (5): 1480–91.
Miller, S.C. et al. (2003). “Hospice Enrollment and
Pain Assessment and Management in Nursing Homes.” Journal
of Pain and Symptom Management. 26:3:791-799.
Ryan, K.J. and Ray, C.G. (ed.). (2004). Sherris Medical Microbiology,
4th ed., New York: McGraw Hill.
Schiller, L.R. (2007). "Management of diarrhea in clinical
practice: strategies for primary care physicians". Rev
Gastroenterol Disord 7 Suppl 3: S27–38.
Sloane, P.D. et al. (2003). “End-of-Life Care in Assisted
Living and Related Residential Care Settings: Comparison with
Nursing Homes.” Journal of the American Geriatrics Society,
51:1587-1594.
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