PHPC 3015
Critical review of prevention and control programmes of Legionnaire disease in Hong Kong
Name: Wong Chui Hei
SID: 1155062441
Introduction
Legionnaire’s Disease has been one of the major pneumonia cases in Hong Kong. Most cases occurred are due to the infectious agent Legionella serogroup 1 bacteria. The patients will first develop chills, headache, fever, muscle pain and may appear other symptoms later, including cough, which may bring up mucus and sometimes blood, chest pain, shortness of breath and gastrointestinal symptoms, such as vomiting and diarrhea. (1)
There are mainly three types of outbreaks, including nosocomial, community-acquired and travel-associated outbreak. Institutional/nosocomial outbreak risk of hospital’s water
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The major purpose is to remove the susceptible water sites which can allow the growth of the bacteria and reach the susceptible host. The WHO recommends the use of Water Safety Plan (WSP) in monitoring the water standard in high risk water sites, including hot and cold-water towers, spa, hot tubs, etc. The plans are systematic and detailed assessment on the prioritization of hazards, and the operational monitoring of barriers. The plan should consist of three major components, system assessment, monitoring and management and communication. (4) In Hong Kong, the Electrical and Mechanical Services Department (EMSD) is responsible for developing water safety plan for the owners of major zone for transmission, which is the water system of buildings in Hong Kong. The WSP takes into consideration of the variable degree of risk in different settings/facilities and the ubiquitous nature of legionella in the environment. (5) The code of practice of prevention of legionnaire disease had complied to the standard of WHO documents in developing a recommended water safety plans in various setting of water sites, which included the three major components of the WSP for each water sites and work similar to the practice in United Kingdom (UK). (6) (Table
Reflective Journal entry Unit 4 In today’s society, one of the primary objectives is to ensure that staffs working in the various department of the health sector have maximum protection, inclusive of the environment in which they live dwell and play. Therefore, adequate measures must be implemented to extenuated environmental and occupational hazards. The occupational and environmental health takes a multidisciplinary approach as it relates to the correct identification of diseases from exposure hazardous agents in the community of in the workplace.
The causative agent in clostridium difficile is a spore forming bacteria, which can be “transferred to patients mainly via the hands of healthcare personnel who have touched a contaminated surface or item” (CDC, 2015). Reasons such as these, is why it is important to teach patients about why they are on contact isolation, and why maintaining thorough hand hygiene is essential for stopping the spread of the disease throughout the hospital. Before the teaching took place, the patient was asked if any previous knowledge was held about the topic of clostridium difficile. The patient claimed no one had explained any part of the disease process or what changes needed to be made on the patient’s end of care. The patient had never had any exposure to this disease, however, the patient seemed rather eager, and was pleased that time was being taken to teach about the importance of containing clostridium
Clostridium difficile infection and transmission prevention continues to represent а difficult and serious challenge in patient safety and infection prevention. A single inpatient Clostridium difficile infection costs more than $35,000 in average and the estimated yearly cost burden for the health care system is more than $3 billion (MedPage Today, 2012). The epidemiology of Clostridium difficile infection is continue to change, and its presence in the community and the healthcare settings has caused healthcare personnel continue to re-evaluate approaches and perspectives. There are many risk factors for Clostridium difficile infection such as an exposure to antibiotics, advanced age, and hospitalization.
This method proves to harmful to those who reside within the site of operation as their water supply is contaminated. This results in those families not having clean drinking water, which leads to health related issues and economic struggles. These issues are widespread across the country and there are limited options in order to find a solution. The most effective and safe option would be to halt all operations of
The organization is required by the Drinking Water Operations or DWO to point out contaminants and tell consumers if the water they are using is safe. (2). Along with AWWA and DWO’s assessment, Houston, Texas has completed numerous, extensive studies of research and found that in 2014 the average number of Chloramine levels was at 2.2%, and the maximum number of Chloramine levels was at 4%. As for inorganic contaminants like Selenium or Arsenic, both were at levels less than average. Studies show that the Arsenic was considered low in this water supply, surely a relief to those drinking the water.
Clostridium difficile, commonly known as “C. diff”, is a gram-positive bacillus. This highly contagious, opportunistic, bacterium is found mainly in long-term care facilities (nursing homes); however, it can also be considered to be a prevalent nosocomial acquired infection. It is a capsule forming, strict anaerobe, and its growth flourishes at body temperatures (thirty-seven degrees Celsius). Clostridium difficile can also be categorized as a motile (flagella present), spore forming bacterium that is found in an individual’s normal flora of the intestine. In addition, the C. difficile reservoir is prevalently found in water and soil reserves; thus, this bacterium can be labelled as ubiquitous in nature.
Each year, 48 million food and water borne illnesses will sicken the United States inhabitants, and an additional 3,000 people will die from those illnesses. Food and water safety is crucial to the public because it directly affects people’s health, and without good hygiene diseases will spread quickly. It is also important to point out that many people live in conditions where they do not have access to resources necessary for human survival, and these are the ones that need the most assistance. For many, it is due to the carelessness of food and water distributors and lack of government intervention. For example, the Flint Michigan Water Crisis, a completely preventable occurrence.
Human beings are hosts for many bacterial species that colonize our skin as their natural flora. The skin acts as a superior barrier and first line of defense against bacterial infections. When they do occur, these infections are mild and easily treatable; however some can become very serious and even life-threatening. Staphylococcus aureus and Streptococcus pyogenes are uncommon bacteria, but they are responsible for a wide variety of bacterial pyodermas [1]. In some cases, the host for bacterial infections can become contagious to others.
Department of Health and Human Services established an objective for Healthy People 2020 to prevent HCAIs, this reflects that the U.S. health care system is committed to and serious about solving this issue. These objectives address two extremely important topics, central line-associated bloodstream infections, and methicillin-resistant Staphylococcus aureus (MRSA) infections. Also, there are other major causes of HCAIs that Health and Human Services is working on their prevention such as urinary tract infections (UTIs) associated with catheters, infections of surgical wounds and sites, C. difficile infections, and ventilator-associated Pneumonia. Researches done on HCAIs shown that we can prevent many of these infections by implementing effective strategies to eradicate it, adapting some advanced prevention tools, and following new prevention approaches. There should be a more focus on HCAIs prevention in acute care settings.
The primary prevention is the best way to eliminate the potential for exposure. Since hand washing is the most effective mean of spread of infection, it would be my primary goal to increase the compliance of hand hygiene among healthcare workers, but also an extensive education of patients and family members on hand washing before and after touching the patient as well as afar any contact with any potentially contaminated materials (surface, body fluids or respiratory secretions). Mandatory education of patients, visitors and healthcare workers, across the system as well as cross department compliance practices are single best mean of preventing the spread of infection. For example, every patient and family member can be educated about hand hygiene, use of PPE-personal protective equipment (face mask, gowns and gloves). Although, the practices are already being utilized, I believe the compliance is poorly monitored.
I have seen instances where some of my colleagues have become sick from drinking tap water around the city. No matter where it is such as at their schools such as Pensacola State College or the University of West Florida, at their homes, or in public spots such as restaurants people have noticed that the water is extremely unsanitary. A quote from the DailyFinance article portrays this exactly “Of the 101 chemicals tested for over five years, 45 were discovered. Of them, 21 were discovered in unhealthy amounts. The worst of these were radium-228 and -228, trichloroethylene, tetrachloroethylene, alpha particles, benzine and lead.
INTRODUCTION Infection Prevention and Control (IPC) is one of the most important agents in the prevention of hospital acquired infections or what we termed nosocomial infections. IPC channels every member of the hospital, which includes, healthcare providers (HCP), patients and the hospitals perse. It is important to practice IPC commandment to every hospital as well as community. The Palestinian Ministry of Health (MOH) adopted the national IPC protocol.
Through the learning from week 1 and week 2, I have learnt that the most frequent adverse event in health-care delivery is health care-associated infections. It is essential for us to follow the infection control practices that both patients and us are at a risk of being infected. Standard Precautions involve the use of safe work practices and protective barriers, for example, the use of personal protective equipment(PPE). At first, I think Standard Precautions are very easy. Everyone knows PPE can protect us from infections and hand hygiene is important throughout the process.
Can an increased hand washing practices by health care provides reduce the rate of catheter associated urinary tract infection (CAUTI)? 3. Between hand washing and the use of alcohol which is a more potent way to prevent hospital acquired infections. 4. Which is better?
Although the packaging itself is bad enough for the bottled, (Ferrier 2001) notes that the chemical composition of the water itself can be more deadly due to limited regulation. The tap water is under keen regulation by the municipality. Besides, (Ferrier 2001) goes ahead to indicate that quality of water coming from the taps is checked routinely for any suspicious particles and chemicals. This is not the case for bottled water. First, as Doria (2010) notes, twenty to twenty-five percent of the bottled water comes directly from tap water without any form of purification through distillation of any other treatment.