According to the Voss and Widmer, (1997) that it is acknowledged that here are many benefits are related with the hand washing which includes the cost reducing and for the human being there are many other benefits like it also prevent from the infections. Similarly the Newsom, (1993) has been stated that hand washing can play its important role in reducing the mortality predates and the morbidity in minimizing them. He also has been stated that the hands washing also prevents in cross prevention and also prevent the human being from infections.
The ratio of the infection is always high in the situation where many people live together or they work together closely, in such situation the probability of the infection is so high. As it has been observed that in the care homes the entire resident they live together like family members and they commonly use and share so many facilities like bath rooms and kitchens so there the probability of spreading infection is so high. But the high probability of spreading the infection can be reduced if the precautions and necessary actions taken on time. And in order to reduce the probability of spreading high ratio of cross infection the awareness and the education can play its effective role. In order to prevent the cross infection basic hygiene requirements are need to be implemented. According to the Bradley & Rees, (2003) have been stated that due to different kind of infections can produce different diseases and the information regarding hand washing benefits can also play its important role in prevention of such diseases those can be produced in the result of cross infections.
There are so may kind of infection diseases those can be easily infect the people where some people are living together and they are sharing the baths, toilets, kitchen and also share the utensils’ and other things they share to use. So the ratio of these kind of diseases can be controlled and can be reduced to a significant numbers if the proper precautions could be undertaken by the people and the awareness of hand washing and other hygiene actions and standards can be implemented and people act on the guidelines to prevent themselves from such type of infections and they can avoid themselves to become victim of such infections, because these infections become cause of many illness among them and these kind of diseases can be easily transfer from one person to other person.
Some of the disease can be life threatening and some of the infections can be more dangerous to the human beings. Underlying the medical conditions some kind of infections are dangerous whereas some of them are curable easily, and antibiotics medicines can play their role as a high resistance and the victims can be recovered its health after taking the antibiotics.
In June 2003 the National Institute for health and clinical excellence has been published the prevention guidelines from the infections in order to control the spreading the infections. These all the guidelines to prevent the people from the cross infection and these all guidelines were based completely on the scientific scholars statement and were also documented, all those conclusions and the positive recommendations were completely based on the HCAI primary principles and on the high standards and all the measures were made and evaluation methods were used and implemented just in order to prevent people from the cross infection to save their lives and to improve their health and life standards.
According to DOH, (2009) that HCAI can also control and prevent the infection through some kind of technical details and technical audits and by creating awareness among the patients to prevent themselves from the cross infections.
1.3 Aim of the Research
There are the following aims and objectives of this research
The researcher will find out about the role and benefits of soap and water in order to minimize the effect of infection
The researcher will also find out the role of water and soap in reducing the number of infected people from cross infection
The researcher will find out the role of soap and water in improving people health quality
According to the Baker et al., (2009) Basically it is the microbiology clinical application to prevent the people from cross infection, there are so many kinds of infections and disease those can be caused just because of viruses, fungi and bacteria and so many kind of infections like blood infection, respiratory infection, bone infections, skin infection and urinary infections. It has been proved that all kind of the infections are not cross infections.
The research method and the tools and research techniques adopted by the researcher to conduct this research will be discussed here in this section in detail. The researcher will also describes here about the tools like charts and diagrams and about the source of primary and secondary data gathering as well, as sampling techniques and data storing techniques and methods will be describe here.
There are following objectives of this research
- The researcher will analyse the literatures critically on the topic of infection and its causes and the methods and guidelines to prevent people from this infection.
- The researcher will also find out the ways and advantages and importance of all methods those can play their role in controlling and preventing the infection in the care homes to improve the quality of health and lives of residents.
- At the end the researcher will make conclusion and recommendations to improve the weak areas and to improve the strategies.
There are the following research questions those have been designed by the researcher to achieve the above aims and objectives related with this research.
- Which steps are necessary to taken under considerations by the care homes to make preventions and making control the infection in the care homes in United Kingdom?
- What are the main hindrances, issues and problems are related while implementing guidelines to prevent the infection in care homes?
- What are necessary and basic actions important to control and prevent the infections in the care homes?
2.1 Significance of infection control programs
Now a day there is a problem worldwide called infection and health care is associated with this worldwide problem, in the hospital everywhere the infection germs are available due to the infections victims and these germs of infections are the main causes of death in the hospitals.
Too much health care resources are required and its cost is so high to offer care services, the cost of health care especially to provide the antibiotic and to provide health care facilities the hospitals need more laboratory studies and medicine supply. According to Rhinehart and Friedman, (2006) that hospitals have acquire the infections germs those can damage the patient’s quality of life. And these germs acquired hospitals need more cost and technology to prevent the patients from the infections that can lead the patients towards the death and hospitals have limited resources to prevent and clean the atmosphere of hospital free from infection germs. With the passage of age the patients suffered from the chronic disease and the major cause of multiple diseases is the infection and due to these chronic diseases the hospitals acquire the infection germs. And one main and major cause of hospital acquired infection is the use of advanced technology and the persistent procedures and due to these causes the old people are suffering from the chronic diseases. The main cause and factors those play their role in acquiring infections in the hospitals include antimicrobial resistant bacteria. And due to these and poor systems and low intentions and unawareness among the people about the use and benefits of hygiene use and overcrowding of patients in the hospitals and due to the shortages of untrained and unskilled employees or staff members those can play their effective role in preventing infections.
There are some considerations which can be used to provide sufficient care and treatment to the infection victim patients and the hospitals and surgeries and care homes must provide the necessary treatment to the sick people at every cost.
There are following considerations those leads towards reflection
Health care services without infections are always required by the people
While during the treatment the people can be affected through the infection in the hospital or through working or eating or sharing toilets or kitchens stuff with infected people due to cross infection bacteria.
During treatment the people pass through damaged procedures and processes that can cause them infection
According to the Bearman et al., (2004) that health care providers can also transfer into the customers and themselves as well during the investigation and observation process the infectious agents in both ways like indirectly or directly.
There are following some factors those can contribute their important role in spreading the cross transmission and those factors are given as under
In the hospital when there are so many people admitted for their treatment and when there is shortage of staff members to provide necessary treatment
Similarly when there are limited sources to control the infection due to less resources and medicines and it might be because of cost factor
In the hospitals there are two kind of main sources of infection and both are discussed in detail below one by one
Exogenous Sources: In this way the infection always spread and the infection bacteria occur just because of the patients those enter the hospitals and come from outside this is called exogenous source of infection bacteria in the hospitals and in this way the others like other patients or staff members they can be affected and the infection can be developed inside them.
Endogenous Source: This is the second way of infection spreading in the hospitals and in this way the bacteria or infection already exist inside the hospital and germs remained inside the part of the hospital and the patients can be affected due to microbes and the patients can be affected seriously.
There are some mode of infection transmission inside the human body and the infection can be developed and damage the human body seriously and other people can become victim of infection, so first of all is the main mean of infection transmission is the disease transmission cycle which states that infection can be controlled when all the other necessary elements are clear, means when the infectious agents is identified and the source of the agent has been identified, the susceptible host must be identified those received the agent must be identified and the source from host to agent must be identified then in this way the infection can be controlled successfully. And the basically the relationship among all is called the chain of the infection and some of the scholars stated it as disease or infection transmission cycle (East, 1999). Similarly East, (1999) has been stated that in order to break the transmission of the infection it is necessary to break down the infection transmission chain and then in this way the infection control is possible.
There are the components of the infection transmission cycle those have been discussed below
Agent is the major component that can cause the disease and that can be one of the between following different agents like parasites, virus, fungi or bacteria, so one of them can be the agent of the infection.
2nd main component of the infection transmission cycle is the reservoir and if there is no reservoir then the infection transmission is not possible, and the agent as discussed above is always resides and its growth is always take place in the reservoir. According to the Ayliffe et al., (2000) have been stated that all the items which includes and take part in the clinical processes and procedures always serve as the infection agent reservoirs and the items like human being, plants, air, soil, animals, solutions and water those can take part in the clinical procedures can serve as reservoir for the infection agents.
- Exit Place
First of all the infection bacteria called the agent get growth in the reservoir and after infection it leave the reservoir that is called the exit place and the only one way is the skin cut, blood stream, surgical suit, puncture and rash which are known as the exit place for the infection agent.
2.5 Modes of infection Transmission
As the researcher has been discussed above about the mode of transmission of the infection agent and its three ways, agent, survivor and exit way as well, all this movement started from agent to survivor and then exit is called the infection transmission mode and there are total five ways of infection transmission which are discussed below one by one.
This means the direct mean of infection transmission like through sexual inter course or through touching the infected person, it can be through the hospital visit frequently because the infection germs can be transferred into human being through hospital atmosphere or through any clinical procedure or it can be possible through infection acquired instrument or area.
This area has been divided into two major sub sections
(i). Indirect Transformation: In this way the infection germs can be transferred through infected (already contained infection germs) through infected needle, any other infected clinical or surgical instrument, gloves or through contaminated dress.
(ii). Direct Transformation: the second main source of the infection transformation is the direct source like through one body to another body, one surface to another surface, one physical transformation to another like from one person blood to another person blood it can be transferred.
2. Droplet Transformation:
This is the second main mode of infection transformation, and in this way the researcher will discuss about the droplet transformation which is always generated by the cough of the already contaminated germs, through the patient (the person who is already contained the infection germs) sneezing, bronchoscope or through his or her talk as well, and the contaminated drops if fallen at some distance (short distance) some scholars have been stated that minimum at one meter distance they can be affected and harmful for the other healthy people. According to the Wilson, (2011), that through air contaminated drops can be transmitted into other people and the infection agent can move easily in the survivor easily and there is no such a way to disturb the air to interrupt this air that contained the agents.
3. Vector Transmission
This kind of infection can be possible through the mosquitoes and the other animals those are already infected through the infection the infection agent always transferred through them those have already this infection inside their body and become cause of infection agent transformation in other physical bodies for example the yellow fever, malaria, plague and fleas for most common here.
4. Common Vehicle Transmission
According to the Pratt et al., (2001) that sometimes the infection agent can be transmitted through the specific material that already contained the infection agent for example the blood that already contained hepatitis A Virus, B Virus and C infection virus and HIV and HCV similarly salmonella spp. Food, in the water some the existence of Shigella or Chol era can also become cause of infection transmission and the infection can be transferred from one people to other people.
5. Airborne Transmission
Some time the droplet nuclei remained in the atmosphere and they might be suspended for a long time in the air and can cause to transfer the infection agents in the other physical human body and especial kind of air ventilators and air handling are required to disturb the droplet transformation of infection from air to healthy body, Measles and M. Tuberculosis are the both kind of infections agents those can easily transmit from air to survivors.
2.6 Infection control practices and its Importance
Infection agent transformation control can be break and the disease spreading can be controlled and can be prevented by creating the awareness among the people regarding the use of water and soap and its role and importance. According to the Wilson, (2001) that the awareness about the disease and infection from the HCV and HIV and from the HCV and the scope of the controlling actions and all other activities those can play their role positively, in order to break the infection transmission spreading cycle or chain it is very important to find out the importance of those steps that can easily play their role in breaking the chain or cycle of the germs transformation. And in order to break the chain first of all the agent transmission methods are very important. Now it is necessary to create the awareness among the people and then it is necessary to pay the attention towards reducing the risk of spreading the infection agents from one body to another body and the main focus must be paid on the cleanliness atmosphere and surroundings and attention must be paid on the cleaning homes and personal cleaning and to the community members as well to prevent the infection and to break the infection agent chain.
This is very important section and in this section the researcher will discuss and will explain about the method those will be adopted to conduct the research which includes the importance of case study selection, research limitations, sample size and sample selection method, research method either quantitative or qualitative, tools and techniques those will be adopted by the researcher to records, making analysis and conclusions will be explained. The researcher will also discuss the source of secondary and primary data and collection techniques and ethical consideration and collected data validity and reliability will be discussed and explained.
According to the Saunders et al., (2009) have been stated that it is the demand and need of the time to choose more than one research methods to conduct the research and to achieve the specific aims and objectives, so researchers must select more than one research methods to obtain valid and reliable results. There are some specific advantages and disadvantages are associated with each research method, the selected research method must be contained the potential to solve the research issue and problem in the available time frame as well as in the limit of resources available to the researcher. In order to achieve the specific aims and objectives of the research, Saunders et al., (2009) have been defined some effective and important steps to achieve the research aims and objectives efficiently and effectively. The researcher will adopt the qualitative research method to conduct this research to achieve the aims and objectives of this research positively because in this way in the available time and other resources the researcher by selecting the case study as tool can achieve the aims and objectives to solve the research problem. According to the Neumann & Lawrence, (2006) that quantitative research method is most suitable for the researchers when they have limited resources as compared to the qualitative research method, but in the medical sciences in the opinion of the doctors and nursing staff there are more advantages for the researchers to adopt the qualitative research methods to collect primary data and through systematic approach the secondary data can be collected with more reliability and validity. Because there are some reasons to adopt the qualitative research methods, and one of the most suitable reason is that qualitative research method is more people centred as compared to quantitative. Through adopting this research method the researcher can easily make the conclusion and can make the positive recommendations.
3.3 Source of data
Here the researcher will use the review of literature as secondary data and the researcher will consult the books, reports, articles and journals, the researcher will also use electronic books, electronic articles and journals as well and websites as well but all the books and articles and press releases and report will be titled on the health care and on the importance of water and soap role in reducing and preventing the people from infections. The researcher will also visit the electronic library as well to download the available material on the topic of infection and its prevention methods and role of water and soap as well in the care homes in the United Kingdom especially. The researcher will also visit the University student portal and physically will visit the University library and will consult the books there and will read out the articles for better understanding and for proper data gathering to avoid biasness and to improve and to increase the validity and reliability of the secondary data.
In this research the researcher has been gathered the about 40 research papers and by adopting the criteria of inclusion and the criteria of exclusion the researcher has been rejected the 17 research papers and the remaining 23 papers were selected by the researcher to conduct the research. And after studying the research papers in details the researcher has again rejected the 8 research papers from the 23 research papers and selected the 15 research papers and then those research papers were evaluated by the researcher as per the aims and the objectives of the research.
The researcher will discuss all the limitations associated with this research in detail and there are main following limitations are associated with this research
Shortage of time
Limited financial resources
The researcher has no already research experience
In this section the researcher will consider all the ethical considerations for the validity and reliability of the data and for these the researcher will not disclose the results to the co workers, colleagues and to the class fellows and the researcher will not include her own opinion in the primary data collection, the researcher will never allow other people to steel her research work. The researcher will use proper and valid resources, will not include the old references and will not make critics to anybody on the behalf of race, colour, sex, age or religion and disability. The researcher will abide by all kind of discriminations and will not disclose any information of the participants and will not use this research work for another academic purpose.
The researcher has designed the following steps to carry on the research to conduct the research in a meaningful way to achieve the research aims and objectives.
4.2 Project Resources
As the researcher is conducting this research as a student to fulfil the academic requirement so all the financial cost will be paid by him and all the cost associated with this research will be paid by the researcher which includes the visiting, lunch, high tea, software purchasing, stationary, travelling and printing expense as well.
|Serial Number||Description of Resources||Cost (£)|
|2||High tea and travelling||150|
|3||Software cost and printing as well||250|
|Background/ Problem or study||X|
|Research question and Objectives||X||X|
|Gathering Literature and Rational||X||X||X|
|Tim Schedule in Weeks||1||2||3||4||5||6||7||8||9||10|
|Collecting Primary Data and Making Analysis||X||X|
|Presenting results and making Conclusion and Recommendations||X||X||X|
|Application of Contingency Plan||X||X|
The researcher has 2 consecutive weeks to make necessary changes, to remove errors as per the recommendations of the honourable supervisor.
During gathering the data the researcher will not include only the research work means published articles or research papers in between the January 2002 to till December 2012, to maintain the validity and reliability the researcher will not include the old research statement.
The researcher will not include the data in the secondary data that has been published before the year 2002 because due to old technology and old trends and due to the old clinical procedures and medicines, and will not include the research papers those were published after the date of January 2013.
In this section the researcher will explain the limitations and the strategy will be explained to overcome those limitations and then after that the researcher will discuss the conclusions of the results made by keeping the results compiling and by using the review of literature as a background of the study and by relating both of them as and when necessary.
According to the Clarke, (2003) that standard precautions always are useful in reducing the probability or chance of occurring infection very low and if these precautions can be implemented effectively then the infection can be controlled easily and the cost of the infection prevention can be reduced.
There are some precautions have been discussed by the researcher
Personal protection from (The staff members must use their own)
Secondly is the use of hand hygiene (the hands must be washed with water and soap)
There are three different kinds of precautions
The combination of the precautions can be used by the nurses or by the administration as well as per requirement. According to the Cozad & Jones, (2003) that in order to reduce and to prevent people from the infection agent combination of the precautions that is the most suitable and the more effective and efficient way.
According to the Goldrick, (1999) that following processes and procedures are required to train and creating awareness among the staff members to train them to prevent people from infection.
On Job prevention practices must be instruct to the people and the methods must be informed and the people must be informed as per job nature
Effective selection of PPE
All the staff people including contractors and regular workers must be trained
According to the Pratt et al., (2007) that the environment must be neat and clean and the neat and clean environment can prevent the infection agent to transmit and the hand hygiene must be implemented because the hand hygiene can play its role in the prevention of infection agent among the people. So all those people must have awareness about the importance of hand washing with water and soap and the staff members must use their own, shoes, gowns, gloves and face masks in this way the infection agent transmission can be reduced. The surgical instruments must be properly sterilize before use and proper precautions must be implemented in the hospitals and proper cleaning system must be implemented in the hospitals and in the care homes.
According to the Larson, (1995) that hand washing is so important and the people must wash their hands with the liquid or soap and make it sure that they have cleaned their both hands and all the surface of both hands have been properly cleaned.
The people must wash their hands with water and soap with alcohol hand gels to properly clean the hands, because this is the basically efficient and effective way to prevent and to reduce the infection agent transmission. So this is also necessary for the patients, doctors, nurses and even then all the workers and all the regular, permanent and contractors to implement and act on the hand hygiene precautions and wash their hands.
The hospital staff members of care home staff members must consider the following points because the following situations can be harmful for them so they must use hand wash before the following situations
Touching the patients
Any Task (aseptic)
And after the touching blood, faces, urine, vomits etc.
After touching patients
The staff members must taken into their consideration the following actions
They must wear gloves and must change the gloves after touching one patient
They must put the gloves in the bin after touching patient and do not reuse them
They must wear the gown before the patient checking and after checking they must wear off the gown and put in the dust bin and for second patient they must wear new gown.
As this is the social and ethical and on job duty of all the members of the hospitals and care home nursing staff to prevent and to break the infection agent cycle for improving the life and health quality of the patients and to keep clean the atmosphere free from infection agents. It is the duty of all the care providers and the hospitals to provide the healthy environment and infection free atmosphere and environment to the patients. It is their social and ethical responsibility to implement the precaution measures at the working place and in the care homes and in the hospitals.