IJCRR

IJCRR - 4(19), October, 2012

Pages: 150-153

Date of Publication: 15-Oct-2012

DOES RADIOGRAPHER AWARE OF HOSPITAL ACQUIRE INFECTION IN RADIOLOGY DEPARTMENT- A CASE REPORT

Author: Suresh Sukumar, SushilYadav

Category: Healthcare

Abstract:Aim: This study was carried out in order to establish whether infection control measureswe?re being undertaken sufficiently in Radiology department and to create awareness among the Radiographer and Staff Nurse working in the Department regarding spread of infectionthrough Radiology Equipment?s. Outcome of the study: From this study we concluded that Radiographer and Staff Nurse should be oriented and create awareness about the radiology equipment spreading the infection and hygiene to follow for personal protection from infection and for the patient care. Proper qualified radiographer has to employ to work in the department. Staff nurse posted in radiology department has to get specialised training to work in radiology department. Conclusion: Healthcare Associated Infections are a major public health concern.Department of radio diagnosis and Imaging and staff need to understand these important issues, and actively participate in solutions to reduce the risk to our patients as well as personal protection.

Keywords: Infection control; Hospital acquired infections; Radiology Department; methicillin resistant staphylococcus aureus

Full Text:

INTRODUCTION
Case details of anpatient come to our Radiology Department:
Patient came to the Radiology Department for the Imaging study prescribed by the consultant for the inpatient department. In the case history of imaging request form, patient has the previous history of hospital-acquired Methicillin Resistant Staphylococcus aureusInfection. Based on the case record and lab report of our hospital we concluded that patient had hospital-acquired Methicillin Resistant Staphylococcus aureus(MRSA)from the previous hospital and got admitted to our hospital for the treatment. During the radiology examination none of our Junior Radiographer working in the department where not aware of hospital-acquired Methicillin Resistant Staphylococcus aureus and the infection spread by the Radiology Department. Do radiology equipment’s spread infection?:- Hospital acquired Infection control in hospitals is concerned with prevention of microorganisms reaching a susceptible to cause to patients6 .Hospitals can become contaminated with potentially infectious organisms and a safe environment can only be achieved by decontamination in the form of disinfection, cleaning and sterilization7 . A major reason for the importance of infection control is to prevent the occurrence of Nosocomial or Hospital Acquired Infections (HAI). These are infections that occur during a patient?s stay in hospital which were not present or during the time of admission2 . In contrast to community acquired infections these infections usually occur as a result of pathogens taking advantage of patients whose normal defences against infection are contravened2We can remove the organism completely from the hospital , but our aim should be to reduce the number microorganism present and dispose the material that support microorganism growth7 . Pathogenic organisms which cause the infection are bacteria, viruses and fungi7 .Bacteria are the largest cause of hospital acquired infection, and pathogenic bacteria usually grow rapidly under environmental conditions found in the human body.Department of Radio diagnosis and imaging (RDI) within the hospital deals with a wide variety of patient groups including the very young, elderly and immunosuppressed. Risk of infection to the patient who are coming to the RDI is more 7 .Patients who are being examined in the RDI will come intocontact with various types of equipment?s which are used to RDI for imaging purpose.Fox 8 carried out a study based on imaging receptors in portable mobile x – ray equipment?s over the course of 7 days. From his conclusion he found that during examinations the imaging receptor came into contact with the patient 68.8%, 25% of the time this contact was directly with the patient?s skin. Out of 40 imaging receptor he found 38 imaging receptor their study were contaminated with bacteria, the most common being Staphylococcus aureus and found that that imaging receptors were acting as reservoirs for cross infection, this is compounded by the fact that mobile radiography is commonly undertaken in areas where patients are likely to be immuno-suppressed or vulnerable to infection risks8 . Swain and Flinton9 from their study, 20 swabbed cassettes were found to have Coagulase-Negative Staphylococci present; six were contaminated with Staphylococcus aureus and one with MRSA. Smith and Lodge argued that the RDI is one of the only departments in the hospital where different patient types wait together and that this increases the potential for microorganisms to be transmitted between patients and through personnel and equipment. In this study cultures were taken of 44 potential fomites within the RDI. It was found that 50.7% of these grew no microorganisms, with 49.3% growing a range and number of organisms.

OBJECTIVE
This study is to create the awareness and knowledge of the hospital acquired infection and equipment?s which spreads infection in Radiology department.

Study designed
Case study

How to create awareness?
Awareness created based on orientation, lecturers and questioners to evaluate for radiographer and radiology staff nurse

DISCUSSION
This case study highlights the issue of Healthcare Associated Infections and the Medical Imaging department3, 4, 5. Hospital acquired infection is one of the major cause of patient death increased morbidity for hospital patients worldwide. Multinational point prevalence studies demonstrate a HAI rate of around 8- 10%4.Radiographer and nursing staff who are working in the radiology department are not aware of infection which spread through the radiology equipment?s. Even though there are less study in the area of radiology department infection control, based on their study,provide the vast knowledge of the equipment?s which spread the infection and method to prevent the infection to staff working in the radiology department and to the patient. 8, 9, 11, 12. Equipment?s which spread infection as follow, 1.x ray cassette, 2.Aprons, 3. Markers, 4.X ray machine, 5.X ray tables, 6.computer radiographic and 7.x ray plates8, 9, 11, 12

Role of Radiographer and staff nurse in radiology department infection control:-
1. Hand hygiene
Improving hand hygiene among healthcare workers is currently the single most effective intervention to reduce the risk of healthcare associated infections1, 12. The Medical Imaging department is characterized by very frequent patient interactions and contact involving multiple staff groups. Some of these patients or patient groups seen in Medical Imaging are at high risk for HAI. There is a real potential for breakdown of hand hygiene involving such a high-density, highacuity patient population in frequent contact with health-care workers. Additionally, some imaging is performed outside of the Medical Imaging department in high-risk environments such as ICU13 .

2. Policies and procedures:-
The Medical Imaging environment is a highly relevant one in relation to these issues. Patient procedures are performed routinely and frequently, ranging from peripheral intravenous access and drug/contrast administrations, through to highly complex and invasive interventional and therapeutic interventions. Body fluids are often involved. Nuclear Medicine imaging techniques can involve in vitro laboratory blood product radio-labelling and patient reinjection of blood products, and serious adverse events have been reported in both processes14.15

3. Cleaning
Clean and decontaminate equipment and your environment appropriately. Sterilise equipmentas appropriate. Medical Imaging equipment may harbour potential pathogens, e.g. MRI scanners and ultrasound equipment16

4. Consider your patients
Consider the “risk” your patients pose to others in respect to infection control, and managethose patients appropriately. Also consider whether any of your patients are at risk of HAI.

5. Personal protective equipment
Wear personal protective equipment appropriately and correctly always perform hand hygiene after removing personal protective equipmentget informed and promote action Understand the issues of HAI and promote a culture of awareness, patient safety and action.

6. Immunisation
Ensure you are up to date with your immunisations and receive yearly influenza vaccinations.

SUGGESTION
Radiographer and staff nurse should be oriented and create awareness about the radiology equipment spreading the infection and hygiene to follow for personal and patient care. Proper qualified radiographer has to employ to work in the department. Staff nurse posted in radiology department has to get specialised training to work in radiology department.

Consultation
Healthcare Associated Infections are a major public health concern.Department of radio diagnosis and imaging and staff need to understand these important issues, and actively participate in solutions to reduce the risk to our patients as well as personal protection.

Conflict of interest statement
We (the authors) confirm that there are no conflicts of interest associated with the submission of this article

ACKNOWLEDGEMENT
Author acknowledges the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors /publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. The author is highly thankful to the referees for their very constructive, valuable suggestions and useful technical comments, which led to a significant improvement of the paper

References:

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6. Horton R, Parker L. In: Informed infection control practice. 2nd ed. Edinburgh: Churchill Livingstone; 2002.

7. Fox M, Harvey J. An investigation of infection control for X-ray cassettes in a Diagnostic Imaging Department. Radiography 2008;14:306-11.

8. Swain JA, Flinton DM. X-ray cassettes: a potential crossinfection risk? Journal of Diagnostic Radiography and Imaging 2000; 3:121-5.

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10. Do lead rubber aprons pose an infection risk??? Helen Boyle a, Ruth M. Strudwick b,* Radiography (2010) 16, 297-303

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15. Fowler, C, McCracken D, 'US Probes: Risk of Cross Infection and Ways to Reduce ItComparison of Cleaning Methods'. Radiology 1999; 213: 299-300.

16. Diagnostic Imaging 'Irish radiologists take urgent action to eradicate superbug'. Nov 28, 2006. (accessed Feb 15, 2009)