Case Scenario You Are Required To Act Your Part As An Enroll

Case Scenarioyou Are Required To Act Your Part As An Enrolled Nurse I

Case Scenario: You are required to act your part as an Enrolled Nurse in an infection control committee meeting to discuss an incident that occurred in your ward: Your client, Mrs Nan Hg who speaks very little English was found in her bed breastfeeding Baby of Mrs Hum Hg who shares a room with her in the Maternity unit. It was identified that Mrs Nan Ng has Positive Hepatitis B serology. 1. Identify the possible outcomes of this incident; especially for the infant. (three points with little explanation)charteredessay.com/nur342-evidence-based-health-research-and-practice-2/ 2. Identify the required follow-up for the infant, and possible services required to adequately cater for the needs of this family. (Five points with little explanation) 3. Provide a report to the management to ensure that individuals or teams are able to implement infection prevention and control practices.

Paper For Above instruction

Infection control is a pivotal component of healthcare practice, especially concerning communicable diseases such as hepatitis B (HBV). This case scenario presents a situation where a newborn in a maternity setting is potentially exposed to HBV through direct contact with an infected mother, Mrs. Nan Hg, during breastfeeding. As an enrolled nurse, understanding the potential outcomes, necessary follow-up actions, and how to inform management to uphold infection prevention measures are crucial steps in ensuring patient safety and effective healthcare delivery.

Possible Outcomes of the Incident, Especially for the Infant

The incident where Mrs. Nan Hg, who is serologically positive for hepatitis B, breastfeeding her infant, has potentially significant outcomes. Firstly, there is a risk of perinatal transmission of hepatitis B virus (HBV), especially if maternal blood or bodily fluids come into contact with the infant’s mucous membranes or broken skin. This can lead to chronic HBV infection in the infant, which poses risks such as cirrhosis and hepatocellular carcinoma later in life. Secondly, the infant could acquire a passive immunity if the mother’s hepatitis B surface antibody (HBsAb) is present; however, this is less likely if the mother has active infection. Thirdly, there is a risk of vertical transmission through close contact in shared room conditions, which could lead to neonatal HBV infection if proper precautions are not taken. Preventive measures, including immunization, are critical to mitigate these outcomes.

Follow-Up for the Infant and Services Required

1. Hepatitis B Immunization: The infant should receive the hepatitis B vaccine within 24 hours of birth to provide passive and active immunity.
2. Hepatitis B Immune Globulin (HBIG): For infants born to HBV-positive mothers, administering HBIG within 12 hours of birth offers immediate passive immunity.
3. Serological Testing: Conduct baseline and follow-up serology (HBsAg, anti-HBs, and HBV DNA) at 9-12 months to determine if the infant has acquired HBV.
4. Family Education and Support: Educate the family about HBV transmission, infection control practices, and the importance of immunization.
5. Coordination with Multidisciplinary Services: Involve hepatology specialists, public health services, and nursing staff for ongoing management and support.

Report to Management for Infection Prevention and Control

Infection prevention and control (IPC) practices are essential in minimizing HBV transmission within healthcare settings. I recommend that management conduct comprehensive staff education sessions specifically addressing the risks associated with HBV and the importance of strict adherence to standard precautions, such as proper hand hygiene, the use of personal protective equipment when handling bodily fluids, and safe breastfeeding practices. Additionally, we should ensure that all healthcare workers involved in maternal and neonatal care are screened for HBV, vaccinated against hepatitis B, and aware of the protocols for managing seropositive patients. Environmental measures should include rigorous cleaning and disinfection of surfaces and equipment in shared patient areas. Documenting such incidents, providing ongoing staff training, and reviewing infection control policies regularly will uphold a culture of safety and accountability.

References

• Centers for Disease Control and Prevention (CDC). (2020). Prevention of Hepatitis B Virus Transmission in Healthcare Settings. https://www.cdc.gov/hepatitis/hbv/topic/clinicians/index.htm
• World Health Organization (WHO). (2017). Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection. WHO Press.
• Australian Government Department of Health. (2018). Hepatitis B Routine Immunisation Schedule. https://www.health.gov.au
• MacDonald, G., & Sabin, C. (2019). Infection Prevention in Maternal and Neonatal Care. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(1), 10-20.
• Lehman, G. A., & Gawande, A. (2021). Implementing Infection Control Measures in Healthcare. Clinical Infectious Diseases, 72(7), 1243-1249.
• Chow, L., & Lai, M. (2020). Neonatal Hepatitis B Management Protocols. Pediatric Infectious Disease Journal, 39(4), 123-127.
• National Institute for Health and Care Excellence (NICE). (2019). Infection Prevention and Control (NG151). NICE Guideline.
• Hoffmann, M., & Smith, R. (2018). Risk Management in Neonatal Care. Neonatal Network, 37(6), 353-359.
• Public Health Agency. (2019). Guidelines for Managing Hepatitis B in Healthcare Settings. Public Health England.
• Johnson, M., & Patel, V. (2022). Respiratory and Bloodborne Pathogen Control in Healthcare. Infection Control & Hospital Epidemiology, 43(4), 432-438.