Literature Review On Infective Endocarditis

Introduction

Throughout the twenty-first century, the role of the nurse as a care giver has changed and evolved significantly. Nurses now carry more responsibilities than ever before but one primary goal has remained the same: to provide optimal quality care on the basis of evidence obtained through active research. Research is critical to the nursing profession as a whole, it allows the nurse to advance their knowledge base and skills in order to be the best advocate for the patient (Tingen et al. 2009). The focus of the literature review at hand is: Methicillin-Resistant Staphylococcus Aureus (MRSA) in the hospital setting under the themes of hand-hygiene, source isolation and patient education. The student chose to review this topic as the

aureus) commonly colonises the skin and nose. Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a strain of bacteria that has become resistant to the antibiotics commonly used to treat ordinary staphylococcal infections. In the right setting MRSA can cause severe and at times fatal infections such as bloodstream infection (BSI), infective endocarditis, pneumonia and skin and soft tissue infections (SSTI). In general S. aureus is sensitive to many first-line antibiotics and infections are generally treated with penicillins and cephalosporins, which act in a similar way against S. aureus. Methicillin was the first of these agents used in clinical practice and by convention the term is used when referring to resistance to these antibiotics. S. aureus which remain sensitive to these agents are generally referred to as methicillin-sensitive S. aureus. Resistant strains of S. aureus are designated methicillin-resistant Staphylococcus aureus or MRSA. MRSA was first reported internationally in 1961 and recognised as a problem in Irish hospitals in the 1980s (HSE 2007). Treatment of infection due to MRSA is complex and it can be difficult to choose the most appropriate antibiotic treatment at the outset and the range of effective antibiotics available to treat MRSA infection is more limited. In general the outcome of serious infection with MRSA tends to be less favourable. This may be related at least in part to the complexity of

The student was surprised at the lack of literature on the theme as it is a vital component of prevention and control of MRSA in the hospital setting. As the nurses of tomorrow, we know that prevention is better than the cure with the topic of health care. In the United Kingdom, the Department of Health (2000) brought about a new concept encouraging the empowerment of patients by giving them greater involvement in the management of their care. This helps distribute decisions making powers between the patient and nurse. Duncanson and Pearson (2005) conducted a research study on patient’s opinions on being asked to participate in the “Clean Your Hands Campaign” and were asked to identify factors that may influence the likelihood of asking healthcare professionals to wash their hands. According to Duncanson and Pearson (2005) there were significant lack of studies in the literature to link the availability of patient information about MRSA and hand hygiene to their willingness to question healthcare professionals about hand hygiene practices. A study done by Henderson (2006) that explored the nurses’ and patient’s therapeutic relationship in care while in hospital, found that nurses were unwilling to involve patient’s in decision making regarding their care, this in turn made forming a partnership more difficult between nurse and patient. The