The fundamental goal of all health care facilities is to provide for the desired outcome of the patients. The purpose aligns with the United States Department of Health’s target for Healthy People 2020 Goals, which aims to minimize preventable infectious diseases and upgrade the health status of the whole population. To attain a good patient desired outcome in nursing care, most health facilities focus on various dimensions that maximize patient satisfaction. However, as the majority of health care facilities continue to improve and structure the standards of the services given to the patients, preventive measures to the rising health care infections have to be taken. Health care infections are a great danger to the patient’s health when being treated at the hospitals. Because of the reality and facts of health care infections in many health care facilities worldwide, prevention is an ultimate priority for necessary improvement in nursing activities. This composition will look into health care infections and give an intervention that will help attain quality improvement goals. Health care infections are infections acquired by the patients while being treated. Health care infections are developed in health care facilities. The infection first appears 48 hours or more after patients have been admitted to the hospital or 30 days. The research indicates that the most adverse events affecting admitted patients are healthcare-associated infections, surgical complications, and adverse drug events.
Patients get admitted to health facilities because they usually have sicknesses that require treatment. However, when workflow and hospital environment raise patients’ susceptibility to diseases, it becomes a problem (Thampi, Fan & Ong, 2020). Thus streamlining this process is fundamental to ensure a safe environment for patients; it is necessary to check into the workflow process of the health caregiver. The workflow process involves; reporting to the hospital, emergency assessment and fixing of chronically ill patients, diagnosis by the patient, treatment, ICU/CCU admission, discharge, and post-discharge care. From the process, we can observe that from access to diagnosis then to the ICU/CCU for chronically sick patients, the most susceptible activity that endangers the patients to health care infections are, Intensive care unit (ICU) analysis and intravenous therapy. The reason is at these processes, health caregivers deal with the patient’s blood. The activities involve opening up blood veins, making them susceptible to infections from the surroundings. Blood vein infections spread and hatch faster into the patient’s body (Schweitzer & Lu 2018). The patients usually have low immunity at the intensive care unit, making them susceptible to infections from the environment. If the intravenous therapy, diagnosis, and ICU processes are safe, the patients’ outcomes will significantly improve.
Research by the US Center for Disease Control and Prevention indicated that 1.7 million hospitalized individuals yearly acquire healthcare-associated infections while being treated because of other health issues; the research also revealed that above 98,000 patients die because of healthcare-associated infections (Haque et al., 2020). Research suggests that infection control processes like cleaning hands using alcohol-based hand clean helps control health-associated infections, reduce deaths, minimize morbidity, and reduce healthcare expenses. Educational intervention for nurses and clinicians can help to improve their handwashing habits to control the spread of health care infection. World Health Organization (WHO) also issued directives to strengthen handwashing habits among the globe members.
Healthcare-associated infections are a basic concern for both patients and health care providers. HCAIs cases continue to increase at an alarming rate. Healthcare-associated infections increase mortality, morbidity, time of hospital stay, and cost. Therefore a lot of changes and research are needed to prevent HCAI and ensure hospital safety. The costs for healthcare-associated infections alone in the United States of America are between $28 and $45 billion; however, 90,000 lives are lost yearly, even with these costs. HCAIS is on the list of the top five killers in the USA.
Steps to quality improve Initiative.
The World Health Organization advocates that hand hygiene is the most significant practice to control and prevent HCAIs (Engdaw, Gebrehiwot & Andualem, 2019). Taking a short time to wash hands using an alcohol-based hand rub controls and prevents HCAIs, reduces morbidity, reduces healthcare costs, and saves lives. However, factors like the availability of alcohol-based hand cleaners hinder hand hygiene. For an instant, Australian research of community nurses indicated poor hygiene practice compared to the standard protocol. World Health Organization advocates and promotes that all health care providers must wash hands before an aseptic procedure, before touching patients, after touching patients, after fluid body exposure, and after touching the surrounding. Center Disease Control has developed guidelines and plans for preventing healthcare-associated infections. The program covers primary infection prevention and control (IPC), organism-specific infections; antibiotic resistance, procedure-associated infections; device-associated infections; and guides for health caregivers in specific settings.
Educational intervention, the Royal College of Nursing advocates and promotes that health caregivers must be trained on infection control (Haque et al., 2018). Multiple studies showed that policy changes and acceptance of multimodal, multifactorial, and multidisciplinary plans provide the greatest possibility of hand hygiene achievement and minimize HCAIs. An educational intervention showing the principles and community understanding of infection and dirt is necessary. Educational intervention that engaged 4,345 health workers in three public health facilities in the USA greatly improved hand hygiene using alcohol hand rub. Nurses, allied HCWs, and physicians enhanced from 14% to 34%, 12% to 44%, and 4.3% to 51%. Other research also indicated how behavior change on hand hygiene could result from educational interventions. Personal Protective Equipment (PPE) protects both health care providers and patients from infectious fluids. However, PPE does not provide 100% protection. For instance, a needle stick can breach PPE. Such instances can cause dangerous hazards like HIV or hepatitis. Respiratory microorganisms such as Bordet Ella pertussis and influenza virus get into patients or health care providers quickly. Vaccines, PPE, and drugs are significant measures to control and prevent such infections.
Quality Improvement proposal evaluation
Microsystem refers to small care providers, administrators, and support staff who deliver services and care daily. Research indicates that most successful corporations focus on small and functional groups that carry out core activities that engage interactions with patients Robson, 2017). An example of microsystems involves a team of lab technicians, a group of primary caregivers, or call center staff. Once the microsystem is identified, the best team is selected and implement new methods for evaluating improvement and improving the work process. Microsystem care has to be very timely, effective, and efficient to all patients. The microsystem should also be in partnership with patients and family members. Performance and measurement feedbacks should be one of the microsystem principles to improve and learn.
After education on hand hygiene and other matters related to Healthcare-associated infections, the Improvement team needs to formulate a plan and identify a method to tell if the changes made have produced the desired outcome of the quality improvement initiative (Alshehari, Park & Rashid, 2018). To do so, series of PDSA cycles in a process known as rapid cycle change. Rapid cycle change is an iterative process; one cycle produces results that inform the next rapid cycle change until the desired goal is reached. The merits of rapid cycle change are that it reduces risk and greatly reduces costs and time wastage while initiating changes that are not disruptive to patient outcomes and healthcare providers.
It is worht at the planning stage to develop a document that indicates timelines and objectives. The PDSA worksheet is required for this purpose by the health facility for health improvement. At the “do” stage, testing prediction in the real world is conducted. PDSA worksheet is used at this stage to implement change. Methods such as suggestion boxes, team meeting bulletin boards, etc., should be used. At the study phase viewing and interpreting information in real-time is done. A run chart is an important tool for achieving the set goals.
Four Rules of Run Chart
Health care facilities’ ultimate goal is to provide desired patients outcome. However patient gets healthcare-associated infections while seeking treatment for other sicknesses. Research indicates that 1.7 million hospitalized persons acquire HCAIs while being treated. The analysis also revealed that more than 98,000 persons die because of HCAIs. The most effective way to prevent HCALs is hand hygiene. Use of PPE and vaccination are also necessary for prevention intervention. Plan-Do-Study-Act (PDSA) and microsystem are two methods to evaluate the success of quality improvement initiatives.
Alshehari, A. A., Park, S., & Rashid, H. (2018). Strategies to improve hand hygiene compliance among healthcare workers in adult intensive care units: a mini systematic review. Journal of Hospital Infection, 100(2), 152-158.
Engdaw, G. T., Gebrehiwot, M., & Andualem, Z. (2019). Hand hygiene compliance and associated factors among health care providers in Central Gondar zone public primary hospitals, Northwest Ethiopia. Antimicrobial Resistance & Infection Control, 8(1), 1-7.
Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., … & Charan, J. (2020). Strategies to prevent healthcare-associated infections: a narrative overview. Risk management and healthcare policy, 13, 1765.
Haque, M., Sartelli, M., McKimm, J., & Bakar, M. A. (2018). Healthcare-associated infections–an overview. Infection and drug resistance, 11, 2321.
Robson, C. (2017). Small-scale evaluation: Principles and practice. Sage.
Schweitzer, S. O., & Lu, Z. J. (2018). Pharmaceutical economics and policy: perspectives, promises, and problems. Oxford University Press.
Thampi, S., Yap, A., Fan, L., & Ong, J. (2020). Special considerations for the management of COVID‐19 pediatric patients in the operating room and pediatric intensive care unit in a tertiary hospital in Singapore. Pediatric Anesthesia, 30(6), 642-646.