Quality Improvement Proposal for Infection Control
Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply "The Road to Evidence-Based Practice" process, illustrated in Chapter 4 of your textbook, to create your proposal.
Include the following:
Provide an overview of the problem and the setting in which the problem or issue occurs.
Explain why a quality improvement initiative is needed in this area and the expected outcome.
Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Title
Your Name
Subject and Section
Professor’s name
Date
Hospital-Acquired Infections
Overview
Infection control is one of the pressing issues in the hospital setting because it leads to hospital-acquired infections (HAIs), bringing danger to both patients and employees. HAIs place a financial burden and increased mortality and morbidity on all the stakeholders. To reduce the incidence of HAIs, it is essential to have an excellent grasp of quality improvement and control (Monegro et al., 2020).
HAIs can be present or can develop at the time of admission. Usually, the incubation period is up to 48 hours before the manifestation of the symptoms. The prevalence and transmission of the infections are assessed by many government agencies such as the Centers for Disease Control and Prevention (CDC) and the National Healthcare Safety Network (NHSN). Some of the HAIs include catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infections (CLABSI), and ventilator-associated pneumonia (VAP) (Monegro et al., 2020).
The CDC conducted research that evaluates HAIs in 183 United States Hospitals. This examined 11,282 patients in total. The results show that 4% of admitted patients incur at least one HAI. Consequently, a study in 2011 shows that around 648,000 admitted patients incurred 721,800 infections. The majority of the diseases are pneumonia and surgical site infections, which account for 21.8% of the overall numbers, respectively. This is followed by the following: gastrointestinal, UTIs, and primary bloodstream infections, accounting for 17.1%, 12.9%, and 9.9%, respectively (Monegro et al., 2020).
Importance of Quality Improvement and Expected Outcome
The quality improvement allows for better sterilization and disinfection of the hospital environment, invasive devices, and hospital equipment used to diagnose and treat patients. Through a thorough application of such health practices, a decrease in the incidence of HAIs is expected. Many guidelines have been released to decrease the rate of HAIs, and the poor compliance of hospitals has been proven to elevate the risk of transmission of nosocomial infections. The CDC released reports on the significant outbreaks caused by the lack of quality control in a hospital. The primary stakeholders responsible for this are the nurses, who are the ones responsible for disinfecting some of the medical equipment and the majority of the invasive medical devices. Despite the various guidelines, a large gap between the guidelines and the actual implementation has been observed over the years. Surveillance is necessary to have a systematic approach in the data gathering and analysis to provide the information vital to quality control planning, implementation, and evaluation (Khan et al., 2015).
Previous Research
One study investigated the intensive care unit (ICU) environment, the healthcare workers' handwashing techniques, and the surface environment in hospitals in Tehran, Iran. The researchers obtained 762 and 605 swab samples from the healthcare providers’ hands and six ICUs. To recognize the type of bacteria present, biochemical methods were done along with the antimicrobial susceptibility testing. All the assessment methods are in line with the clinical and laboratory standards institute (CLSI). NTSYSsp software was utilized to analyze the resistance patterns in the participants and the ICU environment. It has been revealed that the health providers’ hands are crowded by Staphylococcus aureus, Acinetobacter baumannii, Staphylococcus epidermidis, and Enterococcus spp. Consequently, the medical equipment and invasive devices have been infected by resistant isolate like the Vancomycin-resistant Enterococci. All of these bacteria are the significant isolates in HAIs that cause high morbidity and mortality. The results proved that insufficient quality improvement for both the healthcare workers and the ICU environment are the main factors in the spread of infection (Tajeddin et al., 2016).
Delgado-Corcoran et al. (2017) researched a quality improvement project to reduce sternal wound infections in the pediatric population. Surgical site infections or SSIs are frequently observed in the pediatric population who undergo cardiothoracic surgeries. Some of the risk factors are genetic issues, young age, ventilatory support, pre-operative hospitalization, delayed sternal closure, and extracorporeal membrane oxygenation (ECMO). Due to these risk factors, a rise in HAIs, up to 6%, have been demonstrated. The team conducted an observational study of all patients undergoing cardiothoracic surgery from January 1, 2010, to December 31, 2014, in Intermountain West. The researchers investigated the effects of the multi-disciplinary quality improvement project and the effects of non-utilization of the project on the prevalence of HAIs after primary sternal wound closure versus delayed sternal closure. Results show that the infection rates secondary to Staphylococcus species after utilizing...