Reducing the Risk of Healthcare-Acquired Infections

Healthcare-Acquired Infections
Student’s Name
Institutional Affiliation
Healthcare-Acquired Infections
Healthcare facilities consider patient safety to be a top priority. Majority of the facilities take part in activities that are aimed towards improving the effectiveness of healthcare services provided, as well as the health and safety outcomes. Achieving this level of care requires hospitals to develop infection control and prevention activities. The issue of Healthcare-Acquired Infections (HAIs) is significant, especially because of the high number of patients reported to have been infected in hospitals. Wide-ranging incidences reveal that hospitals in the U.S report close to 1.7 million HAI cases, with 99,000 of the infected reported to have died from the infections (Mauger et al., 2014). Similarly, incidences of individuals acquiring infections from local hospitals are common and can be associated with several factors, including poor prevention strategies (Bardossy, Zervos, & Zervos, 2016). The high number of infections calls for effective quality improvement strategies as well as preventive interventions that can be useful in minimising infections. A large number of professionals believe that hospital-acquired infections are preventable through the implementation of evidence-based practices (Bardossy, Zervos, & Zervos, 2016). One of the most effective means of preventing such infections is hand hygiene.
Rationale
Fungal, bacterial or viral pathogens are the main causes of hospital-acquired infections, with the most common being surgical site infections, urinary tract infections, pneumonia, and bloodstream infections (Habbouch, & Guzman, 2018). Among the factors that can increase the risk of getting infected when in hospital is the frequent visits to the hospital and staying in critical care units (Martin-Loeches, Rodriguez, & Torres, 2018). Eventually, patients may encounter several pathogens from the hospital facility, the staff, or other patients. Since the infections are spread through frequent contact, hand hygiene can be an effective method of prevention (Lane, Blum, & Fee, 2010). There is sufficient evidence that proves that hand hygiene can minimise the cases of patients acquiring infections in hospitals (Lane, Blum, & Fee, 2010). The relationship between healthcare-acquired infection reduction and hand hygiene has been demonstrated in several settings for more than 150 years (Ellingson et al., 2014; Lane, Blum, & Fee, 2010). This makes hand hygiene a highly significant component in preventing hospital infections and an effective quality improvement strategy. Nurses play a key role in preventing HAIs since they frequently interact with infected patients (Ellingson et al., 2014). However, nurses and other hospital staff frequently ignore hand hygiene practices. The level of adherence to sanitisation is considered to be lower than 40 per cent, even in highly resourced hospitals. The low percentage can be linked to factors such as understaffing, the lack of proper guidelines, and inconvenient location of sinks (Lankford et al., 2003).
Intended Improvement
Model of Improvement
The Plan-Do-Study-Act (PDSA) cycle will be the most appropriate model of improvement in implementing the quality improvement strategy. The model requires clear description the main aim of the strategy, building an implementation team, establishing measures that guide the change and testing the change in a real environment; most preferably a hospital setting (Agency for Healthcare Research and Quality, 2013; Institute for Healthcare Improvement, 2012). The PDSA model provides a unique framework for developing, testing, and executing a quality improvement strategy. The model is scientific and lessens the desire to take quick actions by allowing for careful study. Incorporating the model allows an individual to first test the quality improvement strategy on a small scale before applying it on a large scale (Agency for Healthcare Research and Quality, 2013).
The cycle has four stages which include;
Plan. Involves setting the aim of the quality improvement strategy and making possible predictions about the outcomes of the strategy.
Do. Involves conducting the quality improvement strategy and recording the issues that emerge from the implementation.
Study. Analysing the data collected from the implementation stage and comparing the information with the previous predictions.
Act. Identify the possible improvements that could be done to make the strategy more effective based on the findings (Agency for Healthcare Research and Quality, 2013).
Aim of the Quality Improvement Strategy
Hand Hygiene is meant to minimise the spread of pathogens that occurs through direct contact with an infected area or healthcare workers. Since pathogens are the main cause of HAIs, developing a means of reducing the spread of these pathogens can be effective in reducing HAIs. Hand hygiene is among the proven methods of reducing the spread of these pathogens, however, a majority of facilities neglect the practice (Secdall, McCosker, & Halton, 2019). Furthermore, the non-compliance is extremely low on a universal scale, meaning that it does not only show the negligence of health workers, but also the policymakers and the managers of the facilities (World Health Organization, 2007). The objective of proposing this strategy is to stress the essence of hand sanitisation so that it is highly considered as a crucial strategy for the broader prevention of hospital-acquired infections.
Measures Selected to Show Changes in the Process and Patient Outcomes
The effectiveness of the strategy is an important consideration since it will determine its application in a real environment. Tracking the improvement of the strategy is an important factor. An effective means of achieving this is to apply the fourth principle of quality improvement, which focuses on the use of data (HRSA, 2011). This principle requires a focus on well-defined and specific sets of data (Massoud, 2000; HRSA, 2011). Identifying the appropriate data to use is important.
In this case, the leading and lagging indicators would provide an effective means of determining whether the strategy has any effect on patient outcomes. Leading indicators provide data on how the process is performing after the strategy has been implemented. Lagging indicators provide information on the system’s performance after implementing changes. For quality improvement, the process measures are regarded as ‘leading,’ while the results of the measures are termed as ‘lagging’ (Health Quality Ontario, 2013). A change in the process measure indicates a change in the performance of the strategy, therefore, data is essential when using the indicator (Health Quality Ontario, 2013). In this case, the most important data includes the number of patients who got infected from hospital visits and the common type of pathogens. A decrease in the number of patients being infected after the hand hygiene strategy is implemented will indicate that the quality improvement strategy is performing effectively. The use of lagging and leading indicators will help to identify the effects of the strategy on patient outcomes.
Possible Changes Made To Implement the Strategy
The changes made will be based on data from previous research that provides reasons why healthcare facilities fail to comply with hand hygiene practices. Determining the factors that cause non-compliance will guide the changes made in implementing the strategy. These changes will ensure compliance during the deployment of the strategy. There are several causes of hand hygiene noncompliance. However, research has pointed out specific causes that are common in most hospitals. For example, a majority of nurses felt that the location of hand rub dispensers was inconvenient and that in some cases, the hand rub dispensers were empty (Chassin, Mayer, & Nether, 2015). Moreover, some of the hospital staff, including housekeepers and food service workers, claimed to be unaware of the importance of using hand rubs whenever they attend to patients (Pronovost, 2015). Also, research indicates that a majority of hospital staff fail to pay close attention to their colleagues concerning the use of hand sanitizers when they attend to patients. This requires a change in the hospital culture to ensure that the staff feels obligated to stop their colleagues from attending to patients without using the sanitizers.
Based on the research, the appropriate changes that would be made include placing the hand sanitizers closer to patients rooms for easy access, developing a maintenance program that will ensure sanitizers are not empty at any given moment, modifying the hospital’s program and education to provide the staff with enough information concerning the essence of hand sanitization, and changing the culture of the organization to make the staff more responsible and obligated to ensure that their co-workers comply with hand hygiene practices.
Context and Planning the Intervention
The quality improvement intervention will be carried out in a clinical setting. This will be in line with the PDSA model of improvement, which requires the strategy to be tested on a small scale before implementing it in a larger setting (Agency for Healthcare Research and Quality, 2013). The project will require the participation of all the stakeholders, including the patients since the effectiveness of the strategy will be determined by the patent outcome. The clinic chosen for the intervention can be based on primary ranking concerning the problems of safety and quality. Meaning that the clinic which is considered to have high records of patients contacting HAIs will be the best choice for applying the intervention. A team will be formed from the clinical staff, including an infection inspection officer, RPI expert, nurses, and housekeepers. The intervention will also follow a five-step Sigma process; Define, Measure, Analyse, Improve, and Control (Scoville, Zak, & Norouzzadeh, 2013). Using this model, the outline of the project will require defining the problem thoroughly, measuring the magnitude of the problem, analysing the cause of noncompliance to hand hygiene, implementing interventions to target specific causes, and controlling the intervention over a specific period. Throughout the intervention process, the selected team will be required to pay close attention to the changes experienced in the clinic.
The major stakeholders involved in the strategy will be policymakers, patients, hospital attendants, and healthcare providers. The patients’ participation is key because the improvement measures will be based on patient outcomes. Patients will be required to give consent to the intervention procedures such as allowing tests to be carried on them before and after admission to the clinic. The policymakers will facilitate the intervention by allowing for the development of policies that guide the staff members on how to use the hand sanitizers and also during the development of a maintenance program that will ensure that the sanitizers are always available. The healthcare providers will facilitate the intervention by adhering to the policies and ensuring that they sanitise their hands before attending to patients. Since the hygiene practice requires the hand sanitizer dispensers to be placed at the entry of patient rooms, compliance from the hospital managers is also crucial because they need to facilitate the release of funds needed to install the dispensers and buy the sanitizers.
Measuring Best Practice
Data Collection Process
The healthcare setting is complex, with a range of factors and interdependencies affecting the outcome of the system. Such a system is continually adapting, unpredictable, and open (Shah, 2019). Thus, a single unit of data cannot be used to understand the behaviour in the health care system. Therefore, any changes carried out in a healthcare facility should be monitored using various data sources to assess its performance. In this case, the process of collecting data will be carried out across the entire clinic. Meaning that every caregiver, patient, and hospital attendant will be monitored. Collecting data from these individuals is crucial since the information received should reflect what is expected from a real hospital setting. The participants will need to be informed of the intervention before its implementation, and they will also be educated on how to implement the hygiene practices prior to its implementation.
Type of Data Collected
The data collected is specific to hygiene practices and their effect on patient outcomes. Since the intervention is aimed at improving patient outcomes, a consistent number of measurements should be carried out daily to monitor the process (Shah, 2019). As a result, every improvement effort will be backed by at least two or three outcome measures that are directly linked to the aim of the intervention. Also, balancing measures are necessary in this case to help in detecting unintended consequences of the changes made in the clinic (Shah, ...