Reducing ventilator infection rate

Capstone Change Project: Reducing Ventilator Infection Rate
Student's Name
Institutional Affiliation
Course Name and Number
Professor's Name
Date
Reducing Ventilator Infection Rate
The proposed change to aid in lowering ventilator-assisted pneumonia (VAP) will include increasing the audit rates for the ventilator patients and closely monitoring the nurses and their skills to gather evidence regarding the gaps in the care of these nurses. While there are presently guidelines that influence the nurses' care practices for the vent patients, the institution currently appears to be inadequately prepared to closely audit patients on ventilators and empower the nurses to practice a combination of evidence-based practice and empathy for these patients (Darawad et al., 2018). In addition, nurses are presently allocated to these patients indiscriminately and not based on experience and qualifications. This change project shall aim to match nurses' skills and experience with the patients' ventilator needs and significantly reduce the likelihood of patients contracting VAP and infections. Audit rates need to increase for the high-risk patients on mechanical ventilation in the hospital's intensive care unit (CU) to identify quickly identify the probable infection mechanisms and correct them proactively.
Nosocomial pneumonia (NP) accounts for up to 18% of the total hospital-acquired infections (Darawad et al., 2018). This condition is highly prevalent in patients in the ICU who are receiving mechanical ventilation (MV). Studies thereby reveal that VAP is the most common mechanically-induced infection among ICU-hospitalized patients (Álvarez-Lerma et al., 2018). In effecting this change, the intent is to alter the present training models and nurse allocation processes within the organization (highly structured and bureaucratic) towards more humanistic care models that engage and empower the staffers to reassess and improve their practice in both their healthcare delivery and change leadership. To effect such a change towards a people-centered model of care in the ICU that encourages employee engagement and highly personalized patient care, we shall use Kurt Lewin's Change Theory (the three-stage – Unfreezing, Changing and Refreezing – model of change).
Justification for the Change
Ventilator-associated Pneumonia (VAP) remains the major cause of death in ICUs. Empirical studies have revealed that VAP-related mortalities stand between 20% and 75% (Darawad et al., 2018). Studies revealed that nurses' adherence to VAP guidelines is positively associated with their knowledge of VAP care (Álvarez-Lerma et al., 2018). An increase in nurses' awareness of VAP care and matching experienced nurses with high-risk vent patients will likely increase the adherence of these nurses to the guidelines. The intent is for nurses to collaborate with experienced nurses to increase competence and skills. Economically, the change will improve patients' quality of care and reduce the costs of treating pneumonia and infections.
Also, we intend to reduce the FTE of the nursing staffers by 260 hours annually per worker from the 2080 hours currently worked by each staffer. Further, the increased skills and collaboration among the nurses will increase the entire organization's efficiency and reduce the expenses related to human errors. Medical errors are the leading causes of death in healthcare institutions within the United States. Skills development by the healthcare institutions shall serve to promote the safety of patients in sensitive situations like the ICU. The legal nursing environment requires a consistent guarantee of safety and an elimination of the culture of blame and shame in the nursing sector. The healthcare institution must view errors as significant gaps in quality and therefore develop a culture that encourages recognition of these safety challenges. Also, this change proposition encourages a healthy work environment and adequate nurse staffing (Álvarez-Lerma et al., 2018). If nurses begin to experience increased outcomes for lowered VAP per MV allocated, the intervention will be a success.
This change proposition is directly linked to the Nurse Practice Act, which requires nurses to be competent and provide people-centered care to every patient that guarantees safe practice for everyone associated with the institution. The increased auditing of patients and the allocation of highly skilled nurses for high-risk patients will promote the organization's care success rates and ICU patient outcomes (Darawad et al., 2018). This change process also improves social justice through the focus on promoting patient dignity. These competent and people-oriented care processes are directly associated with advocacy for the patient who cannot speak to their needs. In addition, this change is related to patient safety and quality care. Nursing and healthcare literature proposes the centrality of compassion and evidence-based nursing practice as the best practices for the present demographically diverse patient populations.
Description of the Health Care Setting
Legend Health Care Resources LLC is a comprehensive healthcare provider located in Minnesota and licensed by the Minnesota Department of Health. The organization is engaged in various care services, including tube feedings, ventilator care, health-related procedures, and medication management. The organization is involved in the direct care for patients requiring a combination of intimate care and evidence-based processes and including ventilators and complex procedures. With the present effects of the COVID-19 pandemic, Legend Health Care Resources LLC has seen an increase in ICU patients on mechanical ventilators.
While the organization's leadership continues to make concerted efforts to care for the ICU patients and minimize VAP and infections according to VAP-adherence guidelines, it lacks the required nurses' skills, close auditing, and experiential care for specific high-risk vent patients. The factors pertinent for this change include nurses' qualifications and collaboration trends in the institution's ICU. The ten nurses working in the healthcare institution's ICU comprise a mix of youth and experience. They can efficiently combine evidence-based and experiential nursing processes for ventilator patients who risk contracting VAP. In addition, the demographics of patients in the ICU presently comprise mainly comorbid patients of advanced ages recovering from severe conditions, including COVID-19. The hospital's mission remains to offer high-quality patient-centered services indiscriminately to all patient demographics (MinnesotaHelp.info, 2021).
Description of Stakeholders
This change will affect the patients and nurses. The nurses will be involved in caring for specific patients and improving their skills to match the...