Infection Prevention and Control Final Project
Executive Summary
Hospital-acquired infections are among the major causes of morbidity and mortality among patients and lead to many challenges for clinicians. Patients receiving healthcare are at risk of contracting infections due to their compromised state of health and the medical conditions with which care is given. They are also exposed to infections when they get into contact with health care interventions such as diagnostic testing, invasive devices or during surgery. The tools used in hospitals can also be contaminated with virus and bacteria, increasing the chances of infections for patients in a hospital. Healthcare setting offers an ideal condition for the transmission of microorganisms from patients to care providers. The close contact between a provider and a patient contribute to increased high rate of infection transmission from either side (Al-Tawfiq & Tambyah, 2014). Besides, some of the surfaces in healthcare facilities have high levels of contamination compared to other; therefore, infection prevention and control require control so that the level of microorganisms can be minimised. To minimise contact contamination, nurses are urged to use gloves and gowns to avoid infection transmission from patient to patient or patient to provider. According to the Centers for Disease Control, the common pathogens that cause infections in healthcare are Staphylococcus aureus, Pseudomonas aeruginosa and E. coli (Mehta et al., 2014). In this project, the problem will be identified alongside with its background, and in particular, the purpose, timeline, budget, proposed implementation, data analysis and nursing theory will be included as part of the project to make it complete.
Problem and Its Background
Healthcare-associated infections are among the major complications in the contemporary healthcare system. Hospital-acquired infections have been increasing day -in day-out causing morbidity and mortality at a high level. A study by Al-Tawfiq & Tambyah (2014) revealed the reason for increasing healthcare-associated infections as the ageing of patients, complexity of care, increased utilization of invasive devices as well as poor usage of antimicrobial therapy. The researches added that multiple factors lead to healthcare acquired infections and understanding each of them is the key to implementing relevant preventive measures. What is more, infections associated with healthcare facilities increase healthcare costs, hence a major concern in the contemporary healthcare systems.
According to CDC, most of the hospital infections are transmitted from patient to patient and some extent, they are also contracted from poorly disinfected hospital surfaces (Mehta et al., 2014). Annually, at least 2.3% to 14.4% of people die due to hospital-acquired infections. Environmental factors and the architectural layout of a hospital facilitate infection transmission; therefore, they are a target in this quality improvement hospital. Preventing hospital-acquired infections is the key to providing quality and safe care. Mehta et al. (2014) asserted that infection prevention starts with the identification of a source of an organism so that the problem can be solved from the root. Room ventilation, decontamination, cleaning, wearing of protective clothing as well as special care for food given to patients are among the things that registered nurses should maintain to prevent hospital-acquired infections.
According to Murni, Duke, Kinney, Daley & Soenarto., (2015), the irrational use of antibiotics, as well as transmission of infections between patients and healthcare providers, are preventable using various programs; therefore they should not be a concern to the current healthcare system. Murni et al., (2015) added that implementation of multifaceted infection control and facilitating stewardship program dealing with antibiotics are among the ways which will prevent hospital-acquired infections. The study also supported the use of antibiotics, hand hygiene compliance and use of various infection control interventions in the reduction of mortality among hospitalised children in the developing countries. Also, the use of recommended antibiotics is advised by WHO which will fight common hospital infections.
Purpose
The purpose of this project is to implement infection prevention and control program based on evidence-based practices. Due to high mortality and morbidity rate among children and adults in hospitals due to hospital-acquired infections, implementing infection control program will be essential to curb the infections likely to occur during nursing practice. Nurses are exposed to workplace-pathogens due to their close contact with patients and their poor working conditions (World Health Organization, 2005). This will ensure that patients are protected from reinfections and promote a safe working environment for both providers and patients. The infection prevention and control program will be multidisciplinary so that it can cover all the probable causes of infections in the healthcare set up. With well-implemented infection prevention programs, infections in hospitals will be minimized, and there will be a conducive environment for both patients and providers. The program will ensure nurses, and other care providers practice safe handwashing practices and wear protective gear before attending different patients.
The stakeholders who will be impacted by the project include all nurses, nursing managers, senior administrators, providers and all casual workers in a healthcare facility. According to Dancer (2014), nurses and healthcare providers are greatly affected by the project because they are the likely people to breach infection control practices and that can increase the risk of transmission of hospital-acquired infections. Patients are also expected to be affected by the project because they will receive quality care from the quality improvement project. Reduced infections rate and reinfections for patients will also be prevented by the project. The ultimate result of the project will be increasing patients satisfaction due to high quality and safe services.
Timeline
The project is expected to be initiated from January 2019 and completed in June 2019. Data collection for a baseline of the project will be collected from hospitals which will be used by the senior leadership to implement relevant programs for infection control. The duration will be enough for planning the activities to be conducted, baseline assessment of the hospitals, executing the decided plan, assessing the impact of the plan and sustaining the implemented program for long-term service. Preparation of the action will be done by senior facility managers. Assessment of the hospital will be conducted by a team responsible for assessing the condition of the hospital and whether the providers and nurses are following the expected safety practices. The implemented program will be expected to educate staff on safety practices during patient encounter and promote a conducive working environment for nurses and other healthcare practitioners (Scott, 2009).
Budget
The projected cost of this project is $50, 000. This includes the cost of preparing the action and planning implementation. The planning can cost approximately $3, 500. The cost of training healthcare providers on how to use the implemented project is $7,200, and this will take approximately two weeks after the project is implemented. Assessment of patient’s satisfaction will be through data collection and analysis which will amount to $25,000 due to the required material and incentives to participate. The other costs is the cost of program implementation within the entire healthcare facility. Implementation cost will add up to $14300 which is inclusive of the material and labor required for successful project implementation.
Proposed Implementation
The project will start by preparing for the action that will take place during the implementation. At this step, all the prerequisites that require addressing are put in place so that nothing is omitted during the project implementation. The second step will be a baseline assessment of the current situation of the hospital. Baseline data will be collected using interviews and group discussions with a senior manager so that the current situation of the hospital can be identified. During the assessment, the strengths and weaknesses of the project are highlighted together with the expected outcomes after the project is completely implemented (Cohen et al., 2010). After the assessment, the plan is executed and implemented according to the expected outcomes.
The results of the baseline assessment will be used during the implementation of the project so that they guide on the interventions required to minimize hospital infections. Plan execution will occur in the month of April 2019 through piloting in some departments, and the implemented project will be assessed for effectiveness for the two months after which it will completely be implemented in all departments. After complete implementation, the project of infection prevention control will be used to improve the quality of care and help answer relevant questions regarding patient safety in healthcare (Dancer, 2014). A review will be conducted after some months to assess whether the project improved patient satisfaction and promoted patient outcome.
Evaluation and Data Analysis
During the evaluation of the project, data will be collected from the hospital which will be compared to the data collected during the assessment before the project was implemented. The compared data will be analyzed to assess nursing compliance rate with the new infection prevention and control program and patient satisfaction as a result of the implemented program. Analysis of the collected data will assist in the evaluation of the project success, and the project will be assumed to be successful if it promotes patients outcome, if it increases patient satisfaction as well as reducing nurse turnover rate (Scott, 2009). The project main aim is to reduce hospital infection rate as a result of contact and unhygienic working conditions. Therefore, reduced hospital infections and increased patient satisfaction are the baselines for successful project implementation.
Nursing Theory and QSEN Standards
This project will align with Jean Watson Theory of Human Caring where the quality improvement project is believed to not reward patients, but also the nurses and other providers (Watson & Woodward, 2010). Nurses embrace the theory which helps them to acquire positive energy employed in the control of infections and pathogens from the surfaces will minimize transmission of the infections from patients to patients as well as from patients to providers (Watson & Woodward, 2010). Also, providing patients with a safe environment while admitted in a hospital is part of care shown to patients without discrimination. Although the infected patients can be separated from the rest of the patients, that is part of care aimed to protect the rest of the patients from infections. The theory assisted in the identification of the relevant interventions required to reduce hospital-acquired infections.
Quality and Safety Education for Nurses is aimed to meet the challenges nurses are expected to meet during the future of nursing practice. The future of nursing requires that all nurses continuously improve the quality and safety of care, and with the nursing education, the goal will become a reality. The six QSEN standards include safety; Patient-centered care, Evidence-Based Practice, Quality Improvement, Teamwork and Collaboration and Informatics (World Health Organization, 2005). The standard that informed this project is a Quality improvement which enhanced the writer’s knowledge on the development of quality improvement standards. Also, it equipped the writer with knowledge on whether a quality improvement project is successful after implementation. Therefore the standard is useful in promoting quality improvement in a healthcare facility by increasing nursing compliance with the standards.
Conclusion
Infection prevention and control program was implemented so that it could protect patients and healthcare providers from contracting hospital-acquired infections. Healthcare infections are common and have led to deaths of many patients and increased the length of stay as a result of reinfections from one patient to another. Therefore, patients with highly infectious diseases should be separated from the rest of the patients to avoid the transmission of infections. Also, nurses and healthcare providers should adhere to infection control practices by wearing gloves and other protective gear as well as ensuring that the working places are regularly disinfected to avoid hospital-acquired infections.
References
Murni, I. K., Duke, T., Kinney, S., Daley, A. J., & Soenarto, Y. (2015). Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study. Archives of disease in childhood, 100(5), 454-459.
Mehta, Y., Gupta, A., Todi, S., Myatra, S. N., Samaddar, D. P., Patil, V., … & Ramasubban, S. (2014). Guidelines for prevention of hospital acquired infections. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 18(3), 149.
Al-Tawfiq, J. A., & Tambyah, P. A. (2014). Healthcare associated infections (HAI) perspectives. Journal of infection and public health, 7(4), 339-344.
Scott, R. D. (2009). The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention.
World Health Organization. (2005). Practical guidelines for infection control in health care facilities (No. Regional Publication No. 41). WHO Regional Office for South-East Asia.
Cohen, S. H., Gerding, D. N., Johnson, S., Kelly, C. P., Loo, V. G., McDonald, L. C., … & Wilcox, M. H. (2010). Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infection Control & Hospital Epidemiology, 31(5), 431-455.
Dancer, S. J. (2014). Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination. Clinical microbiology reviews, 27(4), 665-690.
Watson, J., & Woodward, T. K. (2010). Jean Watson’s theory of human caring. Nursing theories and nursing practice, 3, 351-369.