Healthcare Associated Infections Discussion Paper

Healthcare Associated Infections Discussion Paper

Benchmark Capstone Project Change Proposal: Preventing Central Line-Associated Blood Stream Infections (CLABSI)

In many healthcare settings where nurses work, institutional policy, the levels of awareness of nurses of potential practice problems and how to solve them, and the level of surveillance are all factors that influence care quality. This benchmark capstone change project proposal is an example of an attempt at improving practice through clinical inquiry to enrich the current body of evidence-based practice or EBP ( Melnyk & Fineout-Overholt, 2019). A class of illnesses known as healthcare-associated infections (HCAIs) is acquired by a hospitalized patient upon admission to a healthcare facility. CLABSIs, or central line-associated blood stream infections, are one type of HCAI (Sikora & Zahra, 2021)Healthcare Associated Infections Discussion Paper. It is one of the nurse-sensitive markers of inadequate nursing care that results from low-quality nursing care. However, prevention is achievable through change management and quality enhancement (using EBP). A rise in the prevalence of CLABSI among inpatients with central lines in a rehabilitation institution has been recognized as the nursing practice issue in this case. This is mainly because nurses disregarded the recommendations for preventing CLABSI. This paper presents the complete project change proposal from problem identification to evaluation of the interventions.

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Background

HCAIs such as CLABSI can be transmitted through contact with contaminated objects, infected people, or contaminated environments. HCAIs are a severe health concern because they frequently result in serious consequences, prolonged hospital admissions, and even mortality. They can cause a variety of ailments, including bloodstream infections like CLABSI and upper respiratory infections like ventilator-associated pneumonia or VAP (Haque et al., 2020). Healthcare professionals must maintain strict infection control procedures, adhere to proper hygiene, and wash their hands frequently with soap and water in order to reduce the risk of HCAIs. These safeguards also call for sterilizing medical equipment properly and using consistent aseptic technique to prevent patient exposure to infectious agents. In addition, healthcare institutions should be regularly monitored for potential sources of HCAI transmission. Some of the quality control and certification agencies that do this are the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), the Agency for Healthcare Research and Quality (AHRQ), and the National Committee for Quality Assurance or NCQA Healthcare Associated Infections Discussion Paper.

The rehabilitation center can greatly lower the incidence of HCAIs by implementing stringent infection control methods and ongoing monitoring (Suetens et al., 2018). By ensuring that these procedures and guidelines are observed, the capstone project’s suggested solution aims to reduce the incidence of CLABSI as a major HCAI. HCAIs can happen in outpatient settings, care homes, or hospitals. The majority of HCAI infections happen when microorganisms, which may be bacterial, viral, or fungal in nature, transfer to a human host that is susceptible through the use of devices. The risk of contracting these infections is substantial in critical care units, or ICUs, where the World Health Organization (WHO) indicates that nearly 3 out of 10 inpatients are infected by HCAIs, according to Jayasree and Afzal (2019).

As was already mentioned, CLABSI is the most avoidable kind of HCAI and develops when a central venous line (CVC) is present. When the CVC is contaminated by bacteria or fungi during the placement or modification process, CLABSI can happen. Approximately 0.4 million CLABSIs are reported annually in the United States, and central venous access catheters are thought to be responsible for 90% of all blood stream infections, according to the Agency for Healthcare Research and Quality (AHRQ, 2018). High death rates, lengthier hospital stays, and greater medical expenses are all linked to CLABSIs.

According to Sikora and Zahra (2021), CLABSI has two risk factor points. These are catheter and host variables. The authors claim that the host factors include, among others, bone marrow transplantation, malnutrition, parenteral nutrition, being an infant or extremely old, and immunocompromised condition as in chronic sickness. On the other hand, catheter variables include, among others, a lack of adherence to aseptic technique, multiple CVC catheterization, multi-lumen CVC devices, the type of catheter material, prolonged hospital stays prior to catheterization, and prolonged duration of catheterization procedure. According to Jayasree and Afzal (2019), the incidence of CLABSI is reduced through quality improvement (QI) activities by infection prevention and control strategies as well as improved adherence to the evidence-based recommendations. Additionally, they decrease the number of days spent in hospitals and raise patient survival rates.

Clinical Problem Statement

The perceived reason for the problem of CLABSI in the rehabilitation facility in question has several components. The first is that nurses at the facility do not all seem to be aware of the institution’s central line bundle policy for prevention of CLABSI. Secondly, the nurses that are aware of the policy are not always using it or applying it as required during intervention. Third is that t5he nurses are also not strictly following the central line kit direction. Lastly, the surveillance by the infection control director is not as often and as thorough as required.

The significant and easily avoidable healthcare-related infection known as central line-associated bloodstream infections (CLABSIs) still exists. In American ICUs by 2020, the rate was 0.87 per 1,000 central line days. Between 12% and 15% of CLABSI patients die, and the odds of dying in the hospital are as high as 2.75. Additionally, CLABSIs are linked to longer hospital stays and higher healthcare costs, with each case costing close to an additional USD 46,000 (Toor et al., 2022)Healthcare Associated Infections Discussion Paper. As has already been noted in this work, the majority of CLABSI cases can be avoided with the use of suitable aseptic procedures, monitoring, and management measures.

Staff members who have direct patient contact should be the focus of any interventions to reduce CLABSI. Nurses, service providers, and medical technicians are just a few examples. Sikora and Zahra (2021) provided examples of successful measures, including training for nurses and other healthcare professionals, regular hand hygiene practices, cleaning and sanitizing medical devices, preventing contamination of the environment, stringent isolation precautionary measures, and monitoring analysis of data. Five evidence-based recommendations to avoid CLABSI are included in the standardization of practice listed by the Agency for Healthcare Research and Quality (AHRQ, 2018)Healthcare Associated Infections Discussion Paper. These recommendations include proper hand washing, using chlorhexidine to prepare the skin, maximizing full-barrier safeguards while inserting central venous devices, minimizing use of the femoral vein for catheters in adult patients, and removing extra cannulas.

By employing checklists and being supported by instruction and evaluation, Taylor et al. (2017) demonstrated how quality assurance activities can drastically lower CLABSI in a newborn unit. Their investigation found that the checklists for insertion, routine maintenance, and procedural line access were created based on the current clinical practice guidelines. Following that, adherence and infections were tracked and reported to the unit once every four weeks. It is so obvious where the priority should be when examining numerous academic materials on CLABSI prophylaxis and quality improvement measures.

First off, according to Chi et al. (2020), when evidence-based recommendations for the placement and maintenance of CVCs are observed, CLABSIs are usually avoidable. The prevalence rate is positively impacted by care bundles that have been shown to be effective, such as staff training and development. The use of comprehensive sterilized drapery, sterile gloves, sterile gowns, and the wearing of masks and caps while inserting catheters are examples of the most effective optimal sterile barrier safety measures. Adherence to barrier safeguards will reduce the likelihood of infections, as Alotibi (2021) also agrees. Healthcare Associated Infections Discussion Paper

Purpose of the Change Proposal in Relation to Providing Patient Care in a Changing Health Care System

In a world in which the healthcare landscape is constantly changing, the quality of care has become a very important and central factor in evidence-based practice (EBP). For this reason, having outcomes that point to nurse-sensitive indicators such as CLABSI is an occurrence that is neither desired nor desirable. That is why this change proposal intends to identify available current scholarly evidence for nurse-led compliance to CLABSI prevention bundles as the most effective intervention against CLABSI. This purpose starts with the objectives which are as follows:

The Objectives

Promote independence by educating patients and healthcare professionals about HCAIs and the value of adhering to appropriate infection control practices.
Encourage social fairness by giving medical professionals the means and equipment they need to guarantee that all clients are shielded from HCAIs.
Develop an HCAI prevention plan that is suited to the requirements of various demographics and is culturally sensitive.
Create a surveillance system to keep tabs on and track any instances of infections linked to medical care.

The Rationale

When instituting measures to prevent healthcare-associated infections, independence and social equity should be taken into account for two reasons. First, independence or autonomy offers people the freedom to decide how they want to be treated and to take an active part in that process. In fact, it is one of the bioethical principles besides beneficence, nonmaleficence, and justice (Haswell, 2019). Additionally, autonomy gives people a sense of control over their lives, which can be uplifting and give them a sense of purpose (Haque et al., 2020)Healthcare Associated Infections Discussion Paper. In order to ensure fair access to healthcare, which is vital to lessen gaps in patient outcomes, social justice is also crucial.

As stated above, justice itself is one of the bioethical principles by which healthcare providers must abide and provide to all patients. Healthcare practitioners can guarantee that all individuals have equitable access to care and that treatments are suited to the requirements and desires of the individual by taking autonomy and social justice into account when putting treatments into practice. In the end, this will lead to better health outcomes and a decline in HCAI incidence.

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The PICOT Question

The following is the PICOT question that was formulated to guide the evidence search from databases:

Among inpatients with central lines (P), does the compliance of nurses in using a CLABSI prevention bundle (I) compared to non-compliance (C) result in a decrease in CLABSI rates (O) within a timeframe of 3 months (T)? Healthcare Associated Infections Discussion Paper

Table 1

The PICOT elements for nurse compliance to a CLABSI bundle

P	Patient population or people	The critically ill in-patients who are admitted to hospital and especially in the ICU who will require placement of central venous lines or catheters.
I	Intervention or strategy	The compliance of nurses and adherence to CLABSI prevention bundle guidelines.
C	Comparison or alternative intervention	Non-compliance, non-adherence and disregard for CLABSI prevention guidelines and protocols.
O	Outcome or expected result	A significant decrease in or reduction of the CLABSI rates or incidence.
T	Timeframe or duration of intervention	Three (3) months.

Literature Search Strategy Employed

Very renowned research resources were reviewed in order to find the most trustworthy and recent evidence from the scholarly literature that was accessible. Five of these databases would be used. ProQuest, PubMed, CINAHL, Embase, and the Cochrane Database of Systematic Reviews were the databases consulted. The PICOT inquiry mentioned above was used to develop the search phrases and keywords that would be utilized to aid the search strategy before it began. These are the keywords and phrases that would be used in search queries with the expectation that the search engine crawlers would return publications that particularly cover the PICOT components.

The search keywords and phrases made from the PICOT question were “central line-associated blood stream infections,” “CLABSI,” “prevention bundle,” “nurse compliance,” “non-compliance,” “EBP interventions,” and “reduction of CLABSI incidence.” These were then inputted into several search engines in varying configurations. However, before entering them into the search engine, they had to be coupled with the Boolean operator “AND.” Filters were applied after the initial results were received to eliminate the blatantly irrelevant query results and abstracts. Typically, only full-text articles were taken into account.

Only papers that had been published within the previous five years were taken into consideration during the publication year-based filtering process. Other factors taken into account included solely English-language publications, quantitative research, randomized controlled trials (RCTs)Healthcare Associated Infections Discussion Paper, and systematic reviews and meta-analyses. The highest ranking evidence of efficacy is provided by systematic reviews and meta-analyses, which sit on the highest position on pyramid of evidence.

There were 2,312 publications in total after the process of producing findings and eliminating the results that weren’t relevant to the PICOT declaration. However, it is clear that all of these were generated only since they included some of the keywords and phrases. It was necessary to perform additional filtering in order to keep just the articles that dealt with the PICOT components in great detail. After careful consideration, 33 papers were ultimately chosen as having precisely answered the PICOT question. Included in the chosen 33 were the articles by Acharya et al. (2019), Karapanou et al. (2020), Reynolds et al. (2021)Healthcare Associated Infections Discussion Paper, and Russell et al. (2018). The aforementioned search yielded a large enough number of publications that may speak to the PICOT question and its many components in detail. The publications most notably supplied a response to the question of whether applying and adhering to the provided evidence-based preventative bundles by nurses is an effective approach against CLABSI.

Evaluation of the Literature

To evaluate the literature retrieved within the constraints of time and resources, eight of the 33 articles chosen were considered. The first subject looked at was the research question. In Acharya et al. (2019), the research question was whether the implementation of an educational program to staff on hand hygiene would improve compliance to guidelines and reduce CLABSI rates. The study question posed by Aloush and Alsaraireh is identical to this one (2018). They wanted to know if nurses’ adherence to the recommendations for preventing central line-associated blood stream infections (CLABSI) had an impact on CLABSI rates.

The focus of study for Dombecki et al. (2020) was on the efficacy of chlorhexidine-gluconate (CHG) application in lowering CLABSI in a non-ICU clinical setting. This is intriguing because virtually every other report was about patients in intensive care units. However, the study question still holds up well when compared to those of other articles, including Goldman et al. (2021). Goldman et al. (2021) questioned if socio-cultural variables actually affected CLABSI bundling procedures and outcome measurement. It is possible to classify the use of chlorhexidine-gluconate as a CLABSI bundle practice.

The Karapanou et al. (2020) study sought to determine if high CLABSI frequencies were caused by the inadequacy of central venous catheter insertion and care bundles in hospitals with a high bed occupancy. The adherence to CLABSI preventive bundling is the common subject of the study questions, as shown by the research question by Lee et al. (2018). Accordingly, Lee et al. (2018) questioned if the diversity in central line bundle adherence seen in intensive care units might be explained by changes in the work environments for personnel. Healthcare Associated Infections Discussion Paper

In the same vein, Reynolds et al. (2021) questioned whether using chlorhexidine solutions was an acceptable evidence-based nursing intervention for preventing bloodstream infections linked with central lines (CLABSI). As can be observed, Dombecki et al. almost exactly asked the same research question (2020). In line with the others, Russell et al. (2018) also questioned if there are any evidence-based strategies for reducing CLABSI in an intensive care settings.

Study Sample Populations

A highly intriguing scenario is revealed when the sample populations used by the various studies are compared. Some studies, particularly those that focused on attitudes and views, used nurses as the respondents while the majority made use of in-patients with central lines. Others used complete ICU units as sample units as well. Overall, this evaluation adopts the stance that because the sample populations used in all the research examined here were sufficient, the results obtained were both valid and trustworthy.

A sample of n=34 nurses from a tertiary care hospital in Eastern India was employed in the Acharya et al. (2019) study. Even though it was only a convenience sample by extrapolation, this sample was sufficient by approximation. Aloush and Alsaraireh (2018) took place in Jordan, a Middle Eastern nation. In this investigation, these researchers included a sample of n=171 ICU nurses. Again, given the study’s approach, this sample was sufficient. In a sizable acute care teaching hospital, Dombecki et al. (2020) conducted their survey on non-ICU patients. Children and adults who were inpatients but were not in the intensive care unit (ICU) and had central venous lines made up their representative sample. Goldman et al. (2021) employed a sample of n=74 individuals. This sample was sufficient because the study was qualitative. In the study by Karapanou et al. (2020), n=913 patients who got CVC catheters in a 574-bed university teaching hospital made up the study sample. The accuracy and transferability of the study’s findings were undoubtedly impacted by this rather sizable sample, which was also quite large. Healthcare Associated Infections Discussion Paper

In the study by Lee et al. (2018), the study population consisted of n = 507 distinct adult medical-surgical ICUs, with the study’s context being a collection of hospital medical-surgical ICUs in the United States. A sample of n=14 clinical units were employed by Reynolds et al. (2021) in the context of two sizable hospitals in the southeast of the United States. Last but not least, Russell et al. (2018) used a sample group of n=24 patients in an ICU for liver transplants with 24 beds.

Some Study Limitations

Typically, every research has certain inherent weaknesses. This is due to the limited nature of resources, which implies that scientists may not be able to complete all the work they feel is necessary. The inability to evaluate the impact of the independent variable on length of stay, mortality, and ICU expenditures was one of Acharya et al. (2019)’s weaknesses. One of the drawbacks in Aloush and Alsaraireh (2018) was that the observations were only done during day rotations. This might have impacted how reliable the results were.

One of the shortcomings of Dombecki et al. (2020)’s study was that confounding factors including comorbidities were not taken into account. On the other hand, Goldman et al. (2021) acknowledged that one of the limitations of their study was that the results only represented the state of affairs in three units of a single Canadian hospital. This could have an impact on the results’ representativeness and, consequently, clinical importance.

One drawback for Karapanou et al. (2020) was that the staffing shortages problem might have had an impact on the findings and conclusions. Lee et al. (2018)’s study has the drawback of having a big sample size but a relatively low response rate of 29% only. The study on CHG bathing knowledge and attitudes had a low response rate, which is a problem in Reynolds et al. (2021)Healthcare Associated Infections Discussion Paper. Lastly, a significant drawback of the Russell et al. (2018) investigation is that it was conducted at a time when the prevalence of HCAI infections was at its highest. This could result in a false assessment of the value of prevention.

Applicable Change or Nursing Theory Utilized

Kurt Lewin’s Change Theory

Kurt Lewin’s Change Management Model is one of the change models that were employed in this example, and the recognized quality issue that called for change was an increase in the incidence of CLABSI at a rehabilitation facility. Unfreezing, changing, and refreezing are the three main processes of the model (Hussain et al., 2018). Kurt Lewin’s three-step change model is used to carry out this change (Burnes, 2020; Hussain et al., 2018). The first step in implementing the change is to “unfreeze” organizational processes. At this point, the institution has accepted the need for reform and is starting to implement change procedures. In this instance, organizational CVC insertion processes are examined, and flaws are identified. Change is planned, and the method of execution is chosen.

The second stage involves “changing” from non-compliance to full nurse compliance with the CLABSI preventative bundle standards. This will entail evaluating the nurses’ perceptions, knowledge, and attitudes, gaining their support or buy-in for the change, educating and training them, examining the CLABSI prevention bundles adopted, and finally putting them into practice. The third and last step in “refreezing” is to make this practice a requirement for corporate policy (Hussain et al., 2018; Burnes, 2020)Healthcare Associated Infections Discussion Paper. This entails formal incorporation into the operations and standard operating procedures of the organization.

Plan-Do-Study-Act or PDSA Change Model

Plan-Do-Study-Act, or PDSA, is a systematic, four-stage problem-solving methodology used to enhance a strategy or implement change. It is crucial to involve internal and external stakeholders while implementing the PDSA cycle since they may offer input on what functions and what does not (Spath, 2018). In this case internal stakeholders include the nurses and the patients, while external stakeholders include quality inspection and certification agencies such as the JCAHO and the NCQA or National Committee for Quality Assurance.

In this particular case planning will involve assessing compliance and the factors hindering compliance. It will also involve assembling a quality improvement team and resources for the change. This is where the PICOT is formulated and database search is carried out. In the “Do” stage, the intervention for which evidence of efficacy has been found (compliance with CLABSI prevention bundles) is implemented. After that is the “Study” phase in which an evaluation of the effectiveness of the intervention is carried out. If it was successful, then the “Act” phase is activated. Here, the intervention of compliance to a CLABSI prevention bundle is incorporated into organizational policy and it becomes part of its everyday evidence-based practice or EBP.

Proposed Implementation Plan with Outcome Measures

The implementation plan or strategy to be put in place will involve a number of measures. These will include: Healthcare Associated Infections Discussion Paper

Creating policy awareness on CVC dressing changes by nurses. This will be achieved by measures such as putting signs and reminders at the nursing station in the rehabilitation facility, as well as printing and distributing pamphlets to the nurses.
Conducting secret surveillance through observation and auditing of nurses as they care for CVC lines.
Conducting regular education and training of nurses, as well as proper induction programs for newly hired nurses.
Increasing the frequency of monitoring for risk factors of CLABSI in the patients.

The measurable outcomes expected after this would include the following:

A decrease in the CLABSI rates after three months of implementation.
An increase in adherence to recommended practices by the nurses.
An increase in monitoring for risk factors of CLABSI.
Decreased interference time from completing scheduled therapy sessions at the rehabilitation facility.
A decrease in the additional costs for treating CLABSI events.

How Evidence-Based Practice was Used in Creating the Intervention Plan

Evidence-based practice or EBP is clinical practice in which only those interventions that have enough scholarly evidence supporting their efficacy are used on patients (Melnyk & Fineout-Overholt, 2019)Healthcare Associated Infections Discussion Paper. This was used in creating the intervention plan in this case by following the PICOT or clinical inquiry procedure. A search for evidence was conducted and the evidence reviewed as above. Enough evidence for the recommended intervention was isolated and this would be implemented using the nursing change theories discussed above. Evaluation and translation into practice would then follow.

Plan for Evaluating the Proposed Nursing Intervention

The rehab facility’s quarterly CLABSI rate in comparison to the prior data as well as the number of nurses adhering to the CLABSI package will be included in the data gathering. The information will be gathered through a variety of tools. Dashboard data from the facility’s electronic health record (EHR) system will be used to gather the quarterly rate of CLABSI (Hugo et al, 2022)Healthcare Associated Infections Discussion Paper. The peer auditing tool, EHR system, and covert surveillance will be utilized to count the number of nurses who comply with the CLABSI package and correct nursing recordkeeping.

The infection control director, peer auditors, and covert surveyors are the people who will be in charge of gathering data and reviewing it. The director of infection control will obtain the most recent CLABSI rates from the electronic health record. Peer auditing is carried out by approved nurses who assess the performance of the nurses and their adherence to the CLABSI package. Secret surveyors will compile data on compliance with hand hygiene rules. The facility’s CLABSI team, which is made up of nurses, doctors, infection prevention agonists, improvement specialists, and executive sponsors, will be informed of the results after the evidence-based change project has been implemented. The results will include the pre-intervention and post-intervention CLABSI rates as well as the nurses’ conformance rates (Hugo et al., 2022). Emails, dashboards for preventing injury, and formal meetings will all be used for communication.

Identification of Potential Barriers to Plan Implementation and How to Overcome Them

Potential barriers to implementation include:

Inadequate human, fiscal, temporal, or material resources.
Resistance to change by some staff.
Low-level evidence making the intervention to fail.

These barriers and others can be overcome by amongst other things making sure enough resources are present before starting the project, making sure sufficient buy-in is achieved from all before commencing, and only considering the highest levels of evidence possible such as randomized controlled trials (RCTs) and systematic reviews with meta analyses.

Conclusion

The identified clinical practice problem in this change initiative was the noncompliance to clinical practice guidelines on the prevention of central line-associated blood stream infections (CLABSI) by nurses. This led to an increase in CLABSI rates that then required an evidence-based intervention to forestall. This was discovered through clinical inquiry and implemented as chronicled in this paper. The implementation is to continue for three months after which thorough evaluation is to take place to see if indeed the CLABSI rates have gone down at the rehabilitation facility. If that be the case, then the intervention will become part and parcel of organizational policy and EBP.

Appendix

Informed Consent Form [Exempt]

Principal Investigator:

Co-Investigator:

Faculty Advisor:

You are invited to participate in a research investigation about nurse compliance to CLABSI bundle recommendations.

In the event that you accept to be part of the research effort, you will be asked to allow researchers to carry out observations as you go about your daily duties. These researchers may be covert.

The benefits of this research will include improved patient outcomes such as reduced mortality and hospitalization days.

The potential risks and discomforts include an intrusion into your working space or questioning by “strangers.”

Your participation in this research study is completely voluntary. Even after starting, you may choose to stop at any time without having to give any reasons. Also, you may choose not to answer certain questions or perform certain actions asked of you if you find them offensive, inappropriate, or unprofessional.

We will protect the privacy of your data and your confidentiality and not share your personal information with any third parties.

In case you have any further questions about this research study, please contact the principal investigator with the details below:

Name of PI:

Telephone:

Faculty Advisor:

Telephone:

Signed:

[Participant]: ____________ Name: ____________ Date: ___________

[Principal Investigator]: _____________ Name: _____________ Date: ____________

References

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Suetens, C., Latour, K., Kärki, T., Ricchizzi, E., Kinross, P., Moro, M. L., … & Healthcare-Associated Infections Prevalence Study Group (2018). Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: Results from two European point prevalence surveys, 2016 to 2017. Eurosurveillance, 23(46), 1800516. https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800516

Taylor, J.E., McDonald, S.J., Earnest, A., Buttery, J., Fusinato, B., Hovenden, S., Wallace, A., & Tan, K. (2017). A quality improvement initiative to reduce central line infection in neonates using checklists. European Journal of Pediatrics, 176(5), 639–646. https://doi.org/10.1007/s00431-017-2888-x

Toor, H., Farr, S., Salva, P., Kashyap, S., Wang, S., & Miulli, D.E. (2022). Prevalence of central line-associated bloodstream infections (CLABSI) in intensive care and medical-surgical units. Cureus, 14(3), 1-7. https://doi.org/10.7759/cureus.22809 Healthcare Associated Infections Discussion Paper

Benchmark – Capstone Change Project Objectives

Healthcare-associated infections (HCAIs) are infections that are acquired in a healthcare setting. These infections can be spread by contact with contaminated surfaces, contact with infected persons, or contact with contaminated equipment. HCAIs cause a range of illnesses, from upper respiratory infections to bloodstream infections and are a major health concern, as they often lead to serious complications, extended hospital stays, and even death (Haque et al., 2020). To reduce the risk of HCAIs, healthcare providers must practice good hygiene and follow strict infection control protocols which includes frequent handwashing, proper sterilization of medical equipment, and ensuring that patients are not exposed to infectious agents. What’s more, healthcare facilities should be regularly monitored for potential sources of HCAI transmission.

The findings from this discussion are relevant to the change project focused on healthcare-associated infections. By implementing strict infection control protocols and regular monitoring, the healthcare facility can reduce the risk of HCAIs (Suetens et al., 2018). The intervention proposed by the capstone project aim at ensuring that these protocols and procedures are followed, thereby decreasing the number of HCAIs.

Objectives

Increase autonomy by providing education on HCAIs and the importance of following proper infection control protocols to healthcare providers and patients.
Promote social justice by equipping healthcare providers with the resources and tools to ensure that all patients are protected from HCAIs.

Create a culturally competent HCAI prevention program that is tailored to the needs of diverse populations.

Establish a reporting system to monitor and track any cases of healthcare-associated infections.

Rationale

The rationale for considering autonomy and social justice when implementing healthcare associated infection interventions is twofold. First, autonomy gives individuals the power to make their own decisions about their health care and to actively participate in their own care. Autonomy also provides a sense of control to individuals, which can be empowering and provide them with a sense of agency (Haque et al., 2020). Secondly, social justice is essential in ensuring equitable access to health care, which is necessary in order to reduce disparities in healthcare outcomes. By considering autonomy and social justice when implementing interventions, healthcare providers can ensure that all individuals have equal access to care, and that interventions are tailored to the individual’s needs and preferences. This will ultimately improve healthcare outcomes and reduce HCAI rates.

References

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. https://doi.org/10.2147/RMHP.S269315

Suetens, C., Latour, K., Kärki, T., Ricchizzi, E., Kinross, P., Moro, M. L., … & Healthcare-Associated Infections Prevalence Study Group. (2018). Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Eurosurveillance, 23(46), 1800516. https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.46.1800516