NURS FPX 8030 Assessment 1: Building the Case for Healthcare Improvement
Building the Case for Healthcare Improvement
Slide 2: Hello, my name is ……………….., and today I will address a critical issue facing Johns Hopkins Hospital: hospital-acquired infections (HAIs). Specifically, I will focus on the rise in infection rates, contributing factors, and intervention strategies to enhance patient safety in healthcare institutions. Recent challenges at Johns Hopkins include an increase in central line-associated bloodstream infections (CLABSIs) and surgical site infections (SSIs).
NURS FPX 8030 Assessment 1: Building the Case for Healthcare Improvement The related infections have resulted in horizontal epidemic effects on patients by complicating their conditions and increasing their length of stay, and overall healthcare costs. For instance, the incidences of SSIs were 12% among surgical ward patients, and the incidences of CLABSIs increased by 9% among patients in ICU units last year. These figures call for the application of evidence-based practices (EBP) including; enhanced hygiene, effective catheter care, and sterilization measures to enhance the lives of these patients.
Health Care Safety Problem
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The first threatened area of safety at Johns Hopkins is the increasing incidences of CLABSIs and SSIs which are a major concern to patient safety and recovery. For the past year, the SSIs were found to have risen to 12%, mostly in the surgical wards, and CLABSIs for Intensive care units were found to be 9% more than the previous year (Munro et al., 2024). Such infections also add to the cost, prolong the duration of the diseases, and pose higher risks of mortality (Toor et al., 2022). To address this problem measures towards better hygiene, proper approach towards the catheters, and sterilization measures need to be taken to safeguard the patient’s health.
External Sources Support for Need of Change
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Externals need immediate updates because the infection rates at Johns Hopkins Hospital are on the rise Promisingly, most changes are required for updating information from external sources. Based on CDC and NHSN, Hospital-Acquired Conditions consisting of SSIs and CLABSIs have been gradually increasing in the entire United States; the percentage of SSIs has risen by 10% and of CLABSIs by 8% in the year 2023 (Lafuente et al., 2023). For this reason, the picture painted above holds at Johns Hopkins as these same infections are also on the rise.
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This paper will explore the various causes of HAIs in Johns Hopkins Hospital. Poor hand hygiene among healthcare personnel still counts as a problem despite dialogue. The following discussions will present a brief overview of the first three of these issues. first, Improper hand hygiene among HCWs is still a problem despite periodic or continuous interventions like campaigns and training. Hand hygiene plays a crucial role in the promotion and support of a strategy against the spread of pathogens between healthcare workers and patients. Still, strict hand washing and sanitizing are not maintained because of daily timed pressures, nobody to monitor or enforce, or fewer available hand washing stations or bottles of sanitizers. Second, it was established that patients on long-term catheters are at higher risk because suboptimal catheter care practices contribute to CLABSIs. Long-term use of central lines, incorrect placement, and lack of proper care raise the chance of bloodstream infections. Third, problems with instrument and equipment sterilization processes are cited as contributing to the increase in SSIs. Sterilization means strict compliance with well-set procedures, however, mistakes or carelessness result in product contamination and subsequent infections.
Overcoming these challenges requires the adoption of a system-level approach that includes implementing evidence-based practices as well as encouraging a safety culture in the Johns Hopkins Hospital. The first wave of change would be for hand washing to become mandatory throughout the organization irrespective of the department. Compliance with hand hygiene practices should be checked diligently and there should be consequences for healthcare workers regarding all the protocols. Some methods that have been proposed for increasing hand washing include: increasing physical access to washing facilities by adding more washing stands, training people to use alcohol based on hand washing, and constant feedback mechanisms such as TV screens to alert users on compliance levels. This in turn can allow didactic endeavours to strengthen the message about hand hygiene and its use as a protective measure that prevents HAIs and ensures patient safety.
Importance and Urgency of Addressing Infection Prevention
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Another interventional area to help decrease CLABSIs is catheter care enhancement. Some of the measures that we discuss with patients about catheter care include the correct method of putting the catheter, early signs of infection, and appropriate removal of a catheter when it is no longer needed. This change has been positively correlated with decreased rates of infection, which makes adequate utilization of antimicrobial-coated catheters another good addition to CMS hospital infection prevention interventions. Healthcare providers should be trained and educated on the correct way of handling and management of CLABSIs, and basically, the course should cover the importance of following sterile measures when inserting and maintaining CLABSIs. It is recommended that catheter care practices should be audited periodically to check on the level of compliance with the standard set down.
Desired State for Intervention
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Concerns with HAIs cannot be made to be solely associated with clinical implications of the matter but also owe its significance to other considerations. These infections also have grave repercussions for a patient’s wallet and the community’s healthcare budgets. Management of HAIs often involves a multitude of other treatments like long-term antibiotics administration, multiple surgeries, and longer hospital stays all of which are costly exercises. The costs for hospitals extend beyond the expenses incurred during treatment of various conditions beloved paying regulatory fines for non-adherence to infection safety precautions. Additionally, HAIs have adverse effects on the image of the hospital, which lose the faith and credit of the population in their healthcare organization. A return to normalcy means safeguarding patients from infections and using highly visible means to prove that this is a priority.
There are guidelines by infectious disease organizations in most countries or even globally that can offer a solid foundation. Both CDC and WHO have set goals for decreasing HAIs: hand hygiene, catheter-related care, and sterilization methods. From this paper, the aforementioned guidelines could be applied at Johns Hopkins thereby enhancing improvements in patient safety as well as enhancing the image of the hospital as an institution that embraces infection prevention. For instance, the “5 Moments” hand hygiene promotion material of the WHO describes the precise opportunity time to clean hands during patient management making it easy for the healthcare worker to follow the model(Buetti et al., 2022). Likewise, the CDC guidelines for preventing CLABSI direct that measures are taken to ensure sterile insertion, the use of antimicrobial catheters, and proper observation of the central line.
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Achieving the Desired State for Infection Prevention
To achieve a monumental decrease in HAIs with the intent to enhance patient care at Johns Hopkins we cannot work in isolation, there is therefore the need to include all those constraints in our continuum of care. Consequently, managers in hospitals are directly responsible for providing resources, setting agendas, and promoting matters of safety. Staff and caregivers in general healthcare facilities must have strong beliefs in infection control policies and procedures and must have agreed to embrace continuous staff development including training in infection control measures. Patients also play a role at the hospital by raising their safety concerns like requesting the providers to wash their hands before touching them or being informed concerning the hospital infection control measures(Hannum et al.,2023). Potential resources or lack thereof include: Using financial incentives or reimbursement to fund infection prevention programs Setting explicit measures and goals to reduce HAI Considering and enforcing levels of compliance.
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Aligning with Best Practices for Infection Prevention
The expected result of these intercessions is a decrease in the SSIs and CLABSIs by 35-40 percent within the first six months. Realization of this goal is likely to have a positive impact on patients, healthcare providers as well as the hospital at large. Particularly, the program will benefit patients by allowing them to experience shorter stays in the hospital, decreased mortality rates, and better results. Overall the delivery of enhanced human health care will be beneficial for healthcare providers because they will be at diminished risk for exposure to various infectious agents in their workplace. For Johns Hopkins, decreasing HAIs will not only help the organization to become one of the best healthcare facilities but also to improve patient satisfaction and save more money per patient on non-recurring treatments and longer stays in the hospital.
Conclusion
Therefore, hospital-acquired infections at Johns Hopkins Hospital are an acute problem that requires urgent and consistent intervention. New developments in SSIs and CLABSIs are a threat to patient safety, which results in costs and potentially tarnishes the hospital’s reputation. Studies show that gaining full compliance to these standard precautions, as well as singled-out measures like better hand washing, catheter management, and more thorough sterilization would result in a significant lowering of infection prevalence and better results for the hospital. Adhering to national and international standards will add our efforts in this regard and place Johns Hopkins in the vanguard of infection prevention programs. Using integral teamwork, encouraging accountability, and adopting a refreshed commitment to the highest quality, the hospital is in a position to address the safety of the patients and restate dedication towards improved care.
References
Buetti, N., Marschall, J., Drees, M., Fakih, M. G., Hadaway, L., Maragakis, L. L., Monsees, E., Novosad, S., O’Grady, N. P., Rupp, M. E., Wolf, J., Yokoe, D., & Mermel, L. A. (2022). Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 update. Infection Control and Hospital Epidemiology, 43(5), 553–569. https://doi.org/10.1017/ice.2022.87
Hannum, S. M., Oladapo, O., Salinas, A. B., Weems, K., Marsteller, J., Gurses, A. P., Shpitser, I., Klein, E., Cosgrove, S. E., & Keller, S. C. (2023). Controlling the chaos: Information management in home-infusion central-line-associated bloodstream infection (CLABSI) surveillance. Antimicrobial Stewardship & Healthcare Epidemiology, 3(1), e69. https://doi.org/10.1017/ash.2023.134
Lafuente, E., Terradas, R., Civit, A., García, D., Hidalgo, C., Giro, D., Lacueva, L., Esquinas, C., & Tortosa, A. (2023). Risk factors of catheter-associated bloodstream infection: Systematic review and meta-analysis. PLOS One, 18(3), e0282290. https://doi.org/10.1371/journal.pone.0282290
