NURS FPX 8030 Assessment 2: Evidenced-Based Literature: Search and Organization

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Evidenced-Based Literature: Search and Organization

Hospital-acquired infections also commonly known as HAIs are a real concern affecting healthcare organizations; new cases continue to manifest in facilities within the United States. Thus, the following incidents observed at the Johns Hopkins Hospital, increased Central Line-Associated Bloodstream Infections (CLABSIs) and Surgical Site Infections (SSIs) have become a matter of patient safety, increased expenses, and poor treatment outcomes. Johns Hopkins revealed a 12% increase in its SSI rate and a 9% increase in CLABSIs; therefore, the need for measures to reduce these infections could not be overemphasized(Alrebish et al., 2022).NURS FPX 8030 Assessment 2: Evidenced-Based Literature: Search and Organization The purpose of this paper is to understand the ways to reduce such infection rates, with a focus on, the best and proven methods of infection control. This plan focuses on the case of Johns Hopkins, with a formulated PICOT question to propose interventions to reduce to improve infection prevention.

PICOT Question

To steer the examination and suggest a remedy, a revised PICOT question has been structured:

Is it possible for a combined methodology involving a unified infection control strategy emphasizing hand hygiene (P), catheter upkeep, and sanitization to lower the rates of CLABSIs and SSIs (I) among individuals (C) hospitalized in the surgical and intensive care units of Johns Hopkins Hospital (O) within a six-month duration (T)?

  • P (Population): Individuals admitted to the surgical and intensive care wards of Johns Hopkins Hospital.
  • I (Intervention): An integrated plan for infection control highlighting handwashing, catheter upkeep, and sanitization.
  • C (Comparison): Present infection prevention techniques implemented at Johns Hopkins Hospital.
  • O (Outcome): Reduction in the frequency of Central Line-Associated Bloodstream Infections (CLABSIs) and Surgical Site Infections (SSIs).
  • T (Timeframe): Half a year.

The patients that are being assessed in the study are taken from the surgical and intensive care units; the intervention is a simple one of implementing an IDSS for infection control. This strategy will be compared with current protocols that address the occurrences of CLABSIs and SSIs within a 6-month timeframe.

The Healthcare Safety Problem

The main emphasis at Johns Hopkins Hospital is made on how many CLABSIs and SSIs occur and how often; these complications have the most unfavorable outcomes for patients and affect the functioning of the entire healthcare system(Classen et al., 2024). These infections increase the duration that patients spend in the hospital, the cost of treatment, and mortality rates among patients. Such patients undergo longer recovery periods than those without these infections as part of the complications.CLABSIs are infections that occur when bacteria or viruses invade the patient’s blood vessels through the central line putting the patient at risk of life-threatening conditions including sepsis. SSIs develop from contamination during surgical operations and manifest as surgical site infections, slow healing, or malfunction of interior organs. The current study concurs with findings from the CDC and NHSN to reveal that these infections are national(Oladapo et al., 2024).

Gathering the Evidence

A review of the existing literature was taken to gather knowledge on learned practices aimed at preventing CLABSIs and SSIs. When searching online databases including PubMed, terms like ‘CABSI’, ‘“central line-associated bloodstream infections,” “surgical site infections,” “infection prevention,” “catheter care,” “hand hygiene,” and “sterilization”’ were used. To narrow the field, filters were used to search for peer-reviewed articles published only during the last five years. The works that took place outside health care facilities or that did not relate to the question posed in the PICOT statement were excluded. Results showed that if good hand washing with soap and water and the use of alcohol-based hand rubs are promoted, half of the infections can be reduced.

Analysis of Gaps in Current Practices

Current infection control practices are well understood at this facility, but the increasing numbers of HAIs at the Johns Hopkins Hospital suggest noncompliance. Observations identified several issues, including:

  • Hand Hygiene Practices: Employees, especially in the many areas of fluctuating intensity such as the I.C.U., do not practice adequate hand washing techniques.
  • Catheter Management: Undercleanliness, untimely removal of unnecessary catheters, and poor hygiene on the side of catheter sites foster the development of CLABSIs.
  • Sterilization Procedures: Lack of proper sterilization in surgical units entails wrong handling of gloves and wrong sterilization of tools that have led to SSIs.

Studies similar to Alrebish et al. (2022) will show that compliance with infection control practices including hand washing, gowning, gloveing, and equipment sterilization can significantly help lower HAI.

Proposed Intervention

The proposed intervention will target bringing down CLABSI and SSI rates by 35 %-40% in Six months. It is anticipated that patient and staff protection will be improved, hospital stays shortened, and recovery time will be down healthcare costs due to fewer reoperations and lengthy treatments. The acquired better infection control will also increase public trust to the hospital’s patient safeguards. These problems must be solved because the intervention will facilitate more efficient use of resources and improve the quality of given care.

Expected Outcomes

The proposed preventative framework is intended to reduce significantly the incidence of CLABSIs and SSIs in the Johns Hopkins Hospital. These interventions aim at bringing down the infection rates to a range of 35-40% from the current level of implementation within six months. Possible positive effects arising from such a decrease include; improved safety for the patients together with the healthcare staff, fewer hospitalizations, and reduced costs of treatment. This undertaking is also expected to restore public confidence by demonstrating the proper way of containing and preventing patient infection. In addition, the extent of timely complications due to infections may reduced, meaning that patients recover quickly; are discharged early; and there are more bed spaces available. The intervention will also bring improved cost-effective ways as it will prevent expensive treatments like long courses of antibiotics or follow-up surgeries to treat infections. Consequently, this approach is believed to increase healthcare productivity by lowering the associated costs.

Toor et al. (2022) have performed a study based on data related to Central Line-Associated Bloodstream Infections in Medical-Surgical and Intensive Care Units. The results in this study indicated that in addition to longer duration, lack of proper upkeep of central lines constituted a major source of CLABSIs. As such, the researchers suggest that catheter care bundles should be implemented and where possible championed, staff should adhere to them to reduce infection risks. Their work focuses on the principles of maintaining the best practices aimed at the reduction of HAIs and provides improvement in patients’ outcomes for the relevant investigation.

Monitoring and Evaluation

The process of monitoring and evaluation will be very important in facilitating the success of this intervention (Oladapo et al., 2024). The measures are to include recording of infection rate, hygiene and catheter care, and sterilization procedure conformity. Measures like CLABSIs, SSIs, hand hygiene percentage, and frequency of catheter-related infection incidents will be measured and compared. According to Shehab et al. (2024), international sophisticated systems shall be used to enhance the automated tracking of infections and enhance report response.

Conclusion

Johns Hopkins Hospital still faces major difficulties associated with HAIs, including CLABSIs and SSIs. When the hospital has a strongly defined infection preventive schedule with a focus on hand washing, catheters, and sterilization, the number of infections among patients will decrease, and the condition of the latter will improve (OLeary et al., 2024). The purpose of this initiative is to meet and complement national and international guidelines besides being viewed as a preventive measure for HAIs. By way of regularly screening, orienting, and training the staff, as well as instituting a measurable protocol of care in compliance with benchmarks in the state of Illinois, among others, this intervention has the potential of reaping sustainable positive impacts on the hospital and immunizing the patients.

References

Alrebish, S. A., Yusufoglu, H. S., Alotibi, R. F., Abdulkhalik, N. S., Ahmed, N. J., & Khan, A. H. (2022). Epidemiology of healthcare-associated infections and adherence to the HAI prevention strategies. Healthcare, 11(1), 63. https://doi.org/10.3390/healthcare11010063

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