Healthcare-associated infections (HAIs) remain a major problem in hospitals all over the world since they cause suffering, deaths, and excess costs in the healthcare setting(Ahmed et al.,2021). Specifically, Central Line-Associated Bloodstream Infections (CLABSIs) and Surgical Site Infections (SSIs)have drawn significant attention because their rates are increasing. The latest data available at Johns Hopkins Hospital raises the CLABSIs by 9% and the SSIs by 12%. Such infections prolong hospitalization and increase expenditures but can be prevented by specific measures.NURS FPX 8030 Assessment 4: Methods and Measurement This discussion presents a framework that locates these issues and details recommendations for action. These recommendations involve the use of strategies based on best practices; measurement tools; and characteristics of the partner organizations.

Background and Problem Statement

Increased HAI incidence, especially CLABSIs and SSIs at Johns Hopkins Hospital is a concern for the surgical and intensive care units. CLABSIs result from pathogens that get into the bloodstream through the central line while SSIs arise at the surgical site. Though such infections can be averted when all the appropriate precautionary measures against infections are observed, the increased rates observed suggest that there is a need to address the issue. A guiding question for this investigation is: In patients undergoing surgery or intensive care, how do enhanced hand hygiene protocols and catheter care interventions compare to standard care in reducing CLABSIs and SSIs over six months?

Literature Review and Theoretical Framework

HAIs are one of the most expensive and lethal complications in healthcare, for which they elongate hospitalization duration and raise mortality levels. Several studies show that improper catheter manipulation and improper hand washing are important causes of CLABSIs and SSIs. Munro et al. (2024) highlight that when these issues are handled through specifically designed intervention, there is likely to be up to a 70% decline in the spread of infection.

The Donabedian Model of Healthcare Quality has been deemed effective for reviewing and planning methods of infection prevention and control. This model evaluates healthcare quality through three dimensions: It should also examine the structure, the process, and the outcome of an organization. The structure is defined as the hospital’s resources &structure; the process incorporates specific preventive measures for infections such as hand hygiene practices, and catheter care, although the outcome assesses the decrease in infection rates.

Proposed Interventions to Address CLABSIs and SSIs

The literature reviewed provides multiple evidence-based strategies that should be implemented in Johns Hopkins Hospital to address the rising cases of CLABSIs and SSIs. Therefore, these strategies are primarily centered on changing the form, as well as the regard towards, hygiene modeling practices, sharpening staff FDI, and improving patient care techniques to reduce infection risks most efficaciously. A considerable portion of these interventions involves optimizing hand hygiene, an intervention that has been seen to decrease SSIs by 40%. According to Buetti et al. (2022), measures taken under this domain include the use of automated monitoring technologies aimed at monitoring compliance with hand hygiene standards among healthcare personnel. They also give alerts in real-time, which helps the staff maintain maximum hygiene and fosters accountability. Technology-supported interventions, it is necessary to provide brief training sessions frequently. These sessions serve to remind everybody about correct handwashing procedures, And, the different types of practices and procedures contained in the medical management guidelines regularly inculcate the importance of proper hand washing amongst the diverse healthcare providers.

The second essential aspect, which needs to be modified to reduce the incidences of CLABSIs, is the aspect of care around catheters. Catheterization is one that’s associated with bloodstream infections; therefore, it requires proper management and good handling. Some methods in this respect, are as follows, implementation of what is known as maintenance bundles (Shenoy & Branch, 2023). These are worked-up protocols across the healthcare facility that will cover all aspects of catheter insertion and care. The other key aspect is evaluations that should be conducted frequently to determine the need to keep on using the central lines and the third is fast removal of central lines once they are no longer required. Additionally, specific demonstrations may be performed by the staff to increase their awareness and improve the potential consequences of catheter care guidelines.

Instruments for Measuring the Effectiveness of Interventions

For efficiency purposes of these interventions, formalized culturally appropriate tools like the National Healthcare Safety Network (NHSN) and the hand hygiene observation tool (HHOT) are vital. These instruments are well-established for their validity and have often made use of many infection control studies (Izadi et al., 2021). The NHSN which was started by the Centers for Disease Control and Prevention provides a picture of how many healthcare complications for instance CLABSIs and SSIs may be estimated. It is however important to realize that the NHSN only follows the infection rates and one may therefore discern them, as well as compare them at the national level. This tool stems from the base rate and rate of occurrences by rates and SIRs which are bought proportionally. This is valid and reliable according to test interview outcomes collected after using it in various facilities in the United States.

The HHOT, designed by the World Health Organization (WHO), was adopted to systematize the evaluation of compliance with the existing hand hygiene guidelines. This study obtains both qualitative and quantitative data, which the current investigation also uses, and shares specifics of hand hygiene throughout different clinical activities. This practical application has been proven and checked many times in clinical practice, and the effectiveness of this tool has been confirmed by the fact that it is used in almost all healthcare organizations worldwide. The HHOT not only captures the level of adherence to hygiene guidelines but as well, it reveals areas of opportunity that will require more focused intervention. Increased protocols in hand hygiene and better practices in catheter care using effective assessment tools like the NHSN and the HHOT are perfect strategies for combating the high incidences of CLABSIs and SSIs in Johns Hopkins Hospital. Such measures can be valuable and effective as many of them are based on perspectives derived from evidence-based practice, and can potentially provide major developments in patient safety, decreased incidence of infections, and quality healthcare.

Evaluation of Instruments in Literature

The NHSN and the HHOT have been used in prior infection control research and in studies that state that both are accurate tools for identifying and preventing HAIs (Classen, et al., 2024). For example, according to the NHSN records, it is found that the omission of certain interventions causes a reduction in the prevalence of common infections. Likewise, over time, HHOT has not hesitated to underscore on relationship between; increased compliance with hand hygiene rates together with decreased SSIs. These analytics suggest that these tools will facilitate the achievement of the goals of the interventions at Johns Hopkins Hospital. Mategiatic to quantitative data aggregation and at the national level, the NHSN can be useful when measuring Infection rates. On the other hand, the mixed method which was used at HHOT provides almost endless resources of information about hand hygiene which as a goal can be altered and improved systematically.

Conclusion

High CLABSI and SSIs necessitate urgent improvement of patient safety and containing healthcare expenses at the Johns Hopkins Hospital. The hospital can reduce overall infection rates by adopting evidence-based practices including better hand wash policies and better handling of catheters. The NHSN and HHOT tools will enable accurate measures and assessment of these interventions to provide the requisite information for enhanced improvement. It is also important to note that the strategies that follow not only meet most of the infection challenges currently but also form a strong system that will serve as a basis for modifying the HAI Trends (Wang et al., 2021). By enhancing rigorous implementation and evaluation, Johns Hopkins Hospital could enable a new standard for patient safety and hospital quality and offer patients better values including improved quality and outcomes at lesser costs.

References

Ahmed, N. J., Haseeb, A., Elazab, E. M., Kheir, H. M., Hassali, A. A., & Khan, A. H. (2021). Incidence of healthcare-associated infections (HAIs) and the adherence to the HAIs’ prevention strategies in a military hospital in Alkharj. Saudi Pharmaceutical Journal: The Official Publication of the Saudi Pharmaceutical Society, 29(10), 1112–1119. https://doi.org/10.1016/j.jsps.2021.08.012

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 & Hospital Epidemiology, 43(5), 553–569. https://doi.org/10.1017/ice.2022.87

Classen, D. C., Rhee, C., Dantes, R. B., & Benin, A. L. (2024). Healthcare-associated infections and conditions in the era of digital measurement. Infection Control and Hospital Epidemiology, 45(1), 3–8. https://doi.org/10.1017/ice.2023.139

Izadi, N., Etemad, K., Mehrabi, Y., Eshrati, B., & Hashemi Nazari, S. S. (2021). The standardization of hospital-acquired infection rates using prediction models in Iran: Observational study of national nosocomial infection registry data. JMIR Public Health and Surveillance, 7(12), e33296. https://doi.org/10.2196/33296

Munro, C., Zilberberg, M. D., & Shorr, A. F. (2024). Bloodstream infection in the intensive care unit: Evolving epidemiology and microbiology. Antibiotics, 13(2), 123. https://doi.org/10.3390/antibiotics13020123

Shenoy, E. S., & Branch, W. (2023). Automating surveillance for healthcare-associated infections: Rationale and current realities (Part I/III). Antimicrobial Stewardship & Healthcare Epidemiology, 3(1), e25. https://doi.org/10.1017/ash.2022.312

Wang, C., Jiang, W., Yang, K., Yu, D., Newn, J., Sarsenbayeva, Z., Goncalves, J., & Kostakos, V. (2021). Electronic monitoring systems for hand hygiene: Systematic review of technology. Journal of Medical Internet Research, 23(11), e27880. https://doi.org/10.2196/27880