Change Model for Nosocomial Infections Essay
Change Model for Nosocomial Infections Essay
Purpose of Hand Hygiene in Preventing Nosocomial
Introduction
Nosocomial infections are also known as hospital-acquired infections (HAIs) and are directly or indirectly related to healthcare delivery in hospital settings. Most HAIs, particularly those in the ICU, are caused by bacteria that belong to Acinetobacter. However, other bacteria such as Pseudomonas aeruginosa, Staphylococcus aureus, and E. coli (Denstaedt et al., 2018). These organisms are spread through direct body contact or contaminated body fluids and surfaces. Change Model for Nosocomial Infections Essay
Denstaedt et al. (2018) highlight that HAIs are a potential threat to public health and hospitalized patients’ well-being. Globally, they account for approximately 10% of prolonged hospitalization and 1.7 million cases of HAIs, and one thousand annual deaths. Apart from increasing the costs of care, HAIs increase the number of pathogens resistant to antimicrobials, which presents challenges in progressing towards the prevention and control of HAIs.
Driving Forces
There has been an increase in the prevalence of HAIs recently among hospitalized patients. As such, patients who have poor prognosis, prolonged hospitalization, and increased mortalities. Such an alarming concern has attracted public opinion and sharp criticism of how hospitals promote hospitalized patients’ safety (Denstaedt et al., 2018). This criticism does affect not only affect the general view of the hospitals but also their financial state. Change Model for Nosocomial Infections Essay
Medicare’s decision to stop reimbursement for HAIs has affected the financial performance of these hospitals significantly, forcing them to implement efforts for quality improvement. Initially, the organization was spending a lot on reimbursements for HAIs, and its financial position and reputation had significantly gown down (Denstaedt et al., 2018). However, since the proposed plan aims at preventing HAIs, a decrease in the incidences and prevalence of HAIs will positively influence the organization’s reputation, financial performance, staff, and patient satisfaction
Change Process
According to World Health Organization recommendations, the primary aim of this change process is to reduce HAIs through regular handwashing. As such, the stakeholders involved in this process include doctors, nurses, patients, family members, and support staff. This change process adopts a behavioral change that promotes regular hand hygiene to reduce the risk of spreading or contracting HAIs. All health care staff will be encouraged to develop a routine handwashing habit every time they contact body fluids, blood, before eating and after using the restrooms. Demirel(2019), according to Centers for Disease Control CDC, to reduce HAIs, emphasis should be put on hand hygiene; before performing an aseptic procedure, after exposure to contaminated body fluids, before contact with a patient, after contact with a patient’s immediate surrounding or the patient and after touching an object within patient’s immediate surroundings. Change Model for Nosocomial Infections Essay
Change Model
To increase the chances of a successful outcome post-implementation, the author uses the PDSA (Plan-Do-Study-Act) change model to implement this change initiative. The PDSA model was developed by Walter Shewhart in the year 1920 and highlighted four significant steps; planning, doing, studying, and acting, to effecting change (Al-Hussami et al., 2015). The Planning stage involves developing a plan to test a change where an individual determines objectives, identifies major stakeholders, defines tools for measurement, develops piloting ideas, creates a plan to try a change, and how a pilot test will be conducted, determines the data be collected and analyzed. In the Do phase, an implementer actualizes a test, collects data, documents problems, and observations. The Study phase primarily involves observing and learning from the outcomes where an individual will analyze the data collected and determine if the change has resulted in expected outcomes. If there is a successful change, the pilot test influences the development of implementation plans (Al-Hussami et al., 2015). In the final phase (Act), an individual determines the changes relevant to make and progress to create improvement plans.
According to Al-Hussami et al. (2015), applying this model to this change initiative, in the initial stage (Plan), the author will progress to form an interdisciplinary implementation team comprising of nurses, physicians, LPNs, infection control specialist, and a clinical microbiologist. This team’s primary objective will be to develop an implementation timeline with specific activities and goals and oversee all the pre and post-implementation activities. The leader of the team will be a nurse, and his/her primary role will be to assign roles to team members, act as a communication and liaison among team members, and to make follow-up to ensure that all members strictly adhere to the implementation timeline and activities.
In the Do phase, the team will conduct a pre-implementation assessment and training to identify potential gaps in knowledge about HAIs and educate staff. Education will also focus on teaching staff about handwashing using tools and resources such as brochures, video demonstrations, and posters (Al-Hussami et al., 2015). There will also be a post-assessment to determine whether staff will have obtained the required knowledge. Change Model for Nosocomial Infections Essay
In the Study phase, the team performs a systemic review of HAIs obtained in the second phase of the process. The team will also focus on analyzing the practice of hand hygiene to identify barriers to the change process. Finally, determine the readiness to perform the desired change.
Finally, in the act phase, the leader with the team members will initiate the change process. Regarding information obtained about the proposed change, the leader will ensure that the action addresses the concern of hand hygiene. The primary role of the teams is to provide continuous education on the importance of handwashing. Additionally, explain how hand hygiene reduces the spread of HAIs. Finally, the team will develop programs that will sustain the new change.
Change Agents
Change agents are individuals either from inside or outside who help the organization achieve an expected transformation. Change agents will include infection control specialists, Nurses, Physicians, Assistive nursing personnel, Information specialist Clinical microbiologist. The primary role of change agents is to participate in the change process actively to effect change at various capacities. Infection control specialists are tasked with laying out structures necessary for handwashing, i.e., hand washing procedures, hand washing centers, etc. Change Model for Nosocomial Infections Essay
Nurses, physicians, and assistive nursing personnel are involved in ensuring proper hand hygiene when performing their duties, when reporting to work, before and after handling a patient, before and after doing a procedure, before leaving home, and continuing supporting each other performing hand hygiene. The information specialists are instructed to conduct data collection and make reports about the new change. These reports are detailed and include handwashing in the unit, the challenges to this change, and finally, the ways of overcoming these challenges. Clinical microbiologists are significant in explaining the nature of these pathogens and how to reduce susceptibility to them. They also determine the pathogens that are present at the unit by taking samples for inspection. Finally, they guide why the change is necessary.
