HAI-Related Interventions Report (Assessment)

Introduction

In complicated healthcare settings with multiple challenges and severe issues, medical providers, including organizations, clinicians, and nurses, should know various reliable, evidence-based strategies. Regarding nosocomial infections or HCAIs, effective interventions include frequent, careful handwashing, hospital sanitation, hospital waste management, personal protective equipment, vaccination, medication storage and handling, antibiotic stewardship, and technology implementation.

Therefore, this paper aims at providing leadership and change management strategies and communicating and collaborating strategies that can favorably impact the problem. The paper will also examine the importance of state board nursing standards, governmental policies, technology, care coordination, and community resources for preventing HCAIs.

Leadership and Management Strategies

While adopting particular changes, professionals’ actions should be constantly supervised and supported by competent management capable of implementing practical changes and responding to functional concerns. Furthermore, the management should select a specific approach and determine coherent strategies to promote systematic transition in the staff’s workflow. In this respect, one of the most advanced and effective leadership models that received substantial worldwide support is transformational leadership (TL). Boamah et al. (2018) state that TL has a powerful effect on workplace empowerment, ultimately enhancing nurses’ job satisfaction and patient outcomes and safety, provided that managers serve as a moral and ethical model. Overall, the style requires managers to delegate responsibilities to personnel and stimulate them to transcend the defined expectations.

To realize a meaningful change, leaders should follow definite steps. First, Stouten et al. (2017) recommend conducting an initial analysis to identify existing problems, possible obstacles, and change opportunities. In addition, leaders need to form a clear, engaging vision articulating tasks and goals and a specially selected team that oversees the change process. Regarding infections, when leaders strive to implement particular technology, for example, Health Information System (HIS), to record the HCAIs’ incidents better, they should primarily determine staff’s perceptions and attitudes, costs, and organizational concerns.

Then, managers need to convey the benefits of EMR implementation, including patient safety and workflow, and documentation simplification. Finally, leaders should gather a team with participants from different organizational departments to supervise all phases of change realization.

The development of the proposed intervention will be rested on core ethical principles, including beneficence, respect for patients, equity, and justice. Beneficence implies the absence of deliberate harm and selecting healthcare practices that foster patients’ well-being, health, and interests. For example, this tenet requires prescribing antibiotics only in the case of need and real potential hazards. The second imperative is respect for patients’ values, privacy, and needs, encouraging medical professionals to involve patients in decision-making and deliver a clear, evidence-based presentation of care options’ avails and risks. The final principle is equity and justice, assuming an impartial attitude toward all individuals regardless of their racial, social, and sex affiliations in terms of medical resources distribution.

Communicating and Collaborating Strategies

Communication plays a pivotal role in increasing awareness among colleagues, patients, and the related communities and their support for a specific change. In the case of HCAIs, messages should be directed at patients who stay in medical facilities for a prolonged time and their families and visitors. In addition, while building communication strategies to promote the change, management should gather input from patients and their families to determine possible obstacles and consider patients’ needs and preferences.

Stouten et al. (2017) indicate that leaders should be honest, transparent, and open in their communication. It is critical to discuss both expected benefits and possible barriers and problems associated with a change and encourage questions and even critique from stakeholders, especially from family members and nurses. For instance, implementing technologies, such as HIS or hydrogen peroxide vapor (HPV), can require staff to take advanced training, which may be met adversely.

Besides, Neill (2018) recommends creating a consistent plan, the initial phase of which should be conveyed as a proposal to have the opportunity to make necessary adjustments in the future. Finally, messages should be delivered through various channels, including videos, visual presentations, pictures, workshops, and reminders. The visual format of the change presentation is particularly useful to agitate hand hygiene, hospital cleaning, isolation, and others.

State Board Nursing Practice Standards

In the USA, all states and distinct territories own special regulatory and licensing bodies named Boards of Nursing (BON), comprising the National Council of State Boards of Nursing (NCSBN). The NCSBN gathers governmental agencies to respond to the issues of patients’ safety and welfare, public health, and nursing licensure examinations jointly, supervising nursing practice and education. According to the Nursing Practice Act (NPA), BONs guarantee the quality of care delivered by licensed nurses, thereby protecting public health (Huynh and Haddad, 2020).

Regarding these agencies’ performance, the findings of the study by Winstead and Moore (2020), for instance, examined The North Carolina Board of Nursing (NCBON) and supported its activities in implementing regulatory workshops. NCSBN also considers telehealth’s significance for delivering care and promotes telehealth nursing practice by providing recommendations, statistics, and safety and quality standards (National Council of State Boards of Nursing, 2021). Besides, the HAI Action Plans contribute to federal and state coordination care attempts to prevent HAIs by sharing best practices, resources, and lessons retrieved from collective clinical experience and knowledge.

The Effectiveness of Proposed Interventions

The offered interventions, that is, frequent, careful handwashing, hospital sanitation, protective equipment, immunization, antibiotic stewardship, and technology implementation, have gained substantial support from the scientific community. For example, Fernando et al. (2017) indicate that between 2002–2013, due to Australian hand hygiene compliance programs, the annual incidence of S. aureus bacteremia (SAB) reduced by 63 percent. Another study by Haverstick et al. (2017) demonstrated that patients’ handwashing compliance also significantly reduce nosocomial infection rates, including Staphylococcus aureus and enterococci. Thus, organizations and government agencies need to highlight the importance of appropriate hand hygiene among staff, patients, and visitors.

Another precaution that proves its effectiveness is hospital sanitation which requires providing the safety of clinical rooms, personnel’s uniforms, and equipment for patients. In this regard, Caselli et al. (2019) propose to apply an innovative sanitation strategy, titled Probiotic Cleaning Hygiene System (PCHS) resulting in a 99 percent reduction in antimicrobial resistance bacteria irrespective of resistance type. Moreover, this method led to a 60 percent decrease in antibiotic consumption and 75 percent in allied costs.

Concerning antibiotic stewardship, Ho et al. (2020) emphasize its importance because such dangerous infection as C. difficile tends to increase due to antibiotics overuse. Besides, the benchmark for HAI of Mayo Clinic Hospital at Rochester exceeds the national standard on almost all acute infections, including CLABSI, CAUTI, and Clostridium difficile, which indicates the strict observance of prophylactic measures (“Mayo Clinic,” n.d.) In terms of savings and profitability, the financial benefit of HCAI prevention practices varies from $25 billion to $31 billion (“Healthcare-Associated Infections,” n.d.). Overall, simple, tested rules and actions can save millions of lives, alleviate workflow burden, and economize billions of dollars.

Technology and Care Coordination

Because of the diversity errors stipulated in the human factor, health care providers need advanced technical support. In this respect, Health Information System (HIS) is an innovative documentation instrument specifically designed to collect, store, transmit, and manage healthcare data to facilitate clinical workflow and boost individual and population health outcomes. Currently, HIS implies different terms, including electronic medical record (EMR), clinical decision support (CDS), and computerized provider order entry (CPOE), among many others. These systems provide multiple benefits such as quick access to complete, accurate information about patients’ histories and practical reminders and guidelines on drug interactions or allergies.

This notably facilitates the therapeutic decision-making process and diagnosis and diminishes the probability of faults. Furthermore, Feldman et al. (2018) specify that immunization alerts provided by HISs resulted in a 12 percent growth in children’s well-being and a 22 percent decrease in medication receipt mistakes. HIS also favors tight cooperation between clinicians and patients, allowing them to connect in case of need.

Care coordination (CC) is an elaborate strategy ensuring the deliberate organization of patient care activities and ceaseless information exchange among all stakeholders to deliver safe and productive care. In brief, CC aims at synchronizing the delivery of patients’ care and treatment from various health providers and specialists. Concerning CC’s effectiveness, scientists have performed profound research estimating CC plans and their advantages. For instance, Conway et al. (2019) discovered that CC plans were frequently associated with better patient and health service outcomes, especially when nurses were engaged in active, in-person interactions with patients. CC programs also decrease the risk of contamination by reducing patients’ hospital stay and needless contact with other people.

In summary, the paper has provided leadership, change management, and communication strategies that promote HAI prevention. Specifically, while implementing a change, leaders should conduct an initial analysis of the environment, create a clear, engaging vision and form a special team. Regarding communication, leaders should be honest, transparent, and open, prepare a coherent plan, and use various visual channels. The efficacy of offered interventions, including hand hygiene, sanitation, isolation, and antimicrobics stewardship, has been supported by numerous studies in different countries. Finally, care coordination, health information systems, and other technologies can be beneficial instruments while preventing or even eliminating HCAIs.

References

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Caselli, E., Arnoldo, L., Rognoni, C., D’Accolti, M., Soffritti, I., Lanzoni, L., Bisi, M., Volta, A., Brusaferro, S., & Mazzacane, S. (2019). Impact of a probiotic-based hospital sanitation on antimicrobial resistance and HAI-associated antimicrobial consumption and costs: A multicenter study. Infection and Drug Resistance, 12, 501-510. Web.

Conway, A., O’Donnell, C., & Yates, P. (2019). The effectiveness of the nurse care coordinator role on patient-reported and health service outcomes: A systematic review. Evaluation & The Health Professions, 42(3), 263-296. Web.

Feldman, S. S., Buchalter, S., & Hayes, L. W. (2018). Health information technology in healthcare quality and patient safety: Literature review. JMIR Medical Informatics, 6(2), e10264. Web.

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Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection. Critical Care Nurse, 37(3), e1-e8. Web.

Healthcare-Associated Infections: Overview. (n.d.). Health People. Web.

Mayo Clinic Hospital Rochester: Complications & deaths. (n.d.). Medicare. Web.

National Council of State Boards of Nursing. (2021). NCSBN’s environmental scan COVID-19 and its impact on nursing and regulation. Journal of Nursing Regulation, 11(4), S1–S36. Web.

Neill, M. S. (2018). Change management communication: Barriers, strategies & messaging. Public Relations Journal, 12(1), 1-26.

Stouten, J., Rousseau, D. M., & De Cremer, D. (2018). Successful organizational change: Integrating the management practice and scholarly literature. Academy of Management Annals, 12(2), 752-788. Web.

Winstead, J., & Moore, C. M. (2020). Outcomes and impact of a nursing regulatory orientation workshop for nurse leaders. Journal of Nursing Regulation, 10(4), 22–29. Web.