The National Patient Safety Goals (NPSG) are formulated by the Joint Commission annually and seek to address the most prominent contemporary issues in healthcare (The Joint Commission, 2019). They are separated into five categories: ambulatory health care, behavioral health care, critical access hospital, home care, and hospital. These groups are not exclusive, and the same goals may appear in several chapters.
The differentiation is used to identify critical points of interest for different institutions and care providers as outlined by the names. The Joint Commission also provides suggestions for possible methods to address each issue outlined in its goals, though it leaves interpretations to individual facilities. As such, the documents offer a comprehensive framework for problem identification and resolution for medical institutions around the nation.
Most of the recommendations are non-specific, even when detailed proposals are taken into consideration. According to The Joint Commission (2019), key hospital goals for 2019 involve patient identification, staff communication, safe medicine and alarm use, infection prevention, patient safety risk identification, and surgery mistake prevention. The facilities that follow the goals are expected to develop effective measures for the satisfaction of these needs via evidence-based practice.
With regards to hospitals, infection prevention is a prominent topic, with five different goals discussing the avoidance of conditions that result from various aspects of hospital treatments. This paper will focus on the goal, particularly in surgical environments, and the importance of hair removal for the purpose.
Your Hospital NPS Goal
The decision has been made to work towards fulfilling the goal NPSG.07.05.01 in the 2019 NPSG document. According to the Joint Commission (2019), the goal is to “implement evidence-based practices for preventing surgical site infections” through education, policy implementation, regular assessments, stakeholder data sharing, antimicrobial agent administration, and appropriate hair removal.
While healthcare institutions throughout the United States try to maintain the best possible standards in these areas, there are areas of contention, and evidence-based practice spreads gradually. In general, most facilities could improve their standards considerably if they could access a unified set of guidelines based on the latest findings. As such, the improvement process should involve data gathering on topics such as hair removal and its role in infection.
Your Hospital NPS Goal’s Interventions
The intervention determined to be necessary for the issue is an investigation into evidence-based practices surrounding hair and post-operative infection. The methods generally employed at the Center involve shaving the skin area where the operation will be taking place. However, the validity of the procedure is often in question, both with regards to the necessity of hair removal and the applicability of razors to the task.
Al Maqbali (2016) notes that when doing so is necessary, hair should not be removed with razors and suggests clippers and depilation cream as safer alternatives. As such, the program creators determined that hair removal should only be conducted if the growth interferes with the operation.
The reviewers also found that a change in the methods employed for the procedure is necessary. Allegranzi et al. (2016) provide a strong recommendation to avoid the use of razors at all times, whether before the operation or in the operating room and to employ clippers for hair removal. Shaving has the potential to increase the risk of infection compared to both shaving and no hair removal due to its tendency to damage and irritate the skin (Allegranzi et al., 2016). Clippers do not have the same issue, but they do not reduce infection incidence, either, and so should only be used if necessary (Al Johani, 2017). The new policy adopted at the Center is designed to comply with this recommendation.
Nursing-Focused Problem Example to Be Solved
Nurses usually perform hair removal at the direction of the surgeon. The determination of the need for the procedure is left to the discretion of the practitioner, but the nurse who is assigned the task determines the specific method used to remove the hair. Some nurses still have not adopted the latest hair removal policies, using razors for the job and endangering patients as a result. It is challenging to evaluate the difference between the two tools in practice without a dedicated experimental trial, and so they may not pay sufficient attention to the distinction. Furthermore, the environments of most operating rooms make oversight by other nurses challenging, and so dissemination of the latest knowledge happens slowly even if some staff members adopt contemporary practices.
Nursing-Focused Problem Solution
The proposed solution is to introduce alternate methods for preoperative hair removal that reduce the incidence of infection. Clippers appear to be the preferable option, as Al Johani (2017) supports their use as less likely to cause infection than that of razors. The goal is specific and measurable, as it requires that every nurse begins using clippers instead of whichever approach he or she was using before. It is attainable because the use of clippers does not require specialized training, and the tool is not expensive. It is relevant because it is likely to reduce postoperative infection rates. Lastly, it is timely, as it is possible to set a realistic deadline of one month.
Nursing-Focused Solution Implementation
The facility will assign a team of experienced nurses to gather evidence about the importance of the use of clippers in hair removal. They will formulate a guideline based on their findings and publish it for other staff members. They will then hold training sessions, in which they will explain the importance of using clippers and demonstrate how to use them safely. One session should be sufficient for each staff member, as it is possible to condense the necessary information to a sufficiently small amount. If the facility does not have enough clippers to accommodate its needs, it will purchase them in sufficient amounts. After the training, the nurses’ knowledge will be evaluated, and the use of razors in preoperative hair removal will be considered a deviation from best practice.
Nursing-Focused Solution Evaluation
The central statistic that will be tested as a measure of success for the program is the incidence of surgical site infections in patients undergoing surgery. The existing systems that are used to gather data on surgical site infections will continue functioning and collect data such as the amount of hair removal decisions for comparisons. Six months after the end of the training program should be sufficient to gather an adequate sample of patients to determine whether the implementation is effective. Success should manifest as a significant reduction in the proportion of patients that develop an infection after their surgery. Statistical analysis will likely be necessary to evaluate whether the decline is permanent.
Conclusion
The purpose of the NPSG is to improve the overall care quality in the nation by ensuring that each healthcare facility follows the latest guidelines. Infection prevention is a concern, especially in surgical sites, where proper hygiene is critical. Hair removal is an area where improvement is possible, as razors are both commonly used and unsafe. As such, it is possible to address the problem by using clippers for the procedure.
Six months after the end of the education, the data gathered throughout the period will be compared to that before it via statistical analysis to determine whether the proportion of the patients with infections decreases. A significant reduction in the incidence of surgical site infections is expected.
References
Al Johani, N. B. (2017). Nursing evaluation of risk factors associated with surgical site infection among coronary artery bypass graft patients at King Abdulaziz University Hospital. American Journal of Nursing, 6(3), 165-175.
Al Maqbali, M. (2016). Pre-operative Hair Removal: A Literature Review. International Journal of Nursing and Clinical Practices, 3(1), 1-6.
Allegranzi, B., Bischoff, P., De Jonge, S., Zeynep, N., Zayed, B., & Gomes, S. (2016). New WHO recommendations on preoperative measures for surgical site infection prevention: An evidence-based global perspective. The Lancet Infectious Diseases, 16(12), 276-287.
The Joint Commission. (2019). 2019 national patient safety goals®. Web.