Long-Term Nursing Facility Management Risks FACILITY-ACQUIRED INFECTIONS

Long-Term Nursing Family Management Risks

The major risk management issue of our hospital is the spread of nosocomial infections, more popularly known in the medical circle as hospital-acquired infections. This infection is something that a patient can contract or develop besides the condition for which he is admitted (Duel et al. eds, 2004). The include infections, which surface after discharge and occupational types among the workforce of the facility. These are widespread globally and assert strong impact among patients and facility workforce. The most common sites, according to a recent survey, are the urinary tract, the catether site, respiratory tract, bacteremia, skin and soft tissue, lower respiratory, surgical and the eyes (Duel et al., eds).

In our 150-bed facility in Chicago, pneumonia is a critical respiratory nosocomial infection concern. Our facility is a component of one of the biggest network of medical care facilities in Illinois. The chief cause of pneumonia was found to be caused by the use of ventilators with 32 cases increasing to 41 in a year alone and a loss of close to $2 million to the facility. Management introduced a clinical and operational improvement plan to address the spread of the infection and save on ventilator-associated-pneumonia. The Plan was developed from a study, entitled "The Benefits of a Comprehensive Oral Care Regimen for Patients at-Risk for Ventilation-Associated-Pneumonia or VAP." The Plan advocates the use of swabs and suctions to hang in patients' rooms to remind them to use them on a 24-hour basis. The savings realized from the swabs justified the cost made on the suctions, which were introduced at a later time.

This Plan also consists of regular assessment of the oral cavity every half-day by a registered nurse; provision of oral cleansing agents for intubated and unconscious patients every 2-4 hours; brushing the teeth every 12 hours; deep orop[haryngeal suctioning every 12 hours; change in suction canisters and tubing and of yankauer catheters...

The Plan reduced incidence of VAP to 10 and a savings of $1.1 million on added costs.
Discussion

Recent changes in funding and the delivery of health care resulted in an increase in the prevalence and severity of illnesses, specifically nosocomial diseases, among patients in the facility and to critical care beds (Conly & Johnston, 2001; Anderson & Rasch, 2000). These patients were subjected to greater risks of contracting nosocomial infections as the most common among other conditions (Conly & Johnston, Anderson & Rasch), specifically pneumonia. The first option considered by management was a restructuring of the hospital environment. A second was the acquisition of more effective antimicrobial medicines. But the special committee organized to conduct a review of the situation came up with the successful oral care plan earlier discussed.

The Norwegian Institute of Public Health surveyed the 42,900-institution-bed long-term care facilities for the elderly in 2000 and found four most common nosocomial infections (Eriksen et al., 2004). These infections were highest at the rehabilitation and short-term wards where the use of antibiotics was lowest. This facility realized the need for more infection control initiatives, such as infection control programs and a tighter monitoring of nosocomial infections (Eriksen et al.).

Another long-term nursing facility for elderly patients in Oslo, Norway was found to suffer from hospital-acquired infections at 6.5% among its 13,762 patients at the time of the survey, especially among long-term psychiatric patients (Andersen & Rasch, 2000). It was also discovered that this facility was poorly staffed and the facility itself was overcrowded. It was structurally inadequate with few private rooms, few bathrooms and toilets, no isolation rooms, and defective ventilation systems. These hospital-acquired infections resulting from the shortages can only be addressed by incurring more costs in medical and nursing care as well as in administering antibacterial medicine of 157-500 Nkr per day, which is equivalent…