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Nosocomial Infections
Synthesis
The evidence-based approach utilized and advocated by all the authors cited in this essay can be viewed through the lens of a PDSA process as described by Hadaway (2006). For example, Pronovost and colleagues were interested in reducing the incidence of preventable CR-BSIs in the ICU setting in Michigan. They first identified an evidence base supporting an intervention and then planned how to implement the intervention to cause a small-scale change. This evidence base, as well, is nothing more than the sum of several research groups engaging in the PDSA process. The intervention(s) is then implemented to test its efficacy, the results studied, and significant positive or negative outcomes are acted upon. The research reviews by Kampf et al. (2009) and Hadaway (2006) represent a synthesis of the findings from several studies, which they used to support their theses regarding hand hygiene and CR-BSIs, respectively. Rhine's (2006) editorial also outlined interventions supported by research findings, which was motivated by a single study showing improved NICU CR-BSI rates can be maintained for a period of years.
From a nurse's perspective, however, the PDSA process is designed for small-scale changes. The first step would be to identify an evidence base...
The editorial by Rhine (2006) would be a good place to start, with its recommendation to change NICU culture so that patient safety is paramount. For example, both Hadaway (2006) and Rhine (2006) suggest giving nurses the authority to stop a procedure if best practice guidelines are not being followed. One measure implemented in Michigan was the formation of a team consisting of a physician and nurse, who were given the responsibility for implementing the ICU intervention and helping to collect data for the study (Pronovost et al., 2006). Hadaway (2006) suggests that a change in ICU culture should begin at the top, with organizational leaders who champion a change in culture that emphasizes patient safety. Regardless of how an ICU cultural change is implemented, the PDSA process demands that a realistic goal be set first.
The four publications reviewed in detail here universally recommended improving hand hygiene habits for all ICU clinicians (Hadaway, 2006; Pronovost et al., 2006; Rhine, 2006; Kampf, Loffler, & Gastmeier, 2009). A possible intervention might include the installation of alcohol-based hand rub dispensers in convenient locations, such as doorways, along with a poster outlining best…
References
Hadaway, L.C. (2006). Best-practice interventions: Keeping central line infection at bay. Nursing, 36(4), 58-63.
Kampf, G., Loffler, H., & Gastmeier, P. (2009). Hand hygiene for the prevention of nosocomial infections. Deutsches Arzteblatt International, 106(40), 649-655.
Pronovost, P., Needham, D., Berenholtz, S., Sinopoli, D., Chu, H., Cosgrove, S. et al. (2006). An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine, 355(26), 2725-2732.
Rhine, W.D. (2006). Eliminating nosocomial infections in the NICU: Everyone's duty. Journal of Perinatology, 26(3), 114-143.
Potential topics 1. Patient positioning 2. Nosocomial infections 3. Infrequent monitoring Picot Question In mechanically ventilated patients on a pulmonary Med Surg floor, does positioning the patient in a semi fowlers position result in a decrease incidence of nosocomial pneumonia when compared to the supine or side lying positions? Positioning can play a crucial role in developing nosocomial infections. Those under mechanical ventilation may experience a higher rate of nosocomial pneumonia (Gunay et al., 2018). Positioning
Problem From the onset, it is important to note that nosocomial or healthcare-acquired infections (HAIs) happen to be rather common in our healthcare settings. In basic terms, nosocomial infections could be defined as the all those infections that are acquired or contracted within the healthcare environment. To be more specific, the World Health Organization – WHO (2020) defines the said infections as all those infections that “affect patients in a hospital
Applying the Theory of Planned Behaviors to Nosocomial Infections Identify a public health theory you will use to support the implementation of your prevention and health promotion activities. Provide evidence that supports the use of this theory within the program you designed According to the tenets of the theory of planned behavior, individuals first think about a behavior (e.g., the intent to act) and only then proceed to act (Chambers & Benibo,
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
One possible explanation for the differences observed in the studies could be that the strengths of the chlorhexidine solution were different. It could also be that over time more effective techniques have been developed in the application of the solution, as the results do appear to improve over time. There are limitations to the methodology of the study which are centered on the use of secondary data for analysis. The
70% 36-38 0-0-5 Overall Rate SIP 2a Subtotal Measure Title Data Period Rate/Value Numerator Denominator Missing Excluded Cat-E) Invalid Cases Population Numerator SIP 2b Data Prophylactic Jul-04 Antibiotic selection for Aug-04 surgical patients CABG Sep-04-100% 10-10 0-0-33 SIP 2b Subtotal SIP 2c Prophylactic Jul-04 Antibiotic selection for Aug-04 Cardiac Surgery Sep-04 0-1 0-0-42 SIP 2c Subtotal SIP 2d Prophylactic Jul-04 Antibiotic selection for Aug-04 hip arthroplasty Sep-04-100% 8-8 0-0-35 SIP 2d Subtotal Measure Title Data Period Rate/Value Numerator Denominator Missing Excluded Cat-E) Invalid Cases SIP 2e Population Numerator Data Data Prophylactic Jul-04 Antibiotic selection for Aug-04 surgical patients Knee arthroplasty SIP 2e Subtotals SIP 2f Prophylactic Jul-04 Antibiotic selection for Aug-04 surgical