Capella 4020 Assessment 4

Capella 4020 Assessment 4 Improvement Plan Tool Kit

Name

Capella University

NURS-FPX 4020 Improving Quality of Care and Patient Safety

Prof. Name

Date

Improvement Plan Tool Kit

The safety improvement plan for healthcare-associated infections (HAIs) in the Pearl River County Hospital (PRCH) is grounded in evidence-based practices. Thus, an improvement plan tool kit is prepared for healthcare professionals, primarily nurses, to incorporate recent and trusted evidence in their healthcare practices. This tool kit is divided into four broad themes related to HAIs, which help healthcare professionals navigate recent evidence for successful implementation of the quality improvement plan.

Annotated Bibliography

Theme 1: Risk Factors and Etiology of HAIs

Liu, X., Long, Y., Greenhalgh, C., Steeg, S., Wilkinson, J., Li, H., Verma, A., & Spencer, A. (2023). A systematic review and meta-analysis of risk factors associated with healthcare-associated infections among hospitalized patients in Chinese general hospitals from 2001 to 2022. Journal of Hospital Infection, 135, 37–49. https://doi.org/10.1016/j.jhin.2023.02.013

This review article provides valuable information on common risk factors associated with HAIs, including sociodemographic characteristics such as age (more than 60 years) and male gender. Moreover, invasive procedures, chronic diseases, comatose state, immunosuppression due to diseases and therapies, and prolonged hospital stay (more than 15 days) are other significant factors leading to hospital-acquired infections. For nurses at PRCH, this resource is beneficial as it assists in identifying risk factors within their patient population. This resource helps nurses to tailor infection prevention strategies to address the specific needs of their patient population. For instance, the incident of Mr. John reveals age, gender, invasive procedure, and chronic disease as risk factors for developed surgical site infection (SSI). Therefore, this resource is invaluable for nurses in implementing quality and safety improvements related to HAIs, ultimately contributing to enhanced patient outcomes, improved patient safety and quality of care, and reduced healthcare costs.

Murni, I. K., Duke, T., Kinney, S., Daley, A. J., Wirawan, M. T., & Soenarto, Y. (2022). Risk factors for healthcare-associated infection among children in a low-and middle-income country. BMC Infectious Diseases, 22(1), 406. https://doi.org/10.1186/s12879-022-07387-2

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Murni et al. (2022) study investigates risk factors for HAIs among the pediatric population. The research identifies factors like age (less than one year), length of hospital stay (more than seven days), systemic sepsis, use of invasive lines (urinary and central venous catheters), and substandard antibiotic therapies as significant contributors to HAIs in children. Although this study focuses on pediatric patients, these factors also contribute to HAIs in adults and older adults. This resource provides valuable information for nurses at PRCH to tailor targeted infection prevention strategies. The resource’s value lies in enhancing nurses’ awareness of key risk factors and guiding their decision-making processes to improve patient safety and quality of care. For instance, nurses can utilize this information while implementing safety improvement plans on infection control protocols, frequent hand hygiene practices, and patient education and engagement practices. Moreover, nurses can use this information in instances such as during patient assessments, care planning, and interdisciplinary team discussions. Thus, nurses and other healthcare professionals can proactively address infection prevention measures and mitigate HAI risks.

Shrestha, S. K., Trotter, A., & Shrestha, P. K. (2022). Epidemiology and risk factors of healthcare-associated infections in critically ill patients in a tertiary care teaching hospital in Nepal: A prospective cohort study. Infectious Diseases, 15, 11786337211071120. https://doi.org/10.1177/11786337211071120

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This study investigates 300 patients admitted to the ICUs of tertiary hospitals in Nepal. According to the study, the significant factors leading to HAIs in critical patients are the use of invasive devices (catheters, invasive lines, and mechanical ventilators) and sedative therapies. Nurses in PRCH can utilize this resource to focus on implementing infection control and prevention strategies and antibiotic stewardship, which are designed in the safety improvement plan. By emphasizing appropriate infection control practices, hygiene care, and proper handling of invasive devices, this resource reduces the incidence of HAIs, enhancing the quality of nursing care and improving patient safety in critical care settings. Nurses can use this information in various situations, such as when planning care and treatments, central line insertion, and adjusting sedation protocols. Moreover, they can disseminate this information while educating other healthcare professionals, patients, and their families. Hence, this resource provides PRCH’s nurses with actionable evidence to implement quality and safety improvements to maintain patient safety.

Theme 2: Prevention and Control Strategies for HAIs

Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies to prevent healthcare-associated infections: A narrative overview. Risk Management and Healthcare Policy, 13, 1765–1780. https://doi.org/10.2147/RMHP.S269315

A comprehensive review of literature studies presents several strategies to prevent HAIs. The narrative overview discusses hand hygiene protocols, environmental cleaning, educational initiatives, surveillance, and antimicrobial stewardship programs as effective and primarily employed strategies worldwide. However, hand hygiene, environmental cleanliness, and stewardship programs have an overwhelming impact on reducing HAIs and improving health outcomes. This resource is a guiding tool for nurses while implementing quality and safety improvements.

For instance, nurses at PRCH can use the information provided in this resource to prioritize regular hand hygiene practices, ensure thorough environmental cleaning, participate in surveillance and infection monitoring, and advocate for antimicrobial stewardship initiatives. Consequently, the targeted strategies in this resource minimize patient safety risks and improve the overall quality of care, hence declaring the resource most valuable and relevant for PRCH quality and safety issues. Nurses can utilize this resource in various instances, such as during staff education, where nurses can share insights from the article to create awareness among healthcare professionals. Additionally, nurses can incorporate information from the article into patient engagement initiatives to empower patients and families regarding infection control measures.

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Lowe, H., Woodd, S., Lange, I. L., Janjanin, S., Barnet, J., & Graham, W. (2021). Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: A qualitative study. Conflict and Health, 15(1), 94. https://doi.org/10.1186/s13031-021-00428-8

Lowe et al. (2021) conducted a qualitative study to identify the challenges and opportunities associated with infection prevention and control (IPC) practices. While discussing the challenges of IPC implementation, this article also focuses on the importance of IPC measures for preventing HAIs, recommending it as a significant strategy to prevent infections in healthcare settings. According to the article, these measures minimize the spread of pathogens in healthcare settings, reduce morbidity and mortality, and optimize healthcare outcomes, maintaining patient safety.

IPC strategies include hand hygiene, environmental cleaning, and antimicrobial stewardship, which are integrated into our safety improvement plan for PRCH. Nurses can benefit from this resource as it offers valuable insights into the broader context of IPC challenges, providing a perspective to compare their practices and limitations within PRCH. By understanding the importance of IPC and opportunities, nurses can adapt their practices to identify innovative solutions for preserving patient safety and reducing the risk of HAIs. Additionally, this article underscores the need for resilience, adaptability, and interprofessional collaboration in overcoming barriers, thus offering a broader horizon for PRCH’s nurses to implement safety and quality improvement plans.

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Puro, V., Coppola, N., Frasca, A., Gentile, I., Luzzaro, F., Peghetti, A., & Sganga, G. (2022). Pillars for prevention and control of healthcare-associated infections: An Italian expert opinion statement. Antimicrobial Resistance and Infection Control, 11, 87. https://doi.org/10.1186/s13756-022-01125-8

This resource presents an expert opinion statement outlining the importance of IPC initiatives to prevent HAIs. This resource offers a practice guide for healthcare professionals and organizations to implement these initiatives successfully. The resource emphasizes essential strategies the World Health Organization (WHO) recommended, such as hand hygiene, antimicrobial stewardship, infection surveillance, and training and education. For nurses at PRCH, this resource is a valuable reference for implementing quality and safety improvement plans within the healthcare setting. This resource offers insights into best practices and evidence-based strategies that nurses can employ to implement successful infection prevention measures, strengthen hand hygiene protocols, achieve targets and objectives, and improve the quality of nursing practice and patient safety. The information within this article can be primarily used during resource allocation and policymaking within the hospital. It can be integrated into daily practice to create a safety and quality improvement culture.

Theme 3: Technology-assisted HAI Detection and Prevention

Arzilli, G., De Vita, E., Pasquale, M., Carloni, L. M., Pellegrini, M., Di Giacomo, M., Esposito, E., Porretta, A. D., & Rizzo, C. (2024). Innovative techniques for infection control and surveillance in hospital settings and long-term care facilities: A scoping review. Antibiotics, 13(1), 77. https://doi.org/10.3390/antibiotics13010077

This scoping review by Arzilli et al. (2024) explores innovative techniques for infection control and surveillance in hospital settings and long-term care facilities. The various technologies discussed in this review are machine learning, Artificial Intelligence (AI), and natural language processing. These technologies have promising results in empowering patients, reducing workload, cost-effectivity, and improved personalization. According to the article, these technologies enhanced real-time surveillance by improving communication between patients and providers. The authors combine current literature on the effectiveness of these innovations, providing insights into their practical application in healthcare settings through equitable access and improved digital knowledge. This paradigm-shifting knowledge is invaluable for nurses at PRCH to enhance their understanding of emerging HAI prevention and control technologies. Nurses can leverage this information to apply electronic/AI surveillance systems introduced in the safety improvement plan. This resource is highly relevant and valuable as nurses can learn about these innovative interventions for infection control to not only improve patient safety but also reduce the cost associated with complex treatments of HAIs. Thus contributing to minimizing patient safety risks and improving the overall quality of care.

Behnke, M., Valik, J. K., Gubbels, S., Teixeira, D., Kristensen, B., Abbas, M., van Rooden, S. M., Gastmeier, P., van Mourik, M. S. M., van Mourik, M. S. M., van Rooden, S. M., Abbas, M., Aspevall, O., Astagneau, P., Bonten, M. J. M., Carrara, E., Gomila-Grange, A., de Greeff, S. C., Gubbels, S., … Gastmeier, P. (2021). Information technology aspects of large-scale implementation of automated surveillance of healthcare-associated infections. Clinical Microbiology and Infection, 27, S29–S39. https://doi.org/10.1016/j.cmi.2021.02.027

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This article explores the technological aspects essential for the large-scale implementation of automated surveillance systems. This resource guides along with the roadmap for healthcare professionals to implement automated surveillance within healthcare settings. These elements include data collection, electronic health records integration, data quality assurance, and feedback mechanisms. However, the article discusses several implementation challenges, including infrastructure, interoperability, and data security in automated surveillance systems. Nurses in PRCH use this information to understand the importance of automated surveillance systems, as introduced with the safety improvement plan. By incorporating these guidelines, nurses identify infection incidences within the hospital and collaborate with IT teams to implement automated surveillance systems. Additionally, nurses can utilize automated surveillance data to inform infection control protocols, educate staff, and advocate for resources to support HAI prevention efforts, preventing patient safety and improving the quality of care at PRCH.

Streefkerk, H. R. A., Verkooijen, R. P., Bramer, W. M., & Verbrugh, H. A. (2020). Electronically assisted surveillance systems of healthcare-associated infections: A systematic review. Eurosurveillance, 25(2), 1900321. https://doi.org/10.2807/1560-7917.ES.2020.25.2.1900321

Capella 4020 Assessment 4

This systematic review emphasizes the importance of electronically assisted surveillance systems in preventing HAIs. The review examines various technologies for surveillance, including computer algorithms, machine learning, and electronic health records systems. The authors assess these systems’ effectiveness, accuracy, and usability in detecting and monitoring HAIs and their impact on infection control practices, patient safety, and patient outcomes. This resource is a valuable guide for nurses to implement the safety and quality improvement proposed for PRCH. Nurses can use the findings to analyze the capabilities and limitations of electronically assisted surveillance systems. This analysis will help them compare their healthcare setting, ensuring seamless implementation of quality and safety plans. For example, nurses can integrate findings from the review into staff education sessions to raise awareness about the effectiveness and benefits of electronic surveillance systems. Through this knowledge, nurses can facilitate timely detection and intervention for infection control, ultimately enhancing patient safety and quality of care at Pearl River County Hospital.

Theme 4: Patient Engagement and Empowerment in HAI Prevention

Croke, L. (2020). Fostering patient engagement can aid in infection prevention efforts. AORN Journal, 111(5). https://doi.org/10.1002/aorn.13049

Croke (2020) discusses the importance of fostering patient engagement in infection prevention efforts within healthcare organizations. The resource explores various strategies for involving patients in infection control measures, such as education on proper hand hygiene, encouraging active participation in infection prevention protocols, and promoting open communication between patients and healthcare providers regarding infection risks and prevention strategies. Nurses can utilize this resource to implement patient and family education initiatives outlined in the safety improvement plan. During hospital stays, they can educate patients and their families about the importance of infection control measures, such as hand hygiene and environmental cleanliness. These educational initiatives will reduce HAIs, prevent patient safety, and improve the healthcare quality provided within PRCH. Additionally, nurses can involve patients in surveillance activities by encouraging them to promptly report any signs or symptoms of infection. This resource is most valuable as it relates to the safety improvement plan, assisting nurses in enhancing patient safety, improving infection control outcomes, and creating a culture of collaboration and shared responsibility for HAI prevention at PRCH.

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This study highlights the importance of empowering patients to prevent HAIs through active participation in infection control practices using various strategies such as promoting hand hygiene, encouraging vaccination, and patient education on risks and preventive measures. The primary focus of this study is to stress the need for patient-provider to reduce the transmission of pathogens within healthcare settings, thus maintaining patient safety. Nurses can use the information provided in the article to improve their practices, engage the patient and their families, and promote infection control practices within the PRCH. For example, through active demonstrations and theoretical knowledge, nurses can involve patients and their families in preventing the risks of HAIs. Additionally, nurses can use this resource to develop patient-centered educational materials, such as pamphlets, brochures, and video presentations. Lastly, incorporating findings from this resource into discharge planning can ensure the continuity of infection prevention practices beyond the hospital setting. Thus impacting patient safety and improving the quality of healthcare.

Oliveira, M. de C., Dalcól, C., de Carvalho, R. E. F. L., & Poveda, V. de B. (2023). Patient participation in surgical site infection prevention: Perceptions of nurses, physicians and patients. Revista Da Escola de Enfermagem Da USP, 57, e20220459. https://doi.org/10.1590/1980-220X-REEUSP-2022-0459en

This study investigates the perceptions of nurses, physicians, and patients regarding patient participation in surgical site infection (SSI) prevention. Through qualitative research, the study explores the roles and perspectives of each stakeholder, highlighting the importance of patient engagement in reducing infection risks. The authors discuss various factors influencing patient participation, including communication, education, and empowerment strategies. Nurses can use the findings from the study to advocate for increased patient involvement in infection prevention activities, such as preoperative education on hygiene practices and postoperative wound care. This resource is most valuable for our patient, Mr. John, as knowledge about these practices would have prevented the incident of SSI. Additionally, nurses can incorporate patient-centered approaches into their practice, such as encouraging patients to ask questions, voice concerns, and actively participate in decision-making processes related to SSI prevention. By fostering a patient-centered care and partnership culture, nurses can empower patients to play a more active role in their healthcare, reduce SSI rates, and improve patient safety at PRCH.

References

Croke, L. (2020). Fostering patient engagement can aid in infection prevention efforts. AORN Journal, 111(5). https://doi.org/10.1002/aorn.13049

Capella 4020 Assessment 4

Donskey, C. J. (2023). Empowering patients to prevent healthcare-associated infections. American Journal of Infection Control, 51(11, Supplement), A107–A113. https://doi.org/10.1016/j.ajic.2023.03.008Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies to prevent healthcare-associated infections: A narrative overview. Risk Management and Healthcare Policy, 13, 1765–1780. https://doi.org/10.2147/RMHP.S269315