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Nursing Final Paper


Healthcare associated infections (HCAIs) are the type of infections acquired in the settings where people receive health care. These acquired infections pose a major hurdle to the healthcare institutions. These infections cause significant patient deaths, illnesses morbidity, and financial expenses. Some of the infections are preventable. They determine patient care and patient safety level. Decrease in the healthcare associated infection occurrences is achievable via efficient infection prevention and control within healthcare facilities such as hospitals. These undesirable outcomes are surgical complications, nosocomial infections and adverse drug events. The actual incidences of these diseases may be under-approximated because the pathogen incubation period may be longer than the admission duration in the hospitals. A notable example is that of surgical location infections, which are, usually, detected after patients' discharge from the healthcare facilities. These surgical site infections are more evident 21 days after operation.

The infections' transmission means among the medical practitioners and the patients are making contact that may be direct or indirect, airborne, vectors such as fleas and respiratory droplets. There are approaches for deterrence of healthcare associated infections. These methods include appropriate use of defensive gears such as masks, hand hygiene, aseptic technique and environmental infection control means (Camins, 2010).

Change in Behavior and Organizational Culture

Prevention of healthcare-associated infections behaviors determines an organization's performance. The sum of the organization's behavior aids in the definition of its culture. Collaboration among healthcare workers, such as nurses and administrators, through proper teamwork, safety and communication models are crucial ingredients in an effort to improve safe and reliable healthcare services. Development of the above strategies and simultaneous implementation creates a stable framework for practical implementation of better technologies and methods of prevention. Health care providers are well equipped with information on infection prevention. However, adherence to these measures may be questionable. Non-adherence reasons, mostly provided by the caregivers range from time constraints, presumptions that the patients are uninfected and inconvenient. The higher is the rate of compliance to these guidelines, the lower are the incidences of healthcare associated infections. The caregivers' behavioral change has a tremendous impact on reducing the rate of infections.

However, relying purely on the health care providers' knowledge and assumptions are not sufficient if the guidelines have to be translated to the clinical practice. Organizational changes and interventions are crucial in an attempt to understand the barriers of the correct translation of the standard guidelines and policies into day to day clinical practices (Tsai, 2011). The standards of practice should be duration specific, measurable, and the number of the affected patients should be defined. Organizational implementation of the evidence-based guidelines should improve the current operating procedures. Planning of multi-sectoral intervention is necessary in order to ensure that the staff is in agreement with the proposed changes and concurrence that the new approaches are significant. The organization should ensure that there is sufficient staffing, resources and knowledge required for proper and efficient implementation of the prevention changes. Development of the results evaluation is also necessary. The full commitment of all the stakeholders of the healthcare facilities from the top administration to all staff is vital in the implementation of the best clinical practices.

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Teamwork and Accountability

Healthcare organizations that support and promote the partnership culture can develop effective Infection Prevention Control measures. Teamwork coupled with proper leadership, adaptability and support results in excellent organization performance. There is a method of developing multi-departmental clinical teams trying to prevent the infections occurrence. These clinical teams are crucial in effecting changes in the organizations. Staff working in teams has a higher significance for decreasing the rates of the patient mortality and morbidity. A multidisciplinary approach aimed at improving antibiotic prescription remarkably decreased inappropriate prescriptions, thus leading to a decrease in extended spectrum beta-lactamase producing Enterobacteriaceae infections (Aboelela, 2011).

After development of the standards, all the healthcare facilities should identify the person who will bear the task of responsibility and accountability in leading standard’s implementation. The identified person should be able to monitor and report performance progress regularly. Cooperation among different management systems is reliable for effective Infection Prevention Control, which is subsequently influenced by the organizational culture. Every level of service delivery from top administration to junior care giving should work in a team and be accountable. Trust and teamwork improve cohesion and promote performance in the healthcare sector because every level's effort becomes one large integrated development of progress in the service delivery. Success occurs if every employee at all service levels fulfill their duties in the prevention and execute it according to the established guidelines. Employee responsibility and accountability are crucial in the prevention of infections.

Leadership Roles

Effective and strong leadership, especially the very top of healthcare organization is considered crucial in ensuring that there is an achievement of success in the prevention of healthcare associated infections. Healthcare facilities whose leaders exhibited a full commitment towards the fight against healthcare associated infections are less likely to have barriers for prevention of infections implementation (Horan, 2010). Leaders must be able to claim full ownership of the initiatives aimed at preventing the health associated infections, so that the junior employees can follow suit. Successful leaders advocating infection control should develop an excellent clinical culture and be able to communicate effectively with other employees. They should be able to overpower the resistance experienced from staff or other challenges in the organization. Leaders who are perceived to be the role models to other staff and can inspire them to have a better chance of developing more initiatives.

Strategic thinking that includes teamwork coalition and the use of personal reputation in transmitting ideas and supporting them is important in leading prevention efforts. The leaders tasked with the role of setting priorities and communicating them to the other staff influence performance of infections prevention at every level of the organization. Leaders should ensure their staffs with job satisfaction. There is a positive correlation between compliance with infection prevention, control and positive job satisfaction. Contrary, low job satisfaction is positively related to the undesirable outcomes such as mortality, morbidity. Therefore, the leaders should possess excellent collaborative skills. Moreover, they should take full ownership of the initiatives aimed at preventing the healthcare associated infections, so as the other members of the staff can follow their leaders' path. Effective and committed leadership is very vital in ensuring that the initiatives are achieved.

Communication Skills

Effective communication is central to achieving any initiatives developed in the organizations. Insulation of the healthcare sector has been considered as a major hindrance towards healthcare quality improvement. The presence of an efficient and reliable communication culture in a healthcare organization is vital. It creates proper awareness about the transmission means, the risks imposed by diseases and the prevention channels crucial in curbing the transmission of the healthcare associated infections (W.H.O. 2005).

Excellent communication skills are crucial at all healthcare service delivery levels, from the top management to the junior care givers and between hospital workers. Without effective communication in the hospitals, most sectors will face the decline. To encourage other staff to embrace the infection prevention protocols, effective communication leading to mutual understanding is a sure way to success. Additionally, good communication within different organizations ensures proper understanding of the practical strategies within hospitals subsequently leading to the increased performance levels.

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Actions to Change an Outcome

From the video, Kelly McTavish is a patient family member. Kelly, whose father is in the health care facility should also be aware of the health care related infections. Kelly was not informed. She should have considered the importance of proper hand washing which is important in reducing the spread of body substance contamination such as fecal matter and respiratory secretions to other surfaces. Another character is Dena Gray, who is a registered nurse, should have made more effort in communicating with co-workers and patients. If Dena had communicated effectively, she could have prevented the transmission of infection in the hospital.

Nathan Green is the director of the Post-operation department. He wants to commence new methods of infections prevention. Nathan should be ready for changes that are behavioral and unit culture change so as to be able to implement the new approaches aimed at disease prevention. Another character is Janice Upshaw, who is in charge of infection prevention. Janice aims at reducing infections using team-based approach. Janice should incorporate the idea of teamwork and accountability at all levels of the service delivery in an effort to achieve her goals, namely reduction of diseases. Manuel Hernandez, who is a Medical Student, is tasked with confidence in the service delivery. Manuel Hernandez needs to gain confidence in order to make a difference for his patients. Manuel should learn to be more adaptable and should be more flexible and embrace change in his duty. He should exhume confidence so as to gain respect and confidence of the patients (Tsai, 2011).

Change makes individuals leave their comfort zones, and it may be unpleasant. Manuel experiences a difficulty in integrating habits resulting from previous training and the daily workflow in the medical practice. Manuel is impatient to implement the new evidence-based practices as they provide information about infection control, resources required and quidelines how to apply them. Feedback of the approaches is also crucial for data comparison within and without the hospital setup. The decision on the best method is made possible through the feedback received.