Reducing Hospital associated Infections
The surgical care of the patient involves invasive procedures which increase the risk of infection spread from patient to patient due. Nurses have the responsibility as the primary patient custodians to promote positive patient outcomes through the application of evidence-based practice to achieve a positive patient outcome. The use of chlorhexidine antiseptic bathing by patients pre-operatively is one of the evidence-based practices that can be effectively utilized to prevent the risk of HAIs to patients prior to undergoing surgical interventions (Webster & Osborne, 2015). This assignment will expound on a nursing-focused plan for the implementation of chlorhexidine bathing for preoperative patients in the medical-surgical unit to reduce the incidence of HAIs postoperatively using the ACE Star Model Evidence-Based Practice Process. The plan will focus on first providing evidence of a need for change incorporating data and statistics as well as evidence from previous practice experiences and research.
The microorganisms can be microorganism that colonizes the patient's skin preoperatively or can be acquired post-operatively due to unhygienic patient care procedures and interventions. The Center for disease control (CDC), indicates that there is at least one nosocomial infection occurring for every 25 patients admitted in hospital daily in the USA (CDC, 2016). The burden of nosocomial infections in the USA was reported by CDC to be 722,000 patients with over 75,000 patients dying due to nosocomial infections (CDC, 2016). The surgical site infections contributed 157,500 nosocomial infections which were the highest source of nosocomial infections in the USA healthcare. The challenge of nosocomial infections cuts across other peer nations with Australia reporting over 165,000 nosocomial infections every year. The nursing director will link the change implementation team lead (me) to the hospital management to establish buy-in of the change within the hospital as well as contribute to establishing a formal adoption of the change into the hospital's standard operational procedures.
The epidemiologist will be essential in providing technical support on the modality through the implementation plan as well as helping to manage the statistics to evaluate the effectiveness of the intervention. The team will also incorporate 3 selected surgical department nursing staff members who will be trained on the process and act as mentors and champions within the ward to provide on-job-training for other nurses and champion the implementation of the change. The pharmacist will be incorporated into the team to provide a supply of the chlorhexidine as well as provide a financial perspective of the intervention using chlorhexidine. The multidisciplinary team will ensure that the implementation of the change is first taken up by all members of the patient care teams and owned by the department staff members.
These findings indicate significant effectiveness of the chlorhexidine bathing, Noto et al. , (2015), supported the findings from Climo et al. , (2013) and Swan et al. (2016), with her study indicating an even higher percentage in reduction of HAIs with a 56% infection reduction in patients bathed with the chlorhexidine. Frost et al. Once there is a buy-in by the hospital management on the intervention the change will be rolled out in the department as a pilot to assess its workings. Three staff nurses will be chosen by the unit in charge nurse and they will be trained by the team comprising of the pharmacist, epidemiologist and I on the new approach. They will then be required to implement the change in the ward with supervision from the in-charge nurse as well as mentor other nurses in the unit on implementing the change.
The data on all HIAs occurring from the period of introduction of the intervention will be collected and analyzed by the epidemiologist and recorded. Process, Outcomes Evaluation, and Reporting The desired outcomes will be to have at least a 30% reduction in the rate of HAIs in the first half of the year of implementation. The introduction of antiseptic baths as an intervention to curb post-operative HAIs is essential to ensure positive patient outcomes and prevent infections. The ACE star change model provides a systematic process through the identification of scientific evidence, summation of the evidence and the translation and integration of such evidence to practice. The model offers a valid and stepwise process through which change process can be managed in the health care system effectively avoiding the negative implications of change within an interprofessional space.
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