Custom «Reducing Healthcare Associated Infections in Intensive Care Units» Sample Essay
Table of Contents
Preventing patients’ harms refers to the national challenges in delivering quality health care. Intensive care unit (ICU) is the health care setting where complications appear to be a significant barrier in overcoming patients’critical health care status. They increase mortality rates and lead to prolonged and costly rehabilitation. Healthcare associated infections (HAIs) are often treated independently that results in unexpected complications with which the unit staff is not always able to cope. The paper reveals how the implementation of changes and evidence-based systematic recommendations as well as improving skills of nursing staff contributes to reducing infections in the ICUs.
The Problem Description
Intensive care unit refers to medical departments where the proper functioning of all the elements of the system is crucial. Harms to patients are one of the most critical issues that contributes to the system errors. The report by Tropello, Ravitz, Romig, Pronovost, and Sapirstein (2013) indicates that the problem of the numerous harms like infections, pressure ulcers, ventilator-related pneumonia, delirium, and thromboembolism takes place while addressing them independently. Alongside, multiple healthcare associated infections following the complications are the common dangerous issues patients may face in the ICUs (Pronovost & Bo-Linn, 2012). The focus on preventing separate harms while omitting the possibility of infections has to be shifted to the holistic health care management of critically ill patients. The difficulties in the integral monitoring and timely response relate to the evidence-based guidelines to prevent HAIs. Moreover, the preventive efforts highly rely on the commitment of the nursing staff the shortage and professional expertise of whom require revision.
Change to Address the Issue
To increase the safety of patients, there should be made changes in the quality, organization, and continuity of consistent preventive medical interventions. The advances concern increasing nursing skills, information technology, and unification of preventive guidelines. Pronovost and Bo-Linn (2012) revealed that technology itself is not able to resolve the problem. The system approach in the case means considering all the possible risks and managing them integrally. The health care professionals are to generate the holistic prevention approach following successful translational research programs of central line-associated bloodstream infections (Pronovost, Cardo, Goeschel, Berenholtz, Saint, & Jernigan, 2011). System engineering for idenfying and addressing all the possible infections can become the efficient solution (Tropello, Ravitz, Romig, Pronovost, & Sapirstein, 2013). The latter concerns translating the research evidence of the risks into information technology and nursing practice. Alongside, the permanent advances in the related skills and knowledge of healtcare professionnals should be encouraged. These activities are congruent with the organization’s mission.
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The Consistency with the Organization Guidelines
Adherence to patient safety is the core line of the health care continuum of community hospitals. Community hospitals’ mission implies delivering quality care in the safe and comfort environment and overcoming healthcare risks. Promotion of advances in the field is the part of the vision that reinforces the collaboration values thus contributing to the effective system functioning and patient satisfaction (Tropello, Ravitz, Romig, Pronovost, & Sapirstein, 2013). The standards of advanced nursing practice enable commitment to the values and efficient organization changes.
The scope of practice of critical care nurses includes differential diagnosis and plan of treatment that require excellence in practice and advance knowledge in critical health care. According to Scope and Standards for Acute and Critical Care Nursing (AACN, 2012), an acute care nurse practitioner (ACNP) is reponsible for generating the otcome-focused plan of treatment that can be modified in response to the conditions and environment. This means that advanced nurses are committed to reducing and preventing harms and pay a close attention to comorbidities. To achieve such goals, ACNPs maintain lifelong learning, initiate teaching and coaching, and promote efficient resource utilization applying innovative technologies (AACN, 2012). Consequently, the standards define the broad spectrum of opportunities to implement change.
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The seven-step change model of Lippitt serves the basis for implementing changes and involves shifting the system to the new quality of nursing processes. The theory appears to be the most appropriate and can be compared to the other additional stages like awareness and evaluation indicated by Rogers as well as unfreezing movement and refreezing change by Lewin (Marquis, & Huston, 2015, p. 171). In this case, the advanced nurses play the leading role in guiding the change process to the restraining objects like technology ans structural and human resources. The mentioned forces are regarded to be the primary barriers in delivering efficient critical care and reducing patient harms (Gershengorn, Kocher, & Factor, 2014; Sarti, 2014; Tropello, Ravitz, Romig, Pronovost, & Sapirstein, 2013).
The theory provides the detailed plan for overcoming these barriers in the nursing terms. In particular, the model includes evaluation, planning process, changes implementation and post-evaluation of outcomes that are essential in the advanced nursing practice (Mitchell, 2013). Consequently, while committing to the seven phases of the change management, a nurse practitioner has all the opportunities to suceeed.
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Implementing the Change
The change implementation consists of detecting the problem constraints, fulfilling changes as well as controlling them and their outcomes. To guide the process, the preliminary plan should be involved where points for the members’ initiatives should be left. Prevention system involves the exploration of the patient’s safety in the ICUs, its factors, and heath care associated risks. Sarti et al. (2014) consider the patient’s needs assessment to be the primary step in the safe care delivery and overcoming expertise errors. For these purposes, the case study of the unit functioning may be helpful. Involving the health care professionals of the unit and interviewing the patients in the process means making them aware of necessary changes to the system. These activities coincide with the assessment phases of Lippitt’s model. The nurse practitioner should possess a wide range of interdisciplinary skills to lead the technology and knowledge changes and generate the evidence-based plan and preventive guidelines. Developing the plan for enhancing the risk managment corresponds the fourth stage by Lippitt (Mitchell, 2013). Testing new technologies, organizing training sessions in systems engineering and infections control, as well as coaching in system thinking constitute the elements of the change implementation and maintenance. Finally, post-evaluation of the positive outcomes requires clinical audit and patient interviewing. On the way, the nurse practitioner as a change agent should reinforce the professional skills of the team.
Skills to Facilitate Change
Advanced nurses become leaders in the initiated changes that means mastership in the broad range of skills. They concern leadership skills in initiating changes and maintaining motivation in the team and advocating for patient’s satisfaction as a result of changes and technological competencies to argue for the efficiency of engineering advances. Alongside, the need for the mentioned skills may be compensated by technicians and the consulting team. The coaching and training staff are supposed to have excellent educating skills that clinicians and advanced nurses should develop. The plan is impossible to fulfiill without collaboration in the team. Communication skills and conflict management refers to another necessary domain of competencies that should be promoted among all members of the health care team (AACN, 2012)
Intensive care units play the dominant role in the provision of stability of the health care system. Meanwhile, health care associated infections constitute significant barriers to the safe and efficient functioning of the critical care system. Thus, it is necessary to including health care associated risk management in the system monitoring directed to reduce HAIs complications. To maintain the plan, translational research and technological advances to monitor and timely respond to risks should be implemented into practice. Specialized training and coaching in the healthcare team is another option of changes. The Lippitt’s model is found to be the most appropriate for the nurse practitioner to succeed with the change plan. It provides the detailed framework for the evaluation, promotion, and maintenance of advances that contribute to patient safety and team collaboration.
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