Role Of Surface Environment In Healthcare

Question: Discuss about the Role Of Surface Environment In Healthcare. Answer: Project Aim The aim of the project is to prevent increasing incidence of HAI in the healthcare setting with the help of key strategies emerging from literature. The project would be significant in reducing healthcare costs associated with HAI as well as the burden of morbidity and mortality related to the issue. With the reduction of HAI rate within the care setting health care professionals would be better able to achieve desired health outcomes for the patients within the care setting. Relevance of clinical governance to the topic The National Safety and Quality Health Service Standards (NSQHS) 2012 provide a nationally uniform and consistent set of measures of quality and safety that are to be applied across healthcare service settings. These standards are known for proposing evidence-based improvement strategies for dealing with gaps between best practice outcomes and current practice outcomes affecting patients across communities. The Standard 3 of NSQHS relates to prevention and control of healthcare associated infections. As per the standard, clinical leaders and senior managers working in healthcare settings are to implement systems for preventing and managing healthcare associated infections. These strategies are to be communicated to the entire workforce for achieving proper outcomes. The standard has the underlying principle of preventing patients from acquiring infections that are preventable in the first place. Research indicates that HAI can be effectively managed when evidence-based strategies are applied. For adhering to the above mentioned standard, effective governance and management system are to be maintained. Governance requires the managers to implement strategies and undertake proper surveillance of rate of HAI incidents. The actions in relevance to clinical governance that are to be undertaken are multidimensional. A risk management approach is to be undertaken while implementing procedures, policies and protocols. Further, there is a need of monitoring the implemented protocols, procedures and policies in a regular manner. The efficiency of infection prevention and control systems has to be reviewed at the highest level of governance in a regular manner. Surveillance is crucial for the entire care setting, and the data generated from the surveillance are to be monitored by committees who are delegated and accountable for overseeing the functioning of the care setting. Governance is also required in developing processes and systems for reporting, analysing and investigating re ports of HAI that align with the risk management strategy of the organisation. Compliance with change is crucial for being monitored, and effectiveness of changes to practice are also to be valuated with the help of suitable clinical governance (.safetyandquality.gov.au 2012). Evidence that the issue is worth solving Healthcare associated infections (HAI), also known as nosocomial infections, are those infections that are acquired by patients admitted to a healthcare setting for receiving any form of treatment. Such infection, which are preventable, include surgical site infections, catheter-associated urinary tract infections, central line-associated bloodstream infections, and ventilator-associated pneumonia. HAI has been found to occur in almost al kinds of care settings such as acute care hospitals, outpatient care, long-term care facilities and ambulatory surgical settings (Sievert et al. 2013). According to Loveday et al. (2014), infectious organisms change their characteristics rapidly over time, and this leads to major challenges for infection control and management within healthcare settings. Of major concern is the transmission of bacteria which are resistant to antibacterial agents, such as Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). Challenges also emerge while combating diseases caused by Clostridium difficile and multi-resistant Gram-negative bacteria such as those producing extended-spectrum beta-lactamases (ESBLs) or carbapenemases. As opined by Pfaller et al. (2017) Australian healthcare settings are always in demand to provide accurate and best quality care services to patients who present evolving needs. Due to the rising patient population and drastic variations in comorbidities, large patient numbers receive treatment in close proximity to each other. Patients undergo invasive procedures, get medical devices placed within the body and are administered broad-spectrum antibiotics. In addition, they are also administred immunosuppressive therapies. Such conditions lead to suitable opportunities for the spread and organisms that are infectious and pathogenic. Every year, such infection occurs in a considerable section of the total patient population and HAI is thus the most common complication that affects patients within care settings. Though some progress has been achieved in controlling the incident rate of HAI, much is still to be done. One in twenty-five hospital patients suffers from HAI at any given day of the year in Australia. About 165,000 Australians contract infections in hospitals in Australia every year. Apart from the concern of patient due to infections, issues arise in relation to increase use of health services like extended hospital stay length and reduced access to care provision. Greater demands are placed on the healthcare workforce to address the needs of the patients adequately. Studies conducted oversees and in Australia indicate that mechanisms are there which can be implemented for reducing the rate of infection in care settings. It is also to be mentioned that Australia does not have a national system for monitoring HAI and thus an exact data on the burden of hospital-acquired HAIs is not possible to be gained (Slimings et al. 2014). Key stakeholders Stakeholders are the individuals who have a role in bringing about the proposed change and are directly or indirectly impacted by the change. For the present case, the key stakeholders who would have an active involvement in the change to be brought about are registered nurses, clinicians, patients, family members, health care managers, supervisors, healthcare leaders, advisory board, and funding body. Registered nurses draw most of the attention in this regard since the strategies that are to be implemented rely on the practices of these professionals for their success outcomes. The patient population have a direct association as a project since their health condition and wellbeing would be changing for the betterment. It is to be expected that with the project in practice, patients would be able to combat the risks of suffering HAI in the long term. Successively, there would be a positive impact on the family members as well. The funding body would be allocating the required resources, they play an active role in this context. The clinicians are accountable for the clinical outcomes of the patients, and thus their input is valuable (Lewis et al. 2017). It would be pivotal to communicate the necessary information about the project in a timely manner. Any issues arising in due course are to be discussed and effective resolution are to be achieved (Swan et al. 2016). CPI Tool The Clinical Practice Improvement project would fundamentally differ from research in that the project would include changes in the form of interventions delivered, adoption of new strategies and role changes among professionals. The underlying principle would be to apply research into practice (Taylor et al. 2016). The CPI project aiming at making positive and praiseworthy changes in the processes of preventing HAI for enabling effective outcomes would make the use of the Plan-Do-Study-Act (PDSA) model. The PDSA model, or tool, has been widely accepted as a proper rapid cycle improvement tool. The unique feature of the model is that it is cyclic in nature in impacting and assessing changes. The purpose of using this tool is to establish a causal or functional relationship between changes and outcomes (Chartier et al. 2017)). In the first stage of planning, a detailed and accurate evidence-based planning is to be done. Changes are to be brought about based on this planned guideline outlined. The next step involves implementing the set strategies into practice. This is to be done with the help of the concerned stakeholders within the care setting. It is to be ensured that all members of the organisation are communicated with the necessary information about the impact of the change on them. Successively, the change that is to be brought about is to be analysed, reviewed and documented. It is necessary to compare different sets of data collected through appropriate data collection methods against relevant estimates. Further, necessary actions are to be taken based on the information gathered about the progress of the project. If the goals are met, then actions are to be taken accordingly. The plan can be endorsed, and further actions can be taken for renewing it. Modifications can be brought about eventually is required to suit the needs in future. The PDSA cycle would thereby act as the plan of excellence for addressing the selected clinical challenge (Reed and Card 2016). Summary of proposed intervention Jackson et al. (2012) had highlighted that behaviour of nurses is crucial in preventing HAIs across settings. Clinical staffs, including the nurses, are to demonstrate maximum adherence with the guidelines set in place for upholding the protection of safety of the patients. Research further points out that a lack of understanding about HAI among professionals leads to the high rate of the same.For this rationale, it would be necessary to enhance the level of knowledge the individuals have. This would be done through the dissemination of information booklets within the setting at all levels of employees (Polin, Denson and Brady 2012). According to Weber et al. (2013), maintenance of hygiene within the care setting is of utmost importance for reducing HAI rate. The setting would need to initiate practices of maintaining hygiene by using effective infection control agents such as disinfectants and sanitisers. Further, two most crucial practices would be adequate hand sanitisation and use of personal protective equipment (Carling 2013). Assistance would be provided to ensure that nurses and other professionals use hand sanitisers in a more frequent manner, especially before coming in contact with a patient and after finishing caring for the same individual. The care setting would have adequate provision for personal protective equipment such as gloves, aprons, masks. Anderson et al. (2012) brought into limelight the fact that use of such equipment helps in preventing spreading of infectious agents among individuals to a considerable extent. The next step would be to implement the No Touch method of surface disinfection. The respective wards of the care setting would be made disinfected through Ultra-Violet rays and hydrogen peroxides, whichever suitable and available. These are known to have bactericidal effects. In this regard Moore, Muzslay and Wilson (2013) stated that the mentioned method is more effective than those methods that involve touching the surface for disinfecting it. Barriers Lack of motivation of and encouragement might pose as major barriers in implementing the outlined strategies (Leis and Shojania 2016). Professionals have been found to lack self-motivation in changing the process of care delivery, and thus it would be crucial to understanding their concerns for addressing them. Different motivational factors are to be drawn in to guide the workers in a positive direction. Readiness from the managers of the organisation might also be a barrier to the implementation of change. There might be lack of eagerness to support the changes. Additionally, their responses might be negative under certain circumstances. Lack of funds and availability of resources might be the other barriers to implementing change. Sustainability of the change also depends on the mentioned factors. In shortage of resources and funds, there might be a gap generated in the flow of adherence to change (Guintlo et al. 2016). Lastly, cultural barriers are noteworthy then individuals form diverse background work in collaboration with each other. Nurses might be showcasing resistance to the new strategies since they might be against their cultural preferences (Foley and Vale 2017). Evaluation of project The project aims at preventing and controlling HAI within the care setting in an effective manner. The outcomes of this would be measured through rate of incidence of HAI among different wards. Data would be collected over a period of six months. Subsequently, the data would be compared with the previously collected data on the rate of HAI prior to implementation of change. The evaluation would be done with the help of health information records, questionnaires and group discussions (). The process needs to be revised as per the requirement. If predicted results of the project are not attained, then the project would be considered for re-implementation with aligned modifications. This can be considered six months after the implementation of the program. Professional education and training would be required at the fundamental level for propagating a suitable understanding of the need of the project. The quality improvement project would be a continuing process, wherein leadership woul d support the recognized organization to its true potential. Reference Anderson, O., Brodie, A., Vincent, C.A. and Hanna, G.B., 2012. 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