NURS6650 - Written Prevention and Control Campaign Assessment 3 Answer

Introduction

Healthcare-acquired infections (HAIs) are infections that occur when a person is undergoing treatment for another illness (Adhikari et al., 2019). HAIs may take place in any type of healthcare facility, including hospitals, ambulatory surgery centers, end-of-life care facilities, and long-term care facilities (Giraldi et al., 2019). It poses a critical threat to patient safety and healthcare quality worldwide. Despite extensive infection prevention and control methods, HAIs continue to bother patients, causing unnecessary suffering and imposing a costly strain on healthcare systems (Giraldi et al., 2019). In response to this essential issue, a comprehensive program called the "Guardian Care Initiative” is introduced in this study which focuses on reducing the incidence of hospital-acquired infections within healthcare settings. This initiative acknowledges an essential fact that preventing HAIs necessitates a multidimensional approach incorporating all aspects of patient care, from the moment a patient enters a healthcare facility to his discharge (Haque et al., 2019). The initiative aims to significantly reduce HAIs by implementing evidence-based measures, establishing an infection prevention culture, and maintaining the highest hygiene standards. It can be said that the campaign represents a commitment to patients' well-being and signifies a pledge to provide healthcare that is safe, effective, and free from avoidable harm.

Context and Target Audience

Within the context of the Guardian Care Initiative, several factors significantly influence the campaign's design and implementation. This section will discuss the clinical context, patient/client mix and acuity, staffing mix and levels, and the characteristics of the target audience.

Clinical Context : The infection prevention campaign takes place in the fictitious healthcare setting of "Bayside General Hospital," a bustling 300-bed acute care facility. This clinical context is characterized by a constant influx of patients with a wide range of medical conditions, making it a dynamic and challenging environment for infection prevention and control (Adhikari et al., 2019). With a constant stream of patients seeking care for a wide range of medical conditions, Bayside General Hospital poses unique challenges and opportunities. The size as well as intricacy of this hospital setting necessitate a comprehensive and adaptable approach to infection control.

Patient/Client Mix and Acuity : At Bayside General Hospital, the patient/client mix is a tapestry of diversity, encompassing individuals across all age groups, from pediatric patients (0-18 years) to geriatric patients (above 65 years). Within this demographic mix, patients exhibit varying acuity levels, with some facing life-threatening conditions necessitating intensive care, while others seek treatment for less severe medical issues. The GuardianCare Initiative will only be successful if this diversity is acknowledged and accommodated. A high degree of adaptability and a patient-centric strategy will be required for infection prevention measures so as to address the unique needs, vulnerabilities, as well as healthcare journeys of every individual receiving a hospital's care (WHO, 2023).

Staffing Mix and Levels : The hospital employs a multidisciplinary team, which consists of medical professionals, nurses, administrative workers, and support staff. Staffing levels fluctuate in response to shifts and patient admissions, thereby impacting the capacity to uphold infection prevention protocols consistently (CDC, 2019). Maintaining adequate staffing levels and ensuring that all staff members are well-trained in infection prevention practices will be essential for the success of the campaign (CDC, 2019).

Characteristics of the Target Audience : The GuardianCare Initiative's target audience extends beyond healthcare providers to include patients and their families. Understanding the socio-economic backgrounds, educational levels, and cultural diversity of these audiences is indispensable. It is crucial to develop communication plans and educational materials that respond to these diverse characteristics (CDC, 2019). Adequate information on infection prevention must be effectively communicated like conducting workshops and providing visual aids to bridge potential gaps in health literacy and cultural understanding.

Justification

The GuardianCare Initiative is substantiated by a wealth of de-identified data, combined with a robust body of literature, highlighting the pressing need for a comprehensive infection prevention and control campaign.

By analyzing the clinical indicators associated with infection prevention control in different healthcare institutions, it is understood that there is a high demand for an effective infection prevention campaign that focuses on reducing the incidence of hospital-acquired infections within Bayside General Hospital efficiently while complying with meeting unique needs of the patient and respecting their cultural diversity. A notable surge of HAIs is observed in healthcare institutions in Australia with a specific emphasis on categories such as surgical site infections (SSIs) and catheter-associated urinary tract infections (CAUTIs) (Mitra et al., 2021). The doubling of SSIs after major surgical procedures constitutes a major reason for concern, as it has resulted in severe difficulties for patients with increased patient morbidity, prolonged hospital stays, and an unpleasant increase in healthcare costs (Seidelman & Anderson, 2021). These alarming trends highlight a large void in the past infection prevention strategies, prompting the immediate launch of the GuardianCare Initiative.

While incorporating the de-identified data to justify the launch of this campaign, it is acknowledged that the audit results conducted by our quality improvement team have further endorsed its necessity. The results of the audit exposed vulnerabilities in Bayside General Hospital like poor hand hygiene compliance among healthcare providers, poor environmental cleaning, as well as deviations from central line-associated bloodstream infection (CLABSI) prevention guidelines (Appendix B). These data underscore the susceptibility of the patient population to preventable infections, emphasizing the urgency of intervention. Moreover, a survey was also conducted among the healthcare providers of Bayside General Hospital in Australia to gain accurate results. The survey encompassed questions regarding infection prevention knowledge, awareness of recent HAIs, and perceptions of current infection control measures (Appendix A). Particularly, 78% of respondents were concerned about the rising trend of HAIs, and 92% agreed that better infection prevention techniques were required. These survey findings reflect the intensity of the situation, affirming the critical need for the GuardianCare Initiative.

The GuardianCare Initiative's explanation is backed up by an extensive body of literature on infection prevention in healthcare settings. Published studies like Mitra et al., (2021) Alrebish et al., (2023) emphasize the dire consequences of hospital-acquired infections (HAIs), including surgical site infections (SSIs) and catheter-associated urinary tract infections (CAUTIs). These adverse effects impose greater patient morbidity, longer hospital stays, and significant financial pressures on healthcare systems (Despotovic et al., 2020). The GuardianCare Initiative's objectives to reduce HAIs align perfectly with established literature's focus on the critical need for comprehensive prevention strategies (Fernando et al., 2017). By drawing on this evidence, the campaign is well-positioned to address the pressing issue of HAIs effectively.

Campaign SMART Goals

SMART Goal 1 : To reduce Surgical Site Infections (SSIs) up to 75% within 12 months through the rigorous implementation of evidence-based prevention protocols for improving patient safety, healthcare quality, and financial efficiency. The evidence-based surgical site infection prevention protocols will include strict adherence to aseptic techniques during surgery, pre-operative antibiotics in accordance with guidelines, and comprehensive post-operative wound care (Seidelman & Anderson, 2021).

SMART Goal 2 : To achieve a 65% reduction in Catheter-Associated Urinary Tract Infections (CAUTIs) within 18-22 months by implementing best practices in catheter care and continuous monitoring. This includes using aseptic techniques during catheter insertion, regular catheter maintenance, as well as timely removal when no longer required (Mota, & Oliveira, 2019). Continuous monitoring will include routine examinations, rapid detection of catheter-associated issues, and regular staff training to ensure compliance with catheter management procedures (Bearman et al., 2019). This goal enhances patient comfort, reduces healthcare expenses, and aligns with a commitment to safety and effectiveness (Bearman et al., 2019).

Campaign Structure

The GuardianCare Initiative adopts a structured approach to effectively address the reduction of hospital-acquired infections (HAIs), specifically surgical site infections (SSIs) and catheter-associated urinary tract infections (CAUTIs).

Phase 1: Formation of team

In this phase, the formation of a cross-disciplinary team will be conducted. A team comprised of infection control specialists, nurses, physicians, and the maintenance staffs will be assembled. A comprehensive review will be explored based on the evidence-based infection prevention protocols, including those for SSIs and CAUTIs (Haque et al., 2019).

Phase 2: Education and Training

In this phase, all the team members will be provided with training sessions on infection prevention, emphasizing aseptic techniques, proper catheter care, and hand hygiene (WHO, 2018). The educational materials like relevant videos, posters, and pamphlets will be distributed among the team to reinforce infection prevention practices (CDC, 2017).

Phase 3: Implementation

Under this stage, evidence-based strategies for infection prevention like strict adherence to aseptic techniques during surgery, pre-operative antibiotics in accordance with guidelines, using aseptic techniques during catheter insertion and regular catheter maintenance will be implemented so as to prevent the spread of infection in hospital settings (Mota, & Oliveira, 2019). Continuous monitoring of infection rates will be initiated with compliance with protocols along with feedback will be collected both from the patient as well as the team members so as to identify areas for improvement (Fernando et al., 2017).

Phase 4: Evaluation and Adjustment

In this stage, the pre- and post-infection data will be analyzed and compared in order to understand the effectiveness of infection control campaign implementation in reducing SSIs and CAUTIs (Despotovic et al., 2020). Based on the data analysis, some necessary adjustments will be made to the protocols and training programs for further improvement.

Phase 5: Ongoing Maintenance and Sustainability

The last step will include a long-term sustainability plan development so as to ensure ongoing adherence to infection prevention practices. Moreover, continuous education will be provided to the staff by conducting training workshops along with integrating the infection prevention campaign strategies into the hospital's culture (Fernando et al., 2017).

Evidence-Based Content of Campaign

In order to combat the decline in hospital-acquired infections (HAIs), particularly surgical site infections (SSIs) and catheter-associated urinary tract infections (CAUTIs), the GuardianCare Initiative is supported by a solid foundation of evidence-based information. The focus of evidence-based SSI content is on recognized practices for aseptic surgical procedures. Extensive research has demonstrated that strict adherence to these protocols significantly reduces the risk of SSIs (Seidelman & Anderson, 2021) (Bearman et al., 2019). This infection prevention campaign places a strong emphasis on extensive staff training regarding sterile procedures, the usage of suitable pre-operative antibiotics, maintaining normothermia, and appropriate wound care following surgery (Despotovic et al., 2020) (Fernando et al., 2017).

On the other hand, optimizing catheter management procedures is the emphasis of evidence-based content for CAUTIs (Mota, & Oliveira, 2019). The importance of using the right techniques for catheter insertion, keeping them clean, and removing them on schedule when they are no longer required medically is highly essential so as to prevent infection spread in healthcare facility (Mota, & Oliveira, 2019) (Despotovic et al., 2020). The GuardianCare Initiative promotes aseptic catheter insertion, regular maintenance of catheter, and reliable monitoring systems. These protocols are firmly rooted in guidelines published by organizations such as the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) (CDC, 2017) (WHO, 2023). By implementing these evidence-based practices, the campaign is committed to reducing HAIs, enhancing patient safety, along with improving healthcare outcomes in line with the best available knowledge and guidelines in the field.

This visual timeline serves as a roadmap, guiding the campaign's progression and ensuring that activities are conducted in a logical sequence.

Timeline

A table has been presented that outlines the campaigns sequential phases as well as their respective timeframes

Campaign Phase	1-2 months	2-4 months	4-6 months	6-8 month	8-10 months	10-12 month	12-14 month	14-16 month	16-18 month
Preparation
Education and Training
Implementation
Evaluation and Adjustment
Ongoing Maintenance

 

Table.1: Timeline of Campaign

This visual timeline serves as a roadmap, guiding the campaign's progression and ensuring that activities are conducted in a logical sequence.

Evaluation Measures

A multifaceted evaluation approach has been developed to determine how well the GuardianCare Initiative is performing in relation to accomplishing its SMART objectives. This strategy supports the campaign's goals of reducing catheter-associated urinary tract infections (CAUTIs) and surgical site infections (SSIs). For SMART Goal 1, one of the primary evaluation measures comprises continuous monitoring of surgical site infection (SSI) rates in major surgeries. Tracking the prevalence of SSIs both before and after the GuardianCare Initiative's deployment is part of this approach. By comparing pre-campaign and post-campaign data, it can be possible to quantitatively assess the effectiveness of our infection prevention protocols in reducing SSIs (WHO, 2023; CDC, 2019).

 In addition, with an aim to ensure that the surgical teams strictly follow evidence-based guidelines, periodic audits will be conducted. These audits will measure how well healthcare providers adhere to recognized SSI prevention strategies (Mitra et al., 2021). Any violations from these protocols will be quickly identified and corrected, increasing the effectiveness of our activities as a whole. Moreover, the evaluation strategy will also comprise of analysis of patient outcomes and collecting of their feedback so as to gauge the impact of SSIs on patient well-being (Mitra et al., 2021). This involves evaluating post-operative complications and the length of hospital stays in relation to SSIs.

Apart from this, for SMART Goal 2, the incidence rates of catheter-associated urinary tract infections (CAUTIs) are continuously monitored throughout the campaign period. This ongoing tracking will help to assess the effectiveness of the infection prevention campaign in real-time, enabling to make immediate adjustments when necessary (CDC, 2019). The evaluation measures must also include routine audits of catheter insertion, maintenance, and removal processes. These audits will assist the team members in figuring out whether healthcare providers are adhering to the recommended standards for catheter care, spotting any flaws, as well as implementing corrective measures to minimize CAUTIs (Mota, & Oliveira, 2019). In addition, in order to gain valuable insights into the patient experience, the GuardianCare Initiative will collect feedback through patient satisfaction surveys. By comprehending the patient perspective, the campaign aims to facilitate patient-centered improvements in catheter management practices (CDC, 2019).

References

Adhikari, B., Lewis, B., Vullikanti, A., Jiménez, J. M., & Prakash, B. A. (2019). Fast and near-optimal monitoring for healthcare acquired infection outbreaks. PLOS Computational Biology, 15(9),. https://doi.org/10.1371/journal.pcbi.1007284

Alrebish, S. A., Yusufoglu, H. S., Alotibi, R. F., Abdulkhalik, N. S., Ahmed, N. J., & Khan, A. H. (2022, December). Epidemiology of healthcare-associated infections and adherence to the HAI prevention strategies. In healthcare, MDPI, 11, 1, 63. https://doi.org/10.3390/healthcare11010063

Bearman, G., Doll, M., Cooper, K., & Stevens, M. P. (2019). Hospital infection prevention: how much can we prevent and how hard should we try? Current Infectious Disease Reports , 21, 1-7. https://doi.org/10.1007/s11908-019-0660-2

Centers for Disease Control and Prevention (CDC) (2017). Catheter-associated Urinary Tract Infection. https://www.cdc.gov/hai/ca_uti/uti.html

Centers for Disease Control and Prevention (CDC) (2019). Best Practices for Environmental Cleaning in Healthcare Facilities: in Resource-Limited Settings. https://www.cdc.gov/hai/pdfs/resource-limited/environmental-cleaning-RLS-H.pdf

Centers for Disease Control and Prevention (CDC), (2017). Surgical site infection (SSI). https://www.cdc.gov/infectioncontrol/guidelines/ssi/index.html

Despotovic, A., Milosevic, B., Milosevic, I., Mitrovic, N., Cirkovic, A., Jovanovic, S., & Stevanovic, G. (2020). Hospital-acquired infections in the adult intensive care unit—Epidemiology, antimicrobial resistance patterns, and risk factors for acquisition and mortality. American Journal of Infection Control , 48(10), 1211-1215. https://doi.org/10.1016/j.ajic.2020.01.009

Fernando, S. A., Gray, T. J., & Gottlieb, T. (2017). Healthcare‐acquired infections: prevention strategies. Internal Medicine Journal , 47(12), 1341-1351. https://doi.org/10.1111/imj.13642

Giraldi, G., Montesano, M., Sandorfi, F., Iachini, M., & Orsi, G. B. (2019). Excess length of hospital stay due to healthcare acquired infections: methodologies evaluation. Annali di Igiene, Medicina Preventiva e di Comunita , 31(5). 10.7416/ai.2019.2311

Haque, M., McKimm, J., Godman, B., Abu Bakar, M., & Sartelli, M. (2019). Initiatives to reduce postoperative surgical site infections of the head and neck cancer surgery with a special emphasis on developing countries. Expert review of anticancer therapy, PubMed , 19(1), 81-92,. https://doi.org/10.1080/14737140.2019.1544497

Mitra, M., Ghosh, A., Pal, R., & Basu, M. (2021). Prevention of hospital-acquired infections: A construct during Covid-19 pandemic. Journal of Family Medicine and Primary Care, 10(9), 3348. 10.4103/jfmpc.jfmpc_742_21

Mota, É. C., & Oliveira, A. C. (2019). Prevention of catheter-associated urinary tract infection: what is the gap in clinical practice?. Texto & Contexto-Enfermagem , 28. https://doi.org/10.1590/1980-265X-TCE-2018-0050

Seidelman, J., & Anderson, D. J. (2021). Surgical site infections. Infectious Disease Clinics, 35(4), 901-929. https://www.id.theclinics.com/article/S0891-5520(21)00067-2/fulltext

World Health Organization (WHO)(2018). WHO competency framework for health workers’ education and training on antimicrobial resistance (No. WHO/HIS/HWF/AMR/2018.1). World Health Organization. https://iris.who.int/bitstream/handle/10665/272766/WHO-HIS-HWF-AMR-2018.1-eng.pdf

World Health Organization (WHO)(2023). Catheter-associated urinary tract infections. https://openwho.org/courses/IPC-CAUTI-EN#:~:text=CAUTI%20Prevention%3A&text=Preventive%20measures%20include%20using%20standardized,of%20CAUTI%20in%20your%20facility .

World Health Organization (WHO), (2023). Infection prevention and control. https://www.who.int/teams/integrated-health-services/infection-prevention-control

Appendixes

1. Survey Questionnaires
2. Are you aware of the recent increase in hospital-acquired infections (HAIs) at your facility?
3. Do you believe that existing infection prevention measures are effective in reducing HAIs?
4. Are you concerned about the impact of HAIs on patient outcomes and healthcare costs?
5. Have you encountered instances where infection prevention protocols were not followed?
6. Do you think your healthcare facility needs enhanced infection prevention strategies?

Infection Prevention Audit

Introduction

This audit aims to evaluate the adherence to infection prevention protocols within Bayside General Hospital. Your candid responses are vital in ensuring the safety and well-being of our patients.

Section 1: Hand Hygiene Compliance

1.1. Do you consistently follow hand hygiene protocols before and after patient contact?

• Always
• Sometimes
• Rarely
• Never

1.2. Are hand sanitizers and handwashing facilities readily available and accessible in your work area?

• Always
• Sometimes
• Rarely
• Never

Section 2: Environmental Cleaning

2.1. Is the environment (patient rooms, equipment, common areas) adequately cleaned and disinfected on a regular basis?

• Always
• Sometimes
• Rarely
• Never

2.2. Have you encountered situations where environmental cleaning standards were not met?

• Yes
• No

Section 3: Central Line-Associated Bloodstream Infection (CLABSI) Prevention

3.1. Are CLABSI prevention protocols followed when inserting and maintaining central lines?

• Always
• Sometimes
• Rarely
• Never

3.2. Have you witnessed instances where CLABSI prevention protocols were not followed?

• Yes
• No

Section 4: General Awareness

4.1. Do you feel adequately informed and trained on infection prevention measures?

• Yes
• No

4.2. Have you received recent infection prevention training or updates?

• Yes
• No

Section 5: Suggestions and Concerns

Please share any suggestions or concerns you have regarding infection prevention practices at Bayside General Hospital.

Thank you for your participation in this audit. Your feedback is invaluable in our ongoing efforts to enhance infection prevention and provide safer care for our patients.

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