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HCMG101 Health Care System Question: Identify a health care issue that interests you and explain why. Develop a rationale using evidence-based research, including: Statistical findings Probable stakeholders Logical conclusions Answer: Introduction Hospital acquired infections (HAI) which are also termed as nosocomial infection is a type of infection that is normally acquired in a health care setting or clinic. This kind of infections can be acquired from hospitals, clinics, nursing homes and health care settings. HAI can spread through contaminated surgical instruments, bed linens, or droplets. Infection may also spread trough staffs or outpatients. HAI can be seen after potent surgeries as the normal micro flora of the skin might become opportunistic. This paper aims to shed light on one of the main factors of hospital deaths among the neonates and others that are the hospital acquired infections. The project focuses on the strategies that can be taken to bring improvement in the health care setting regarding the spreading of HAI. The report also provides with the possible barriers that can be faced for implementing the change in the organization. Discussion Statistical Findings   It has been estimated by the Centers for disease Control and prevention, United States, that HAI is the cause of about 90000 deaths in a year. HAI is found to be one of the leading causes of neonatal deaths and still births all over the world (Magil et al., 2014). The wide spread prevalence of the infections makes it an important topic of my project. It is an important health care issue of most of the health care setting that needs to be addressed. HAI  Occurring in US Acute Care Hospitals, 2014 (Zimlichman et al., 2014) Major Site of Infection Estimated Number Pneumonia 157,500 Gastrointestinal Illness 123,100 Urinary Tract Infections 93,300  Infections  from Bloodstream 71,900 Surgical site infections obtained from any inpatient surgery 157,500 Other infections 118,500 Estimated total number 721,800 The above statistics shows that the rate of HAI is quite high in US in most of the acute healthcare settings and needs to be addressed. Nosocomial infection can only be controlled by implementing the quality control measures in the health care sectors. The quality of approach should be evidence based and change should be brought about in a clinical organization to reduce the HAI possibilities. Barriers To The Change Any new change in an organization comes with several obstacles. The newly appointed staffs might not be well aware of the skills and the duties. There can be lack of trust regarding the changes introduced by the managers (Grol et al., 2013). The older clinical staffs might find that the previous techniques were better. Lack of resources can be another cause that might affect the measures taken for controlling HAI. In order to assess whether the changes that have been implemented are appropriate, benchmarking can be done, which helps to compare the health care service of my concerned setting with the national standard of controlling HAI (Grol et al., 2013). There should be structured interventions; there should be proper checklists for the infection control measures. There should be proper quality and risk management techniques. Quality services are services that are appropriate to each of the consumer’s needs. All the procedures and the treatments should be timely and in an appropriate manner. In order to address the different barriers, it is required to prepare a proper implementation plan which is being provided below. Quality Services And Strategies Since it is about the management of the nosocomial infections, there should be certain facilities present in the healthcare settings such as- Maintaining cleanliness, and regular application of the anti microbial agents (Donskey, 2013). There should be separated isolation units for the patients suffering from communicable diseases. Specific measures should be taken such that the infection does not spread in the baby ward. As HAI can spread from hospital equipments and bed linens, special care should be taken to while sterilization of the hospital equipments (Donskey, 2013).   Use of Ultraviolet light treatment for sterilization, proper sanitation protocols in the hospitals like thorough hand washing and the use of alcohol rubs (Huis et al., 2012). Hand washing, use of gloves for reducing the risks of transmission of the disease. Reports say that use of gloves can reduce the risks of pathogen infections that are blood borne (Huis et al., 2012). Use of Surface sanitizing agents such as Non flammable alcohol vapor, hydrogen peroxide vapours (Rutala & Weber, 2013). The commonly touched surfaces in the hospital ward should be regularly cleaned. Sterilization methods like antimicrobial chemicals, ionizing radiations, dry heat and moist heat can be used as effective methods of sterilization (Rutala & Weber, 2013). Keeping A Record Of The Sentinel Events Maintaining checklists Maintaining risk registers In order to improve the quality of care or to prevent the HAI, it is necessary to identify and keep a record of the sentinel events associated to HAI and the root cause of those events. There should be appropriate management protocols and risk registers to keep a record of the events (Akova et al.,2012). The risk management strategies should include collection of the clinical audits and reports regarding the clinical incidents related to HAI, using the clinical indicators, screening of the adverse outcomes, peer supervision and review of the medical emergencies (Anderson et al., 2014).   There should be proper risk registers that would list the risks according to the priorities. Proper check lists should be maintained. Once the risk had been assessed and addressed, they should be removed from the safety checklist. A systematic way should be present to escalate the high risks for a department (Pincock et al., 2012). There should be a continuous review and the monitoring of the maintenance of cleanliness in the hospital ward. Involvement Of The Stake Holders Employee empowerment is important for increasing the quality of the treatment. There should be effective programming order to involve all the stake holders (Grol et al., 2013). The leaders of the clinical setting should create an organizational environment that people should have the mentality to accept the changes that are need to be taken in the clinical setting. The indicators of the quality has to be assessed immediately and based on those indicators, assessment should be done periodically (Grol et al., 2013). It is necessary to impart education to the clinical staffs about the importance of proper disinfection. Emphasis should be given to the staffs to focus on the maintenance of cleanliness in the hospital, maintenance of the proper hand and hygiene, maintaining cleanliness in the isolation units (Grol et al., 2013). In order to reduce the HAI and to spread awareness there should be provisions for financial rewards and penalties for staffs. An open communication is required in the clinical setting to implement any change. Any improvements should be addressed from the topic. It is the duty of the managers of the health care settings to look over the matters and to check all the requirements have been addressed or not. In order to implement any change in a healthcare setting regarding the prevention of the HAI, it is not required to worry about the time frame, as the clinical staffs can start maintaining hygiene from the very first day. Conclusion Nosocomial infection has been found to be the most common complexities that are associated to healthcare setting. Most of the HAI are easily controllable by taking up continuous quality improvement strategies and the different risk management techniques. It can be already understood from the report that in US there had been a substantial increase in cost due to the HAI, therefore specific strategies can be taken up. The paper proposes several barriers that may come along the changes in the healthcare setting such as luck of trust for the new change and more. The paper further focuses on involving the different stakeholders for the improvement strategy. Emphasis has been given to maintain the proper sterilization and the cleanliness protocols, like use of soaps and hand washes and alcohol swabs, use disinfectants and antimicrobial agents. Emphasis has also been given to maintain proper risk registers and checklists for recording the prevalence of the sentinel events related to HAI. Thus it can be concluded that measurement of the cause of the infections, proper preventive measures can mitigate the rate of HAI in clinical settings. References Akova, M., Daikos, G. L., Tzouvelekis, L., & Carmeli, Y. (2012). Interventional strategies and current clinical experience with carbapenemase?producing Gram?negative bacteria. Clinical Microbiology and Infection, 18(5), 439-448. Anderson, D. J., Podgorny, K., Berríos-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L., … & Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S66-S88. Donskey, C. J. (2013). Does improving surface cleaning and disinfection reduce health care-associated infections?. American journal of infection control, 41(5), S12-S19. Grol, R., Wensing, M., Eccles, M., & Davis, D. (Eds.). (2013). Improving patient care: the implementation of change in health care. John Wiley & Sons. Huis, A., van Achterberg, T., de Bruin, M., Grol, R., Schoonhoven, L., & Hulscher, M. (2012). A systematic review of hand hygiene improvement strategies: a behavioural approach. Implementation Science, 7(1), 92. Magill, S. S., Edwards, J. R., Bamberg, W., Beldavs, Z. G., Dumyati, G., Kainer, M. A., … & Ray, S. M. (2014). Multistate point-prevalence survey of health care–associated infections. New England Journal of Medicine, 370(13), 1198-1208. Pincock, T., Bernstein, P., Warthman, S., & Holst, E. (2012). Bundling hand hygiene interventions and measurement to decrease health care–associated infections. American journal of infection control, 40(4), S18-S27. Rutala, W. A., & Weber, D. J. (2013). Disinfection and sterilization: an overview. American journal of infection control, 41(5), S2-S5. Weber, D. J., & Rutala, W. A. (2013). Self-disinfecting surfaces: review of current methodologies and future prospects. American journal of infection control, 41(5), S31-S35. Zimlichman, E., Henderson, D., Tamir, O., Franz, C., Song, P., Yamin, C. K., … & Bates, D. W. (2014). Health care–associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA internal medicine, 173(22), 2039-2046.

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