In this case study, the healthcare providers delayed to take actions, leading the patient to severe sepsis. On admission, the patient was already at risk for infections due to her low white blood cell counts. The patient could have been protected from developing severe sepsis if the healthcare providers continuously assessed her to monitor the outcomes of care although the patient’s surveillance cultures were negative on admission. This is an example of hospital acquired infection (HAI). With the increase in gram negative resistant bacteria and the immunosuppression of cancer patients, it is important that healthcare providers use quality improvement skills as emphasized in the QSEN competencies to assist in developing the skills to manage
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
Daniels (2011) said that sepsis is one of the leading causes of death in hospital patient worldwide and severe sepsis causes around 37,000 deaths in the UK every year. Czura (2011) has defined it as a life-threatening condition that arises when the body’s response to infection injures its own tissues and organs and sepsis can be present in any patient and in any clinical setting. Based on the learner’s reading, she became aware of the importance of identifying the early inflammatory markers such as temperature less than 36 degrees or more than 38.3 degrees, heart rate greater than 90 beats per minute (bpm), respiratory rate greater than 20 breaths/minute, altered mental state, white cell count lesser than 4g/l or greater than 12g/l and blood glucose greater than 7.7 millimoles for non-diabetic patients. Presence of any two of these will follow further test and if sepsis is indicated then commence the sepsis six care bundle within the hour, contact the doctor and critical care outreach team. The sepsis six care bundle which was developed by Daniels et al (2010) has shown to improve delivery of reliable care across a range of clinical settings which is now used in many UK
“Early Recognition and Treatment of Sepsis in the Medical-Surgical Setting,” focuses on the nurse’s role in being able to identify early signs of sepsis and initiating the sepsis bundle quickly. In the article, “Nurses’ Critical Role in Identifying Sepsis and Implementing Early Goal-Directed Therapy,” it explains how the interventions in the sepsis bundle have decreased mortality from 37% to 30.8% in a two year study conducted in 165 different health care sites. This article also details clinical guidelines and timelines for implementing the sepsis bundle. Early stages of sepsis and clinical manifestations are discussed in the article, “Helping Patients Survive Sepsis,” with emphasis on the i...
An Interprofessional Sepsis Workgroup was formed and using Lean Management principles gaps in sepsis care, identification of care delays, and time-wasting workflows were documented.
Pressure ulcer development in patients admitted to the ICU is classified under the Quality and Safety Education for Nurses (QSEN) topic of safety. Safety by definition reduces the risk of harm to patients and providers through system effectiveness and individual performance (Cronenwett et al., 2007). Patient outcomes significantly improve if pressure ulcers in the ICU are prevented; patient pain related to pressure ulcers is eliminated and the risk of infection associated with pressure ulcers is greatly reduced (Cooper, 2011).
Health care facilities - whether hospitals, nursing homes or outpatient facilities - can be dangerous places for the acquisition of infections (EHA). The most common type of nosocomial infections are surgical wound infections, respiratory infections, genitourinary infections and gastrointestinal infection (EHA). Nosocomial infections are those that originate or occur in health care setting (Abedon). They can also be defined as those that occur within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation (Inweregbu). These infections are often caused by breaches of infection control practices and procedures, unclean and non-sterile environmental surfaces, and ill employees (EHA). Immunocompromised patients, the elderly and young children are usually more susceptible to these types of infections. Nosocomial infections are transmitted through direct contact from the hospital staff, inadequately sterilized instruments, aerosol droplets from other ill patients or even the food and water provided at the hospital (EHA). The symptoms of nosocomial infections vary by type but may include inflammation, discharge, fever, abscesses, and pain and irritation at the infection site (Stubblefield).
The role of nurses in the prevention of MRSA in the hospitals cannot be overemphasized. The prevalence of MRSA in hospitals calls for awareness and sensitization of all party involved in patient caregiving in the hospital. According to Wilkinson and Treas (2011), nurses take on many roles in the hospital: a caregiver, advocate, communicator, leader, manager counsellor, change agent and an educator. (Wilkinson &Treas. (2011) p.13.) The target of healthy people 2020 is to reduce MRSA and all other hospital acquired infection by 75% in the year 2020. (Healthy people 2020) This cannot be achieved without the maximum support of nurses because nurses have regular one on one contact with patients on daily basis.This paper will take a closer look at the role of a nurse as an educator in the prevention of MRSA in the hospital. One of the nurse’s roles in the prevention of MRSA in hospitals is patient/visitor/staff education.
Purpose: Current evidence based research demonstrates that the utilization of defined sepsis care guidelines, provide time sensitive treatment protocols that help guide nurses through effective early initiatives in reducing patient mortality. Since time of treatment for sepsis is outlined as being most effective if delivered in the first six hours following diagnosis, it is imperative to treat patients as soon as they arrive in the hospital for treatment. Emergency departments (ED) are the most common initial route of care that patients take for hospitalization of sepsis type infections. Currently many hospitals do not have a defined treatment protocol that initiates this needed treatment to start in the ED. Sepsis bundles offer ED nurses the guidelines that are needed to help care for such patients.
According to the Clinical Excellence Commission (2014), approximately 6,000 deaths per annum are caused by sepsis in Australia alone. These mortality figures are higher than breast cancer (2,864) and prostate cancer (3,235) combined (Cancer Australia, 2014). Despite advances in modern medicine and increased understanding of the need for timely recognition and intervention (Dellinger et al, 2013), sepsis remains the primary cause of death from infection worldwide (McClelland, 2014). Studies undertaken by The Sepsis Alliance (2014) and Schmidt et al, (2014) state that 40% of patients diagnosed with severe sepsis do not survive.
Restatement of thesis: Hospital Acquired Infections (HAIs) may cause unexpected life-threatening illness and undue financial strain for patients and their families by significantly increasing hospital length of stay and the cost of treatment for these infections.
Quality care, safe practices and principles, and accountability constitute the foundation of any health care organization (Huber, 2014). Addressing patient safety issues and improving health care quality may include reorganizing operations to improve efficiency, coordinating care with interdisciplinary team members, and using information technologies (Wang, Cha, Sebek, McCullough, Parsons, Singer, & Shih, 2014). In this paper, I will review my organization’s quality program goals, objectives, and management structure, how quality improvement (QI) projects are selected, managed, and monitored, and how nursing staff are trained and supported in
Within the Surviving Sepsis Campaign they introduced guidelines and bundles which may beused as the basis of a sepsis performance improvement program. The Guidelines were based around a six-point action plan (...
The infection control plays an important role for the prevention from bacteria and other microorganism that may affect the condition of the patient.
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
Quality Improvement or QI entails changes, due to collective efforts of healthcare workers and patients, that aim to improve “patient outcomes (health), better system performance (care) and better professional development” (Batalden & Davidoff, 2007). For a healthcare facility, QI activities can include implementing and perfecting an infection control policy. The purpose of improve the infection control policy is to prevent and reduce the spread of pathogens through patient to staff, staff to patient, and patient to patient contact (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2012). Following a facilities’ infection control policy involves all healthcare workers and anyone in contact with patients and used equipment