Healthcare environments are significantly prone to the risk of infection. Apparently, given the many avenues for possible infection that are evident in healthcare environments, there is an urgent need for intervention that such places demand. Several studies have revealed that all the people who participate in such environments stand a risk of getting infected, an aspect that further raises concern on the way those in charge of such places conduct their activities. The current paper identifies where the risk stems from, the possible interventions that should be initiated to curb the involved risks and it provided a reliable model that can be used to enhance the levels of hygiene and proper disposal methods of various apparatus that could complicate further the situation if not handled well.
The current paper frames a PICO strategy that can be used to solve the identified challenge of increased infections in the healthcare environments. The aim of the current paper is to define strategies and techniques that can be applied to decrease and prevent the risk of infection in healthcare environments. Largely, the healthcare environments phrase is used in reference to hospitals, nursing facilities and any other caregiving institutions that possess high levels of risk as regards to infections. The specific intervention that will be applied in this case is enhanced hand hygiene, a clean environment, that include the use of germicidal wipes), and the use of chlorhexidine and proper disposal of gloves with aim of controlling and decreasing the risk of infection.
Change Model Overview
The current paper applies the Change Model based on the John Hopkins Nursing EBP Model. The model adopted herein considers three main parameters; practice, education and research. It also considers the internal and external forces that influence the intended outcomes of the entire undertaking.
On the other hand, education refers to the quest to enhance the knowledge of what needs to be done to combat the risk of infection in the healthcare environments. Apparently, it involves the sensitization of all the players who participate actively in such environments. The educational need in this context will be met only if information is disseminated on a timely manner to all the aforementioned players to ensure that they use it to evade instances that could lead to new infections.
Research gives the implication of continuous study on the best and sustainable ways to combat the risk of infection in healthcare environments. It also implies the investigation on the way to incorporate and re-adjust the internal and external factors so that they could contribute positively to the elimination of the identified challenge. The three parameters of practice, education and research should be consistent and in support of each other to maintain the balance, an aspect that will enhance the attainability of the intended goal.
Practice Question
Step 1: Recruit Interprofessional Team
The attainment of the identified goals will require that a team is established whose mandate is to implement and put into practice the theoretical framework of the proposed model. Thus, the team to be hired will involve the following professionals, and their teams: a pharmacist, a pharmacologist, a nutriotionist, waste disposal expert, certified public health expert, nurse, and social caregivers.
Step 2: Develop and Refine the EBP Question
The question held in this paper is, ‘how to decrease and prevent the risk of infection in healthcare environments?’ As mentioned earlier, the paper has a specified PICO approach on assessing the possible solution to the identified challenges. The population aimed in this exercise is the hospitalized patients. The interventions proposed in this paper include improved hand hygiene, a clean environment, and use of chlorhexidine and proper disposal of gloves. The strategies will compared to environments with poor hand hygiene, dirty operating environments and poor methods of handling used gloves. The desired outcome in the context of the current paper is improved health and a reduced risk of infection in healthcare environments.
Step 3: Define the Scope of the EBP
Infections that arise in healthcare environments are described as nosocomial infection. The Centers for Disease Control and Prevention (CDC) (2016) notes that 1 in every 25 patients across the US stands the risk of being infected at a hospital they may be seeking treatment. Further, the report suggests that up to 100000 people die every year following infections arising from their caregivers. Healthcare-associated infections (HAI) is a serious problem that, if not addressed urgently, could push people to avoid seeking medical attention at hospitals, a situation that will complicate healthcare provision among the members of the public.
Steps 4 and 5: Determine Responsibility of Team Members
All the members of the team are important in mitigating the identified risk of infection. The pharmacologist will be helpful in identifying the infectious organism that could be involved in the reported cases. The pharmacist will help identify the drugs required to control the effects of the infections. The nutriotionist will help advice on the foods that those infected should eat to control the results of the infections. The waste disposal expert will advise on the best practices in the efforts to effectivels dispose and destroy waste that could enhance the risk of infection. The public health expert will be advising on the strategies to be implemented when dealing with patients in a public facility setting. The nurse will be playing the role of providing professional care to the patients in the facility. The social caregivers will be learning the entire process so that they can implement it in other cases that they could deal with into the future.
Evidence
Steps 6 and 7: Conduct Internal/ External Search for Evidence and Appraisal of Evidence
In the course of the study, I found both qualitative and quantitavie evidence that supported the process adopted for the current exercise. Apparently, the evidence pointed out to the fact that ineffective strategies and the careless handling of facilities enhanced the risk of infection of patients in hospitals.
Steps 8 and 9: Summarize the Evidence
Various studies have been published describing the scope of hospital-based infections in the midecal care niche. In addition to the CDC (2016) reports citing 1 in every 25 patients getting infected daily, other studies have revealed a complex problem that could take years to solve.
Weber and Rutala (2013) found out that the challenge of disinfecting medical apparatus and hospital surfaces was a major problem that influenced the worrying statistics being reported. In their study, Weber and Rutala offered a solution that, although popular in its theoretical framework, its implementation has been relatively low in many hospitals. The self-disinfection of surfaces that Weber and Rutala write about is a futuristic approach whose implementation will change the scope as it is currently.
A recent study estimated the number of new infections and deaths stemming from hospital-associated infections in American hospitals (Kanerva, Ollgren, Virtanen, & Lyytikäinen, 2009). In their study, the authors found out that the statistics were worrying and the consequences if the problem was not addressed could be dire. In another study, Katz (2004) found out that handwashing, in a proper manner and using medicated handwashers was an effective way of addressing the challenge of nosocomial infections in healthcare environments.
Step 10: Develop Recommendations for Change Based on Evidence
The current paper recommends that both patients and healthcare experts ought to understand the avenues for infection in healthcare environments. However, it is important that all those involved in such setting engage in effective hand washing to ensure that infections are controlled. Additionally, all forms of waste and other contaminated materials should be disposed in a proper manner. It is also important to ensure that healthcare environments are hygienic from all contexts to enhance the ability to reduce the risk of infection.
Translation
Steps 11, 12, and 13, 14: Action Plan
The implementation of the described process will take place in various phases. First, the healthcare environment, in this cases a hospital facility, will have all its surfaces and materials disinfected and any materials suspected to be already infected destroyed. Afterwards, the identified team will play their specific roles to enhance the ability to curb the risk and effects of infections in such environments. Handwashing will be an aspect that must be insisted on if the success of the process nis to be expected. Proper disposal of waste will also be initated to ensure the risk of infection is significantly wiped out.
Steps 16 and 16: Evaluating Outcomes and Reporting Outcomes
The major expected outcome is the reduction of the number of cases of infection initated at the healthcare environment. It is expected that the cases of disease arising from communicable infection in the hospital will be significantly reduced. Measuring the outcome will involve comparing the recorded cases before and after the undertaking of the exercise. The results will then be analyzed to understand the effect of the initiative, and any challenge that will be noted will be addressed within the earliest time possible.
Steps 17: Identify Next Steps
The aim of the exercise is to ensure that hospital-based infection are entirely eliminated in the society. Therefore, the current exercise is undertaken with the aim of implementing it on a larger scale. Undertaking the exercise on a large scale will require the cooperation of health policy makers at both the state and federal levels. If the findings are positive and sustainably applicable, the implementation of the exercise on a large scale can be permanent by adopting the legal frameworks to sustain its undertaking.
Step 18: Disseminate Findings
The findings will be disseminated through the popular nursing and healthcare journals for peer-reviewing among experts. Additionally, the information can be communicated through the media to ensure that the public is aware of the role in the resolve to reduce the risk of infection in healthcare environments.
Conclusion
The exercise described in the current paper is a positive step to addressing the challenge of infection in healthcare environments. This paper uses the John Hopkins Model that advocates for three main levels of implementing change. Practice is the first of the three levels and it involves the actual undertaking of the identified positive aspects of change in the exercise. Education is another level and it deals with the dissemination of the findings to the expert audience and the public to help foster the popularity of the revalations. Research is another level and it involves follow-up studies on the topic to ensure that the best strategies are employed all the time. Maintaining high levels of hygiene, which involves handwahsing and proper waste disposal, is an important step in reducing the risk of infection in healthcare environments.
References
Centers for Disease Control and Prevention,. (2016). Healthcare-associated Infections (HAI) Progress Report | HAI | CDC. Cdc.gov. Retrieved 31 July 2016, from http://www.cdc.gov/hai/surveillance/progress-report/index.html
Kanerva, M., Ollgren, J., Virtanen, M., & Lyytikäinen, O. (2009). Estimating the annual burden of health care–associated infections in Finnish adult acute care hospitals. American Journal Of Infection Control, 37(3), 227-230. http://dx.doi.org/10.1016/j.ajic.2008.07.004
KATZ, J. (2004). Hand washing and hand disinfection:more than your mother taught you. Anesthesiology Clinics Of North America, 22(3), 457-471. http://dx.doi.org/10.1016/s0889-8537(04)00027-6
Weber, D. & Rutala, W. (2013). Self-disinfecting surfaces: Review of current methodologies and future prospects. American Journal Of Infection Control, 41(5), S31-S35. http://dx.doi.org/10.1016/j.ajic.2012.12.005
