...Improving Hand Hygiene Practices 1.0 Introduction Health-related infections account for about 100,000 deaths per annum in the United States. A world-wide systematic review revealed that the occurrence of health-related infections range from between 1.7 to 23.6% per 100 patients. Hospital costs inherently associated with the healthcare-related infections range between 30 to 34 billion US dollars; yet these infections can be prevented through hand hygiene. Critical epidemiologic evidence supports the claims that hand hygiene reduces the transmission of healthcare-related infections. Although it is hard to link hand hygiene and the improvement of healthcare-related infections, organizations such as the Joint Commission, World Health Organization among others, acknowledge the essence of hand hygiene as a universal guideline to reduce healthcare-acquired infections. As such, this proposal focuses on interventions to improve compliance with hand hygiene as a pathway to reduce healthcare-associated infections, rather than the efficacy of hand hygiene to reduce healthcare-associated infections. 1.1 Statement of Purpose Compliance with hand hygiene practices among healthcare workers, nurses, physicians and patients has been low, averaging at approximately 39%. A study conducted in the year 2001 that was aimed at improving hand hygiene compliance and interventions found that there was poor compliance across hospital unit types and other settings. In particular, workers, nurses, physicians...
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...An APIC Guide 2008 Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs) Developing and Applying Facility-Based Prevention Interventions in Acute and Long-Term Care Settings About APIC APIC’s mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. The Association’s more than 12,000 members have primary responsibility for infection prevention, control and hospital epidemiology in healthcare settings around the globe. APIC’s members are nurses, epidemiologists, physicians, microbiologists, clinical pathologists, laboratory technologists and public health professionals. APIC advances its mission through education, research, consultation, collaboration, public policy, practice guidance and credentialing. Look for other topics in APIC’s Elimination Guide Series, including: • • • • Catheter-Related Bloodstream Infections Clostridium difficile Mediastinitis MRSA in Long-Term Care Copyright © 2008 by APIC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission of the publisher. All inquires about this document or other APIC products and services may be addressed to: APIC Headquarters 1275 K Street, NW Suite 1000 Washington, DC 20005 Phone: 202.789.1890 Email: APICinfo@apic.org Web: www.apic.org ISBN: 1-933013-39-7 ...
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...Introduction This paper explain the Accountability of a nursing professional based on an evidence report from Agency for Healthcare Research and Quality Assessment(AHRQ) , the report is " Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 6: Prevention of Healthcare–Associated Infections)" under the head Quality Improvement and Patient Safety What is Accountability? In Fundamentals of Nursing it says “The ability and willingness to assume responsibility for ones’ actions and accepting the consequences of one's behavior.” Accountability of nursing professional is a legal obligation; for a professional nurse it is relating to ethics and moral responsibility. Within the kingdom of professional accountability, there are many factors. The American Nursing Association (ANA) states in its code that the nurse will assume accountability for nursing judgment and actions. A professional nurse has the responsibility to take decisions and practice within the scope of care, calling upon his/her information and skills to make judgments in favor of the patient. A professional nurse is accountable to their profession, their patients, employer, and other health care team members and to themselves. Nurses are accountable to provide safest care for their patient based on evidence based practice and safe nursing interventions. Nursing profession as a whole is build up on accountability, unselfishness, integrity and social justice. A professional...
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...Retrospective analysis of catheter-acquired urinary tract infection (CAUTI): Relationship to stroke diagnosis Abstract Background: Eighty percent of hospital-acquired urinary tract infections are associated with urinary catheters (Joint Commission Resources, 2011). Catheter-acquired urinary tract infections (CAUTI) continues to be at the forefront of the fight against hospital-acquired infections (HAI). Despite ongoing efforts to decrease the incidence of catheter-acquired urinary tract infections (CAUTI) in the acute care setting, overall standardized infection rates (SIR) for CAUTI have decreased only 7% since 2009 (Centers for Disease Control and Prevention (CDC), 2013). Purpose: The purpose of this study was to compare patients with a diagnosis of stroke to patients without a primary diagnosis of stroke to determine if patients diagnosed with stroke had a higher incidence of CAUTI infection. A secondary aim was to examine use of antibiotics, steroids, length of hospital stay, catheter days, and ICU length of stay in both stroke and non-stroke patients. Methods: The study method is a retrospective chart review analysis uses data from an 874-bed large teaching hospital located in the Southeastern United States from 2011 and 2012. After approval from both the Nursing Scientific Advisory Committee and the Institutional Review Board of the institution, analysis of data began. Results: 600 patients were potential candidates for analysis. Of the 600 patients...
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...PREVENTING CATHETER ASSOCIATED URINARY TRACT INFECTION Elizabeth Quartey Abstract According to the CDC estimates in 2002 there were 1.7 million Healthcare-Associated Infections (HAI), and 99,000 HAI- associated deaths in the hospital. The report stated that the four largest categories of HAI, responsible for more than 80% of all reported HAI, are central line-associated bloodstream infections (CLABSI, 14%), ventilator-associated pneumonia (VAP, 15%), surgical site infections (SSI, 22%), and catheter-associated urinary tract infections (CAUTI, 32%). HAI are a great financial costs to health care facilities. The Centers for disease Control and Prevention (CDC) estimates the medical cost of HAI in the U.S. hospitals as $6.65 billion in 2007, and that number has increased to almost $10 billion a year currently. Statement and Significance of the Problem One in 20 patients who are admitted to a hospital will be a victim to an infectious agent they are exposed to during their hospitalization according to the Centers for Disease Control (CDC) (Goodman, Brenda, 201, Hospital-Acquired Infections cost $10 Billion a year). The five most common infections are surgical site infections, infections associated with the use of devices like central lines, catheters, ventilators and clostridium dificile are costing the health care System in the USA almost $10 billion a year to treat. In the article Vitamin D has the potential to reduce the risk of Hospital-Acquired...
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...Microbiology and Infection Control Adrian Loadholt 1/15/2015 Dr. Momeny The article I read was entitled ‘putting it into practice: Infection control professionals’ perspective on early career nursing graduates’ microbiology and infection control knowledge and practice. Healthcare associated infections are most common but preventable infections in hospital patients. Control and prevention of healthcare-associated infections is a major focus and challenge for healthcare institutions worldwide. The article was related to a study conducted in Australia. The study included all females, who qualified as registered nurses and had spent at least 5 years working as a registered nurse before commencing their current infection control practitioner role. Half of the nurses were aged 35–59 years and had completed their undergraduate training in the university setting, while the other half were hospital-trained nurses aged 40 years or older. All but one participant had taken training in infection control. All participants indicated that many new graduates had deficits in their infection control and associated microbiology knowledge, with some describing graduates’ level of infection control knowledge as ‘very poor’ or ‘basic’. One of the participants thought that the new graduates’ would lose knowledge after a period of time in the workplace. The participants agreed that increasing the amount of microbiology in the curriculum would improve graduates’ understanding and implementation...
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...Capstone Project Abstract Background Hand washing and hand hygiene are consider to be the number one, cheap essential measure of preventing and controlling spread of hospital acquired infections (HAIs). Hand washing and hygiene can significantly reduce the burden of disease, in particular in hospitalized patient Unfortunately compliance to hand hygiene recommended standard procedures by the health care workers (HCWs) has been unacceptably poor. In order to design education program, identification of several risk factors associated with poor hand hygiene (HH) compliance is of extreme importance. Objective: The purpose of this study is to implement a hand hygiene program for increase compliance with hand hygiene among health care worker in 97 beds hospital. The key target for compliance to HH is not only health-care workers but also policy-makers and organizational leaders and managers. Methods.: Compliance to hand hygiene will be evaluated through direct observation of HCWs ,to helps pinpoint areas of strength or weaknesses in HH behavior, so as to develop training program that will help HCWs to complaint with HH . Evaluation will be based on direct observation and survey audit, observing the HCWs during routine patient care to ensure that hands hygiene are performed before and after getting in contact with patient and patient environment. In addition, survey audit based on the HCWs perception, knowledge and attitude...
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...Hygiene Guidelines and Impact on Infection Rates. American Journal Infection Control, 35, 666-675. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2137889. Graphic BackgroundInformation|This study examines the implementation of the Center for Disease Control and Prevention (CDC) hand hygiene guidelines and analyzes whether compliance impacts patient outcomes, especially hospital acquired infections (HAI). The correlation of hand hygiene (HH) and HAI is very well described in this study. Rates for HAI were determined both pre and post implementation of the guidelines. A structural abstract is included with this study. There is an introduction which explains the intent of the study is to and examine how the CDC guidelines are implemented, the compliance rates for HH and how that relates to HAI rates.| Review of Literature|There have been numerous clinical practice guidelines by federal and professional organizations which were intended to improve quality of patient care and minimize variances in clinical practices. There have been three versions of the HH guidelines with the last version in 2002. There have been few studies done to correlate the practices of HH with HAI rates. This study was conducted in 2007 but is still relevant today. Compliance with HH guidelines is still low and maintaining improvement very challenging. The researchers used 52 references in this study including the CDC and National Nosocomial Infection Surveillance (NNIS) reports. Several...
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...Running head: TURNING KNOWLEDGE INTO PRACTICE Student’s Putting Infection Control Knowledge to Practice Brandy S. Narro Grand Canyon University NRS-433V August 5, 2012 Student’s Putting Infection Control Knowledge to Practice According to the Centers for Disease Control and Prevention, 1 in 20 hospitalizations will be further complicated by hospital acquired infections (HAI’s) (2010). Examples of HAI’s are wound infections, respiratory infections, infections of the urinary tract and gastrointestinal tract. These infections result in an estimated 90,000 deaths per year (CDC, 2010) and $20 to $40 billion healthcare dollars on preventable complications (CDC, 2009). This study examines the possibilities of arming student’s with a multifaceted approach to hand hygiene and the lasting effects on the practice. After obtaining approval from the medical center’s institutional review board, 75junior-level baccalaureate nursing students consented to voluntary study participation. Although the study indicates the students “agreed” to participate, the question remains whether or not participating in the study was in any way connected to a participation grade for the research course in which the students were concurrently enrolled in at the time of the study. The additional exposure and attention paid to hand hygiene and infection control would benefit these study participants. The major variables are not specifically identified in this study...
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...Preventing Hospital Associated Infections April Shannon Walden University NURS 4000 Section 04, Research and Scholarship for Evidence-Based Practice November 18, 2012 Change in Practice: Preventing Hospital Associated Infections Benjamin Franklin was quoted as saying “an ounce of prevention is worth a pound of cure.” With the increasing costs of healthcare and the emergence of multi-drug resistant organisms this truth still resonates today. Hospital associated infections (HAIs), have been a complication in hospitals for many years. The purpose of this assignment is to address this problem in nursing practice, and discuss evidence on practices that will address this issue. The problem Hospital associated infections (HAIs) can be defined as an infection acquired in hospital by a patient who was admitted for a reason other than that infection. An infection occurring in a patient in a hospital or other healthcare facility in whom the infection was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility (central line associated bloodstream infections, catheter associated urinary tract infections, surgical site infections, ventilator associated pneumonia, etc.) (World Health Organization, 2002). HAI’s have become one of the leading caused of hospital related deaths in the United States. However, these infections have been proven...
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...Prevention of Central Line Infections Kaitlin Kapple Walden University NURS 4000 Section 4, Evidence-Based Nursing Practice July 13, 2015 Prevention of Central Line Infections Central line catheters are widely used in healthcare to administer medications, fluids, blood products, and parental nutrition. There are over five million central line catheters placed in the United States a year (Bashir, 2012). With the large amount of central line catheters being placed, there is an increased risk of infection. Central line infections are a serious health condition and are the fourth most common type of hospital-acquired infection (Bashir, 2012). The purpose of this paper is to explain why central line infections occur and how nurses can prevent these infections. Practice Setting Problem Over ninety thousand central line infections occur each year in the United States. While many of these are treated, it is noted that twenty-five percent of these infections end in death (Bashir, 2012). Despite the noted decrease of central line infections in the United States, the Center of Disease Control states that the current rate of infection is approximately three infections per one thousand catheter days (Bashir, 2012). Central line catheters provide an entry point for bacteria to enter the body into a person’s bloodstream. This leaves patients at risk for local and systemic infections. Bloodstream infections from catheter infections one week after the central line was placed, has...
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...Nursing Research Utilization Project Proposal Abstract The issue of controlling and preventing hospital-acquired infections is a major problem in the Healthcare system. Most patients admitted to hospitals are at some risk of contracting a hospital-acquired infection (Paterson, 2012). Some patients are more vulnerable than others; these include the elderly, patients with defective immune systems, and premature babies. Hospital-acquired infections remain a major concern, and they can occur in any care setting, including acute care within hospitals, outpatient surgery centers, clinics, and long-term care facilities (such as nursing homes or rehab centers). Four categories account for 75% of all acquired infections in the acute care hospital setting. These are surgical site infections, central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections (Nassof, 2009). Urinary tract infections comprise the highest percentage (Paterson, 2012). These infections usually are spread by the contaminated hands of healthcare providers or the patient’s family members. They are also caused by contaminated surfaces or hospital equipment that has not been properly cleaned (Nassof, 2009). The rate of exposure to infectious materials could be reduced if healthcare providers adhered to certain standard precautions such as hand hygiene. The proposal for this nursing research utilization project is to educate nurses on the importance...
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...nosocomial infections that occurred within the past year. In your report, categorize the different parameters (i.e. person, time, place and ethnicity and gender) used in the compilation of data into the information summative. Hypothetically, Good Health Hospital is assumed to have possessed nosocomial infections as in any real hospitals where patients seek admission for treatment. According to Center for Disease Control and prevention (CDC), and Pennsylvania Department of Health (PADOH), a healthcare associated infection (HAI) which is also known as nosocomial infection is an infection that a person gets while staying as a patient in a hospital or other health care facility (PADOH, 2008). Hence, it is clearly understood that patients always acquired nosocomial infections during the process of receiving health care services from health professionals in any hospital or healthcare setting. PADOH has also confirmed that HAIs are the primary contributors of most sicknesses and mortalities in the world. For example, in American hospitals alone, HAIs account for about 1.7 million infections causing 99,000 deaths each year. Therefore, based on the analysis of Good Health Hospital records, research had shown that a great number of recent nosocomial infections that had happened before were identified. Among the different kinds of nosocomial infections verified, few infection type have been listed as followed: 1. Surgical site infection (SSI). 2. Urinary tract infection (UTI). 3....
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...insertion and foley catheter care were used to educate nursing staff and improve outcomes. The purpose of this paper is to educate nursing on how to be proactive with this issue and to inform the providers when there is no further need for the catheters to reduce infections in patients. Practice setting problem Urinary tract infections (UTIs) account for approximately 35% of nosocomial infections but are the lowest in mortality and cost (Burke, 2003). Patients with UTIs as a secondary diagnosis have an average length of stay of 9.1 days versus those without a urinary catheter of 4.7 days. As individuals live longer, the probability of them being hospitalized and requiring specialized care services is increased (Hobbs, 2001). Hospitalization of any aged person increases the risk for them to have a urinary indwelling catheter, which predisposes them to a nosocomial urinary tract infection (Saint, 2003).Nurses are responsible for placing and maintaining the indwelling catheters. Often non-licensed staff are being delegated these tasks, without the proper training and education on routine catheter care and catheter insertion. Importance of the clinical problem and its significance to nursing practice Nosocomial infections more than double the mortality and morbidity...
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...The statistics of healthcare-associated infections (HCAIs) in United Kingdom is just about 50,000 cases every year, in that, during 2008–2009, there were 36,097 reported cases of Clostridium difficile (Health Protection Agency, 2009). Almost the same rate is listed for Germany, highlighting a clear need for decisive action. This research examines the main causes if HCAIs, and discusses the relationship between compliance with hand hygiene guidelines and stress among nursing professionals in one German hospital (Knoll, Lautenschlaeger, & Borneff-Lipp, 2010). This paper explores the factors associated with hand hygiene compliance of nurses during routine clinical practice. The purpose of this research was to clarify whether external factors such as ward capacity, or level of nursing intensity had an influence on nursing staff compliance with hand hygiene guidelines. The research questions in this study are; does hand hygiene between healthcare workers decrease healthcare associated infections (HCAIs)? Does exterior factors influence on nurses compliance with hand hygiene guidelines? The hypothesis of this study is; workload factors like maximum ward capacity, severity of patient cases, have an influence on nurse’s compliance with proper hand hygiene guidelines. Study Variables A total of nine variants were used in this paper. Records from the descriptive interviews were used as dependent variables. The ward-specific workloads considered on one side as the rate of...
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