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NR341/342 Healthcare-Associated Infections Paper

NR341/342 Healthcare-Associated Infections Paper

Healthcare-Associated Infections

There have been heightened calls for better patient care, safe patient care, and reasonable healthcare costs in recent years. Even though there have been efforts to achieve such goals, various events still exist in health care that threatens patient safety and lead to poor patient care, hence a need to address them. One of such is healthcare-associated infection (HCAIs). Healthcare-associated infections have been shown to result in various adverse impacts such as longer hospital stays and health care spending. Healthcare-associated infection is connected to pathogens like viruses, bacteria, and fungi (da Silva et al., 2018). An infection can occur at any healthcare facility like; assisted living, orthopedic centers, urgent care, hospitals, and even dialysis centers. HCAIs are important causes of morbidity and mortality in the United States and are associated with a substantial increase in health care costs each year (Healthy People 2020, 2021).

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In general, HCAIs are the leading cause of sickness and death, with critical medical, financial, and emotional repercussions to both the patient and the healthcare facility. One way of addressing the problem is through quality improvement and evidence-based practice projects. Central to quality improvement and evidence-based practice project initiatives is an analysis of published literature and research guidelines to get the best evidence that supports the effort. Therefore, the purpose of this assignment is to interpret two articles relevant to the topic of healthcare-associated infections.

Description of the Matrix Table Data

From the matrix table, it is evident that the two studies were both focused on ways of addressing healthcare-associated infections and preventing them, specifically, CAUTI. While Zurmehly (2018) article had education and incidences of CAUTI, the article by Bui et al. (2020) used total antimicrobial defined daily dose and chlorhexidine bathing. While both studies used quantitative design, the first article was a quasi-experimental design; the second article was a randomized controlled trial. Both studies had 95% levels of confidence. In addition, any result with a p-value bigger than 0.05 was considered non-significant. Both nurses and patients formed part of research subjects in the case of Zurmehly (2018) article. On the other hand, the research subjects in the other article were patients only. One of the instruments used is the Braden Scale. Its reliability ranges from 0.83 to 0.99. The research findings provide evidence to support the clinical problem. From the findings, healthcare-associated infections are still common in the healthcare setting, which highlights the need for better intervention. Implementation of nurse protocols that focus on reduction of the same is therefore key in reducing the rates of infection.

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Conclusion

Healthcare-associated infection is one of the leading causes of death and high healthcare spending in the world today. Therefore, there is always a need to come up with better strategies to control the same. In particular, this write-up has focused on catheter-associated urinary tract infections which are also common in clinical settings. While various strategies have been applied in trying to address and control the same. The implementation of an educational nursing protocol was found to be effective in lowering the rates of CAUTI significantly. However, bathing using chlorhexidine was not such effective as was predicted. The question remains, can these protocols be placed as the standards of practice, especially the ones shown in research papers, to be effective?

References

Bui, L. N., Swan, J. T., Perez, K. K., Johnson, M. L., Chen, H., Colavecchia, A. C., … & Graviss, E. A. (2020). Impact of Chlorhexidine Bathing on Antimicrobial Utilization in Surgical Intensive Care Unit. Journal of Surgical Research, 250, 161-171. https://doi.org/10.1016/j.jss.2019.12.049.

da Silva, A. A., Marques, A. F., di Biase, C. B., Zingg, W., Dramowski, A., & Sharland, M. (2018). Interventions to prevent urinary catheter-associated infections in children and neonates: a systematic review. Journal of pediatric urology, 14(6), 556-e1. https://doi.org/10.1016/j.jpurol.2018.07.011.

Healthy People 2020. (2021, November 28). Healthcare-associated infections. Healthcare-Associated Infections | Healthy People 2020. https://www.healthypeople.gov/2020/topics-objectives/topic/healthcare-associated-infections

Zurmehly, J. (2018). Implementing a nurse-driven protocol to reduce catheter-associated urinary tract infections in a long-term acute care hospital. The Journal of Continuing Education in Nursing, 49(8), 372-377. https://doi.org/10.3928/00220124-20180718-08

Appendix A: The Evidence Matrix Table

 

Article

  

References

 Purpose

Hypothesis

Study Question(s)

 Variables

Independent(I)

Dependent(D)

 Study Design Sample

Size &

Selection

 Data Collection

Methods

  

Major Finding(s)
1 Zurmehly, J. (2018). Implementing a nurse-driven protocol to reduce catheter-associated urinary tract infections in a long-term acute care hospital. The Journal of Continuing Education in Nursing, 49(8), 372-377. https://doi.org/10.3928/00220124-20180718-08

 

 This research examines the impact of a nursing quality improvement education program on the rates of catheter-associated urinary tract infections. Dependent variable: rates of catheter-associated urinary tract infections

Independent variable: Education program

 Quantitative N=120

Convenient sampling was used to select the research subjects in a large long-term acute care hospital in the Midwestern state.

 Use of questionnaire Upon the implementation of the education program, various important findings came up, including:

 

–          A reduction of urinary catheter days by 10.1 %

–          A reduction in CAUTI incidences by seventy-four percent.

–          The implication is that the education initiative was effective in decreasing the rates of catheter-associated urinary tract infections and the number of catheter days.
2 Bui, L. N., Swan, J. T., Perez, K. K., Johnson, M. L., Chen, H., Colavecchia, A. C., … & Graviss, E. A. (2020). Impact of Chlorhexidine Bathing on Antimicrobial Utilization in Surgical Intensive Care Unit. Journal of Surgical Research, 250, 161-171. https://doi.org/10.1016/j.jss.2019.12.049

 

 The purpose of this study was to ascertain bathing using chlorhexidine lowered the antimicrobial utilization in the surgical intensive unit, which can result in a lower antimicrobial resistance burden reduction. Dependent: total antimicrobial defined daily dose

Independent: chlorhexidine bathing

 Quantitative N=312

The patient admitted to the facility’s ICU were included after screening using Braden Scale.

 Questionnaire The major finding is that even though the use of chlorhexidine bathing led to a reduction of the antimicrobial defined daily dose, such an impact was not significant, as indicated by a big p-value.

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NR341/342 Complex Adult Health

RUA Interdisciplinary Management of Healthcare Technology Guidelines

Purpose

This purpose of this assignment is for the student to present a complete picture of interdisciplinary care using specific therapeutic modalities in the care of a complex adult health client. The student will demonstrate clinical reasoning skills and will discuss interdisciplinary care that had been incorporated and/or anticipated using a healthcare technology or therapeutic modality for the care of the complex health client.

Course outcomes: This assignment enables the student to meet the following course outcomes:

  1. Provide patient and family centered nursing care to adults with complex health needs using theories and principles of nursing and related disciplines. (PO 1)
  2. Initiate the use of appropriate resources in direct care responsibilities within complex adult health (PO 2)
  3. Demonstrate effective therapeutic communication and relationship skills in family centered nursing care to adults with complex health needs. (PO 3)
  4. Demonstrate effective clinical decision making based on critical thinking skills and legal, ethical, and professional standards and principles when caring for patients and families with complex adult health needs. (POs 4 and 6)
  5. Implement a plan of care for continued personal, professional, and educational development related to nursing practice with complex adult health situations. (PO 5)
  6. Use evidence including research findings from nursing and related disciplines to answer clinical questions related to nursing care of patients with complex adult health needs. (PO 8)

Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

Total points possible: 100 points

Preparing the assignment

Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

  • Choose a therapeutic modality or healthcare
  • Examples of a therapeutic modality include Extracorporeal Membrane Oxygenation, Automatic rotating pronation beds, right and/or left ventricular assist devices, nontraditional ventilator modes.
  • Examples of healthcare technology can include regional O2 saturation monitoring (NIRS).
  • Refer to your faculty member if your selection requires prior
  • Write a 4-5 page paper (not including the title page or reference page) using APA
  • For APA, formatting, or grammar assistance visit the APA Citation and Writing page in the online
  • Include the following sections (detailed criteria listed below and in the Grading Rubric):
    1. Introduction – 5 points/5%
      • The chosen therapeutic modality or healthcare technology meets one of the following criteria:
        • Has been introduced recently at the bedside for care of the complex adult
        • Is a non-traditional modality for very ill patients in special
        • Is being used in a new way to treat a patient with complex
        • Requires specific training above and beyond general entry-level nursing
      • Introduce the therapeutic modality or healthcare

NR341 Complex Adult Health

RUA Interdisciplinary Management of Healthcare Technology Guidelines

  • Name the therapeutic modality or healthcare
  • A brief fictional case is used to illustrate the therapeutic modality or healthcare
  1. Explanation and Background– 15 points/15%
    • Include a clear description of the therapeutic modality or healthcare
    • Discuss how the therapeutic modality or healthcare technology
    • Describe the patient population it is used
    • Include medication, safety, and cost considerations as
  2. Risks and Benefits– 15 points/15%
    • Describe how the therapeutic modality or healthcare technology can benefit the
    • Discuss ways to promote positive
    • Explain the complications that may
    • Discuss considerations for preventing
  3. Interdisciplinary team’s Roles and Responsibilities– 20 points/20%
    • Identify all interdisciplinary team members caring for the patient, such as respiratory therapy, assistive personnel, providers, case managers, clinical nurse specialists, and researchers.
    • Describe the roles and responsibilities of each member of the healthcare team that is involved in the use of the therapeutic modality or healthcare technology.
    • Discuss the roles and responsibilities of the nurse as a member of the interdisciplinary team caring for the
    • Discuss one challenge in working with an interdisciplinary
  4. Nursing Scope of Practice – 15 points/15%
    • Discuss the knowledge needed for the Registered Nurse to provide care for the patient using the therapeutic modality or healthcare technology.
    • Describe skills needed for the Registered Nurse to provide care for the patient using therapeutic modality or healthcare technology.
    • Discuss attitudes needed for the Registered Nurse to provide care for the patient using therapeutic modality or healthcare technology.
  5. Patient Education – 20 points/20%
    • Describe the information to be taught to the patient and/or
    • Discuss how information will be
    • Discuss potential cultural considerations to
    • Explain how the effectiveness of the teaching will be
  6. Conclusion – 5 points/5%
    • Provide a summary of the
    • No new information is
    • Include additional resources for further
  7. APA Style and Organization – 5 points/5%
    • References are submitted with
    • Uses current APA format and is free of
    • Grammar and mechanics are free of
    • At least three (3), nursing, scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided.

Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned.

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Grading Rubric

Criteria are met when the student’s application of knowledge within the paper demonstrates achievement of the outcomes for this assignment.

Assignment Section and Required Criteria

(Points possible/% of total points available)

 Highest Level of Performance High Level of Performance Satisfactory Level of Performance Unsatisfactory Level of Performance Section not present in paper
Introduction

(5 points/5%)

 5 points 4 points 3 points 2 points 0 points
Required criteria

1.       The chosen therapeutic modality or healthcare technology meets one of the following criteria:

·         Has been introduced recently at the bedside for care of the complex adult patient.

·         Is a non-traditional modality for very ill patients in special circumstances.

·         Is being used in a new way to treat a patient with complex needs.

·         Requires specific training above and beyond general entry-level nursing education.

2.       Introduce the therapeutic modality or healthcare technology.

3.       Name the therapeutic modality or healthcare technology.

4.       A brief fictional case is used to illustrate the therapeutic modality or healthcare technology.

 Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
Explanation and Background

(15 points/15%)

 15 points 13 points 11 points 6 points 0 points
Required criteria

1.       Include a clear description of the therapeutic modality or healthcare technology.

2.       Discuss how the therapeutic modality or healthcare technology works.

3.       Describe the patient population it is used for.

4.       Include medication, safety, and cost considerations as applicable.

 Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no fewer than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.

 

Risks and Benefits

(15 points/15%)

 15 points 13 points 11 points 6 points 0 points
Required criteria

1.       Describe how the therapeutic modality or healthcare technology can benefit the patient.

2.       Discuss ways to promote positive outcomes.

3.       Explain the complications that may arise.

4.       Discuss considerations for preventing complications.

 Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
Interdisciplinary Team’s Roles and Responsibilities (20 points/20%)  

20 points

  

18 points

  

16 points

  

8 points

  

0 points
Required criteria

1.       Identify all interdisciplinary team members caring for the patient, such as respiratory therapy, assistive personnel, providers, case managers, clinical nurse specialists, and researchers.

2.       Describe the roles and responsibilities of each member of the healthcare team that is involved in the use of the therapeutic modality or healthcare technology.

3.       Discuss the roles and responsibilities of the nurse as a member of the interdisciplinary team caring for the patient.

4.       Discuss one challenge in working with an interdisciplinary team.

 Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
Nursing Scope of Practice

(15 points/15%)

 15 points 13 points 6 points 0 points
Required criteria

1.       Discuss the knowledge needed for the Registered Nurse to provide care for the patient using the therapeutic modality or healthcare technology.

2.       Describe skills needed for the Registered Nurse to provide care for the patient using therapeutic modality or healthcare technology.

3.       Discuss attitudes needed for the Registered Nurse to

 Includes no fewer than 3 requirements for section. Includes no fewer than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.

 

provide care for the patient using therapeutic modality or healthcare technology.        
Patient Education

(20 points/20%)

 20 points 18 points 16 points 8 points 0 points
Required criteria

1.       Describe the information to be taught to the patient and/or family.

2.       Discuss how information will be taught.

3.       Discuss potential cultural considerations to teaching

4.       Explain how the effectiveness of the teaching will be evaluated.

 Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements were met for this section.
Conclusion

(5 points/5%)

 5 points 4 points 3 points 2 points 0 points
Required criteria

1.       Provide a summary of the paper.

2.       No new information is introduced.

3.       Include additional resources for further learning.

 Includes no fewer than 3 requirements for section. Includes no fewer than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
APA Style and Organization

(5 points/5%)

 5 points 4 points 3 points 2 points 0 points
Required criteria

1.       References are submitted with paper.

2.       Uses current APA format and is free of errors.

3.       Grammar and mechanics are free of errors.

4.       At least three (3), nursing, scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided.

 Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes no less than 1 requirement for section. No requirements for this section presented.
Total Points Possible = 100 points

 

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