Eradicating Healthcare-Associated Infections: Solutions From McNeal Hospital - Research Paper

Introduction

Healthcare-associated infections have been a major problem within the United States healthcare system. Patients usually contract such kinds of infections during the delivery of complex operations, such as those involving dialysis. Healthcare providers across the United States, including McNeal hospital, have tried to devise viable solutions that can help in eradicating such infections, which have fatal consequences for both medical professionals and to the individual patients (Weber, Rutala, & Fried, 2016).

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Human factors that result from their interactions with dialectic machines are some of the leading causes of morbidity that results from these operations. Some of the human factors include suboptimal communication among caregivers that result in errors and individual errors while they operate these dialysis machines as well as unhygienic conditions (Nguyen, Gutowski, Ghiselli, Cheng, Bel, Suryaprasad, Xu, & Patel, 2016). There are three major types of healthcare-associated infections that patients can contact in any healthcare setting. Such infections include catheter-associated urinary tract infection, surgical site infection, and central line-associated bloodstream infection. Dialysis unit in any healthcare providers across the globe provides safe and effective procedures for patients that can improve their health conditions. However, these patients end up contracting the highly dangerous healthcare-associated infections. There must be solutions that can be applied in any healthcare providing centers offering dialysis services like McNeal dialysis unit to help in reducing such cases. This paper will highlight some of the solutions that can be implemented by McNeal Dialysis units and other dialysis units across the globe to enhance their safety culture.

Problem Statement

Healthcare providers have the responsibility of ensuring the overall safety of the society by providing medical attention to all individuals whenever necessary. They are required to uphold an astute culture of safety standards within their systems, procedures, and processes (Nguyen et al., 2016). According to the agency for healthcare research and quality, an organization's safety culture is the product of individual and group values, competency, perception, and behavioral patterns that determine an organization's commitment to its style of professionalism in service delivery (Nguyen et al., 2016). Both back-filtration and back-diffusion provide a pathway for contaminants in dialysis fluid from compromised water quality. On the same note, returning unused items to a common area or using them on another patient before their disinfection increases the chances of contracting healthcare-associated infections for both patients and healthcare professionals involved.

Additionally, failure to screen patients for hepatitis B virus (HBV) and hepatitis C virus (HCV) before admitting them into hospitals also increases the chances of individuals within the healthcare setting contracting infections (Bixler & Patel, 2019). These are some of the avenues through which patients and healthcare staff members contract healthcare-associated infections, which are deadly and fatal. Hospitals are charged with ensuring the safety of the community by decreasing mortality rates within the country. Nonetheless, it remains unclear as to why such mortality rates remain high.

Relevancy of the Problem

Organizations offering dialysis services should operate as highly responsible entities with a well-structured safety culture. They are expected to operate within the five principles of High-Reliability Organization, which include: resilience, deference to expertise, reluctance to simplify, preoccupation to failure, and sensitivity to operations (Kear & Ulrich, 2015). Collectively, these principles ensure all safety standards within an organization are adhered to, thereby enhancing the organizational safety culture. All the stakeholders within the united state's healthcare industry have directed their efforts in ensuring total elimination of these infections among healthcare centers. The country has put in place procedures that can enhance a wholesome collaboration of all stakeholders within the healthcare system to ensure viable and practical solutions that can combat such a problem (Bayoumi, Ahmed & Hassan, 2019). Research on healthcare-associated infections is equally critical for finding feasible solutions and improving healthcare outcomes.

Patients seek health relief from hospitals. However, some of them end up contracting healthcare-associated infections. Consequently, the infections deter some other patients from seeking delicate services such as dialysis, thereby compromising their safety, and, as a result, leading to an increase in mortality rate within the country. Thus, McNeal Dialysis Unit needs to adopt better practices that can enhance their safety culture (Kear & Ulrich, 2015).

Literature Review

According to Kear and Ulrich (2015), infection is the leading cause of hospitalization among nephrology patients, and nurses are critically involved in identifying and controlling infections among patients. Kear and Ulrich (2015) performed research aimed at finding solutions that can decrease infections among nephrology patients. The results from the study indicated that the safety of nephrology patients is compromised due to the massive violation of proper infection control standards in a nephrology setting. Among the solutions, the study provided includes the adoption of the five moments of hand hygiene that was provided by the world health organization (WHO) (Kear & Ulrich, 2015). These moments include before touching a patient, before an aseptic procedure, after a body fluid exposure, and after touching a patient, as well as after touching a patient's surroundings. The study concluded by identifying that in enhancing safety culture practices in a dialysis unit, everyone should be accountable, including the patients (Kear & Ulrich, 2015).

Nguyen, Bixler, and Patel (2019) conducted a study that aimed at highlighting how the hepatitis C virus is transmitted in a healthcare setting and the possible solutions that can be implemented to prevent such transmission. The study identified rushed treatment schedules, high staff turnover, and lack of infection control knowledge by the staff as the factors contributing to non-adherence to the necessary infection control measures in a nephrological setting. The study recommended regular screening of patients with negative anti-HCV antibodies on admission to ensure they are treated separately to minimize the chances of contracting these viruses. Additionally, it also suggested continuous training programs for all dialysis unit staff members to ensure they are adequately updated and healthcare providers to follow the guidelines put in place by the Center for Disease Control and Prevention (CDC) in screening hemodialysis patients.

Bayoumi, Ahmed, and Hassan (2019) performed a cross-sectional study that aimed at highlighting nurses' practices towards applying infection control measures using the notice checklist. The study concurred with Kear and Ulrich (2015) on the critical involvement of nurses in implementing infection control measures. Bayoumi, Ahmed, and Hassan (2019) recommended designing an evidence-based training program for nurses to promote patient-centered care and enhance organizational safety culture. They also recommended awareness creation through the hanging of posters with essential steps of hand rubbing and glove pyramid as well as establishing a follow-up system to ensure constant adherence to infection control measures.

Lewis, Clark, Benda, and Hardwick (2014) conducted a study that aimed at reducing healthcare-associated infections by identifying and aligning work system factors. The study utilized a sociotechnical framework and, in particular, macro-ergonomic analysis and evaluated a 54-chair ambulatory dialysis unit (Lewis et al., 2014). It identified 57 system discrepancies among six healthcare-associated infections risk factors (Lewis et al., 2014). The study developed a multicomponent intervention to address 44 of the discrepancies across four risk factors (Lewis et al., 2014). The results obtained from the study indicated that there was no improvement in access to infection sites and access-related bloodstream infections. The study concluded that inconsistent adherence to infection control measures is a result of organizational and external environmental factors such as service area demographics, suppliers of equipment and machines, and policies of the hospital, among others (Lewis et al., 2014).

Conclusion

For long, healthcare-associated infections have been a menace that has resulted in high morbidity and mortality rates among the Americans. McNeal Hospital's Dialysis Unit needs to establish well structured and stringent measures that enhance the organization's safety culture to curb cases of healthcare-associated infections associated with the organization by instigating appropriate and effective reporting system. Healthcare professionals and specifically, the nurses are at the core in enhancing the necessary safety culture. Some solutions have undergone advancement that McNeal Dialysis Unit can utilize to further improving their safety culture. McNeal can adopt the Five-Moments Hand Hygiene approach, perform regular screening of patients with negative anti-HCV antibodies on admission, and continuously train staff members in the Dialysis unit to ensure that they are adequately updated. Additionally, McNeal Dialysis unit should establish a follow-up system to ensure constant adherence to infection control measures. Combating healthcare-associated infections requires the collaboration of all stakeholders within the healthcare system, including the patients.

References

Nguyen, D. B., Bixler, D., & Patel, P. R. (2019). Transmission of hepatitis C virus in the dialysis setting and strategies for its prevention. Seminars in Dialysis, 32, 2, 127-134. https:// doi.org/ 10.1111/sdi.12761

Bayoumi, M., Ahmed, A., & Hassan, H. (2019). Nurses' practices toward applying infection control measures using NOTICE checklists at a dialysis unit. Connect, 13, 2, 90-101. https://doi.org/ 10.1891/1748-6254.13.2.90

Lewis, V. R., Clark, L., Benda, N., & Hardwick, M. J. (2014). Reducing healthcare-associated infections in an ambulatory dialysis unit: Identification and alignment of work system factors. Ajic: American Journal of Infection Control, 42, 10.) https://doi.org/ 10.1016/j.ajic.2014.05.016

Nguyen, D. B., Gutowski, J., Ghiselli, M., Cheng, T., Bel, H. S., Suryaprasad, A., Xu, F., ... Patel, P. R. (2016). A large outbreak of hepatitis C virus infections in a hemodialysis clinic. Infection Control & Hospital Epidemiology, 37, 2, 125-133. Https:// doi.org/ 10.1017/ice.2015.247

Weber, D. J., Rutala, W. A., & Fried, M. W. (2016). Hepatitis C virus outbreaks in hemodialysis centers: A continuing problem. Infection Control and Hospital Epidemiology, 37, 2, 140-2. https://doi.org/ 10.1017/ice.2015.31

Kear, T., & Ulrich, B. (2015). Decreasing infections in nephrology patient populations: Back to basics. Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association, 42, 5.)