Quality Improvement Initiative in Hospitals
Quality improvement is an essential part of the plans of every hospital that wishes to deliver the best services to its customers. For a long time, nosocomial infections have been a major concern in all hospital operations. The possibility of people acquiring hospital infections is very real. It is an issue that needs to be constantly addressed to a point where the hospital-acquired infections are brought down to zero. As a result, the elimination of nosocomial infections should be a constant target for quality improvement initiatives. This article shall explore the prevention and elimination of hospital acquired infections as a quality improvement initiative. The article shall reconnoiter various facets of this initiative, starting from its purpose, its target audience, its benefits, costs and evaluation.
Keywords: nosocomial infections, quality improvement
The Purpose of the Program or Project
Nosocomial infections are infections that are acquired by people within the hospital environment. Both patients and hospital workers are at risk of acquiring nosocomial infections, but there is an increased risk among patients because of their increased vulnerability to infections due to their immune-compromised state. Nurses are, in particular, in a very close contact with patients. This gives them an enhanced role in the fight against nosocomial infections.
The risk that nosocomial infections present necessitates incessant quality improvement measures. The number of deaths arising from hospital-acquired infections is a marked threat to the quality of healthcare in general. Therefore, several measures to reduce the incidence of such infections have been proposed, and they are all part of the quality improvement initiative.
This quality improvement measure is a multifaceted initiative. The infection control department takes charge of monitoring and surveillance of all cultures from the laboratories (McNamara, Fealy & Geraghty, 2013). Moreover, a program to monitor and keep track of Multiple Drug Resistance Organisms (MDROs) in the surrounding community has been set rolling. This is because such organisms continue to pose a threat to healthcare provision in the hospital. Additional measures include: practicing novel concepts in caring for indwelling urinary catheters so as to reduce urinary tract infections and installing hygiene sanitizer receptacles to each and every patient care unit.
The Target Population/Audience
As it was mentioned earlier, members of the entire hospital community, including physicians, surgeons, nurses, patients and all other hospital workers, are at risk of acquiring nosocomial infections. Therefore, these quality improvement measures are targeted at all the faculties within the hospital community. In particular, special emphasis is put on nurses because of their versatile roles in hospital operations and their close contact with patients.
Special emphasis is also put on patients and the health workers that come into direct contact with them. For instance, all the people that go into the wards –of whom nurses are the most frequent – are expected to make use of the sanitizers before they enter the wards (Madsen, 2000). Some of the measures also target members of the larger community, who are potential carriers of agents of infection. For instance, monitoring of MDROs is a quality improvement measure that targets the larger community and aims at forestalling the entry of such organisms into the hospitals. Therefore, the target audience for the measures listed is a wide audience, right from within the hospital community to the larger community outside the hospital.
Benefits of the Program/Project
The project to reduce nosocomial infections has palpable benefits. The first and most obvious benefit is that it reduces the tremendous cost of human life. Indeed, quite a substantial number of deaths is attributable to nosocomial infections. This is because patients who fall victim to such infections are already immune-compromised and, therefore, exhibit minimal resistance to such infections. Therefore, reducing these infections would, in turn, reduce the number of deaths attributable to the infections.
Another benefit would be that it enables the hospital to save on costs that would be used to purchase antibiotics for the treatment of nosocomial infections. Indeed, the project might, in itself, be very costly; however, the cost of treating nosocomial infections is far greater (Graves, Jarvis & Halton, 2009). Thus, a cost-benefit analysis reveals that the preventive measures taken are profitable.
The community around the hospital also stands to benefit from this project. Indeed, it is an obligation of any healthcare provider to give back to the community. As a way of giving back to the community, the studies involving the monitoring of MDROs would be a way of managing infections arising from such organisms at the community level. This would not only help the hospital keeps such infections at bay, but it would also enable the hospital extend a helping hand to the community in terms of monitoring and preventing such infections.
The Cost or Budget Justification
Indeed, the program would be a costly one to run, given its multifaceted nature. Here is a quick breakdown of the costs that may arise from such an undertaking.
Laboratory culture surveillance would cost between $25 and $30 a test, but the overarching costs would depend on the number of cultures to be done and the turnaround time per culture (Weinstein, Diekema & Edmond, 2007). In a case where 10 samples are studied daily, the total costs for lab culture tests would raise the overall laboratory spending on lab surveillance by about $250 to $300 daily. Therefore, the overall cost would be dependent on the number of tests that are carried out per unit time.
Monitoring MDROs in the surrounding community might be a more costly undertaking because of research and field nature of the job. In essence, a monitoring program that runs for a month might cost over $10,000 on a monthly basis, and this depends on the size of the community in interest and how extensive the monitoring plan is.
The hospital-based measures of preventing nosocomial infections could increase hospital spending by about $5,000 monthly. Again, this is subject to the size of the hospital and the number of patients and staff that it handles.
On the whole, therefore, the entire initiative may cost between $25,000 and $ 30,000 monthly for a hospital with a capacity to admit, say, 200 patients. If the program should run for an entire year, the overarching costs would be about $360,000. This is just a rough outline; a detailed budget will be given in the actual proposal.
The Basis upon Which the Program is Evaluated
The entire program would be evaluated on simple precepts. These would help the administrators of the program to know how successful it is and how much more effort would need to be added. First, the program would be evaluated on the number of patients who acquire nosocomial infections during the program. This number would be analyzed in terms of percentages and ratios to investigate whether or not the program is successful in reducing nosocomial infections. Secondly, the program would be evaluated on the basis of the costs used in treating nosocomial infections. If the costs remain higher than the costs for the preventive measures, then the program would be dubbed a failure (Platt et al., 2010).
Lastly, the program would be evaluated on the basis of whether or not it has successfully tracked and reduced the incidence of infections arising from MDROs, both in the hospital and the surrounding community. The program is meant not only to reduce nosocomial infections but also to help the surrounding community manage and reduce infections arising from MDROs.
Indeed, the danger of nosocomial infections can be handled. The measures that have been laid out in this summary are feasible and affordable. Hopefully, they will help reduce the incidence of nosocomial infections within the hospital.