Mission Statement
It is a 166 bed hospital named X hospital. Emergency department of this hospital is nominated as level 1 trauma centre. There are three ICUs in the hospital like obstetrics, surgery and pediatrics. Dedicated facilities are there for internal medicine, family medicine and anesthesia. Healthcare services of this facility can be availed by patients of all age groups and patients of all socioeconomic classes. These community clinics also include ambulatory surgical centers. This healthcare facility is situated near the commercial port. Hence, there may be high chances of entry of potential pathogens. Hence, biosafety level 4 research facility was started 1 year before.
This healthcare facility is situated at the port, climate at its location is usually humid. Although, X hospital is providing all the important healthcare services, there may be health deterioration of the healthcare staff and patients due to high risk of potential infection. Many patients in the healthcare facility need to stay for the long duration in this healthcare facility, hence there are more chances of infection to these patients. Most of the hospital acquired infections are due to the environmental contamination and poor patient hygiene and it rarely depends on the condition of the patient. This is main obstacle in the expansion of this healthcare facility. Hence, measures should be taken to reduce or prevent infection in patients and healthcare staff in this healthcare facility. Mission statement of healthcare facility to improve healthy living and safeguard health by facilitating access to broad, fully integrated network of the premier quality and prominently affordable care, delivered with kindheartedness, honesty and respect (Lautenbach et al., 2010).
Construction is underway for another 300 bed facility for the neonatal intensive care unit, neurosciences critical care unit, and a burn ICU for adults. It would be ready in next 18 months. Along with this inpatient healthcare facility, network of community clinics are available at different locations. Vision of this healthcare facility is to guide the progression of healthcare to facilitate each and every member of the community to avail better and healthy life. Values of this healthcare facility comprises of quality, compassion, respect, collaboration and foresight. This healthcare facility is setting and exceeding highest level standards. It is also building faster and resourceful healthcare organization to deliver exceptional and appropriate healthcare service to all, at the right place and right time. It is implementing culture of care to provide holistic care. It includes communication with the each patient and family members with sympathy, integrity and candidness. Each patient is going to avail care by considering varied perspectives of the patient. These diverse perspectives of the patient comprises of social, cultural and economic factors. Healthcare service is principally integrated service comprising of different professional like doctors, nurses, clinical laboratory scientist, social workers and management personal of the healthcare facility. This healthcare facility is working in collaboration among different departments by sharing information, knowledge and skills through effective communication. This healthcare facility is anticipating future challenge and it would be helpful in implementing innovative ways to engage in these challenges (Bennett et al., 2007).
Vision
Goals of the infection control programme include:
- To reduce risk of acquirement of healthcare-associated infections in patients,
- To reduce risk of acquirement of occupationally-acquired infections in healthcare staff,
- To reduce resistant endogenous bacterial colonization,
- To eliminate of unnecessary antibiotic therapy,
- To eliminate infective agents (Rello et al., 2010).
Department of Healthcare Epidemiology should play significant role in the infection control and prevention programme. Department of Healthcare Epidemiology is headed by Director of Healthcare Epidemiology, who reports to chief medical officer. Clinical microbiology department should submit laboratory report to department of healthcare epidemiology about surveillance cultures from patients of Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant enterococci (VRE), strain typing for suspected clusters/outbreaks, and environmental cultures. Staff recruited for the infection control and prevention programme include 8 infection prevention preventionist, 1 epidemiology technician, 1 administrative officer, staff for hand hygiene and PPEs audit and student research assistant. Qualification requirements for staff of infection control and prevention programme include doctors, nurses and masters degree in public health. This staff should spend weekly 30 hours for 6 months for infection control and prevention programme (Stricof et al., 2008).
Main Functions of this Staff Should Comprise of:
- collection, analysis and interpretation of data on the occurrence of infections,
- teaching infection control and prevention policies and procedures to patients and healthcare staff,
- monitoring outbreaks,
- handling isolation issues on daily basis,
- development of policies by conducting meetings on regular basis,
- monitoring of patient health and preparation for emergency department (Stone et al., 2009).
There should be effective communication policy to address both internal and external communications. Internal communication can be done by healthcare providers. Communication should be directed towards establishing priorities for preventing future incidence of infection, efficient control of outbreaks and lessening impact of outbreaks. These types of communications should be done in internal meetings. There should be efficient procedure for the receiving and responding to the internal and external notices. These notices would be helpful in communicating important updates on the progress of the infection prevention programme. Materials required for the effective communication are telephone, pager, fax and copying services, and basic office supplies (Perz et al., 2010).
Education to the employees on the control and prevention of infection should be provided on the regular basis. There should be specific communication to each department and unit on the infection control. This information should be provided to the new employees during the new employees orientation programme. Update should be given to clinical employees every three months on the standard precautions implemented and infection control topics. These updates should be given through presentation or through on-line electronic learning modules.
There should be different approach to communicate to the patients. There should be patients’s isolation signs on the door. These signs should be in English and local language. These signs should indicate all the precautions necessary for entering in the patient’s room. Fillers should be placed on the patient’s admission pack to remind them about washing their hands and using alcohol hand rub. Patients should be given access to different education websites with fillers for infection control and prevention. If patient is kept in the isolation, nurse should provide him/her with filler comprising of isolation precautions (Vayalumkal and Martin, 2014).
Goals
Risk assessment should be done by getting input from the Health, Safety and Environment (HSE) department, nurse and doctors. Risk assessment should consider factors like geographic location, healthcare services provided, community people and characteristic of the patients. These risk factors should be assessed based on the probability of episode, intensity of occurrence, preparation of the hospital for risk management and regulatory requirements. This risk assessment would be helpful in prioritizing goals of the infection control and prevention programme. After goal setting next step should be allocation of resources for infection control and prevention. There should be reassessment and modification in the goals based on the issues observed during the activities of infection control. In this hospital highest priority should be given to the prevention of catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI) and needlesticks. There should be development of standardized protocols for infection prevention. These protocols should be in compliance with the standard operating procedures for critical and semi-critical equipments. These protocols should comprise of methods for screening and vaccination, monitoring of exposure and furlough of infection susceptible employees. There should be collaboration between the environmental health and safety department and clinical department for the prevention of both respiratory infections and blood borne infections. There should be monitoring of the implementation of the programme on weekly basis by the chief administrative officer of the programme. There should be evaluation of the material required for the prevention of infection. These materials should support infection control in efficient manner. Emergency department should be well equipped for the screening of the infectious disease like diarrhea, tuberculosis, and influenza (Yokoe et al., 2008).
There should be implementation of various committees like pharmacy and therapeutics committee, antimicrobial subcommittee, environment of care committee, general safety, and emergency management, for the effective implementation of the infection control and prevention. Infection control policies and protocols should be developed by collaborative efforts of the clinical, administrative and infection control team.
Prevention of healthcare associated infections should comprise of prevention of devise associated infections, prevention of surgical site infections, control of epidemiologically-significant organisms, monitoring and improvement in the hand hygiene and adherence to standard isolation precautions. Devise associated infections like Central line associated bloodstream infections (CLABSI) can be prevented by use of ultrasound for insertion, optimal selection of site, sterilization of the necessary requirements, use of 70 % alcohol, aseptic change of dressings and tubing, staff should be educated about the prevention of CLABSI and catheters should be assessed on the daily basis. Prevention of catheter-associated urinary tract infections (CAUTI) should be done by reducing application and duration of urinary catheters, facilitating aseptic insertion, keeping close drainage system, implementing aseptic method for the opening and reconnecting catheters, and CAUTI should be assessed by leader in the group on regular basis (Mermel et al., 2009). Surgical site infections can be prevented by initiation of the antibiotic prophylaxis upon approval from the Antibiotic Subcommittee of the Pharmacy and Therapeutics Committee, promoting hand hygiene and skin preparation, improving environmental controls and it should comply with guidelines for disinfection and aseptic storage of the equipments. Epidemiologically-significant organisms like vancomycin-resistant Enterococcus (VRE), methicillin-resistant, Staphylococcus aureus (MRSA), Clostridium difficile, Acinetobacter baumannii, carbapenemase-resistant Enterobacteriaceae (CRE), and extended spectrum beta-lactamase producing gram negative bacilli (ESBL) should be controlled. Microbiology laboratory reports should be checked on daily basis to identify epidemiologically significant microorganism. If these organisms are identified in a person isolation should be implemented quickly, active surveillance should be performed in ICUs, environmental culture should be performed and there should be electronic record maintenance of the patient with infection and precautions should be taken for such patients on readmission to the hospital (Ray et al., 2009). Hand hygiene compliance should be improved by providing proper education to the personal and this education should be based on the Centers for Disease Control and Prevention (CDC) guidelines. Healthcare Epidemiology and clinical department should work in collaboration for improving hand hygiene compliance. Healthcare Epidemiology department should carry out surveillance in all the departments about hand hygiene and clinical department should monitor hand hygiene compliance. There should be compliance in the isolation precautions. Compliance to isolation can be improved by improving availability of the PPEs. There should also be sufficient availability of PPEs at store room. Proper medical record of the patient should be maintained with isolation. Staff infection should be reported to the employee health unit and patient infection should be reported to the doctor (Saxena and Mani, 2014; Ertugrul et al., 2016).
Staffing Requirements
Prevention of infections associated with the medial equipment and environment should comprise of prevention of infections associated with use of medical equipments, construction, potable water and ventilation (HVAC) system. There should be implementation of strategies for disinfection and sterilization according to the CDC guidelines. Places of high risk of infection should be identified and should be monitored by the infection preventionist on the regular basis. Infection prevention related to the construction should be implemented with highest priority. Unfiltered water should be assessed on the regular basis and filters should be fixed on the fixtures. Infection prevention strategies should be implemented for ventilation (HVAC) system. Air culture should be done in clinical areas.
Prevention of occupationally acquired infections and transmission by infectious staff to others can be prevented by implementing employee health policies, initial and annual assessment of health, immunization for the common communicable diseases, screening of employees for the susceptibility to the blood borne infections, prophylaxis of employees after exposure to the pathogens, furlough of infectious employees, maintenance of list of employees with infections, assessment of the susceptibility to the infections from the history and by carrying out serology testing and isolation of patient and healthcare provider with infection. Outbreaks should be investigated and controlled. In this process, there should be case finding, culture of patient and environment, and analysis of the epidemic pattern. Control measures for outbreaks should be developed and implemented as quickly as possible (Mehta et al., 2014).
Evaluation of infection control and prevention programme should be performed every six months. This evaluation would be helpful to assess whether risk of infection is lowered or not. Evaluation can be performed in different criteria like accurate implementation of the prevention strategies and prioritized goals, accomplishment of set targets for infection control which are in compliance with the policies, standards and regulatory bodies.
This evaluation would be helpful in improving infection prevention prograame. This evalution should be presented to infection control comitee and Committee and Quality of Care Committee.
Use of PPE is used as the measurement indicator for the evaluation of the infection control and prevention programme. Healthcare facility established policy for the use of PPEs both for patients and healthcare staff. These PPEs should be clinical case specific. Proper job-specific training was provided for the use of PPEs. Scheduled audit was performed for adhering to the use PPEs and feedback was provided to the personal about use of PPEs. PPEs like gloves, gowns and masks should be made available for all the time. At the end of the 6 months period, survey was conducted among the healthcare staff about use of PPEs. Survey was conducted for use PPEs by healthcare staff and patients. Information about the use of PPEs by patients should be collected from the healthcare staff. Adherence to the use of PPEs should be evaluated based on the percentage of individuals using PPEs. Number of people using PPEs after implementation of the infection control and prevention programme should be compared with the people using PPEs prior to the implementation of the programme. Evaluation also should be done by observing proper use of PPEs by senior person in the hospital. This observation should comprise of right PPE at the right time and following standard procedures for the use of PPEs. At the end of the programme, there should be significant increase in the number of people using PPEs (John et al., 2017; Verbeek et al., 2016).
Main Functions of this Staff Should Comprise of
References:
Bennett, J. V., Jarvis, W. R., and Brachman, P. S. (2007). Bennett & Brachman’s Hospital Infections. Lippincott Williams & Wilkins.
Ertugrul, S., Aktar, F., Yolbas, I., Yilmaz, A., Elbey, B., Yildirim, A., Yilmaz, K., and Tekin, R. (2016). Risk Factors for Health Care-Associated Bloodstream Infections in a Neonatal Intensive Care Unit. Iranian Journal of Pediatrics, 26(5),:e5213.
John, A., Tomas, M.E., Hari, A., Wilson, B.M., and Donskey, C.J. (2017). Do medical students receive training in correct use of personal protective equipment?. Medical Education Online, 22(1), doi: 10.1080/10872981.2017.1264125.
Lautenbach, E., Woeltje, K. F., and Malani, P. N. (2010). Practical Healthcare Epidemiology: Third Edition. University of Chicago Press.
Mehta, Y., Gupta, A., Todi, S., Myatra, S., Samaddar, D.P., Patil, V., Bhattacharya, P.K., and Ramasubban, S. (2014). Guidelines for prevention of hospital acquired infections. Indian Journal of Critical Care Medicine, 18(3), 149-63.
Mermel, L.A., Allon, M., Bouza, E., Craven, D.E., Flynn, P., O’Grady, N.P., et al. (2009). Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 49, 1–45.
Perz, J.F., Thompson, N.D., Schaefer, M.K., Patel, P.R. (2010). US outbreak investigations highlight the need for safe injection practices and basic infection control. Clinical Liver Disease, 14, 137–51.
Ray, B., Samaddar, D.P., Todi, S.K., Ramakrishnan, N., George, J., Ramasubban, S. (2009). Quality indicators for ICU: ISCCM guidelines for ICUs in India. Indian Journal of Critical Care Medicine, 13(4), 173–206.
Rello, J., Kollef, M. H., Díaz, E., and Rodríguez, A. (2010). Infectious Diseases in Critical Care, Springer Science & Business Media.
Saxena, P., and Mani, R.K. (2014). Preventing hospital acquired infections: A challenge we must accept. Indian Journal of Critical Care Medicine, 18(3), 125-6.
Stone, P. W., Dick, A., Pogorzelska, M., Horan, T., Furuya, Y., and Larson, E. (2009). Staffing and structure of infection prevention and control programs. American Journal of Infection Control, 37(5), 351–357.
Stricof, R.L., Schabses, K.A., and Tserenpuntsag, B. (2007). Infection control resources in New York State hospitals. American Journal of Infection Control, 36(10):702-5.
Vayalumkal, J. V., and Martin, S. (2014). Effective Communication of Infection Control Data: How Do We Give Them What They Want?. American Journal of Infection Control, 42(6), S72.
Verbeek, J.H., Ijaz, S., Mischke, C., Ruosalainen, J.H., et al. (2016). Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. Cochrane Database of Systematic Reviews, 19(4), CD011621. doi: 10.1002/14651858.CD011621.
Yokoe, D.S., Mermel, L.A., Deverick, A.J., Kathleen, A.M., Burstin, H., David, C.P., et al. (2008). Executive Summary: A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals. Infection Control and Hospital Epidemiology, 29, S12–S21.
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
