Leadership Development Plan for Specific Nosocomial Infections - Research Proposal Example

? Leadership Development Plan For Specific Nosocomial Infections (UTI, Wound/Incision, Pneumonia, Sepsis) Nursing I. Background and Significance of the Issue 1.1 Literature related to the issue Nosocomial infections (Hospital acquired infections) are a great challenge in the health care system and are documented to occur 48 hours after admission to hospital or 48 hours after discharge from hospital. It is estimated that 5-10 percent of the United States inpatients acquire a nosocomial infection during their stay in hospital with 6 percent dying annually and other thousands having to procure additional medical attention (Halpin et al., 2011). Nosocomial infections are caused by patient characteristics and hospital characteristics. Patient characteristics entail age, co-morbidities, severity of health status, and surgical and medical procedures. Hospital characteristics entail cross contamination, intensity of nursing care, and the extent to which the hospital adheres to the infection control program. Urinary tract infections, pneumonia, surgical wounds sepsis have been documented as the most common nosocomial infections and hence the prevalence of this research proposal (Hassan et al. 2010). 2. Accrediting or legislative bodies’ mandates/regulations The Hospital Infectious Disease Control Program accredited was accredited into law on January 2007. It required an appointment of a Healthcare Associated Infection Advisory Committee by the Department of Health Services. This team had the mandate of implementing a prevention and surveillance program. Hospitals were to implement procedures, policies that were aimed at preventing ventilator assisted pneumonia, and surgical sites infections as nosocomial infections (Halpin et al. 2011). 3. Professional organizations, standards/position statements Medical Facility Infection Control and Prevention Act is a standard that was signed into law in September 2008. It required that by the beginning of January 20, 2009, hospitals were required to report specific infection rates to the state. Included in the infections and relevant to this research proposal is infections associated with surgical sites. In January 2011, state’s Department of Public Health has been required to post the rates of nosocomial infections outlining their prevalence. This is to help consumers make an informed choice in seeking health care and for hospitals to increase their efforts in preventing nosocomial infections (Halpin, 2011). 4. Stakeholders A program cannot be successful if the nursing profession develops it solitarily. This therefore necessitates the need for involvement of other stakeholders. To begin with, the hospital administration that are the policy makers are important stakeholders that need to be involved. This is since they will be responsible for approving the development plan in their hospital sector. In addition, the community, which comprises the patients both within and outside the hospital sector, needs to be involved as the program is intended to benefit them. Finally, the medical practitioners: nurses, doctors, counselors, and social workers are important stakeholders that need to be involved in the development of the program (Miles & Vallish, 2010). II. Objectives of the Project Objectives should be SMART: Specific, Measurable, Attainable, Realistic, and Time bound. This project objective will be to reduce the prevalence of specific nosocomial infections (urinary infections, pneumonia, and incision sepsis by 22 percent by the end of the one-year project. III. Implementation Plan 1) Involvement of stakeholders Policy makers will be involved in the logistics that will be required in implementing the project and in approving the consent that permits the carrying out of the project in the hospital. The medical practitioners will be involved directly in the implementation of the program as they are the individuals with the direct contact with the patients. The patients will also be involved in how they can protect themselves from acquiring nosocomial infections (Miles & Vallish, 2010). 2) Who else is involved? Disease prevention is a core initiative of the department of public health and the Center for Disease control. This means that the department of public health will be involved in providing with the guidelines, regulations, protocols, and laws that have been enacted to reduce the prevalence of nosocomial infections. They are also involved, as they will play a critical role in the publishing the results that the project developed will garner. They will aid in making evidence based research a reality (Miles & Vallish, 2010). 3) How do you obtain their buy-in? The buy in of the hospital administration will be obtained through research based evidenced that empirically emulates the benefits that the project will bring to the hospital. The administration will have to be convinced that the project is feasible and that the benefits do not outweigh the risks of implementing the project. Consequently, patients and the community consent will be obtained through previous evidence on the effectiveness of the project, and how they are to benefit by being involved in the project (Miles & Vallish, 2010). The medical practitioners as the main culprits of the propagation of nosocomial infection will be obtain by evidencing the role they play and how they can prevent it. Clinical trials and published evidence of the success of the program will be needed. The literature review of the project has to show that it does not aim at compromising patient care and will not cause any harm to the patients. The department of public health needs to be convinced that the project will: modify the environment that propagates spread of disease, and the project is aimed at improving the health outcome of the greater population (Miles & Vallish, 2010). 4) Timeline The timeline of the project will be one year. It will be commenced 48 hours following admission of patients to the hospital and 48 hours following discharge from hospital. The project will be implemented in the surgical wards to assess the incision sites for possibility of developing sepsis. The project will also be implemented in the wards where patients are staying for more than 7 days to assess urinary tract infections. In addition, the intensive care unit where patients are intubated will be assessed for pneumonia (Miles & Vallish, 2010). 5) Education Education is necessary to sensitize the participants in the project, clarify the expectations of the project and clarify any misconceptions about the project from the participants. The clients will be education on the importance of the project during admission and during discharge and their consent for participation obtained. The health care practitioners will be educated on the recent policies, regulations, and laws that have been developed and that will be used as an evaluation criterion (Miles & Vallish, 2010). 6) Include educational materials to be used Charts are one of the educational materials that will be used for the purpose of the project. The project will purpose to hang charts in strategic areas that will aid in elaborating how nosocomial infections can be prevention. Diagrams will also be used to give a pictorial representation of consequences of nosocomial infections and practices that can be implemented to prevent the HAIs. Brochures will be issued to patients and health practitioners outlining the guidelines and protocols as prescribed by the department of public health (Miles & Vallish, 2010). 7) Include all changed/new documents as appropriate Documented evidence of hand washing as the basic technique of reducing nosocomial infections will be inculcated in the routine documentation of procedures. This will be done prior to attending to a patient and after attending to a patient. The current protocols in hospital will be updated with the new protocols as stipulated by the department of public health incase the hospital has not yet adjusted the new regulations as stipulated on January 2011 (Miles & Vallish, 2010). IV. Budget A budget is a representation of how the resources available and projected are going to be utilized to accomplish the project and the expenses that will be incurred in doing so. Resources are classified as 5Ms: Minute, Money, Manpower, Machinery, Materials, and Methods. The 5Ms need to be accounted for (Carpenter, 2006). 1. Staff This represents the M that stands for Manpower. The project will require labor at all stages. To begin with, labor will be required to educate the health practitioners and patients on the project and what is expected of them. Consequently, labor will be required to collect data, analyze, and present the data in a way that is comprehensive and which discussions and conclusions can be made. This will involve 20 staff each being paid approximately $7,000 per month translating to $140, 000 for the whole year (Carpenter, 2006). 2. Supplies Supplies delineate 3Ms representing materials, machinery, and the methods. This includes the preparation of charts for education purposes, diagrams, and brochures. Questionnaires that will be used as an evaluation tool are other supplies that need to be budgeted for. Travelling as a method to assess patients who have been discharged after 48 hours also needs to be budgeted. In approximation, paperwork will cost $ 50,000, travelling for the staff will cost $ 100, 000 totaling to $150, 000 (Carpenter, 2006). 3. Other items as indicated Minute is the other resource that needs to be budgeted for. The one year project will be in three quarters. The first quarter will be assessment, collection of pre entry data, and will culminate with sensitization of the community, patients, and health practitioners about the project. The second quarter will be majored on data collection. The final quarter will concentrate on analysis of collected data, interpretation, conclusion, recommendations, and handing over the report to the relevant authorities. It is estimated that the project will cost approximately $ 300, 000 (Carpenter, 2006). V. EVALUATION 1. Time/frequency The project will run for a period of one year. The staff will work in groups of four in the alternate working days of the week. They will not work over the weekend and will converge during the weekend to compile the results (Miles & Vallish, 2010). 2. Data collection and measurement Data will be collected through researcher-administered questionnaires whether they will be handed to the patients and guided on how to fill. This project will also employ the use of non-participant observant whether the researcher will observe and document on: hand washing, documentation of hand washing, and infection control (Miles & Vallish, 2010). 3. Data analysis Data will be cleaned where incomplete and uncommitted questionnaires will not be used in the analysis. Data will be coded and entered into the computer. It will consequently be analyzed using Software Package of Social Science (SPSS) and presented in the form of charts, graphs, and tables for easier interpretation. Discussions will be made and conclusion and recommendations of the project outlined (Miles & Vallish, 2010). 4. Thresholds The threshold used by the project is to reduce the prevalence of nosocomial infections by 22% this is in line with documented evidence (Miller, 1999). 5. Corrective action to be taken Basing on the threshold outlined above, corrective action will be based on the disparity that exists between the stipulated 22% reduction and the actual reduction obtained by the project (Miller, 1999). 6. Plan to maintain stakeholder buy-in Stakeholders will only be maintained in a project if they feel they belong to the project. This entails that they all stakeholders will be involved in every stage of the project: assessment, implementation, and evaluation phase. Consequently, updating the stakeholders on the current developments of the project another way of ensuring they remain till the termination of the project. Appreciating of the stakeholders is also important so that they feel their efforts as minimal as they may be are being recognized (Miles & Vallish, 2010). 7. How will you sustain the change/improvement? The improvement will be sustained through continued evaluation of the program. Consequently lobby for finances will be important so as to implement the changes in the organization. Sustainability will be achieved by involvement of the stakeholders in implementation and evaluation of the program hence they will feel responsible for its sustainability as they will feel they own it (Miles & Vallish, 2010). VI. Anticipated obstacles 1. Actions to prevent These are the limitations that the project might face during the research activity. To begin with, the time delineated for the project may be short and hence delay or insufficiency in the project. Financial constrains is another limitation for the project. This project requires outsourcing of finances and there is a possibility their some will not honor their pledges (Miles & Vallish, 2010). 2. Methods to address if encountered The project has to have a backup plan in terms of time and finances otherwise its accomplishment and sufficiency will be curtailed. In case the project is time barred, the staff will be forced to use a smaller sample size that might not be the representation of the whole population for generalization to be made. As pertain to financial hurdles, the project will have to come up with initiatives to fundraise: baking cakes for hospital canteen, car washing, and organizing children fares (Miles & Vallish, 2010). References Carpenter, D. (2006). Prevent nosocomial infections at the start. Materials Management in Health Care, 15(7), 46-8. Retrieved from http://search.proquest.com/docview/203644666?accountid=45049 Halpin, H., et al. (2011), Mandatory public reporting of hospital-acquired infection rates: A report from California. Health Affairs, 30(4), 723-729. Retrieved from http://search.proquest.com/docview/864025897?accountid=45049 Hassan, M., et al. (2010), Hospital length of stay and probability of acquiring infection, International Journal of Pharmaceutical and Healthcare Marketing, 4(4), 324-338. doi: 10.1108/17506121011095182 Miles, K., & Vallish, R. (2010), Creating a personalized professional practice framework for nursing, Nursing Economics, 28(3), 171-80, 189. Retrieved from http://search.proquest.com/docview/577373442?accountid=45049 Miller, N. (1999). Northwestern praised for drop in nosocomial infections. Nursing Economics, 17(2), 113-113, 116. Retrieved from http://search.proquest.com/docview/236929678?accountid=45049 Read More