Solution for Pneumonia Disease - Essay Example

?Implementation Plan The emerging development of healthcare service is significantly becoming a major consideration for the modern healthcare serviceproviders in terms of providing evidence based healthcare facilities to their large group of customers. According to the modern competitive healthcare scenario, the organizations seek to provide effective and feasible services to their each customer to achieve competitive and sustainable advantages. Executing any evidence based operations in healthcare service incorporates effective governance and adequate management practices which should be performed by the healthcare institutions (Moran-Patton, 2008). Therefore, the report intends to develop an implementation plan which focuses on preparing functional strategies for pneumonia patients in order to effectively provide quality and value based healthcare facilities. With this concern, the report will comprise a brief description of the existing problems and their adequate solutions associated with offering quality and evidence based nursing facilities. Moreover, the discussion will also include necessary logistics and resources which are significant to effectively address the problems associated with the nursing facilities for pneumonia patients. Proposed Implementation Plan Method(s) of Obtaining Necessary Approval(s) and Securing Support for Proposal Obtaining effective support from nursing institutions would be the major aspect for the research which would provide adequate and substantial helpful information to accomplish the research objectives. The research aims to integrate evidence based practices with clinical awareness to substantiate the proposed plan. In order to accomplish the research objectives the research has incorporated various elements based on statistical evidence as well as to attain substantial support from the management and other associates. The main objective of this proposal is to maintain adequate framework to effectively provide evidence based services for the pneumonia patients. The proposed implementation plan will be presented to the board of directors from various departments as well as to the different management personnel of healthcare facilities. The information will be presented through arranging an assessment program in which experienced board of directors and concerned management personnel will be invited to have a thorough evaluation of the proposed procedural change. Description of the Problem Pneumonia can be considered as one of the major and vulnerable diseases, which creates an inflammatory condition in lungs (Leach, 2010). The disease can be considered as one of the most acute ailments which had killed a large number of children during the year 2008 and there has been considerable number of victims from different age groups across the various nations of the world. Effective vaccination along with taking useful antibacterial treatment and care facilities can significantly prevent pneumonia from affecting human health (World Health Organization, 2008). A ventilator is recognized as a machine which aids a patient to breathe to providing required oxygen by the use of a tube. Ventilator associated pneumonia (VAP) is identified as a kind of lung infection or a pneumonia which grows in an individual while he/she is receiving life-support through a ventilator (CDC, n.d.). It is observed that VAP had resulted in a number of deaths in the US hospitals over the years. For instance, in the year 2002, an anticipated 250,000 healthcare-related pneumonias were reported in the hospitals in the US. Out of which around 36,000 caused death of the person suffering from this critical medical condition. It is also recognized that patients who are being provided with mechanically-assisted ventilation are at greater danger of getting affected by healthcare-related pneumonia. In the year 2011, National Healthcare Safety Network (NHSN) had reported in excess of 3,525 VAPs around different healthcare institutions in the US (CDC, 2013). Description of the Proposed Solution with Rationale The framework for effective solution plan for pneumonia is significantly based upon evidence based model which ensures to provide effective quality care for patients within healthcare institutions. Pneumonia principally occurs frequently in an individual within his/her communities and it further affects hospitalized persons suffering from other reasons. Notably, the disease has been identified to be one of the eight leading death causes witnessed so far. Ventilator-associated pneumonia (VAP) can be identified as a hospital-acquired pneumonia (HAP) which affects people who are receiving ventilation service within the healthcare institutions due to certain other reasons. VAP can further be recognized to occur while receiving treatment through mechanical ventilation. The diagnosing program of VAP requires an intensive clinical suspicion along with bedside observation, radiographic examination as well as microbiologic investigation of respiratory secretions. With this concern, sensible and effective usage of antibiotic is highly crucial, since the resistance systems of the patients continue to be affected on the ventilation system within the intensive care unit thus making them seriously ill. Therefore, an adequate nursing as well as effective respiratory therapy involvement in order to effectively prevent the occurrence is a foremost step for the healthcare institutions (Koenig &Truwit, 2006). The proposed guideline for managing an effective and secured ventilation program that should be adopted by the healthcare institutions has developed through evidence based practices which significantly aims to ensure compliance to prevent VAP within the nursing institutions. In order to prepare an effective and secured plan for preventing VAP, the diagnosis program is one of the most essential steps which can depict or identify the required treatment for the patients served under the nursing care. With this concern, the procedures concerning diagnosis program will be developed or altered accordingly which will ensure to properly identify the affected person within the healthcare institutions. Hence, an effective process will be evaluated in order to ensure prior identification of the causes due to which pneumonia can occur. Therefore, the patients who are admitted will be properly examined and served in a secured environment which encompass anti-bacterial and virus free atmosphere to prevent the causes of pneumonia. VAP is generally suspected at the time when an individual builds up a progressive or new infiltrate process on various clinical diagnosis steps including leukocytosis, chest radiography as well as purulent tracheobronchial secretion tests. Therefore, the clinical diagnosis process for the patients will consider a few major steps to investigate symptoms of pneumonia within the patient’s body such as infiltrate on chest radiography (>48-h) as well as fever >38.30C, sensitivity level of purulent tracheobronchial secretions up to 69% and leukocytosis of > 12 ? 109/ml. Moreover, effective radiological and microbiological diagnosis process will also be evaluated in order to successfully evaluate VAP within the patients in the nursing care units (See Appendix) (Koenig &Truwit, 2006). In terms of offering adequate treatment facilities, the principles for applying appropriate therapy for VAP will be incorporated by proper identification of organisms, through following advanced resistance guides along with rational antibiotic administration procedures. Moreover, the implementation of multiple interventions would further be an effective practice to improve pulmonary infiltrates as well as illness in terms of offering mechanical ventilation process for the patients (Chastre&Fagon, 2002). SMART Objectives of the Proposed Implementation Plan In relation to the proposed implementation plan concerning VAP, the main goal of the overall process will be focused to preserve the quality and excellence of the healthcare services to the patients affected by VAP through effective incorporation of SMART approach. Specific: The objective of the proposed implementation plan will be to maintain specificity towards the identified patients who are affected due to VAP in different nursing institutions. Specificity would be maintained by gathering pertinent information related to the patients from concerned authorities of the nursing institutions who would be able to provide specific data regarding patient population who are affected by this critical medical condition. Measurable: The outcomes of the implementation plan would be measured by comprehensively observing the responses of the patients after they are provided adequate treatment as per the diagnosis made in relation to VAP. Measurement would comprise of blood and urine analysis with culture along with bronchoscope as well as non-bronchoscope assessment. This analysis would enable to provide an understanding to the medical team addressing the patient that if he/she is responding appropriately to the provided treatment or not. In the Appendix section of the paper, measurement tools have been depicted. Attainable: The goal of developing an effective and secured implementation plan concerning VAP has different processes which require various functions to attain each objective of the proposed plan. Therefore, the overall plan would be requiring five months to accomplish each objective of the plan in order to recognize the requirements for ensuring complete nursing facilities for the patients. Realistic: The goal of the implementation plan further ensures to comply with the needs and requirements of the VAP affected patients. Therefore, the implementation plan for VAP will also focus to utilize effective communication learning process both for the patients and the practitioners to ensure adequate nursing facilities for linguistically diversified patients within the healthcare institutions. Time: The required timeframe for the VAP implementation plan for the nursing institutions has been identified to be accomplished within five months of the implementation timeframe. Evidence and Rational Based Change Management for the Support of the Proposal In order to achieve effective support for the proposed plan, the module of change theory developed by Kurt Lewin is one of the major and feasible approaches to effectively perform an evidence and rational based solution proposal. According to the Lewin theory of change, it can be observed that the approach involves three major stages which are found to be more effective and convenient to develop nursing facilities concerning any disease. The three stage approach of change theory significantly incorporates unfreezing, moving as well as refreezing stage. The unfreezing stage within the change management occurs at the time while existing principles as well as practices are being challenged. The contributors and members of the change process should recognize the need for change and are required to move away from the ‘comfort zone’. The moving stage in the changing process is the condition of evolution where the new ideas, experiences as well as behavioral aspects are evaluated in relation to any disturbance or distress situation. And, the refreezing stage of Lewin model highlights the situation when the expected goals are accomplished and the new skills and ideas are becoming common practice for an organization (Moran-Patton, 2008). Therefore, the model developed by Lewin will be incorporated for providing secured and effective nursing facilities for the patients concerning VAP. In order to comply with the nursing care facilities for VAP, the staff in the healthcare institutions should focus towards managing changes with regard to principles, processes as well as adequate decision making skills to provide intensive nursing facilities for their patients. According to the model of change management in the nursing services, it can be observed that the proposed solution related to mechanical ventilation services can ensure to offer secured and effective environment which is adequate to prevent VAP within the healthcare institutions. The proper incorporation of theory in the proposed solution can further ensure to develop quality of the services that are rendered by the staff and assures to achieve positive outcomes from their patients (Moran-Patton, 2008). From the perspective of developing implementation plan for VAP, the change approach of Lewin could further facilitate any nursing institution to develop treatment facilities in relation to prevent the occurrence of VAP within the nursing environment. With this concern, the VAP nursing facilities will also determine to properly conduct diagnosis programs and other clinical processes for each patient in order to prevent pneumonia within the ventilation units of the healthcare institutions. Moreover, an early prevention therapy for VAP will be associated which can further ensure to provide an exceptional treatment and prevention process for pneumonia (Koenig & Truwit, 2006). In addition the implementation plan for VAP will also involve bronchoalveolar lavage (BAL), bronchoscopic protected specimen brush (PSB) as well as protected telescoping catheter (PTC) methods in order to enhance the level of specificity and accuracy in the diagnosis process for VAP. Nevertheless, effective clinical strategy and antibiotic management are also crucial factors in terms of implementation plan for VAP. Therefore, the strategy concerning VAP will further be focused to employ advanced equipments and required apparatus for each step within the different processes (Koenig &Truwit, 2006). Detailed Description of Implementation Logistics In order to develop implementation plan for VAP, the detailed study of the logistics and other related areas is required to be made to improve the service as well as to attain significant outcomes from the patients. The implementation plan will be considerably focused on executing each function with valuable collaborations obtained from various personnel in different departments of the process. An effective collaboration and cooperative approach with the members can profoundly help to successfully implement superior nursing facilities for the patients served under the ventilation units. Therefore, an effective meta-analysis research approach would be conducted for consecutively five months to understand the requirements for ensuring comprehensive medical facilities for the patients (Doig, Simpson, Sweetman&Heighes, 2011). With this concern, an approval will be obtained from governmentally recognized healthcare institutions for the purpose of providing effective nursing care services to prevent the causes of pneumonia. Therefore, consulting and discussing process will also be conducted especially with respiratory therapist, physicians, nurses and other members regarding adequate diagnosis and treatment process for VAP. The collection of information and idea related to VAP can be considered as one of the major aspects of the implementation plan to effectively provide nursing facilities. A comprehensive observation of the information collected from the experts and other healthcare associates will be conducted to enhance the quality and appropriateness of each process of the program. With the purpose of encouraging the compliance of the VAP implementation plan, each task and initiative will be recorded according to an effective sequence to attain the overall goals and objectives without facing any disruption. Moreover, the compliance report which will be collected from Meta analysis will be evaluated and published monthly in order to encourage staff to remain focused within their specific roles and responsibilities (Koenig &Truwit, 2006). Resources Required for Implementation Satisfactory and sufficient resources play an utmost role for achieving goals and objectives effectively for any implementation plan. It is also important to manage and evaluate varied number of participants and members related to the implementation program. Moreover, the observation and knowledge acquiring processes regarding VAP emphasizes on obtaining major comprehensions in terms of developing evidence based implementation plan. The detailed process of clinical practices along with other diagnosis activities are further important factors to prepare an evidence and quality based performance strategy for VAP within the healthcare institutions (Overholt, Melnyk, Stillwell, & Williamson, 2010). In addition, the required technological investment within the process could also offer substantial benefits to develop statistical and numerical information in a more time and cost convenient manner. From the perspective of technological involvement, effective and easy application software will be developed which would enable to encompass each activity conducted within the VAP program (Moran-Patton, 2008). Conclusion According to the present day context, the prevention plan for VAP is quite essential for the healthcare institutions to provide effective and extensive care for their patients. Therefore, an evidence and quality based implementation is highly required for the modern organizations to adequately provide secured treatment process for their patients served under the mechanical ventilation process. This report has demonstrated various valuable stages for evidence based implementation process which also included different methods comprising support, approval as well as detailed solution reports regarding logistics required in the implementation plan. Therefore, it can be concluded that the developed implementation plan for VAP can significantly facilitate healthcare institutions to achieve more success in providing advanced and secured nursing facilities to the patients. References Chastre, J. &Fagon, J. Y. (2002).Ventilator-associated pneumonia.American Journal of Respiratory and Critical Care Medicine 165, pp. 867-903. http://ajrccm.atsjournals.org/content/165/7/867.full.pdf+html CDC. (n.d.). About Ventilator-Associated Pneumonia. Retrieved from http://www.cdc.gov/HAI/pdfs/vap/VAP_tagged.pdf CDC. (2013). Ventilator-Associated Pneumonia (VAP) Event. Retrieved from http://www.cdc.gov/nhsn/PDFs/pscManual/6pscVAPcurrent.pdf Doig, G. S., Simpson, F. S., Sweetman, E. A. &Heighes, P. T. (2011).Statistical Analysis Plan for a multi-centrerandomised controlled trial: Early parenteral nutrition vs. standard care in patients not expected to be fed within 24 h of ICU admission. Retrieved from http://www.evidencebased.net/files/EarlyPN_SAP.pdf Koenig, S. M. &Truwit, J. D. (2006). Ventilator-associated pneumonia: diagnosis, treatment, and prevention. ClinMicrobio Rev 19(4), pp. 637-657. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1592694/ Leach, R. M. (2010). Acute and critical care medicine at a glance.United Kindom: John Wiley & Sons. http://books.google.co.in/books?id=ZaKpstergO0C&pg=PA4&dq=Acute+and+critical+care+medicine+at+a+glance.+United+Kingdom:+John+Wiley+%26+Sons.&hl=en&sa=X&ei=thnUUKCPN87yrQf33YCQDg&ved=0CDYQ6wEwAA#v=onepage&q&f=false Moran-Patton, T. (2008).Defining "quality" for pediatric inpatient care: Nurses championing for systems-level change. Retrieved from https://research.wsulibs.wsu.edu/xmlui/bitstream/handle/2376/3650/T_Moran_Patton_098160489.pdf?sequence=1 Overholt, E. F., Melnyk, B. M., Stillwell, S. B. & Williamson, K. M. (2010). Evidence-based Practice Step by Step: Critical Appraisal of the Evidence: Part I. American Journal of Nursing 110 (7), pp. 47-52. http://www.ncbi.nlm.nih.gov/pubmed/20736710 World Health Organization.(2008). Global action plan for prevention and control of pneumonia (GAPP). Retrieved from http://www.unicef.org/media/files/GAPP3_web.pdf Appendix Measurement Tool Source: (Koenig &Truwit, 2006) Diagnostic Tool Source: (Koenig &Truwit, 2006) Read More