Hospital
acquired infections result in 99,000 associated hospital deaths annually with a
cost of 45 billion dollars because of the infections (Agency for health care
research and quality (2014). The four most common hospital acquired infections
are ventilator-associated pneumonia, blood stream infections, surgical site
infections and catheter associated urinary tract infections (Agency for health
care research and quality (2014). In the recent years, there is emphasis by
both the government and the health care industry to improve the statistics
regarding health care acquired infections. The government has begun requiring
hospitals to report hospital acquired infections rates publicly, in the hopes
that consumers choosing hospitals with lower infection rates will drive
improvement. Medicare a large generator of income for many hospitals has also
began to base reimbursement for services partly from scores publicly published
in regards to hospital acquire infection, if the rate of patient death is not
incentive enough for the health care community, financial incentive may be.
In
recent years many evidence- based research is focusing on this concerning
problem. In the evidence based report that was published by the agency for
health care research and quality the areas of infection rate in hospitals that
are most concerning are, ventilator-associated pneumonia, surgical site -
infections, catheter- associated urinary tract infections and central line
associated blood infections (Agency for health research and quality(2014). The
objective of the report was to analyze of current scientific literature to
determine what is the most effective measures to decrease or eliminate hospital
acquire infection rates. The literature review identifies several strategies
implemented by hospitals to improve quality in the area of infection rates to
include clinician education, Patient education, audit and feedback, clinician
reminder systems, organizational change, financial or regulatory incentives for
patients or clinicians or a combination of the above (Agency for health
research and quality (2014). The objective of the evidence-based research was
to determine the effectiveness of the quality improvement strategies to
decrease infection rates across multiple types of health care settings (Agency for
health research and quality (2014).
The
enormity of this very critical health care problem has increased research to
identifying what is the most effective way to decrease hospital-acquired
infections. Many of the health care organization implemented one of the
following strategies listed above to decrease infection rates and found little
or no effectiveness of decreasing hospital acquired infections (Agency for
health research and quality (2014). The research by the agency for health
research and quality, did see a moderate decrease in infection rates when a
combination of audit with feedback and provider reminder system was implemented
together (Agency for health and quality (2014). Infection rates decreased even
more significantly with financial incentive to improve infection rates (Agency
for health and quality (2014).
Another
important factor revealed in the research that affected implementation of
patient safety and quality initiatives was the health care environment they
were implemented in (Agency for health and quality (2014). The research
divulged that the most successful hospitals in decreasing hospital-acquired
infection had common characteristics. The qualities that promote success included,
existing patient safety structures, a culture of safety, teamwork on a unit
level, availability and management of tools to promote safety, and sound theory
behind safety practices (Agency for health and quality (2014). One area of
weakness that was noted throughout the study was there was little research on
the sustainability of quality improvement initiatives, formalization of the audit tools in evaluating the
decreased infection rates or education on how to effectively use them (Agency
for health and quality (2014).
Many
of the audit tools used to track hospital infection rates could be affected by
human error and lack of standardization. The strategies used to determine if
infection rates are improved over normal care are yet to be determined, because
of the lack of research on best practices for quality control auditing tools
(Agency for health and quality (2014). The research to decrease hospital
infection rates is one of dire importance. The research in this article did
show modest improvement in infection rates but also showed weakness within the
health care system that need addressed. This area of health care research is
one of the most significant and important.
The quality audit
systems of the past are currently being greatly improved with the use of
electronic medical records. As indicated in the text, the practice of nursing
research, the collection of data that has been gathered and reviewed has to be
done in a manner that does not include the opinion of the researcher (Grove, Burns, & Gray, 2013).
The implementation of electronic records is improving data collection on health
care acquired infections but, there is still a great need to develop auditing
tools that are standardized for all hospitals using the electronic medical
record.
References
