Capstone Part 1 - Creating Change In The High Hospital Rates

Capstone Part 1 - Create Change in the High Rate of Hospital-Acquired Infections (HAIs) Among Elderly Patients in Long-Term Care Facilities

Hospitals are the environment where people expect to receive an improvement in their health and well-being. Issues occur when patients get subjected to Hospital-Acquired Infections (HAIs), yet they have much trust in gaining improvement in their well-being. For the elderly population, HAIs are adverse processes that lead to deteriorating health when infections occur while getting treated for medical or surgical conditions. Does the implementation of healthcare changes by nurse practitioners that interact with elderly patients residing in long-term care facilities (P), using strict infection control protocols (I), compared to standard infection control practices (C), lead to a reduction in the incidence of hospital-acquired infections (O) within a two-week period (T)? Research conducted at different long-term care facilities indicates that elderly patients get infected at an average period of 1.7 weeks from the beginning of their stay (Haenen et al., 2019).

There is an immediate need to evaluate the safety of long-term care facilities by implementing strict policies to reduce elderly persons' rate of getting infected.

PICOT

Patient/Problem: The patient population is elderly persons who do not integrate productive healthcare procedures since they can be affected by limited solutions to their issues. Collaboration among nurse practitioners and elderly persons shall be focused on to address the problem. The majority of elderly persons get affected by chronic illnesses like dementia, high blood pressure, cancer, and respiratory issues.

When this occurs, their bodies become vulnerable to infections based on reduced immunological competence and complications of their existent illnesses (Kollia et al., 2018). Elderly persons often find engaging with the normal environment hard since they are at an advanced age, limiting productive work outcomes. When this occurs, living in long-term care facilities becomes imperative as older persons reach a stage where their physical needs become much more important than their psychological needs, which is a dangerous outcome in healthcare departments. Without proper expertise in handling the health conditions of elderly persons in long-term facilities, they can be exposed to infections (Kollia et al., 2018).

Intervention: Integration of nurse practitioners with advanced expertise to better serve the healthcare environments is imperative since they shall analyze risk factors for infections, connect patients to suitable doctors, suggest methods of ensuring suitable treatment options get integrated, and have accurate records management to ensure a long-term facility is managed with advanced expertise. Their interaction with elderly persons and provision of appropriate advice will facilitate guidance in generating better learning.

Comparison: A suitable alternative to offering better health outcomes is to use lifestyle changes to handle illnesses that make older persons prone to infection when receiving treatment. There is a crucial need to integrate current healthcare improvement procedures to ensure collaboration among nurse practitioners and elderly persons when new treatment or care methods are suggested. Technology platforms implemented at long-term care facilities can communicate with elderly people to promote personal care for their issues (Wilson & Small, 2020).

Outcome: Elderly persons who avoid behaviors that cause them to get admitted and those who adhere to treatment methods for their chronic conditions can find it better to prevent infections. It can be possible to increase better healthcare productivity after adhering to all expected healthcare guidelines using procedures known to reduce complications.

Timeframe: Two weeks is a suitable time for the project to implement major healthcare changes for a long-term facility when the different resources get implemented. Reduction of infection rates will be possible when the professionals involved identify risk factors and tailor their expertise to serve various patients' needs at long-term care facilities.

Description of Vulnerable Population: Solving the issue of HAI is possible by addressing social determinants affecting the selected population of elderly persons. Social determinants that affect the health of elderly persons living in long-term care facilities include financial resources, physical movement, food, and social connections (Kollia et al., 2018). Risk factors include the length of stay while exposed to the central venous catheter, mechanical ventilation, body temperature, presence of underlying illnesses, immunosuppression, diabetes, admission to ICU, and lengthy stay there (Zhao et al., 2019). The risk factors mentioned uniquely can result in the occurrence of various conditions like tuberculosis, aspergillosis, surgical site infection, neurological ICU processes, and urinary tract infections (Zhao et al., 2019). When elderly persons do not adhere to suitable social determinants, their health will get adversely affected.

Proposal: Reducing HAIs among elderly persons in healthcare facilities is possible by performing frequent patient research to recognize infections early, avoiding the use of invasive devices, surveillance of a healthcare environment, implementing isolation practices, and using hand hygiene methods that would prevent the spread of contaminants (Cristina et al., 2021). Ensuring healthcare equipment is clean and frequently cleaning the areas in a long-term care facility will generate advanced processes for validating healthcare improvement needs for elderly persons. Resource allocation for ensuring the interventions get implemented includes personnel for cleaning different areas, purchase of cleaning or sterilizing materials, and hiring nurse practitioners with advanced experience in caring for elderly persons.

Nurse practitioners are imperative for working in long-term care facilities since they can identify risk factors for patients to get infections and eliminate them before occurrence. Theoretical Framework/Nursing Theory as the nursing theory, change theory is the suitable framework supporting the project as it posits that Change can be implemented using the unfreezing-change-refreeze model to ensure improved learning (Burnes, 2019). There can be driving forces regulating how Change occurs by influencing a person to perform certain activities needed to ensure equilibrium toward Change (Burnes, 2019). Unfreezing allows recognition of an older pattern; for this project, the pattern is HAIs occurring among elderly persons. Change is then implemented when nurse practitioners integrate their expertise in reducing the occurrence of infections using pertinent resources for better care, and refreezing occurs when implemented Change becomes a new habit.

Paper For Above instruction

In the context of healthcare quality improvement, reducing hospital-acquired infections (HAIs) among elderly patients in long-term care facilities is a vital priority. As populations age globally, the prevalence of HAIs in these settings has risen, contributing to increased morbidity, mortality, and healthcare costs (Haenen et al., 2019). Therefore, implementing strategic interventions rooted in nursing theory can significantly impact patient outcomes, safety, and the overall quality of care provided to this vulnerable population.

Hospitals and long-term care facilities are expected to be safe environments where healing and health improvements occur. However, the reality is that elderly patients are at heightened risk of acquiring infections, often due to immunosenescence, chronic illnesses, and exposure to invasive procedures. According to Haenen et al. (2019), elderly residents in long-term care facilities develop infections typically within 1.7 weeks of admission, underscoring the urgency of proactive infection control measures. The risk factors for HAIs in this population include the presence of indwelling devices such as catheters, mechanical ventilation, immunosuppressive states, and underlying chronic diseases like diabetes and respiratory illnesses (Zhao et al., 2019).

The PICOT framework guides this quality improvement project by delineating the patient population, intervention, comparison, outcomes, and timeframe. The target population comprises elderly individuals in long-term care who are vulnerable due to compromised immune function and chronic illnesses. The intervention involves the integration of nurse practitioners with advanced training who apply strict infection control protocols, whereas the comparison involves standard infection control practices. The expected outcome is a reduction in the incidence of HAIs within two weeks through adherence to enhanced infection prevention measures.

Incorporating social determinants of health, such as social connections, nutrition, mobility, and financial stability, is crucial in understanding and addressing the risk factors for HAIs among the elderly in care facilities (Kollia et al., 2018). Longer hospital stays, invasive devices, and immunosuppression increase infection risks, making early recognition and prevention strategies imperative (Zhao et al., 2019). Early detection relies on frequent patient assessments, surveillance, and prompt intervention, including the judicious use of invasive procedures and strict hand hygiene practices (Cristina et al., 2021).

Implementing these strategies requires resource allocation, including personnel for environmental sanitation, procurement of sterilization materials, and hiring skilled nurse practitioners capable of performing risk assessments and infection prevention. The theoretical underpinning for this initiative is Lewin’s Change Theory, which involves unfreezing current practices, implementing change, and refreezing new habits into routine practice (Burnes, 2019). This framework emphasizes the importance of organizational readiness and supportive leadership in sustaining change, particularly in complex healthcare environments such as long-term care facilities.

By fostering a culture of safety, continuous staff education, and patient engagement, healthcare providers can significantly reduce HAIs in elderly populations. The success of such interventions will be reflected in decreased infection rates, improved patient outcomes, and enhanced safety protocols, ultimately contributing to higher standards of care and patient satisfaction in long-term care settings.

References

• Burnes, B. (2019). The origins of Lewin's three-step model of Change. The Journal of Applied Behavioral Science, 56(1), 32–59. https://doi.org/10.1177/0021886319862208
• Cristina, M. L., Spagnolo, A. M., Giribone, L., Demartini, A., & Sartini, M. (2021). Epidemiology and Prevention of Healthcare-Associated Infections in Geriatric Patients: A Narrative Review. International Journal of Environmental Research and Public Health, 18(10), 5333.
• Haenen, A. P. J., Verhoef, L. P., Beckers, A., Gijsbers, E. F., Alblas, J., Huis, A., Hulscher, M., & de Greeff, S. C. (2019). Surveillance of infections in long-term care facilities (LTCFs): The impact of participation during multiple years on healthcare-associated infection incidence. Epidemiology and Infection, 147, e266.
• Kollia, N., Caballero, F.F., Sánchez-Niubó, A. et al. (2018). Social determinants, health status and 10-year mortality among 10,906 older adults from the English longitudinal study of aging: the ATHLOS project. BMC Public Health, 18, 1357.
• Zhao, X., Wang, L., Wei, N., et al. (2019). Risk factors of health care–associated infection in elderly patients: a retrospective cohort study performed at a tertiary hospital in China. BMC Geriatrics, 19, 193.
• Wilson, R., & Small, J. (2020). Care Staff Perspectives on Using Mobile Technology to Support Communication in Long-Term Care: Mixed Methods Study. JMIR Nursing, 3(1), e21881.