A reduction in hospital readmission of patient populations in all sections of the healthcare facility should be the goal of an effective prevention program. Readmission rates are rising in inpatient and outpatient settings due to a complete lack of education and non-compliant patients. Central lines are a significant concern that leads to increased hospital readmissions. Because central venous catheters (CVCs) compromise the skin’s integrity, patients are more susceptible to microbial and fungal infections. Preventing this is a challenging task to undertake (Wilder et al., 2016). Whenever healthcare professionals are dealing with non-compliant individuals and central venous lines, various interventions are required to improve the plan of care.
The importance of educating healthcare professionals to become even more aware of why individuals get re-admitted and implementing adequate infection control measures is critical. Healthcare practitioners should frequently demonstrate appropriate central line management while also adequately teaching patients regarding their diagnosis. Maximum sterile care should always be taken when changing dressings. If a dressing gets wet, loosened, or noticeably unclean, it should be replaced. It should be changed every seven days, irrespective of how the dressing loos. When a CVC is no longer required, it should get removed immediately. The number of daily central lines, the reasons for dressing change suggestions, and plans for central line removal were all tracked using a line-rounding audit tool. One strategy for reducing COPD exacerbations and readmissions among patients who have been discharged within the last month has been to provide ongoing education to healthcare personnel, patients, and family members.
The compliance of these healthcare professionals is one potential challenge that could jeopardize the proposed improvements. Because many employees dislike change, it can be challenging to persuade them to comply with new processes. Seasoned nurses, for instance, have their routines, making it challenging to keep them up to date on new policies and procedures. Another difficulty comes when healthcare workers try to save time by taking shortcuts. When the end of the tubing is not securely closed off, it might result in central-line infections. Nurses take shortcuts by looping the end of the tubing and connecting it to it instead of looking for a suitable hub protector. When I told my DON about this, she said that nurses are usually in a rush and do not recognize that this allows microorganisms to easily contaminate the tubing’s end, elevating the infection risk, not just on central lines but also on IV sites. Often we do not have the appropriate resources, or supplies are out of stock. To assist reduce infection, mistakes, exacerbations, and readmissions, it is critical to make sure all supplies are available. However, I believe that providing in-depth education on readmissions to this healthcare personnel, together with feedback, demonstration, and verbal understanding, will benefit facilities and lead to fewer patients returning to the hospital. Such steps are being taken to reduce rates as low as possible in the hospital setting while working with available resources.
CAUTI’s are one of the most common types of Hospital Acquired Infections (HAI), and they are also one of the most preventable HAI. Decreasing CAUTI occurrences starts with educating healthcare professionals about HAI. Facilities must also implement evidence-based strategies that ensure patient safety, decrease HAI, and increase patient satisfaction. According to the AHRQ Safety Program for decreasing CAUTI’s in hospitals, three clinical components must be understood and implemented every time: appropriate indications for use, proper insertion technique and maintenance care, and prompt removal when no longer needed (AHRQ, 2020). For my project, my goal is to help reduce CAUTI occurrences at my facility by the end of the year. I will also develop various strategies to help keep the CAUTI rate at a minimum at the facility. So, the first step in the action plan is to develop educational tools and training for staff members to strengthen their knowledge and competency of infection control and prevention. Understanding the causes of CAUTI will allow the team to develop proper interventions to decrease CAUTIs from occurring.
Furthermore, the team must also collaborate with other healthcare professionals such as infection control specialists, and physicians that are involved in clinical patient care. All healthcare professionals must understand what CAUTI is, how it is caused, and how it can be prevented. Empowering staff to take proactive roles in educating one another and assessing for appropriate indications, care and prompt removal is vital to patient’s safety. Engaging staff in CAUTI prevention means designating specific nurses and physicians to help educate, inspire, and motivate their team members. They can share evidence-based research findings and best practices to keep everyone informed. For instance, a charge nurse can be responsible for assessing catheters and their appropriate indication and support the discontinuation if no need continues to exist. Delegating ancillary team members to have roles in assessing best practice catheter care is completed and coaching others on appropriate techniques can assist in positive patient outcomes as well.
The next step is to ensure that the facility provides staff members with appropriate resources. The resources could be, CAUTI toolkits, insertion checklists, and computer-generated reminders when catheters have reached 48 hours, prompting discontinuation. These types of tools and equipment will support appropriate care and help decrease the occurrence of CAUTI. So, the facility must ensure that there are enough equipment for staff members to utilize to meet compliance requirements. Moreover, another step is to have daily staff meetings that allow staff members to discuss current practices, review current data and develop strategies to address the issue in real-time. Internal communication with frontline staff members will allow the team to develop a cause-and-effect diagram. A cause-and-effect diagram is a tool that will help identify, sort, and display possible causes of a specific problem. The diagram will be used to identify areas of improvement and develop effective strategies.
Potential challenges that might compromise these proposed interventions can be a lack of effective collaboration and staff compliance. Getting everyone to be “on-board” and stay consistent is a challenge. The decisions and actions of healthcare providers are influenced by multiple factors including, organizational culture, personal attitudes, qualifications, the composition of the workgroup, physical resources available, and the design of the work systems and process (Spath, 2018). Performance improvement projects should be systematic and have a defined process. To effectively solve problems, people from different levels of the organization and from different workgroups must collaborate. (Spath, 2018). The resources that are needed for a CAUTI improvement project consist of utilizing and maximizing the information and tools that already exist within the facility, and many of these resources already exist. For instance, care for a patient with a catheter requires healthcare professionals to demonstrate proper hand hygiene and wear PPE. They must also maintain a clean and disinfected environment. Since PPE, soap, hand sanitizer, and cleaning materials are things facilities must always have on hand, staff members will always have access to those items. The challenge is ensuring they are utilizing those items and being more accountable and aware of their role in preventing CAUTIs.