PA004 Design and Implementation

PA004 Design and Implementation

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Western Governors University

D025 Essentials of Advanced Nursing Roles and Interprofessional Practice

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Date

PA004 Design and Implementation

Healthcare Program Summary

Hospital-acquired infection prevention programs aim to reduce or eliminate healthcare-associated infections (HAIs), which occur when patients develop infections while being treated for other medical conditions (Haque et al., 2020). Although these infections are most commonly associated with hospitals, they can also develop in surgical centers, long-term care facilities, and various healthcare environments. HAIs are a significant concern due to their contribution to increased morbidity, mortality, and healthcare costs. In the United States alone, over 500,000 patients contract such infections annually, underscoring the need for effective prevention strategies.

The program focuses on preventing several major infections, including central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), ventilator-associated pneumonia (VAP), Clostridioides difficile (C. difficile), tuberculosis (TB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). The annual budget for this prevention initiative is approximately $1,500, primarily allocated to hiring an infection prevention nurse responsible for protocol development, staff screening, and education. Additional costs encompass training healthcare personnel, supplying appropriate personal protective equipment (PPE), maintaining cleaning materials, and educating patients.

The overarching goals of the program are to reduce infection rates, enhance the knowledge of both patients and healthcare staff, and decrease overall healthcare expenditures. Another critical aim is to improve patient safety and treatment effectiveness by limiting antibiotic resistance and preventing secondary complications.

Target Population

The main population targeted by this program includes patients receiving care in healthcare settings, with particular attention to subgroups at higher risk. These subgroups include surgical patients, individuals with urinary catheters or central lines, patients undergoing antibiotic therapy, and those with compromised immune systems. Although these groups are more vulnerable to acquiring HAIs, it is important to recognize that other patient populations can also be affected.

Nurse’s Role in Program Design

Nurses play an indispensable role in the development and implementation of infection control programs (Flaubert et al., 2021). As the primary patient contacts, nurses collect crucial data and report infection cases, which informs healthcare teams about infection trends and outbreaks. Furthermore, nurses are central to educating patients and staff, ensuring communication is clear and understandable, thereby fostering adherence to infection prevention protocols.

Nurse Advocacy for the Target Population

Nurses act as patient advocates by conducting antimicrobial surveillance, reviewing medication regimens, and promoting appropriate antibiotic use. They also enforce infection control measures, such as the proper use of PPE, which protects both healthcare workers and patients (Lee et al., 2021).

How Does Advocacy Influence Program Design?

By advocating for patient needs, nurses influence the design of infection prevention programs to address clinical challenges effectively. They facilitate education on antimicrobial stewardship and preventive practices through evidence-based approaches, ensuring the program aligns with frontline realities and patient safety goals.

Recommended Evaluation Tools

The Infection Control Assessment and Response (ICAR) tool, developed by the Centers for Disease Control and Prevention (CDC, 2019), serves as a comprehensive guide for assessing and improving infection prevention practices within healthcare facilities. The tool covers multiple domains, including training programs, hand hygiene compliance, and antibiotic stewardship, making it essential for continuous quality improvement.

Healthcare Team Members Required

The infection prevention team is multidisciplinary and often led by infection control nurses. Essential members include:

Team Member	Role
Infection Control Nurses	Lead program design and oversee implementation
Physicians	Provide clinical expertise and antibiotic oversight
Pharmacists	Monitor medication use and antibiotic stewardship
Environmental Services Staff	Ensure proper cleaning and disinfection
Administration	Provide resources and policy support
Occupational Health Staff	Monitor staff health and PPE compliance

Nurse’s Role in Program Implementation

In the implementation phase, nurses carry out numerous responsibilities such as following infection control guidelines, delivering patient care, educating patients and communities, monitoring program progress, and collecting data for ongoing program evaluation and planning.

Comparison of Nurse’s Role: Design vs. Implementation

Aspect	Role in Program Design	Role in Program Implementation
Focus	Planning, data analysis, and resource allocation	Following protocols and delivering patient care
Activities	Designing protocols based on frontline experience	Educating patients and healthcare workers
Contribution	Providing insights to tailor interventions	Monitoring effectiveness and suggesting improvements

References

CDC. (n.d.). Nursing home COVID-19 infection control assessment and response (ICAR) tool facilitator guide. Retrieved February 21, 2024, from https://www.cdc.gov/infectioncontrol/pdf/icar/nursing-home-icar-facilitator-guide.pdf

CDC. (2019). Infection control assessment tools. Centers for Disease Control and Prevention. https://www.cdc.gov/hai/prevent/infection-control-assessment-tools.html

Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). The role of nurses in improving health care access and quality. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573910/

Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies to prevent healthcare-associated infections: A narrative overview. Risk Management and Healthcare Policy, 13(1), 1765–1780. https://doi.org/10.2147/RMHP.S269315

Lee, Y., Salahuddin, M., Gibson‐Young, L., & Oliver, G. D. (2021). Assessing personal protective equipment needs for healthcare workers. Health Science Reports, 4(3). https://doi.org/10.1002/hsr2.370