Executive Summary

Nightingale Community Hospital is a 180-bed acute care hospital that is a not-for profit entity. The hospital is community based and provides leadership in quality health services in which they provide. Their vision is to be the hospital that people choose, the place employees, physicians and volunteers want to work and a hospital of choice for the community. They are committed to providing a healing environment to their patients with a compassionate commitment to healthcare excellence.

The U.S. Department of Health and Human Services (HHS) is the U.S. government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. HHS is responsible for almost a quarter of all federal outlays and administers more grant dollars than all other federal agencies combined. The mission of the U.S. Department of Health and Human Services (HHS) is to enhance the health and well-being of Americans by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services. In addition, HHS is also responsible to provide better services to people by adapting to new technologies to keep pace with the advancement in technology. As we compare the health and human services from last ten years to present, it is very clear to analyze how health and human systems have improved over the years. The Department manages programs that cover a vast spectrum of activities that impact health, public health, and human services outcomes throughout the life span.

Nightingale Community Hospital's care and treatment are planned to ensure that they are appropriate to the patient's needs and severity of disease, condition, impairment, or disability. Furthermore, care is supposed to be planned and provided in an interdisciplinary collaborative manner by professionals. The hospital assesses pain in every patient in addition to planning operative

Currently HIDTAs fund 752 initiatives throughout the country. These initiatives include multi-agency investigative, interdiction and prosecution activities, drug use prevention and drug treatment initiatives, as well as many others. Treatment and prevention are a main focus of the HIDTA program and all twenty-eight HIDTAs support prevention initiatives around the country. HIDTA works with community-based coalitions and follow evidence-based prevention practices including community mobilization and organizational change. A few examples of these prevention initiatives include; the Safe and Sound Initiative, the Rio Arriba County Empowerment Project, and the Houston HIDTA Drug Prevention and Awareness Initiative.

The HAI legislation is implemented by State laws. The Bill was introduced to the House of Representatives in November 11 2007, and then was referred to the House Committee on Energy and Commerce. At last the bill was referred to the Subcommittee on Health. The legislation is also implemented by enforcing itself through awareness. There are currently 32 states that are requiring facilities, by law, to report HAI data to National Healthcare Safety Network. Overall the CDC is in charge with implementing the HAI prevention and reporting guidelines. According to the article “Healthcare-associated Infections” The CDC, in collaboration with other organizations, has developed guidelines for the prevention of CLABSI and other types of healthcare-associated

Stephanie Ardito, after learning about three MRSA infections in her neighbor, decides to research on hospital infections. She found alarming high numbers of HAIs spread. For example, in 2009, of 1.8 million people that acquired HAIs, 100,000 of them died. HAIs also place an additional burden on hospitals. A research in 2010 estimated a $4.4 billion of additional hospital care resulting from treating HAIs. Quoting from an article titled “Staying Safe in the Hospital,” Ardito lists actions that patients can take in order to prevent HAIs. Patients should monitor their medication intake, medical test results, follow-up treatment plans; look for coordinated care from multiple caregivers; follow methods to prevent infections, specially washing hand; speak up to physician when there is a concern about HAIs; and to insist on discharging to prevent hospital readmission. This article is a great combination of many statistics from many researches, providing evidences for a growing issue of HAIs. Lastly, the author also compiles

In regards to achieving higher value, the prevention of health -associated infections leads to better quality of life. To sustain state HAI prevention programs, these policy interventions can aid in accelerating HAI prevention by implementing a public health model. This public health model will promote adherence to evidence –based practices and focus on prevention efforts. There are several federal initiatives underway to advance HAI prevention; this allows time for states to enhance their HAI programs. Laws pertaining to HAI prevention have been passed by 32 states including the District of Columbia as of January 2011. The Affordable Care Act of 2010 and Patient Protection has placed emphasis on prevention of HAI through the CMS Hospital Inpatient Quality Reporting Program. This has created a national mandate for public reporting of HAI. Value based purchasing strategies and federal pay for performance has been implemented in 2013 through the Affordable Care Act.

This plan involves preventing future HAIs from happening to prevent further costs. HAIs have been estimated to cost twenty-eight to forty-five billion in excess healthcare costs (Zimlichman et al., 2013). Effective evidence based practice for infection control must be in place and all employees must comply. Healthcare administrators should use evidence based practice to implement these infection controls and make sure there are checks and balances to ensure every employee is complying with the guidelines. In addition, the healthcare administrator must make sure that the organization receives every dollar that their healthcare organization should receive from the insurance company to prevent any more loss financially. To get payment from The Centers for Medicare & Medicaid Services (CMS), hospitals are required to report data about some infections to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) ("Healthcare-Associated Infections (HAI) data", 2016). In addition, CMS has provided incentives for hospital that beat averages of HAIs at healthcare organizations. The healthcare administrator must make sure they report to the CDC’s NHSN and prevent future HAIs. Also, the administrator should thoroughly and routinely check to make sure the insurance company properly reimburses the right amount to the healthcare organization. If the healthcare administrator implements procedures to provided infection control based on evidence based practice and monitors the reimbursement process properly following correct procedures, the administrator can help the healthcare organization reduce future costs for

The organizations must ensure its infection prevention policies and procedures are up to date and that all staff have completed and continue to complete this training on an annual basis, or sooner should there be a sudden increase in patient infections. In addition, the organization should also increase awareness as far as antibiotic resistance to both the stakeholders and staff. Written infection prevention policies and procedures should be accessible to staff at all times.

Healthcare acquired infections are a concern in healthcare facilities. Organizational changes can influence infection prevention. There are several quality and safety interventions that can assist with reducing infection transmission, such as hand washing. In general, the longer a patient remains in the hospital the sicker they become. Many of the uncomplicated admissions become complicated after an extended hospital stays. Nursing home patients are generally admitted to a facility based on overall decline in health, but soon experience community acquired infections from the facility. Implementation of infection control by involving the interdisciplinary staff members can decrease the occurrence of infection.

CPHS operates and participates in a surveillance system that is compliant with Public health Information Network (PHIN) Guidelines and Heath Insurance Portability and Accountability Act (HIPAA). This surveillance system monitors health problems and identify health threats (i.e. infectious diseases, chronic diseases, environmental hazards, bioterror threats) and the changes in the occurrence of health problems and hazards. Reportable information is submitted in a timely manner. All activities in regards to surveillance and investigation is supported by appropriate resources such as epidemiologists to assess, investigate, and analyze.

The Centers for Disease Control and Prevention (CDC), Office of State, Tribal, Local and Territorial Support are providing funds for LPHSA.

Healthcare facilities are always looking for new ways to improve and provide better care for their patients. As the market of healthcare has rapidly become more competitive, healthcare systems are looking for new ways to improve service and care. These new ideas for improvement not only have positive outcomes for patients but, save the healthcare system money at the same time. One of the major problems hospitals have faced is hospital acquired infections (HAI’s). These infections happen in addition to what the patient came into the hospital for. One of the major changes has been the repayment from the Center for Medicaid and Medicare (CMS). CMS will no longer pay for any type of HAI that has been contracted during a

Keeping in mind the end goal to enhance the current examination design, the Staff Selection Board (SSC) has as of late reported to delay the Combined Graduate Level Examination (CGL) that was to be hung on May 8 and May 22, 2016.Additionally, the commission prior declared to lead the Tier 2 examination on August 13 and 14, 2016. In the interim, this choice of the commission has given more opportunity to the understudies to get ready well for the Tier I exam.

Global Health Security Agenda (GHSA) fundamental collaboration of the multilateral and sectoral relationship between nations, international organizations and non-governmental sectors are vital to the prevent, detect and respond framework. The support of GHSA has contributed to JEE tool under the IHR, helping to identify the most urgent needs of countries in high risk of infectious disease outbreaks and strengthening their potential for health security surveillance.