HAPU Nurse Outcome

Braden scale is a tool used to predict patient’s risk for pressure ulcer. However, when this tool is not used to its fullest potential, it does not help to decrease the patient’s risk of developing pressure ulcers. Many over look a Braden score of sixteen is being high and not at risk but, scores under eighteen are considered to at risk for pressure ulcer development. Nursing interventions need to be in place before a new development of pressure ulcers. Nurses need to use these provided tools and carry out appropriate nursing interventions according to the results. When a nursing care is not a written requirement, many nurses overlook the benefits of the tool and neglect to provide the best nursing care.

Through medical advances in technology and practice, nurses have been afforded the opportunity to provide lifesaving care to patients. However, this lifesaving care comes with the risk of healthcare-associated infections (HAIs). Generally speaking, HAIs are infections directly related with the delivery of healthcare and are often caused by viral, bacterial or

Infection on the individual can be a risk to residents, Increase time in recovery, increase length of stay, loss of earnings and cause potential death.

Elimination of HAI’s are a top priority for many healthcare related organizations and as such, the reduction of certain types of HAIs have been achieved. On the national level, the HAI Progress Report states that there has been, “Au 46 percent decrease in central line-associated bloodstream infections (CLABSI) and a 19 percent decrease in select surgical site infections (SSIs) between 2008 and 2013” as well as “an 8 percent decrease in hospital-onset MRSA bacteremia and a 10 percent decrease in hospital-onset C. difficile infections between 2011 and 2013” (CDC, 2015).

The purpose of the ANTT is to protect the patient and nurse from infection and to prevent the spread of pathogens. This can have a huge effect on the recovery rate of the patient. HCIA can mean a longer stay or readmission to hospital and in some cases lead to disability or death (Hart 2007). This information suggests that the ANTT is not being carried out correctly and Department of Health (2005) support this by stating that 9% of patients contract HCAI’s per year in UK hospitals.

Majority of the cost would be on educating the staff through a meeting and written documents. The entire healthcare team and the staff of the unit will be affected by this change. The physicians and nurses will be affected the most because they are the ones doing the morning rounds on the patients, but the house keepers and patient care assistants will also be affected because they to will need to plan a time to go into the rooms when it is least disruptive for the patient.

PH factored the costs associated with employee separation, recruiting, hiring, productivity loss, and orientation and training. The replacement costs range of $22,000 to $93,000 per nurse when aligned with the injured nurses WCC cost. The costs for instituting a patient handling program can be significant. The cost to pilot the safe patient handling program that uses SMART slide sheets totaled $27,000 in equipment cost. Each pilot nursing unit has budget allocations for employee training that will be used to pay for each of their employees 4 hour training sessions. AHM will provide PH a $150,000, grant to use if house wide implementation is

As a hospital, quality care should be a priority for patients that are going to be treated for a sickness, or any type of procedure that is going to take place. A lot of times a patient gets an infection while they were at the hospital, on top of being treated for what they original came in for. Health facilities should be environments of healing, which they are, but they also have tons of various types of germs and infections, which grasp onto individuals that have weak immune systems/are sick. Some infections that are at hospitals are Tuberculosis, VRE, VAP, C-Diff, UTI, and MRSA. Preventive measures to stop the spread of the infections is lacking tremendously in the work and aim to provide safety for all patient’s health. The work

The first hospital was in a SICU with a 19-bed unit and the second were a SICU in a 10-bed unit. To recruit health care providers to participate a convenience sampling was used. With convenience sampling it is the best method used to address the needs of the study. A convenience sample works well with recruiting participants in a clinical setting or specific organization, such as this study the health care providers were the participants in an intensive care unit setting. It is noted within the study that a small sample size was used. The saturation was achieved within the study to have SICU’s use the ambiguity concept to help gather information on the causes of non-compliance to guidelines for preventing HAI’s and VAP, which in turn will help with the implementation of new guidelines to be used in SICU’s reducing HAI’s and VAP (Gurses et al.,

These patients are more at risk of developing sepsis because their immune system may not have the capacity to fight off the infection as the rest of the population (McClelland, 2014). If sepsis develops in a patient, especially a patient who is more at risk, it is important for the nurse to recognize that an infection has developed such as redness, swelling, fever, and drainage. The nurse should assess the patient for possible signs and symptoms of infection including a urinary tract infection, infection in a wound either from diabetes or a surgical wound and presence of a respiratory infection (Bernstein, 2013). An infection can occur anywhere in the body and completing an assessment is important when there is an infection present. If the infection is ignored or not treated, it can become systemic. A systemic infection will destroy the tissue and can eventually reach the blood stream causing a fever, increased heart and respiratory rate, decrease in blood pressure, increase in blood glucose, altered mental status and a severe increase or decrease in WBC. Once treatment has been initiated, how the body responds to the treatment will depend on the severity of the sepsis. If the body does not respond to the rapid fluid replacement or other measures to sustain life, then the patient is in septic shock (McClelland,

Implementing Braden Scale screening as part of the nurse’s plan of care allows for early detection of risk factors, and gives the patient the best opportunity to prevent HAPUs and provide early intervention if an ulcer is developed. While the Braden Scale has been widely used, there are still many facilities that have not given it the required focus and attention it deserves, and subsequently their staff do not place a substantial importance on its use, as well. In a study by Mallah, Nassar, & Badr (2015), the authors were able to reduce the occurrence of HAPUs by over 60%. When a tool that has already been evidenced to provide that significant of a result has been documented, particularly for a problem as prevalent as

Highlighted in the Keogh Review, and the Francis Report - Avoidable harm was inflicted by HCAI - Hand hygiene not routine amoung staff (REF). - Patients were not encouraged or assisted with hand hygiene, leading to risk of infection, staff lack awareness. - Further training needed - Staff and visitors need to comply with guidelines.

When a patient is admitted to the hospital an initial assessment is done. During that assessment we are already thinking of what kind of care and treatment this patient will need in order to dis-charge him as soon as possible. The longer a patient remains in the hospital, the more at risk he is for Hospital Acquired Infections. “Hospital-acquired pneumonia is the second most common nosocomial infection, but carries the highest mortality rate of 30-50 percent. Ventilator-associated pneumonia is a type of HAP that is associated with endotracheal intubation and me-chanical ventilation” (Pellico, 2012). “It is reported that HAP accounts for 25% of intensive care unit infections, and 90% of those occur during mechanical ventilation” (ATS & IDSA,

Patients in the ICU can also be impacted negatively by P/Ns at the level of infections on the unit. Aycan et al. discusses how NIs are linked to mortality and morbidity in the ICU. When a patient develops an infection, they are likely to stay longer in the hospital, which increases overall costs to the hospital and to the patient. The article claims that there is evidence that supports that long LOS in hospitals affect the country’s economy more than the staff’s salaries. Thus, since the research found an association between P/Ns and an increased risk for NIs (which, ultimately lead to a longer LOS) there needs to be a mandatory, as well as adequate, staffing ratio in the ICU to keep patient’s healthy and to keep costs down in the long

For patients to remain free from infection while hospitalized, nurses must have a standard of care for