Table of Contents
The sphere of healthcare is most often characterized by the presence of different problems. One of the most wide-spread problems is hospital-acquired diseases which deteriorate the quality of provision of healthcare and may even lead to patient’s mortality. That is why, medical practitioners attempt combating such issues by introducing different initiatives, which address different hospital-acquired diseases. This paper explores the strategy of preventing and mitigating hospital-acquired pneumonia in the format of a proposal for change. It is based on the research of the defined disease and presents measures for considerable positive change, along with the rationale for such change. Moreover, it presents communication and collaboration strategies that are required for the advanced nurse leader to enact the change in one’s surrounding. Similarly, it analyzes the possible advantages and disadvantages of the change and its possible predicted effect on the health of population. The proposed strategy would allow achieving a significant decrease of cases of hospital-acquired pneumonia by means of adequate application of proposed changes. Its outcomes would most probably lead to the significant increase of quality of life of population by means of avoiding the risks of obtaining hospital-acquired pneumonia.
The Proposal of Change and Rationale
Before proposing a rationale for the management of described condition, there is a need to evaluate the issue’s relevance. Thus, the findings of the previously conducted investigation demonstrate that hospital-acquired pneumonia (HAP) is one of the most common cases of all hospital-acquired diseases. The statistical evidence demonstrates that it is one of the most common healthcare-associated infections, as it accounts for 22% of infections, along with surgical site infections (Speck, Rawat, Weiner, Tujuba, Farley, & Berenholtz, 2016). Specialists define this condition as inflammation of lungs, typically caused by infection, which negatively affects the alveoli and interstitial lung tissues (Schlossberg, 2015). Furthermore, some studies demonstrate that HAP accounts for 15% of all nosocomial infections (Weber & Salgado, 2013). It is evident that as any hospital-acquired disease, HAP is caused by various factors, which create conditions for its development, decrease the resistance of patient’s organism or both. Additionally, there is evidence that it is associated with increased patient mortality, when compared to other types of pneumonia with the ratio of 19.9% against 10% (Rothberg et al., 2014). Therefore, there is a need for the provision of strategy, which would allow to efficiently avoid the development of HAP and fosters the recovery of patients, who acquired the illness.
The proposed strategy focuses on the regulation of critical domains, responsible for the creation of conditions for the development of HAP and decreas the resistance of patient’s organism. Its change model defines the division of responsibilities between nurses and physicians, which result in the removal of risk factors, associated with the stimulation of HAP. Thus, scholars define that the risk factors, associated with HAP, include bacteria (such as Legionella in hospital’s portable water) (Schlossberg, 2015) and the usage of ventilator therapy. The latter is associated with the increased risk associated with reintubation, steroids, bloodstream infection, prior antibiotic therapy and bronchoscopy (Liu et al., 2013). Moreover, it is difficult to identify ventilator-associated pneumonia because of the presence of underlying cardiopulmonary disorders (Kollef, 2012). Consequently, there is a need for the change model to manage the process and structural factors, which allow mitigating the causes for the disease’s development. Thus, the process measures include head or bed elevation, regular daily lung assessment, oral care minimum six times daily, and subglottic suctioning (Speck et al., 2016). Additionally, some scholars propose the management of hospital water, in order to combat bacteria-stimulated causes of HAP. Among such interventions is maintenance of water temperature above 55 degrees Centigrade, ultraviolet irradiation or sonication of the usage of biocides, the usage of charcoal filters and proper plumbing practices (Schlossberg, 2015). Similarly, these systemic measures should be enhanced by additional practices. These include the use of closed suctioning systems and catheters, change of damaged ventilators, promotion of easy access to noninvasive ventilation equipment and removal of condensate (Speck et al., 2016). Likewise, medical practitioners are expected to perform hand hygiene and avoid the usage of antimicrobials on the systemic basis. As a result, the predominant part of these interventions would result in decrease of HAP incidence and patient mortality, caused by it.
Communication and Collaboration Strategies
It is also significant to denote that the application of the proposed strategies requires the introduction of specific communicative and collaborative strategies. The reason for this is the need for provision of integrity of the proposed measures through enhanced interaction of medical practitioners between each other and the patients. In this sense, the general aim of such collaboration is working together, in order to provide qualified care and monitor patients’ progress (Unützer, Harbin, Schoenbaum, & Druss, 2013). Additionally, such a practice is important because of the risks of malpractice when applying the approach of interprofessional collaborative care (Gonzalo, Wolpaw, Lehman, & Chuang, 2014). Similarly, collaborative methods allow monitoring a wide range of spheres, which influence the patient’s condition (Klompas et al., 2014). Thus, the basic proposed strategy is the release of comprehensive instructions, which present basic interventions, allowing to manage the risks of HAP. Furthermore, the principles of cooperation should be built on the basis of mutual understanding and memorizing the crucial aspects of the proposed strategy. As a result, the whole staff would function within a single domain of knowledge regarding the risks of HAP and the appropriate management interventions.
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Advantages and Disadvantages of the Change and Its Effect on Population Health
Lastly, there is a need to evaluate the advantages and disadvantages of the proposed interventions. Thus, the main advantage is the ability to mitigate the risk factors, associated with HAP and related patient mortality. That is why, the quality of life in general population is expected to increase, as well as the ratio of illness occurrence is estimated to decrease. At the same time, the disadvantage of the strategy is related to the need for systemic change and its natural restricting factors. Among them is the need for the standardization of requirements and the introduction of additional courses or general instructions. Similarly, there should be measures, which allow controlling the strategy’s actual efficiency. These aspects may lead to additional expenditures. Notwithstanding this fact, the percentage of savings because of the strategy should overcome the proportion of financial expenditures.
Therefore, it is expected that the proposed strategy would allow increasing the overall percentage of healthy population and decrease the disease associated expenditures. Thus, scholars claim that the introduction of various strategies of mitigation of hospital-acquired diseases allowed decreasing the bunged expenditures from $20–$40 billion to $9.8 billion (Zimlichman et al., 2013). Thus, the proposed strategy would intensify this progress because of the validity of the proposed interventions.
Summarizing the discussed topic, the paper concludes that the proposed strategy is one of the most effective measures used to regulate HAP incidence. Thus, it proposes a model which addresses the process and structural factors, which allow mitigating ventilator associated and non-associated HAP. As a result, medical practitioners obtain a comprehensive instruction for monitoring patients and their hospital environment. This is achieved by regular visits, mitigation of the increase of pathologic bacteria and other microorganisms, as well as correct patient placement and safe medical interventions. Similarly, the paper proposed focusing on collaboration and cooperation of medical practitioners and patients by means of adherence to local and global instructions. This awareness and collaboration lead to the relevant interventions of every medical practitioner towards the patients with the risk of HAP incidence. Consequently, the proposed strategy allows decreasing HAP associated patient mortality ratio by bettering the quality of life of citizens along with significant healthcare expenditures reduction.