Free Essay. Indirect Nursing Activity: Managing Healthcare-Associated Infections

Indirect and semi-direct nursing interventions have significant impacts on the quality of patient care and treatment outcomes. Nurses perform indirect care activities to support the overall efficacy and effectiveness of direct care. One of the most critical indirect nursing activities is the management of Healthcare-Associated Infections (HAI) in specialist units such as the emergency department, pediatric ICU maternity wards, and neonatal ICU. This issue, according to Hammoud, Ghazi, Nassredine, and Haidar (2017), has been one of the most severe health problems for decades until now. The past research indicates that one person out of every 25 patients hospitalized in the US healthcare facilities acquires HAI because of poor adherence to infection control measures among nurses (Hammoud et al., 2017). This problem is also associated with differing levels of compliance with policies, safety standards, and transmission-based precautions. Nurses, therefore, should have a proper understanding of the practices for preventing and controlling healthcare-associated infections as a way of reducing the risk of the potential spread of contagious diseases.

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Assessment of the Indirect Nursing Situation

Managing HAI, besides other indirect nursing activities, is performed for the benefit of the patient. While this practice does not involve direct contact between nurses and other people, it has a significant influence on patient care and outcomes. However, a study by Russell et al. (2018) indicates that there is a correlation between compliance to infection control practices and the level of knowledge about HAI among nurses (Russell et al., 2018). The authors analyzed survey responses from certified nurses in the US, working in two significant healthcare facilities. Russell et al. (2018) found that nursing professionals have a high level of compliance with HAI control standards. Also, this class of healthcare workers has favorable attitudes towards controlling and preventing the spread of infections in healthcare settings but had differing knowledge of managing HAI (Russell et al., 2018).

A study by Godfrey and Schouten (2014), on the other hand, suggests that carefully-implemented and well-conceived practices of managing HAI save money, prevent deaths, and reduce illnesses. However, the standards for managing infections in healthcare settings vary widely. There is evidence that proven interventions that allow nurses to manage infections in different units of a healthcare facility have not been adopted, especially in resource-limited settings (Godfrey & Schouten, 2014). Ongoing education of monitoring and preventing infections, besides policies of safe injection, also have a significant influence on reducing HAI infections (Godfrey & Schouten, 2014). Research by Kakushi and Evora (2014), shows that nurses spend only 2.1 hours per day on indirect patient care and 29.5 hours on direct interventions. Thus, this phenomenon explains why the management of HAI is a critical issue.

Implementing Change and its Evaluation Criteria

Deliberative Nursing Theory by Jean Orlando is an essential theoretical framework that guides the implementation of change strategies, especially in healthcare settings. As such, this theory is of great importance in implementing a plan for addressing the problems underlying the management of HAI in the indirect nursing situation. This nursing model has five main stages that guide change implementation, particularly in the context of healthcare (Tyra, 2008). These phases are assessment, diagnosis of the problem, planning change, implementing it, and evaluating its efficacy. Since the assessment and the diagnosis of the issue have been done, the plan for implementing change focuses on planning, implementing, and, more importantly, evaluating the effectiveness of the methodology.

This change plan focuses on involving link nurses in preventing and controlling HAI. In this regard, link nurses refer to a specialist team of professionals that specialize in specific topics and issues in the field of healthcare. Therefore, these specialists would play leading roles in overseeing adherence to standards of managing HAI. Also, link nurses would mobilize other professionals towards a common goal of managing the spread of healthcare-associated infections. Infection control link nurses (ICLN) would evaluate the efficacy of HAI control programs. Since ICLN are experts in controlling and preventing infectious diseases, they are in a better position to identify gaps in applicable and relevant evidence-based nursing practices.

Godfrey, Villa, Dawson, Swindells, and Schouten (2013) studied the correlation between the availability of resources in healthcare settings and the attitudes of healthcare workers towards the emergence ad spread of HAI. Godfrey et al. (2013) found that hospitals that had not dedicated adequate resources to managing infections were unlikely to implement procedures and policies for monitoring patients and preventing HAI. Hence, ICLN health workers would monitor and supervise other nursing professionals in performing procedures that govern hand hygiene, respiratory hygiene, and isolation of patients in different units of the facility.

The fifth phase of the Deliberative Nursing Theory involves an assessment of the effectiveness and efficacy of the change model. The timeline for implementing this plan, however, will take five months. Assessment metrics like change readiness, adherence to the project plan, and benefits realization would be of great importance in implementing the project. This way, ICLN would regularly assess the level of adherence to relevant policies, the attitudes of nurses towards the program, and, more importantly, the clinical outcome of the change plan.

Effects of the Change Plan on the Nursing Profession

This plan aims at improving compliance with policies and transmission-based precautions in healthcare settings. Hence, this change has positive impacts on the nursing profession since it helps nurses to enhance their knowledge about the strategies for reducing the risk of HAI. This change model also facilitates the identification of evidence-based practices for improving clinical outcomes and the quality of patient care through proper management of infections.

Conclusion

Indirect care in nursing is critical for patient care. The prevention of healthcare-associated infections in ICUs, and the emergency department, among other units of a hospital, is a critical indirect practice that nurses perform. The change plan aims at minimizing deaths and illnesses associated with HAI. It also improves the profession through the improvement of nursing activities and evidence-based practices designed by ICLN healthcare professionals.

References

Godfrey, C., & Schouten, J. T. (2014). Infection Control Best Practices in Clinical Research in Resource-Limited Settings. JAIDS Journal of Acquired Immune Deficiency Syndromes, 65, S15-S18. doi:10.1097/qai.

Godfrey, C., Villa, C., Dawson, L., Swindells, S., & Schouten, J. T. (2013). Controlling Healthcare-Associated Infections in the International Research Setting. JAIDS Journal of Acquired Immune Deficiency Syndromes, 62(4), e115-e118. doi:10.1097/qai.0b013e3182845b95

Hammoud, S., Ghazi, B., Nassredine, M., & Haidar, M. A. (2017). Nurses' Awareness of Infection Control Measures and the Role and Effect in Patient and Family Education. European Scientific Journal, ESJ, 13(27), 59. doi:10.19044/esj.2017.v13n27p59

Kakushi, L. E., & Evora, Y. D. M. (2014). Direct and Indirect Nursing Care Time in an Intensive Care Unit. American Journal of Nursing, 22(1), 150-157.

Russell, D., Dowding, D. W., McDonald, M. V., Adams, V., Rosati, R. J., Larson, E. L., & Shang, J. (2018). Factors for Compliance with Infection Control Practices in Home Healthcare: Findings from a Survey of Nurses' Knowledge and Attitudes Toward Infection Control. American Journal of Infection Control, 46(11), 1211-1217. doi:10.1016/j.ajic.2018.05.005Tyra, P. A. (2008). In Memoriam: Ida Jean Orlando Pelletier. Journal of the American Psychiatric Nurses Association, 14(3), 231-232. doi: 10.1177/1078390308321092