Preventing CLABSIs and HAIs - Essay Sample

One of the leading challenges in healthcare settings is the prevalence of nosocomial infections. Hospital-acquired infections (HIAs) in general, and centra-line associated bloodstream (CLABSIs), in particular, place a significant burden in the healthcare sector (Centers for Disease Control and Prevention, 2020). While hospitals have established robust strategies to deal with HAIs, there are still high morbidity and mortality that leads to increased costs in healthcare. Prolonged hospital stays due to HIAs result in the need to implement efficient prevention measures. Increasingly, hospitals are embracing and adopting CLABSIs legislations that prioritize mandatory timely reporting of preventable related infections. This paper highlights strategies that can be implemented within hospital settings to reduce HIAs and CLABSIs prevalence significantly.

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HIAs and CLABSIs contribute to numerous deaths each year and pressure the healthcare system due to their treatment's huge costs (Bell & O'Grady, 2017). Hence, addressing these issues is a matter of urgency, and so an evidence-based approach must apply. One reliable prevention strategy is the use of chlorhexidine baths. Other workable options include proper hand hygiene and the proper use of antibacterial catheters. This strategy requires the involvement of all stakeholders, particularly front-line health workers who have direct contact with patients. Patients and families also require proper education to participate in their care. Healthcare institutions are increasingly adopting these suggestions as part of their evidence-based practice (Healthy People, 2020). Besides these integrative prevention strategies, alternative strategies such as the Affordable Care Act and the pay-for-performance, and organizational strategies that promote efficient data reporting. Care providers need the right support to establish and maintain care practices that promote good hygiene. They also need proper frameworks to punish caregivers who do not comply with the required reporting.

The prevention of HAIs and CLABSIs is achievable through legislative requirements for efficacy and efficiency. Legislative frameworks such as the Affordable Care Act (ACA) require healthcare institutions to adhere to mandatory reporting protocols as a basis for funding (Woodward & Umberger, 2016). This approach is necessary given that intrinsic motivators may not be sufficient to ensure behavioral and psychological change. Medical experts acknowledge the importance of such legislative frameworks in enabling the government to understand the extent of the infections and guaranteeing value for money by holding healthcare institutions accountable. For instance, the exacerbating effect of HAIs and CLABSIs in developing countries draws heavily from under-reporting. A multiagency initiative helps to determine the evidence of CLABSIs, determining the importance of medical billing for the infections, and proper reporting in centralized state and federal databases.

There are robust policy, practice, and outcome monitoring frameworks to reduce the extent of HIAs and CLABSIs. The Center for Disease Control (CDC) and the National Healthcare Safety Network (NHSN) work independently and jointly towards improved guidelines for determining the contribution of laboratory-confirmed bloodstream infections (LCBIs) to bloodstream infections (Latif et al., 2015). Once the relationship is established through this joint effort, the Centers for Medicaid Services (CMS) designs the International Classification of Disease (ICD) standards that guide CLABSI coding for billing. The NHSN receives CLABSI data from healthcare facilities across the country through the various providers using the set guidelines. This streamlined communication ensures a timely response to the infections and the assessment of prevention strategies to determine when and how change should apply for each case. This progressive and holistic approach lacks in less developed countries, where the feedback process does not help much.

An effective CLABSI prevention strategy must have a mechanism to incentivize achievements and help encourage all healthcare establishments to apply standardized protocols. The government uses disease incidence as a basis for funding so that healthcare facilities that comply are rewarded through continued, regular budget disbursements. This incentive approach informs the establishment of a central database that compares each state and healthcare facilities' outcomes to ensure a progressive improvement towards reducing incidence (Fan et al., 2016). States that perform badly regarding infection incidence are required to demonstrate their commitment to CLABSIs prevention and outline their unique approaches towards improved outcomes. The NHSN and the CDC rely on such reporting to determine the efficiency of different guidelines, standardize the most effective approaches, and improve those that do not give the best outcomes.

In conclusion, HIAs and CLABSIs prevention are central to the realization of improved healthcare outcomes. These infections have a significant burden on healthcare as they increase hospital stay, increase disease severity, and burden nurses. One of the Healthy People objective, which relates to the CLABSI prevention, is the requirement for mandatory reporting through increased disease surveillance and the proper management of infections when they occur (Healthy People, 2020). At the hospital level, medication, hygiene practices, and proper dissemination of information help improve the environment for reduced infections. A multiagency approach helps with disease monitoring, while an incentive approach requires that hospitals become responsible for patients' safety through the implementation of best practices (Centers for Disease Control and Prevention, 2020). Continuous improvements help to strengthen the most productive strategies and review those that do not work.

References

Bell, T., & O'Grady, N. P. (2017). Prevention of central-line associated bloodstream infections. Infectious Disease Clinics, 31(3), 551-559.

Centers for Disease Control and Prevention (CDC). (2020). Bloodstream Infection Event. Retrieved 23 August 2020, from https://www.cdc.gov/nhsn/PDFs/pscManual/4PSC_CLABScurrent.pdf

Fan, C. J., Pawlik, T. M., Daniels, T., Vernon, N., Banks, K., Westby, P., ... & Makary, M. A. (2016). Association of safety culture with surgical site infection outcomes. Journal of the American College of Surgeons, 222(2), 122-128.

Haddadin, Y., Annamaraju, P., & Regunath, H. (2020). Central-line associated bloodstream infections (CLABSI). In StatPearls [Internet]. StatPearls Publishing.

Healthy People. (2020). Healthcare-Associated Infections | Healthy People 2020. Retrieved 23 August 2020, from https://www.healthypeople.gov/2020/topics-objectives/topic/healthcare-associated-infections

Latif, A., Halim, M. S., & Pronovost, P. J. (2015). Eliminating infections in the ICU: CLABSI. Current Infectious Disease Reports, 17(7), 35.

Sammons, B. (2015). Illicit Injection Drug Use as A Risk Factor for Hospital Onset Central Line-Associated Bloodstream Infection. In Open Forum Infectious Diseases (Vol. 2, No. suppl_1, p. 271). Infectious Diseases Society of America.

Woodward, B., & Umberger, R. (2016). Review of best practices for CLABSI prevention and the impact of recent legislation on CLABSI reporting. SAGE Open, 6(4), 2158244016677747.