AHRQ's Healthcare-Associated Infection Program related to Patient Experience

Clinical Question 

The Problem 

HAIs are diseases that people contract as they receive treatment for other infections in healthcare facilities. They are deadly, costly, and mainly preventable. A fundamental of the AHRQ's mission is to enhance the healthcare safety of all Americans. One way AHQR accomplishes this mission is through financing projects for preventing and reducing HAIs. The AHRQ's mission is to enhance the effectiveness, efficiency, safety, and quality of healthcare through the use of evidence for enhancing healthcare, improving healthcare results via research, and transforming research into practice. Some of the severe HAIs that result in prolonged hospice stays and eventually augmented mortality risk and healthcare costs, including catheter-associated urinary tract infections (CAUTIs) ( McGinley, 2010) . These infections make up over 80 percent of all HAIs. HAIs are amongst the significant risks to the safety of patients, and they affect 1 in each 31 hospital patients at any particular time. Over a million HAIs take place throughout the US healthcare system annually, resulting in the loss of thousands of lives, and significantly increasing the healthcare costs.

The prevention and reduction of these infections may be challenging for people who provide patient care. In addressing these issues, AHRQ funds various initiatives that focus on HAIs in general. AHRQ's HAI programs finance projects for helping frontline healthcare practitioners as well as other clinical workers avert HAIs through enhancing the provision of care to patients. The AHRQ accomplishes this through a vigorous set of contracts and grants focused on practical research – or research which improves the capacity of doctors in the health area to fight HAIs ( McGinley, 2010) . Such type of research conveys information to the frontlines of care rapidly by assisting healthcare providers better comprehend how to use established techniques of creating safer care. Due to the large number of HAIs reported in clinical settings across the US, along with high healthcare costs they impose on the healthcare system, there is a need for implementing an AHRQ's HAI Program that can improve the patient experience.

Significant of Problem 

HAIs are a major concern to everyone since patients should not become sicker from infections that are preventable in clinics and health facilities. National objectives require considerable HAIs reduction. For healthcare institutions, the stress is increasing to prevent and minimize HAIs, amongst the major sources of preventable deaths in the US. HAIs infect almost two million patients, with about 99,000 people losing lives, and also amounting to about $33 billion in healthcare costs annually ( McGinley, 2010) . The growing inquiry on HAIs is as a result of increased efforts of public reporting, greater attention from certification agencies, and increased accountability amongst spenders. For instance, Medicare has halted reimbursing clinics for the extra costs related to some HAIs. The protection of patients from hospital-acquired infections is a progressively prudent industry choice for organizations, on top of being in the best interests of patients.

There is a need for a comprehensive federal program for preventing and reducing all kinds of HAIs. The program must aim to reinforce the synchronization and effect of state efforts by creating state goals for preventing HAI and establishing both short-term and long-term goals. The AHRQ has a crucial role in this state effort. On top of mechanisms of implementing and testing potential resolutions in the healthcare sector, AHRQ has created a range of applied, evidence-based data and tools which physicians, as well as medical institutions, can apply to enhance, prevent or minimize HAIs cases, thus improving patient experience in healthcare settings.

Agency-financed initiatives previously have generated highly effective and scalable programs, such as one which assisted over 100 Michigan ICUs considerably minimize, and sustain for three years, the CLABSI rate. Another project assisted various Indianapolis hospital systems in reducing MRSA infections by 60 percent in ICUs ( McGinley, 2010) . A recent national AHRQ initiative worth $17 million for fighting HAIs will develop such programs and finance efforts to establish potential resolutions for reducing and preventing HAIs. For instance, recently, under an AHRQ grant, the Michigan Health & Hospital Association partnered with Hopkins research Peter Pronovost, M.D., to implement the Comprehensive Unit-based Safety Program (CUSP) program across a whole State. The program comprised uniting a team at all facilities for collecting necessary data, participating in regular project meetings, and attending conferences yearly. Every team adopts the necessary interventions, and the healthcare outcomes are shared among the teams. According to McGinley (2010) , the project demonstrated similarly remarkable outcomes across the state. Its adoption in over 100 ICUs in Michigan was attributed to minimizing the rates of bloodstream infections and assisted the average ICU in minimizing its rate of infection from 4 percent to 0.

PICOT Question 

In all patients with Healthcare-Associated Infections, is an AHRQ's HAI program related to patient program more effective than the existing AHRQ programs in preventing and reducing HAIs?

Purpose of the Paper 

Overall, the objective of this paper is to propose and discuss an AHRQ's HAI program that would help in preventing and reducing HAIs in a healthcare setting and thus improve the experiences of patients during their stay in hospitals.

Levels of Evidence 

Type of Question 

The type of question asked to answer the PICOT question is what AHRQ program could be adopted to prevent and ease the spread of HAIs in healthcare settings, and therefore improve experiences of patients suffering from HAIs or those who are exposed to hospital conditions which would likely result in HAIs.

Best Evidence 

Particularly, AHRQ's HAI program finances projects for assisting frontline healthcare practitioners as well as other health workers in preventing HAIs through improving healthcare provided to patients. The AHRQ achieves this through donations focused on applied research, or research that expands the clinicians' capability in the health field to fight HAIs (Houser, 2018). Thus, through an evidence-based HAI program, based on AHRQ's evidence-based research knowledge, it is possible to prevent and cut the spread of HAIs in healthcare settings among patients with extended stays in health facilities, and therefore improve the patient experiences. So, by conducting comprehensive research, this paper will be able to identify an AHRQ's HAI program that could help in improving patient experience in healthcare settings through preventing and reducing HAIs.

Search Strategy 

Search Terms 

Healthcare-associated infections (HAIs)

HAIs programs

Infections

Preventing HAIs

Types of HAIs

Patient Safety

Evidence-Based Program

Healthcare Research and Quality's (AHRQ's)

Databases Used 

The Library Databases

Good Scholar

Refinement Decisions Made 

First, the search strategy was general, focusing on HAIs and AHRQ's. However, the search strategy was streamlined and focused more on AHRQ's HAI's programs, HAIs programs, and How to prevent HAIs. Through this, the search results were more refined and focused on some existing ARHQ's HAIs programs for preventing HAIs.

Identification of two Most Relevant Articles 

Two articles were identified, which are most relevant to the research problem. The first article discusses how Kamishibai Cards (K Cards) could be used as a tool for encouraging interactions between staff and leaders. The researchers established that K Cards are a practical tool for sustaining EBPs and promoting communication between hospital staff and management, keeping compliance on frontline workers' minds to help reduce HAIs ( Shea et al., 2019) . The second article identified discusses the CUSP program as an AHRQ program aimed at preventing UTIs in hospital infections ( Saint et al., 2016) . The researchers propose that this program is best suited for improving patient experiences by reducing HAIs.

References 

Houser, J. (2018). Nursing research: Reading, using, and creating evidence, 4th ed. Burlington, MA: Jones & Bartlett Learning.

McGinley, P. (2010, March 17).  AHRQ: Preventing healthcare-associated infections . Patient Safety & Quality Healthcare. https://www.psqh.com/analysis/preventing-healthcare- associated-infections/ 

Saint, S., Greene, M. T., Krein, S. L., Rogers, M. A., Ratz, D., Fowler, K. E., ... & Faulkner, K. (2016). A program to prevent catheter-associated urinary tract infection in acute care.  New England Journal of Medicine ,  374 (22), 2111-2119. 

Shea, G., Smith, W., Koffarnus, K., Knobloch, M. J., & Safdar, N. (2019). Kamishibai cards to sustain evidence-based practices to reduce healthcare–associated infections.  American journal of infection control ,  47 (4), 358-365.