HAIs are diseases that patients acquire when being treated for surgical or medical conditions, and most of them are preventable. Contemporary healthcare uses various forms of invasive procedures and devices for treating patients and helping them recover. Infections may be related to the procedures such as surgery and devices such as catheters, or ventilators. Often, health-associated infections (HAIs) lead to huge financial and emotional costs for both the patients and their families ( Nuvials et al., 2015) . For most HAIs, it is the payer or hospital – sometimes both – which bears most of the financial cost. HAIs are major causes of morbidity and mortality in the United States, and are related to a considerable upsurge in annual costs of healthcare. At any particular time in the US, 1 in each 25 patients hospitalized acquire HAI ( Nuvials et al., 2015) . Because of the high cases of HAIs recorded in healthcare facilities around the United States, as well as substantial healthcare costs imposed on patients and family members, and the healthcare system, it is important to implement AHRQ-funded programs for preventing and reducing HAIs, as a way of improving patient experience in hospitals.
Significant of Problem
HAIs are a major contributors of complications across the care continuum and could be transmitted among different healthcare facilities. Nevertheless, recent research indicate that the implementation of existing prevention practices could result in up to a 70% decrease in some HAIs. Similarly, recent modelling data indicates that noteworthy decreases in in resistant bacteria such as MRSA, could be accomplished through collaborative actions between healthcare providers in a particular area ( Haque et al., 2018) . The CDC identifies that almost 1.7 million patients hospitalized in healthcare facilities acquire HIAs annually when receiving treatment for other diseases, and that patients who Die from HAIs are over 98,000 annually ( Haque et al., 2018) . There, HAIs are a major health issue that needs to be addressed. One of the ways that AHRQ has tried to prevent and reduce HAIs is through the Comprehensive Unit-based Safety Program (CUSP). This program combines methods for enhancing safety culture. Communication and teamwork, as well as various evidence-based practices.
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Purpose of the Paper
Generally, this paper aims to synthesize the two research articles most relevant to the research topic by analyzing how the researchers conducted their research, and the implications and findings of their research.
Synthesis of Literature
Concepts
In the article by Saint et al. (2019), Catheter-associated urinary tract infection (CAUTI) is a popular device-related disease in clinics. CAUTI can be prevented through both technical factors – proper maintenance, hygienic insertion, and correct catheter use – and socioadaptive features like behavioral and cultural changes in hospitals. Similarly, Shea et al. (2016) explored the usage of Kamishibai Cards (K Cards) as an instrument for encouraging compliance relations between staff and leaders.
Methods
In the research by Saint et al. (2019), the AHRQ funded national Comprehensive Unit-based Safety Program aimed to minimize CAUTIs in non-ICUs and ICUs. The key features of the program were to disseminate information to clinics and sponsor agencies, date gathering, and direction on major sociadaptive and technical factors in preventing the CAUTI. Catheter and the UTI data was gathered in three stages – baseline, implementation, and sustainability, in three, two and twelve months, respectively. The researchers employed multilevel negative binomial models to evaluate changes in the use of catheter and rates of CAUTIs. On the other hand, in the article by Shea et al. (2016), the researchers examined a single unit of a children’s clinic to evaluate K Card’s acceptability. The researchers recorded interventions and interviews. The Health Belief Model (HBM) was used for analysis. Also, HAIs rates, bundle compliance and central line utilization were explored.
Participants
In Saint et al. (2019), professional societies, government agencies including CDC, academic researchers, and state hospital associations. In Shea et al. (2016), staff members from the children’s hospital participated in the research.
Instruments
No instruments were used. The authors did not describe.
Implications for Future Work
The approach used in the article Saint et al. (2019) to the catheter-associated UTIs prevention employed both cultural and technical interventions. A similar coordinated effort should be to expand the program to longstanding care environments, whereby preventive information is narrower. Moreover, the implications of the research by Shea et al. (2016) asserted that an important step to adopt is to move forward beyond theory to offer practical sustainability tools. By capturing what happened on one unit of hospital, the authors offer opportunity for identifying major leadership factors – leadership style and communication – influence the adoption, acceptability and sustained uptake of EBPs.
Generally, the findings of the articles offers evidence for the research purpose, which was to suggest and present an AHRQ-funded program which would help to avert and decrease HAIs in hospital settings and enhance patient experience. The articles discuss to programs – K Cards, and CUSP, which could be used to achieve the article purpose.
Questions for Next Step
How can CUSP be used in healthcare settings to reduce HAIs? How can CUSP and K Cards be used to reduce HAIs and improve patient experiences in healthcare settings?
Conclusion
Overall, HAIs are a major health concern in the United States, and lead to significant medical costs for patients and their families. The AHRQs is committed to preventing and reducing the rates of HAIs in hospital settings. Researchers have established that a coordinated effort focused on socioadaptive and technical interventions could minimize the rates of catheter-associated UIT in the non-ICU environment. In particular, the CUSP could be effective in reducing catheter-associated UTI. However, the program could only be useful in non-ICUs. Besides, K Cards are useful devices for supporting EBPs and supporting communication among workers and leadership – to help them comply with the existing health procedures.
References
Haque, M., Sartelli, M., McKimm, J., & Bakar, M. A. (2018). Health care-associated infections– an overview. Infection and drug resistance , 11 , 2321.
Nuvials, X., Palomar, M., Alvarez-Lerma, F., Olaechea, P., Otero, S., Uriona, S., ... & Seijas, I. (2015). Health-care associated infections. Patient characteristics and influence on the clinical outcome of patients admitted to ICU. Envin-Helics registry data. Intensive care medicine experimental , 3 (1), 1-2.
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.
