It is true that encouraging improvements have been made in the delivery of safe and high quality healthcare care. However, even as mankind recognizes these improvements, it should be understood that serious challenges remain. Infection control is among the issues which present challenges for practitioners. In particular, nurses are struggling to keep infections in check (Davies et al., 2008). If interventions are not implemented swiftly, the gains that have been made could be reversed. Vascular access is among the specific areas of nursing practice which could benefit from interventions. From both personal experience and literature review, it was established that vascular access is a source of some of the infection control challenges that practitioners grapple with and that patient education is a promising intervention.
Safety Concern
Vascular access infection in a patient receiving hemodialysis is the issue of safety concern that has been selected for discussion. This issue was chosen because it relates directly to the Capstone project. More importantly, the selection was based on the fact that researchers have raised alarm over safety issues arising from vascular access infection. For example, Gork et al. (2019) noted that the infection rate resulting from vascular access is worryingly high. This concern was shared by Lafrance et al. (2008) who agreed that vascular access accounts for a large number of infections that patients acquire while receiving treatment. The mere fact that it is highly prevalent is not the only issue that makes vascular access a safety concern. This problem has been linked to a number of adverse outcomes in the healthcare setting. For example, Mohamed et al. (2019) identified vascular access infection as among the factors responsible for the hospitalization of patients undergoing hemodialysis. In addition, according to these scholars, this infection is to blame for the hundreds of deaths that occur in hospitals across the globe every year.
Delegate your assignment to our experts and they will do the rest.
It should be understood that there are some complexities that amplify the safety concerns arising from the vascular access infections. These complexities include the need to access the bloodstream for the administration of treatment, limited professional competency and comorbid conditions (Morikane, 2016). Basically, nurses operate in difficult conditions that allow for vascular access infections occur. For example, a nurse may lack the skills needed to prevent the infection among patients with comorbid conditions for whom vascular access is the most promising mode of administering treatment.
Outcomes
Vascular access-related infections present implications for a number of nursing sensitive outcomes. The cost of care, hospitalization and death are some of these outcomes. As already noted above, the infections are behind patient deaths and hospitalizations. Moreover, as a result of these infections, patients and providers incur high costs. For example, patients pay higher amounts to treat the infections in addition to the fee that they pay for the treatment of the illness for which they are receiving hemodialysis. Hospitals can also incur high costs when patients who develop the infections sue them for negligence. Given that vascular access-related infections are linked to negative outcomes, no effort should be spared in eliminating them.
Intervention
In recognition of the dangers that vascular access-related infections pose, the healthcare community has developed interventions to address this issue. One of the interventions that have proven to be highly effective is staff education. Numerous scholars have confirmed the effectiveness of this intervention. For instance, DeVries (2019) established that placing emphasis on staff education holds the key to preventing the infections. In particular, the staff should be educated on such issues as how to follow protocols and identify the early signs of the infections. Yousif, Abu-Aisha an Abboud (2017) also shed light on the impacts of education. They determined that if conducted properly, practitioner education helps facilities to create a culture of safety. They identify hygiene as among the specific issues that the education should address. There is no doubt that adopting patient education enables nurses to play a leading role in preventing these infections.
Evaluation Plan and Data
The intervention described above is indeed promising and would help providers to reduce the incidence of vascular access-related infections. However, to confirm that the intervention is indeed effective, the providers would need to adopt an evaluation plan. Evaluations play a vital role in healthcare as they provide facilities with standards and expectations against which to assess performance (Moule et al., 2017). To establish the effectiveness of the intervention discussed above as part of the evaluation process, a provider would need to examine such data as the incidence of vascular access-related infections. If it observes a drop in the number of these infections following the adoption of the intervention, the provider can conclude that the intervention has worked. Feedback from patients could also be used as an evaluation tool. When patients speak positively about how the education has transformed their health, practitioners will have a basis to find that the patient education has delivered the intended outcomes. The views of the staff could also form the evaluation process. The facility could confirm that the intervention has worked when the practitioners issue positive reviews and seem more productive.
Relation to Professional Safety Issues
In order to gain an even clearer and deeper understanding of the intervention, it is helpful to relate it to professional standards. The American Nurses Association (ANA) is among the organizations that have developed standards that concern safety. One of this organization’s standards is that nurses and healthcare facilities should create a culture of safety (ANA, n.d). Basically, the ANA expects providers to take all necessary steps to eliminate all hazards that could harm patients. Patient advocacy and centeredness are another value that ANA upholds. This value is reflected in the intervention because the intervention provides medical personnel with the insights, skills and perspectives that they need to promote safety. As they adopt this intervention, nurses and providers will be making it clear that they recognize the importance of a culture of safety.
In conclusion, ensuring patient safety is among the key obligations of nursing practitioners. These professionals are expected to invest in safeguarding the wellbeing of their patients. Vascular access-related infections are among the issues that underscore the need for nurses to increase their commitment to safety. These infections are responsible for hospitalizations, death and high healthcare costs. Fortunately, such measures as patient education have been shown to be an effective intervention. Nurses should move with speed to spearhead the adoption of this measure and other effective strategies.
References
American Nurses Association (ANA). (n.d). Culture of safety. ANA. Retrieved September 28, 2019 from https://www.nursingworld.org/practice-policy/work-environment/health-safety/culture-of-safety/
Davies, B., Edward, N., Ploeg, J., & Virani, T. (2008). Insights about the process and impact of implementing nursing guidelines on delivery of care in hospitals and community settings. BMC Health Services Research. doi:10.1186/1472-6963-8-29
Gork, I., Gross, I., Cohen, M. J., Schwartz, C., Moses, A. E., Elhalel, M. D., & Benenson, S. (2019). Access-related infections in two haemodialysis units: results of a nine-year intervention and surveillance program. Antimicrobial Resistance & Infection Control. https://doi.org/10.1186/s13756-019-0557-8
Lafrance, J. P., Rahme, E., Lelorier, J., & Iqbal, S. (2008). Vascular access-related infections: definitions, incidence rates, and risk factors. American Journal of Kidney Disease, 52 (5), 982-93.
Mohamed, H., Ali, A., Browne, L. D., O’Connell, N. H., Casserly, L., Stack, A. G., & Hussein, W. F. (2019). Determinants and outcomes of access-related blood-stream infections among Irish haemodialysis patients; a cohort study. BMC Nephrology. doi: https://doi.org/10.1186/s12882-019-1253-x
Morikane, K. (2016). Risk factors for vascular access-associated infections in patients on hemodialysis with catheters. Open Forum Infectious Diseases, 3 (suppl_1). doi: https://doi.org/10.1093/ofid/ofw172.274
Moule, P., Amoogum, J., Douglass, E., & Taylor, J. (2017). Evaluation and its importance for nursing practice. Nursing Standard, 31 (35), 55-63.
Yousif, K. I., Abu-Aisha, H., & Abboud, O. I. (2017). The effect of an educational program for vascular access care on nurses’ knowledge at dialysis centers in Khartoum State, Sudan. Saudi Journal of Kidney Diseases and Transplantation, 28 (5), 1027-33.
