The Phases of Change Management

Current infection rates and desired rates of Stanford hospital 

The healthcare environment is a major factor which contributes to the patients' outcome. According to Stanford hospital statistics, 7 out of 10 patients in the hospital have a high possibility to contract healthcare-associated infections. The desired rate of infection is, however, 2 out of 10 patients. Consequently, in a past research of identifying the association of aggregated infections for CLABSI, MRSA, and CDI, the Stanford hospital was first place with hospital-acquired infections rate of 30.9 percent followed by UCSF medical center with 26.2 percent, and third was California pacific med CTR-Pacific campus with 21.1 percent (StanfordInfections, 2018). These figures portray the need for more research to acknowledge the number of new hospital infections in different care units to aid in the development of a preventive approach. The risk of infection can, however, be prevented and controlled through various cost-effective and straightforward strategies. These strategies may include hand hygiene, environmental hygiene, screening and cohorting patients, vaccinations, cleaning, sterilization, antibiotic stewardship, and care coordination. These strategies can be done by both the patients and the medical staff. 

Hand hygiene is a simple approach to preventing and controlling the high risk of infection. Hand hygiene has to be implemented as the medical facility policy. Patients should ensure to wash their hand before and after treatment to prevent the risk of infection. The surgical staff should also take part in hand hygiene (Eads & Maruzzella, 2016). They should clean their hands and forearms prior to a surgical procedure. They should also wear sterile gloves provided by the medical care to prevent infection of both the patient and the surgeon. The medical staffs also have to clean and disinfect their hands before and after attending and treating a patient. Use of hand sanitizers is useful in disinfecting hands in a medical institution. 

Environment hygiene contributes to the control and prevention of infection in healthcare institutions. Certain bacterial microorganisms can survive on environment surface hence contributing to the high risk of infection. When the medical staff and patients touch such surfaces, the bacteria may be transmitted leading to infection. Therefore the environment has to be kept clean at all times. Cleaning and disinfecting the hospital environment is essential (Eads & Maruzzella, 2016). Wastes and used equipment such as syringes have to be disposed to prevent infecting the patients. Implementation of disposal bins will also reduce environmental contamination hence reducing the chances of infection to the care providers or patients. Cleaning hospital facilities and its environment is a simple measure to maintain hygiene. Cleaning removes dirt and microorganisms in the hospital surfaces hence preventing contamination of the patients and the medical staff. 

Provision of sterile environment will also reduce the risk of infection. Sterilization can be achieved in two ways which are physical and chemical means. Physical means involves the use of heat or irradiations to kill microorganism. Chemical methods include the use of gas sterilization such as ethylene gas. The surgical section has to be kept sterile at all times to prevent infection of the patients (Berrios-Torres et al., 2017). The medical tools used such as syringes should also be kept under sanitary conditions to prevent and control infection. 

Screening and cohorting patients should be included in a medical center to control and prevent infection. Patients who are contagious should be kept in separate medical wards to avoid the spread of diseases or infection (Berrios-Torres et al., 2017). Patients with the same disease should be kept in one room since infection can spread from one patient to another. Separating the patients according to the disease they have will reduce infection on patients. 

Vaccination is necessary for the control and prevention of infection. The medical staff may contribute to the spread of diseases and infection since they interact with numerous patients with diverse types of diseases. Therefore the healthcare facility must ensure vaccination is being done to their staffs. Vaccination helps reduce the spread of infection to medical staff and the patients. 

Antibiotic stewardship also helps reduce the risk of infections. Misuse of antibiotics by patients has led to a high chance of infection. Misuse of antibiotics may make patients resistant to some medications (Mosadeghrad, 2014). Whenever they develop an infection, it becomes difficult to treat and therefore are greater channels transmitting infections. Creating a program which helps the appropriate use of antibiotics choice and dosing. This help minimizes the patient outcomes and controls great situations like C. difficile infection as well as antibiotic toxicity. 

Care coordination is also essential to reduce and control infections. Communication in the surgical preparation, organization, and postoperative care among the care providers may lead to the infection of the surgical site which can be avoided. The medical staffs need to coordinate care and communication in the surgical room to prevent the threat of breaking the sterility of a surgical room mainly during a surgical process when many crucial activities are happening altogether. Therefore care coordination helps a lot in averting surgical room infection hence controlling and preventing infection in patients. 

The interprofessional care system is highly effective for successful health care improvements. Implementing hygiene practices in a health care system is effective with teamwork in the medical facility. The different professional departments will work together implementing hygienic practices such as ensuring the use of sterile equipment, use of hand hygiene and effective disposal of medical equipment. Interprofessional collaboration will ensure the necessary sanitary procedures are followed in surgical rooms and in patients ward to reduce the high risk of infection. Interprofessional collaboration is also effective in that all medical professional will receive adequate education on how to improve the hygienic conditions in a healthcare facility. The interprofessional collaboration, through discussion, may come up with important and effective ideas on how to reduce the risk of infection in the healthcare system. Also, through interprofessional care system, patients will be kept aware and guided on the different ways of reducing the high risk of getting an infection, for example, being taught the importance hand hygiene after receiving treatment. Implementing cleaning, hygiene, and disinfection in each department will contribute to a clean environment hence controlling the spread of infections. Therefore, control and prevention of infections may be done through teamwork and interprofessional collaboration at all levels. 

The change plan to improve the health care environment has to be understood and implement for effective patient care outcome. In general, a health facility has to perform activities such as hand hygiene, environmental hygiene, screening and cohorting patients, vaccinations, antibiotic stewardship, and care coordination to improve the environmental conditions in a healthcare institution. The change plan aims to achieve and improve the healthcare sanitation and hygiene to reduce the spread of infection in the medical facility. It also aims at controlling the daily operations in the hospital and managing the hygienic operations to reduce the rate of infections in a healthcare institution 

References 

Berríos-Torres, S. I., Umscheid, C. A., Bratzler, D. W., Leas, B., Stone, E. C., Kelz, R. R., ... & Dellinger, E. P. (2017). Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surgery , 152(8), 784-791. 

Eads, V., & Maruzzella, G. (2016). The clinical nurse as an agent of change. Medsurg Nursing, 25(3), 173–175. 

Mosadeghrad, A. M. (2014). Factors influencing healthcare service quality. International Journal of Health Policy and Management, 3(2), 77. 

StanfordInfections. (2018). About| Hospital-Acquired Conditions at Stanford Hospital. Retrieved from https://www.stanfordinfections.info/about/