It is a fact that nosocomial infections have been rampant in the recent past in this institution with six cases having been reported in its ward number 10 of E. Coli. The main reason has been indicated as being sanitation from suppliers that supply different foodstuffs to the hospital. As part of the duties assigned to me to analyze my home area hospital records and itemize the recent cases of nosocomial infections, which frequently cause illness at the health facility, I used information from agencies as well as evaluating data from common nosocomial diseases as to come up with a contingency plan in response to the same.
My main hospital of focus in my area is the Baptist Princeton where 7 patients were infected, 4 deaths recorded. However the case was not only in this hospital but in six others as well. In the past year alone, On March 29 the Alabama Department of Public Health (ADPH) released a preliminary announcement that two of six hospitals reported infections in patients related to products prepared by a single pharmacy named as Med IV ("CDC and ADPH Investigate Outbreak at Alabama Hospitals; Products Recalled"). There were six hospitals and 19 infected patients involved with an outbreak of Serratia marcescens bacteremia in patients who were fed liquid nutrients by IV catheter. Nine patient deaths occurred among the total population of 19 patients. All nine deceased patients had evidence of Serratia marcescens infection. Most of these hospital cases are centered in Birmingham, Alabama. Basing on the figures of infected people and the number of deaths, we can say that this was a deadly calamity.
The Alabama DOH updated that on March 30, 2011 the data on Serratia-infected patients who were alive and those dead were according to hospital and location. Of particular interest is the fact that the first Serratia case was noted in January, 2011 and was followed by another Serratia-infected patient in February. These two initial cases were followed by 17 patient infections in March that established an ongoing epidemic pattern. The Serratia-infected patients ranged in age from 38 to 94 years old. There were 8 male and 11 female Serratia marcescens infections. Alabama cases and deaths by hospital as of March 30, 2011 are
● Baptist Princeton, 7 patients, 4 deaths
● Baptist Shelby, 5 patients, 2 deaths
● Medical West, 3 patients, 1 death
● Cooper Green Mercy, 1 patient, no deaths
● Baptist Medical Center Prattville, 1 patient, 1 death
● Select Specialty Hospital of Birmingham, 2 patients, 1 death
Some of the questions for the administrator can be the measures that the hospital is taking to make sure that the issues of nosocomial diseases are litigated, and a repeat is not experienced. This is a great question that will give an overview of what the users should expect from the hospital and something that can help create consumer confidence among the users of the hospital. Another important question include some of the plans that the hospital has in respect to training of personnel to effectively respond to the cases (Friis & Sellers, 2014).. It is important for the hospital to have adequate personnel that can be able to deal with these cases whenever they arise on time so that the impact is not as much as what was experienced in the past. The hospital should be able to provide a breakdown of the measures that they have put in place in making sure that they have these personnel.
The third question that I will ask if the management has taken any efforts on advising patients on some of the practices that they should adhere while at the facility to avoid cases of contamination whether it this disease or any other. It is important for patients to be careful on what they touch while at the hospital as they can easily acquire diseases if not careful. The fourth question is whether the hospital has enough resources to enable it stage up efforts in response to these cases whenever they occur. This is important because it is a must for the hospital to have all the resources that can enable it prevent more damages as experienced in the past case scenario.
The fifth question is whether the hospital has involved any other stakeholders in trying to find a way that it can deal with these cases. This is also important so as to know who are involved in protecting the public from the impact of these cases. It also helps the public to know who to hold responsible in case the institution fails in its mandate to guarantee the lives of the patients. The last question is whether the hospital has implemented any changes in its system from its last disaster, and if any how is it functional as far as effectiveness is concerned.
The main target audience is the patients and users of the institution but it is also important to involve all the stakeholders including physicians, workers and the authorities like the state offices and the DOH. One of the key elements of the implementation will involve developing key metrics throughout the plan. This will ensure that the entire plan turns out to be a success. Some of the things to consider include fluctuations in the income and financial status of the hospital, just in case we lack enough funds, there can be a way out of it.
The second most important thing is to make sure that we develop a way in which we can be able to understand the root causes of the issues and also come up with ways in which solutions to these problems can be identified (Terry, 2012). Some of the things to consider here will include asking ourselves questions about some of the things that we have failed to implement that might cost us, what we are doing to bring everything on track, what positive things have happened and also what negative things have happened as well. We can also find a way in which we can bring resources back to the equation.
The third step to consider is to make sure that individuals put in efforts to making the plan work. If there are any individuals that might not work towards making the plan work, they should be cautioned and if need be, should be retrenched. What will contribute to the success of the plan if all the stakeholders are willing to work as a group putting all their efforts as individuals. The fourth step is to evaluate the progress of the implementation plan and also to look at what other institutions are doing in making sure that their systems are working. This will help ensure that we have the right programs and strategies in place, and in case we fail, we have a way of implementing a better plan.
Basing on the implementation steps above, some of the recommendations that I can make to the head of department is to first involve all departments in the formulation of key metrics of the plan (Robert, 2009). Involving all departments is important in making sure that all aspects of the institution have been represented and that the organization is working toward a common goal. It is also important for all workers and stakeholders to be represented especially when it comes to policy formulation, so that everyone feels part of the organization.
The second recommendation that I can make is for the head of department to formulate an oversight committee that can be on standby just in case there is a rising case. This oversight committee will be responsible for identifying the main causes of the calamities and they also easily come up with a timely solution in respect to the same. This is something that prevents more damages. The third recommendation is for the head of department to make sure that everyone is participating in the efforts to implement the plan by making a follow up and if necessary grouping everyone in workable teams under a team leader. This is also a good step in making sure that individual efforts contribute to the ultimate success.
Another recommendation is for the head of department to come up with a tem to do the evaluation and research on the implementation of the plan. It can be internally formulated team or the organization can resort to outsourcing (Macera, et al, 2013). The main objective is for the team to be very thorough and to offer accurate results. The team should also be in a position to advice the department on the next step to take in ensuring that it corrects the issue. Lastly the department should also come up with a financial plan to help in the implementation of the program as other steps might require the organization to spend a little extra.
Basing on the recommendations some of the safety protocol itinerary that must be placed in public access areas of the hospital include putting measures to prevent central line-associated blood stream infections. The staff should be vigilant with this issue and make sure that it is done in the best way possible. Some of the things to consider include washing hands, using full-barrier precautions, cleaning the skin with chlorhexidine, avoiding femoral lines, and removing unnecessary lines. It is also important to re-engineer hospital discharges. This can be done through reducing potentially preventable readmissions by assigning a staff member to work closely with patients and other staff to reconcile medications and schedule necessary follow-up medical appointments. Lastly we can ensure that we educate the patients on how they can carry themselves in the hospital and also the mode with which they can use the blood thinners safely.
References
Friis, R. H., & Sellers, T. (2014). Epidemiology for public health practice (5th ed.). Burlington, MA: Jones & Bartlett Learning.
Macera, et al (2013). Introduction to epidemiology: Distribution and determinants of disease (1st ed.). Clifton Park, NY: Cengage Learning.
Robert H (2009) Clinical Epidemiology: The Essentials M - Medicine Series NY: Lippincott Williams & Wilkins
Terry M (2012) Primary Care: A Collaborative Practice NJ: Elsevier Health Sciences
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