Introduction: One of the essential competencies of health workers is leading change. Participants initiate changes during their time on-site, which will benefit them and sponsoring organizations (Skelton-Green et al., 2007). This paper discusses a project proposal to prevent hospital-acquired infection during IV insertion at Truxtun Surgery center.
Overview of the Organization
Truxtun Surgery Centre is an Ambulatory Surgical center located in Bakersfield, California. The current location of the facility is 4260 Truxtun Ave, Suite 120, Bakersfield, California (NPI, 2022). They majorly offer the following services; colonoscopy, biopsy, endoscopy, laser surgery, cataract surgery, injection spine (lumbar, sacral), etc.
Preliminary overview of the project
Hospital-acquired infections are acquired during a hospital stay; they were not present or not in the incubation stage during admission (Monegro et al., 2022). It can be caused by viral, bacterial, and fungal pathogens. These include surgical site infections, central line-associated bloodstream infections, etc. They are commonly manifested by abdominal pain, rebound tenderness, palpitations, suprapubic pains, shortness of breath, altered mental status, productive cough, etc.
The risk for hospital-acquired infections depends on the patient’s immune system, control measures in the facility, and the prevalence of pathogens in the environment (Monegro et al., 2022). The risk factors include; repetitive invasive procedures, older age, frequent visits to health institutions, indwelling devices, long stay in a health facility, multiple underlying conditions, etc.
The transmission of pathogens causing infections occurs either through direct contact with health workers or the environment. Extraluminal migration, colonization, and biofilm formation are responsible mechanisms for central line-associated bloodstream infections (Monegro et al., 2022). The common causative organisms for biofilm formation on catheters are staphylococcus epidermidis and staphylococcus aureus. Coagulase-negative staphylococci located in the skin is the primary cause of colonization of central lines hence associated with central line blood infections.
This project is intended to prevent hospital-acquired infection during IV insertion in Truxtun surgical center, California. The facility is known for ambulatory surgical services, which most of the procedures require intravenous access.
To prevent surgical acquired infection cases during IV insertion, instituting interventions to prevent infections is needed. My leading change quality improvement topic is preventing hospital-acquired infection during IV insertion at Truxtun surgical center.
The title of my project is preventing hospital-acquired infection during IV insertion, whereas the purpose is determining was of preventing hospital-acquired infections during IV insertion. The need for this project arose from the high number of post-operation infections, reduced client satisfaction, and staff proposal needs for change.
Applying the Leading Change Framework
This project will address post IV insertion bloodstream infections, protracted hospital stays, catheter-related blood infections, increased healthcare costs, and morbidity and mortality from blood infections. The causes of post IV insertion bloodstream infections can be divided into; education and training factors, physician factors, nursing factors, clue bundle, and compliance. The bonefish below elaborate on the possible causes of acquired infections during IV insertion.
I envision Truxtun surgery center will not be having hospital-acquired infections related to IV insertion. This will be accomplished through extensive training in IV site infection prevention, specifying the roles of physicians and nurses and compliance to the clue bundle.
I find my timing is good to start this project because of rising cases of post IV insertion infections and complications in the institution, for example, bloodstream infections, protracted hospital stays, catheter-related blood infections, and increased healthcare costs.
To carry out my project, I will engage the CEO of the facility, the physicians, Nurses, clinical microbiologists, infection control specialists, health care epidemiologists, information specialists, and some patients.
Institution CEO Approves and allows research to take place.
Physicians Give information and protocol for surgery procedures.
Nurses Provide information on managing IV sites post-insertion.
Microbiologists Provide information on the infection causative organisms.
Patients Provide information on caring IV sites at home and hospital.
Infection control Guide on infection prevention strategies
Information specialist Provide data and information on prevalence and incidence
of post IV insertion infections
My mentor and colleagues are likely to be influential in the success of my project. They have encouraged and supported me in carrying out this research. Some have even gone further and promised to provide necessary research materials. Also, I don’t expect opposition to this project because it is relevant and useful in our health facility.
This project is manageable in size; I can carry it out without difficulty. The facility has enough human and material resources for this project. There are printers too, which will be used to print questionnaires. Also, the staff-to-patient ratio is good, and this will not cause inconveniences when collecting information from staff.
The workplace I currently work at is an outpatient setting that wants the nurses to act quickly with admissions and discharges of the patients’ undergoing procedures like colonoscopy and endoscopy. In short-time interaction with patients and heavy workload, infection control is one of the important measures to follow. Performing the right technique to insert and remove iv is very important to prevent infection in such patients.
The facility is an ambulatory surgery center, which means it operates during the day or it works on same-day surgery basis. This will limit data collection from patients compared to inpatient and outpatient facilities. Also, because infection manifests later after the procedures, it will be hard to determine if the source of infection was at the hospital premises or home.
Sharing the Good News
I need to involve other interested parties/staff for this project to succeed. I will have to present the proposal to them for this to happen. I will discuss the project’s usefulness to their daily practices and the possible benefits. I will post my proposal to the hospital website for easy access and present it in health promotion meetings. Also, after completing my project, I will submit my project to the CEO of the institution, the infection prevention officers, the head of the surgery department, surgeons, and nurses for verification and implementation. The presentation will take place in a scheduled meeting.
Project Evidence Base
- The incidence and prevalence of hospital-acquired infections during IV insertion at Truxtun surgery center in Bakersfield, California.
- The causes of hospital-acquired infections during IV insertion at Truxtun surgery center in Bakersfield, California.
- The preventive measures for hospital-acquired infections during IV insertion.
Monegro, A., Muppidi, V., & Regunath, H. (2022). Hospital Acquired Infections. Ncbi.nlm.nih.gov. Retrieved 2 February 2022, from https://www.ncbi.nlm.nih.gov/books/NBK441857/.
NPI. (2022). Truxtun Surgery Center Inc in Bakersfield, California – Ambulatory Surgery Center Address and Contact. Npino.com. Retrieved 2 February 2022, from https://npino.com/surgery-center/1578505079-truxtun-surgery-center-inc/.
Skelton-Green, J., Simpson, B., Scott, J. (2007). An integrated approach to change leadership. Nursing Leadership,20 (3), 1-15. doi:10.12927/cjnl.2007.19277
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