Healthcare-Associated Infections in Hospice Care
Hospice care is a necessary form of care delivering care, quality, and comfort to people diagnosed with serious illnesses and approaching the end of their life (Kirby, 2018). Having participated in hospice care, the key activities included checking vital signs and issues that the patient may have, recording medical concerns, and administering prescribed medication. Healthcare-associated infections (HAIs) have become a significant issue of concern in healthcare facilities, especially in the hospice wards. These are infections that patient gets when getting care or treatment for medical and or surgical care. However, many of these infections are preventable. Hence, adopting evidence-based measures to curb the menace has been integral. The primary goal of any intervention is to prevent, reduce and ultimately eliminate HIAs. This paper describes a proposed evidence-based project addressing the HIA’s concerns in hospice care facilities.
HIAs are regarded as a major quality concern issue to hospice care as they have become an additional concern requiring medication. The infections have become more resistant to medication as well as virulent. With the quality and comfort of the patient a major concern in hospice practice, it has become inevitable for care providers in the facility to collaborate to prevent, reduce and eliminate infections. Within the hospice care facilities, the presence of HIAs has caused teamwork in adopting evidence-based practice to address the issue or improve outcomes.
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Notably, this issue/problem majorly affects the less mobile patient within the hospice care unit. This implies that the infections are obtained via the care providers as the transmitting agents. Additionally, with the patient high dependence rates on others people’s care, there is a tendency for the patient to get infected with such infections easily. The consequences of HAIs are far-reaching, affecting not only patient experience and outcomes but also the facility’s work environment and quality of care. Taking a detailed look at the impact of healthcare-acquired infections, they have been an inhibiting factor to the patients’ quality and comfortable hospice care experience. In this case, patients infected by such cases contribute to their health issues (Alemu et al., 2020). For example, patients receiving pain-relieving medication would require additional medication to address the new infections, compounding their overall care experience. The experience of HIAs is a minus on the comfort and quality of care given and patients (Seok et al., 2022). Hence it can be said that compromise on care quality and patient experience reduces the overall objective of hospice care. Concerning patient experience, the infections make the work environment unsafe for healthcare workers and patients, bearing in mind there is a high risk of spreading infection and compromise of workers and patient health status (F Cyr et al., 2019).
Healthcare-acquired infections cause strain on nurses and other care providers working in the hospice care unit (Alemu et al., 2020).). This significantly affects the nursing profession, as such issues are demanding and demeaning to their input. According to Healthcare-Associated Infections | Healthy People 2020. (n.d), any factor issue or occurrence reducing nurses’ overall contribution to the patient’s welfare compromises the overall practice. However, such incidents call for additional research on evidence-based practices to solve and improve the care delivery and patient experience.
Curbing the healthcare-acquired infections spread called for a collaboration approach. However, diverse practices can be deployed to address the issue. The care facility was equipped with hand washing points in almost every corner and entrance to address this issue. Damilare et al. (2020), regarded hand washing as an integral exercise that helps to reduce infection transmission from one person to another. In addition to installing hand washing points, hand sanitizers and wearing gloves and other protective clothes would also be used. Hand hygiene is recognized as a great way to prevent infections hence key towards preventing the spread of infections causing germs within hospital settings/environments (Abalkhail et al., 2021).
Despite hospice care dedicated to quality and comfort for the end of life, it is key to provide the best possible care and environment for the patients (What Are Palliative Care and Hospice Care, n.d). Healthcare-acquired infections can be a barrier to the best hospice care possible. However, a constant and effective hand washing culture within healthcare organizations can be the difference in providing the best care and unsafe patient experience.
References
Abalkhail, A., Mahmud, I., Alhumaydhi, F. A., Alslamah, T., Alwashmi, A. S. S., Vinnakota, D., & Kabir, R. (2021). Hand hygiene knowledge and perception among the healthcare workers during the COVID-19 pandemic in qassim, Saudi Arabia: A cross-sectional survey. Healthcare, 9(12), 1627. https://doi.org/10.3390/healthcare9121627
Alemu, A. Y., Endalamaw, A., Demeke, M. B., Mekonen, D. K., Birhan, B. M., & Wubet, A. B. (2020). Healthcare-associated infection and its determinants in Ethiopia: A systematic review and meta-analysis. PLoS One, 15(10) https://doi.org/10.1371/journal.pone.0241073
Damilare, Ogundeji Kolawole, RN, RM, RPHN,B.N.Sc, M.Sc. (2020). Hand washing: An essential infection control practice. International Journal of Caring Sciences, 13(1), 776-780. https://www.proquest.com/scholarly-journals/hand-washing-essential-infection-control-practice/docview/2410490698/se-2
F Cyr, D. A., Alidéhou, J. A., Johnson, R. C., Houngbégnon, O., Sègbè, C. H., & Bankole, H. S. (2019). Healthcare-associated infections: Bacteriological characterization of the hospital surfaces in the university hospital of abomey-Calavi/so-ava in south Benin (West Africa). BMC Infectious Diseases, 19https://doi.org/10.1186/s12879-018-3648-x
Healthcare-Associated Infections | Healthy People 2020. (n.d.). HealthyPeople.Gov. Retrieved June 12, 2022, from https://www.healthypeople.gov/2020/topics-objectives/topic/healthcare-associated-infections#:%7E:text=Emerging%20Issues%20in%20Healthcare%2DAssociated%20Infections&text=antibiotic%2Dresistant%20pathologens%3A-,Catheter%2Dassociated%20urinary%20tract%20infections,Clostridium%20difficile%20infections
Kirby, E. G. (2018). Patient Centered Care And Turnover In Hospice Care Organizations. Journal of Health and Human Services Administration, 41(1), 26-51. https://www.proquest.com/scholarly-journals/patient-centered-care-turnover-hospice/docview/2051209589/se-2?accountid=45049
Seok, J. M., Si-Ho, K., Kim, H., Moon, C., & Wi, Y. M. (2022). The epidemiology of bloodstream infection contributing to mortality: The difference between community-acquired, healthcare-associated, and hospital-acquired infections. BMC Infectious Diseases, 22, 1-7. https://doi.org/10.1186/s12879-022-07267-9
What Are Palliative Care and Hospice Care? (n.d.). National Institute on Aging. Retrieved June 12, 2022, from https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care
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Assignment: Pharmacotherapy for Cardiovascular Disorders
…heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…
—Murphy et al., 2018
Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.
Photo Credit: Getty Images/Science Photo Library RF
As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm
To Prepare
Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
Review the case study assigned by your Instructor for this Assignment.
Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
By Day 7 of Week 2
Write a 2- to 3-page paper that addresses the following:
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.
Here is the case study below…
Case Study
BN is a 74-year-old African American male who is seeing his PCP because he noticed when he woke up that his “heart was not beating right; it feels like it is going to slow.” He denies chest pain, SOB, N/V. He notes feeling dizzy earlier in the day. 6 weeks earlier his PCP started him on Diltiazem CD to further lower his BP to goal. His Metoprolol was lowered at that time as well from 75 mg to 50 mg BID. His PCP recommends he be admitted to the hospital.
Upon presentation to the hospital:
PMH:
HTN x 7 years
Type II DM
CAD s/p angioplasty 2 years ago
MI 3 years ago
EF = 60%
PVD s/p left femoral to posterior bypass
Hx of A Fib x 4 years
Medications:
Digoxin 0.25 mg QD KCl 40 mEq QD Vitamin C 500 mg QD
Diltiazem CD 180 mg QD ASA EC 325 mg QD Vitamin E 400 IU QD
Metoprolol 5- mg BID Warfarin 5 mg QD Ibuprofen 200 mg 2 tabs prn headache
Lisinopril 20 mg QD Famotidine 20 mg QHS Multivitamin QD
Imdur 30 mg QD Lantus 26u QHS Ca++/Vit D 500mg/200 IU BID
HCTZ 12.5 mg QD Humalog 8u with meals
PE:
BP 110/50 Pulse 38 bpm Resp 14/min
Rest of physical exam unremarkable
Labs:
K+ 6.9 WBC 5,800/mm3
Na+ 135 Hct 35%
Cr 1.9 Dig 2.78
BUN 35 INR 2.3
Gluc 102