Transforming the Safety Culture at Mcneal Hospital Dialysis Unit

Transforming the Safety Culture at Mcneal Hospital Dialysis Unit

Introduction

Healthcare-associated infections have been a major problem within the United States healthcare system. Such kinds of infections are always contracted during the delivery of complex operations, such as those involving dialysis. Healthcare providers across the United States, including McNeal hospital in collaboration with relevant authorizes and bodies such as Center for Disease Control and Prevention (CDC) and the National Health Service (NHS), have tried to device viable solutions that can help in eradicating such infections which have fatal consequences for both medical professionals and to the individual patients (Weber, Rutala, & Fried, 2016).

Human factors that result from their interactions with dialytic machines are some of the leading causes of morbidity that results from these operations. Some of the human factors include suboptimal communication among caregivers that result in errors and individual errors while they operate these dialysis machines as well as unhygienic conditions (Nguyen et al., 2016). There are three major types of healthcare-associated infections that patients can contact in any healthcare setting. Such infections include catheter-associated urinary tract infection, surgical site infection, and central line-associated bloodstream infection. Dialysis unit in any healthcare providers across the globe provides safe and effective procedures for patients that can improve their health conditions. However, these patients end up contracting the highly dangerous healthcare-associated infections. There must be solutions that can be applied in any healthcare providing centers offering dialysis services like McNeal dialysis unit to help in reducing such cases. This paper will highlight some of the solutions that can be implemented by McNeal dialysis units and other dialysis units across the globe to enhance their safety culture.

Problem Statement

Healthcare providers have the responsibility of ensuring the overall safety of society. They are required to uphold an astute culture of safety standards within their systems, procedures, and processes (Nguyen et al.  2016). According to the agency for healthcare research and quality, an organization’s safety culture is the product of individual and group values, competency, perception, and behavioral patterns that determine an organization’s commitment to its style of professionalism in service delivery (Karkar and Ayman, 2016). Both back-filtration and back-diffusion provide a pathway for contaminants in dialysis fluid from compromised water quality. On the same note, returning unused items to a common area or using them on another patient before their disinfection increases the chances of contracting healthcare-associated infections for both patients and healthcare professionals involved.

Additionally, failure to screen patients for hepatitis B virus (HBV) and hepatitis C virus (HCV) before admitting them into hospitals also increases the chances of individuals within the healthcare setting contracting these infections (Nguyen, Bixler & Patel, 2019). These are some of the avenues through which patients and healthcare staff members contract healthcare-associated infections, which are deadly and fatal. Hospitals are charged with ensuring the safety of the community by decreasing mortality rates within the country, why have hospitals become a causative agent of deaths within the country?

Relevancy of the problem

Organizations offering dialysis services should operate as highly reliable organizations with a well-structured safety culture. High-reliability organizations are expected to operate within the five principles of High-Reliability Organization, which include: resilience, deference to expertise, reluctance to simplify, preoccupation to failure, and sensitivity to operations. Collectively, these principles ensure all safety standards within an organization are adhered to, thereby enhancing the organizational safety culture. All the stakeholders within the united state’s healthcare industry have directed their efforts in ensuring total elimination of these infections among healthcare centers. Patients seek health relief from hospitals. However, some of them end up contracting healthcare-associated infections. Consequently, the infections deter some other patients from seeking delicate services such as dialysis, thereby compromising their safety and, as a result leading to an increase in mortality rate within the country.

Additionally, healthcare-associated infections have also been identified as the second leading cause of death within the United States. A wholesome collaboration of all stakeholders within the healthcare system is necessary for ensuring viable and practical solutions that can combat such a problem. Further research on healthcare-associated infections is equally critical for finding feasible solutions and improving healthcare outcomes.

Literature Review

According to Kear and Ulrich (2015), infection is the leading cause of hospitalization among nephrology patients, and Nurses are critically involved in identifying and controlling infections among patients. Kear and Ulrich (2015) performed research aimed at finding solutions that can decrease infections among nephrology patients. The results from the study indicated that the safety of nephrology patients is compromised due to the massive violation of proper infection control standards in a nephrologic setting. Among the solutions, the study provided includes the adoption of the five moments of hand hygiene that was provided by the world health organization (WHO). These moments include before touching a patient, before an aseptic procedure, after a body fluid exposure, and after touching a patient as well as after touching a patient’s surroundings. The study concluded by identifying that in enhancing safety culture practices in a dialysis unit, everyone should be accountable, including the patients.

Top of Form

Nguyen, Bixler, and Patel (2019) conducted a study that aimed at highlighting how the hepatitis C virus is transmitted in a healthcare setting and the possible solutions that can be implemented to prevent such transmission. Among the factors that the study identified to contribute to non-adherence to the necessary infection control measures in a dialytic setting include rushed treatment schedules, high staff turnover, and lack of infection control knowledge by the staff. The study recommended regular screening of patients with negative anti-HCV antibodies on admission. The study also suggested continuous training programs for all dialysis unit staff members to ensure they are adequately updated. Additionally, the study recommended healthcare providers to follow the guidelines provided by the center for disease control and prevention (CDC) in screening hemodialysis patients.

Bayoumi, Ahmed, and Hassan (2019) performed a cross-sectional study that aimed at highlighting nurses’ practices towards applying infection control measures using the notice checklist. The study concurred with Kear and Ulrich (2015) on the critical involvement of nurses in implementing infection control measures. The study recommended designing an evidence-based training program for nurses to promote patient-centered care and enhance organizational safety culture. The study also recommended awareness creation through the hanging of posters with essential steps of hand rubbing and glove pyramid. Additionally, the study recommended establishing a follow-up system to ensure constant adherence to infection control measures.

Lewis, Clark, Benda, and Hardwick (2014) conducted a study that aimed at reducing healthcare-associated infections by identifying and aligning work system factors. The study utilized a sociotechnical framework and, in particular, macro-ergonomic analysis and evaluated  54-chair ambulatory dialysis unit. It identified fifty-seven system discrepancies among six healthcare-associated infections risk factors. The study developed a multicomponent intervention to address 44 of the discrepancies across four risk factors. The results obtained from the study indicated that there was no improvement in access to infection sites and access-related bloodstream infections. The study concluded that inconsistent adherence to infection control measures is a result of organizational and external environmental factors such as service area demographics, suppliers of equipment and machines, and policies of the hospital, among others (Lewis, Clark, Benda & Hardwick, 2014).

Conclusion

For long, healthcare-associated infections have been a menace that has resulted in high morbidity and mortality rates among the American populations. McNeal hospital’s dialysis unit need to establish well structured and stringent measures that enhance the organization’s safety culture to curb cases of healthcare-associated infections associated with the organization by instigating appropriate and effective reporting system. Healthcare professionals and specifically, the nurses are at the core in enhancing necessary safety culture. Some solutions have undergone advancement that McNeal dialysis unit can utilize to further improving their safety culture.  McNeal can adopt the Five-Moments Hand Hygiene approach, perform regular screening of patients with negative anti-HCV antibodies on admission, and continuously train staff members in the dialysis unit to ensure that they are adequately updated. Additionally, McNeal dialysis unit should establish a follow-up system to ensure constant adherence to infection control measures. Combating healthcare-associated infections requires the collaboration of all stakeholders within the healthcare system, including the patients.