Hospital Acquired Pneumonia Essay
Description of the National Healthcare Issue/Stressor
Hospital-acquired pneumonia (HAP) refers to pneumonia that a patient develops within a hospital setting after at least 48–72 hours after being admitted (Pássaro et al; 2016). HAP is the second leading hospital-acquired infection and cause of death among critically sick patients. HAP is allied to an elevated rate of mortality and morbidity, as well as increased healthcare costs (Torres-García et al; 2019). According to Min et al (2018), the incidence of HAP worldwide is…
Assignment: Analysis of a Pertinent Healthcare Issue: Hospital Acquired Pneumonia
The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Hospital Acquired Pneumonia Essay . Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.
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Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.
In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected. Hospital Acquired Pneumonia Essay.
To Prepare:
• Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.
• Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected.
• Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor. Hospital Acquired Pneumonia Essay.
The Assignment (3-Pages):
Analysis of a Pertinent Healthcare Issue: Hospital Acquired Pneumonia
Develop a 3- page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:
Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples. Hospital Acquired Pneumonia Essay
RESOURCES/READINGS
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
• Chapter 2, “Understanding Contexts for Transformational Leadership: Complexity, Change, and Strategic Planning” (pp. 37–62)
• Chapter 3, “Current Challenges in Complex Health Care Organizations: The Triple Aim” (pp. 63–86)
Read any TWO of the following (plus TWO additional readings on your selected issue):
Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians—Implications for the physician workforce. New England Journal of Medicine, 378(25), 2358–2360. doi:10.1056/NEJMp1801869
Note: You will access this article from the Walden Library databases. Hospital Acquired Pneumonia Essay
Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN-prepared workforce goal. American Journal of Nursing, 118(2), 43–45. doi:10.1097/01.NAJ.0000530244.15217.aa
Note: You will access this article from the Walden Library databases.
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231–245. doi:10.1097/NAQ.0000000000000303
Note: You will access this article from the Walden Library databases.
Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250–256. doi:10.1370/afm.2230
Note: You will access this article from the Walden Library databases.
Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’ work settings, roles, and education preparation? Journal of Professional Nursing, 33(6), 400–404. doi:10.1016/j.profnurs.2016.11.005
Note: You will access this article from the Walden Library databases.
Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. Journal of the American Board of Family Medicine, 31(4), 588–604. doi:10.3122/jabfm.2018.04.170388
Note: You will access this article from the Walden Library databases. Hospital Acquired Pneumonia Essay
Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56), 1–15. doi:10.1186/s12960-016-0154-3. Retrieved from https://human-resources-health.biomedcentral.com/track/pdf/10.1186/s12960-016-0154-3
Poghosyan, L., Norful, A., & Laugesen, M. (2018). Removing restrictions on nurse practitioners’ scope of practice in New York state: Physicians’ and nurse practitioners’ perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354–360. doi:10.1097/JXX.0000000000000040
Note: You will access this article from the Walden Library databases. Hospital Acquired Pneumonia Essay
Ricketts, T., & Fraher, E. (2013). Reconfiguring health workforce policy so that education, training, and actual delivery of care are closely connected. Health Affairs, 32(11), 1874–1880. doi:10.1377/hlthaff.2013.0531
Note: You will access this article from the Walden Library databases.
Description of the National Healthcare Issue/Stressor
Hospital-acquired pneumonia (HAP) refers to pneumonia that a patient develops within a hospital setting after at least 48–72 hours after being admitted (Pássaro et al; 2016). HAP is the second leading hospital-acquired infection and cause of death among critically sick patients Hospital Acquired Pneumonia Essay. HAP is allied to an elevated rate of mortality and morbidity, as well as increased healthcare costs (Torres-García et al; 2019). According to Min et al (2018), the incidence of HAP worldwide is 5–20 cases per 1000 admissions. The high incidence of HAP indicates the need to address the issue.
In my healthcare organization, HAP is very common among patients in the ICU, and particularly patients who are mechanically ventilated. Similarly, the rate of HAP is also relatively high in patients within the medical-surgical ward and the general ward as well. In the organization, HAP in all units leads to an increased rate of morbidity and mortality, longer period of hospital stay, as well as, increased costs for both the patient and the organization. This is consistent in other organizations where hospital-acquired infections like HAP are associated with higher mortality rate, prolonged period of hospitalization, as well as higher healthcare costs (Pássaro et al; 2016) Hospital Acquired Pneumonia Essay.
In the organization, the rate of HAP is particularly high among older adults, patients in the ICU, as well as patients with prolonged use antibiotics and glucocorticoids. The high incidence of HAP among patients with lengthy use of glucocorticoids is allied to the reduced immunity that makes individuals susceptible to infections. Similarly, long-term use of antibiotics is a major risk factor for hospital-acquired pneumonia due to resistant to antibiotics. In my healthcare organization, HAP is associated with an increased rate of mortality, admission to the ICU, and an increased period of hospital stay. In addition, the organization spends a lot of finances in the treatment and care of HAP.
Summary of the Two Articles
According to Brett et al (2019), HAP is allied to elevated morbidity and mortality rate and also increased medical costs. HAP is also a leading factor for transfer to the ICU and results in a prolonged hospital stay. Risk factors associated with HAP include advanced age, a longer period of hospital stay, being a male, dysphagia, numerous comorbidities, as well as chronic obstructive pulmonary disease (Brett et al; 2019). Brett et al (2019) further indicate that poor oral hygiene causes buildup of dental disease which is a major risk factor in HAP. Accordingly, Brett et al (2019) explain that improved oral hygiene can be effective in decreasing the rate of HAP Hospital Acquired Pneumonia Essay. Other strategies that can reduce the rate of HAP include early mobilization, effective hand hygiene, proper management of dysphagia, and prevention of viral infections (Brett et al; 2019).
Deng et al (2019) explain that HAP is a very common hospital-acquired infection and a leading cause of death among hospitalized patients. Multi-drug-resistant organisms (MDROs) are attributed to the numerous cases of HAPs, and particularly within the ICU and emergency departments (Deng et al; 2019). Wide usage of broad-spectrum antibiotics is attributable to bacterial resistance, one of the risk factors for HAP. Hospital Acquired Pneumonia Essay.
Strategies used to Address HAP
The study by Brett et al (2019) demonstrates that interventions such as improved oral care, increased movement, and mobility, as well as dysphagia management, are effective in preventing HAP. The study indicates that improved oral care is an important modifiable risk factor for HAP. Comprehensive oral care facilitated by nurses is effective in preventing HAP as it prevents the buildup of dental plague which is a major risk factor in HAP.
Increased mobilization is also an intervention that can be used in preventing HAP especially among patients with acute ischemic stroke. The intervention involves turning the patient from “supine position to right and left lateral resting position” after every two hours and passively mobilizing the four limbs. This intervention has been shown to be effective in reducing the rate of HAP. The mobilization intervention also integrates pre-operative patient education, breathing exercises, as well as pre-operative physiotherapy (Brett et al; 2019). Brett et al (2019) further explain that suitable management of dysphagia and particularly among post-stroke patients is important in reducing the rate of HAP. This intervention includes nurses screening patients for dysphagia and implementing the appropriate interventions. This is because dysphagia has been shown to cause aspiration pneumonia because food or liquids can enter the airway when patients have difficulties in swallowing and hence introduce bacteria to the lungs. Therefore, effective management of dysphagia can prevent aspiration pneumonia.
Preventing and treating infections caused by multi-drug-resistant organisms can go a long way in preventing HAP (Deng et al; 2019). Long-term use of antibiotics has been shown to be a major risk factor for HAP due to antibiotic resistance. Interventions that can be used to address the issue of multi-drug resistance include relieving the inflammatory reactions among patients, improving organisms’ clearance, reducing the period of mechanical ventilation, addressing patients’ immunity, and increased the success rate of ventilator weaning (Deng et al; 2019).
References
Brett M, Russo P, Cheng A, Andrew S, Rosebrock H, Curtis S, Robinsion S & Kiernan M. (2019). Strategies to reduce non-ventilator-associated hospital-acquired pneumonia: A systematic review. Infection, Disease & Health, 24(4), 229 – 239. Hospital Acquired Pneumonia Essay
Deng, D., Chen, Z., Jia, L, Bu J, Ye M, Sun L, Gen Y, Wen Z, Chen G & Fang B. (2019). Treatment of hospital-acquired pneumonia with multi-drug resistant organism by Buzhong Yiqi decoction based on Fuzheng Quxie classical prescription: study protocol for a randomized controlled trial. Trials, 20(817).
Min, J. Y., Kim, H. J., Yoon, C., Lee, K., Yeo, M., & Min, K. B. (2018). Hospital-Acquired Pneumonia among Inpatients via the Emergency Department: A Propensity-Score Matched Analysis. International journal of environmental research and public health, 15(6), 1178. https://doi.org/10.3390/ijerph15061178.
Pássaro, L., Harbarth, S. & Landelle, C. (2016). Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review. Antimicrob Resist Infect Control, 5(43 (20).
Torres-García, M., Pérez Méndez, B. B., Sánchez Huerta, J. L., Villa Guillén, M., Rementería Vazquez, V., Castro Diaz, A. D., López Martinez, B., Laris González, A., Jiménez-Juárez, R. N., & de la Rosa-Zamboni, D. (2019). Healthcare-Associated Pneumonia: Don’t Forget About Respiratory Viruses. Frontiers in pediatrics, 7(168). Hospital Acquired Pneumonia Essay.