Nursing

Website spotlight: Organizational issues for prevention of HAIs and the systemic nature of the problem

Staff Development Weekly: Insight on Evidence-Based Practice in Education, July 1, 2011

You can't read anything about patient safety and quality or health reform without running into the topic of healthcare-associated infections (HAI). The issue tops a list of priorities for many health-related government institutions (e.g., Agency for Healthcare Research & Quality, CMS), nonprofit organizations (e.g., IHI, National Patient Safety Foundation), current research and publications, and patient advocacy groups. Popular media has recently been shining a light on the problem as well as the use of tools, such as checklists, as part of the solution for prevention.

Intense process improvement and research efforts in Michigan ICUs have gained a lot of attention for demonstrating significant reductions (and subsequent sustainability of those reductions) of HAIs. The work of Peter Pronovost, Atul Gawande, and others is quickly gaining traction. One of the troubling aspects of HAIs is the systemic nature of how they occur, the complex contributing factors, and the organizational issues of detecting and preventing them (not to mention their breadth of type and severity). HAIs are a problem wrought with cost and reimbursement pressures, challenges in allocating organizational resources, and care team performance factors.

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