Introduction
Control of healthcare-associated infections requires concerted efforts of healthcare providers, caregivers, visitors, and patients. Healthcare-associated infections emanate from the spread of pathogens, such as bacteria, fungi, viruses, and parasites, from one person to another in a hospital environment. These pathogens usually cause catheter-related urinary tract infections, central line-associated bloodstream infections, surgical site infections, and ventilator-associated pneumonia. Partnering to Heal is a training video, which simulates a scenario where systematic practices of a physician, a registered nurse, an infection preventionist, a family member, and a medical student contributed to the death of a patient, Winnie Ross, owing to the occurrence of healthcare-associated infections. The video illustrates how ineffective communication and poor prevention of healthcare-associated infections resulted in the death of the patient. In this view, the essay explains how healthcare providers and family members could have prevented the occurrence of healthcare-associated infections by assuming the identity of a physician, a registered nurse, an infection preventionist, a family member, and a medical student.
Change of Behavior and Culture
Prevention of healthcare-associated infections requires a change in the behavior of healthcare providers. The video demonstrates how individual behavior contributed to the occurrence of nosocomial infections. Understanding the risks of healthcare-associated infections, Nathan Green did not take his time to visit patients, monitor their conditions, and supervise healthcare providers. Dena Gray touched a contaminated surface, did not wash her hands, and shifted intravenous line without gloves, hence, infecting the patient with nosocomial infections. Kelly McTavish was a family caregiver, who innocently played a great role in the spread of pathogens from his father to the patient, who died. Since her dad was suffering from surgical site infections, Kelly McTavish touched the dressed wound with gloves, left the unit with them, and contaminated the surface at the nurse station. In essence, Kelly McTavish did spread pathogens from his dad to Winnie by contaminating the surface, where other nurses touched. Weber, Anderson, and Rutala (2013) state that surface contamination by hands and gloves is the major cause of healthcare-associated infections among patients.
A review of the video demonstrates that organizational culture contributed to the spread of nosocomial infections and the death of the patient. Nathan Green was the director of the post-operation unit, who did not use his position of influence to transform organizational culture by ensuring that the hospital adopted the culture of hand hygiene. Weber et al. (2013) explain that prevention of nosocomial infections requires a transformation of organizational culture for people to appreciate the essence of hygienic conditions in the provision of healthcare. Moreover, the fact that the weekend contributed to the death of the patient, the hospital needs to transform its organizational culture so that healthcare providers could understand that the health conditions of patients are not dependent on days of the week.
Teamwork
The video depicts how healthcare providers, caregivers, visitors, and patients did not collaborate in preventing the spread of nosocomial infections. Evidently, the lack of a team-based approach in the prevention of nosocomial infections contributed to the death of the patient. The video shows that Janice Upshaw was more reactive rather than proactive in the prevention of nosocomial infections. The way Janice Upshaw reported the death of the patient indicates that she had no recent information about her condition, and thus, it implies that she had not instituted any preventive measures. From the simulation, it is apparent that everyone is accountable for the occurrence of nosocomial infections.
The video also shows that nurses did not want to cooperate with the family caregiver for they appeared indifferent. The caregiver was struggling to help her father with minimal assistance from a healthcare provider and whenever she asked for help they ignored her. The nurse, who was seated at the nurse station saw the caregiver walking carelessly with gloves while contaminating surfaces, but she did nothing to warn colleagues or disinfect the surfaces. Moreover, the doctor did not want to work in a team because she downplayed the concerns raised by Manuel Hernandez. Ceballos, Waterman, Hulett, and Makic (2013) argue prevention of nosocomial infections requires cooperation among healthcare providers, caregivers, patients, and visitors because they are agents of these infections. Thus, teamwork enhances accountability because everyone has defined roles in a team.
Leaders’ Goals
Goals that leaders set in the prevention of healthcare-associated infections have a marked influence on individual behavior, organizational culture, and teamwork. As the director of the post-operation unit, Nathan Green had the responsibility of ensuring that patients do not contract surgical site infections because they are susceptible to healthcare-associated infections. From the video, it is evident that the lack of appropriate goal of zero-rating the occurrence of healthcare-associated contributed to the spread of healthcare-associated infections. Despite the fact that Nathan Green had appropriate knowledge and was ready to commence new prevention efforts, he showed no personal goal aimed at preventing the spread of healthcare-associated infections among healthcare providers, patients, caregivers, and visitors.
Janice Upshaw was a new healthcare provider, who had the responsibility of zero-rating the occurrence of infections using a team-based approach. Since she was supposed to mobilize healthcare providers, family members, and visitors in the prevention of healthcare-associated infections, she did not have the appropriate social skills to mobilize them. From the video, it is apparent that Janice Upshaw was unfriendly and hostile to healthcare providers because when she requested attention, a nurse was shocked that something must have gone wrong. The conversation that ensued indicates that Janice Upshaw reprimanded healthcare providers instead of coaching and mobilizing them to work as a team. Ceballos el al. (2013) recommend health managers create interdisciplinary quality improvement teams by mobilizing healthcare providers to collaborate in the prevention of healthcare-associated infections. Therefore, Janice Upshaw did not exhibit any personal goal of mobilizing healthcare providers to collaborate on improving the quality of care and protecting patients from nosocomial infections.
Effective Communication
Effective communication plays a significant role in the prevention of healthcare-associated infections. The video shows that Manuel Hernandez was a promising medical student, who wanted to improve the quality of care offered to patients. Manuel Hernandez critically monitored the progress of the patient and noted that her temperature increased to 1010F, which is abnormally high. However, he failed to communicate effectively to the doctor because he was a mere medical student. If the doctor had encouraged him to communicate without feeling confronted, Manuel Hernandez would have communicated effectively.
Furthermore, when Manuel Hernandez pointed out the concern of a swelling arm at the left arm, ineffective communication made the doctor insist that the patient’s history indicates that the cat scratched it and caused a rash. Given that the cat had scratched the right arm, Manuel Hernandez did not inform the doctor that the cat did not scratched the left arm. In this view, the doctor could have reviewed his perception of the swelling arm and made informed decisions. Poor communication between healthcare providers and patients contributes to the occurrence of medical errors (Taran, 2011). Evidently, effective communication would have made Manuel Hernandez provide invaluable advice, hence, enabling the doctor to correct her erroneous perception.
Actions of the Five Characters
Nathan Green could have visited the patients, Tom and Winnie, and assessed their conditions effectively with a view of protecting them from possible healthcare-associated infections. Landelle, Pagani, and Harbarth (2013) explain that judicious use of gloves, gowns, and strict hand hygiene is imperative in the prevention of healthcare-associated infections. In this view, Nathan Green could have come up with guidelines for healthcare providers, family members, and visitors to follow in preventing the spreading of healthcare-associated infections.
The act of touching surfaces without washing hands made Dena Gray transfer pathogens to Winnie. Mathur (2011) states that hand-washing is an effective preventive strategy for healthcare-associated infections because it eliminates pathogens on hands. Thus, Dena Gray could have washed her hands before touching gloves, wearing them, and transferring intravenous lines from one arm to another.
As prevention, Janice Upshaw should have understood the practices of healthcare providers and the condition of the patient so that she could formulate appropriate intervention measures. Ceballos et al. (2013) state that mutual respect, empowerment, communication, and accountability are elements of teamwork that enhance collaborative efforts and patient outcomes. In this case, Upshaw should have ensured that there were collaborative efforts, which emanated from her team-based approach.
Kelly McTavish should not have left the unit with contaminated gloves because she would contaminate surfaces with them, and hence, spread pathogens to other people in the hospital. According to Weber et al. (2013), contaminated environmental surfaces contain resistant pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, and vancomycin-resistant Enterococcus (VRE). Therefore, Kelly McTavish should not have used her gloves in touching her clothes and benches because they were potentially contaminated surfaces.
Regarding the signs and symptoms, Manuel Hernandez could have given his point of view and insisted that the condition had worsened due to possible sepsis, even though the weekend was approaching and the doctor had instructed the administration of antibiotics. Taran (2011) states that doctors require a constant update of the progress that patients undergo so that they could make informed decisions in time to save lives. Hence, Manuel Hernandez should not have kept quiet and adhered to the instructions of the doctor.
The favorite character in the simulation is Manuel Hernandez because he had the zeal of improving patient outcomes and employing evidence-based practice in his decisions. The video depicts Manuel Hernandez as a serious healthcare provider, who closely monitored the progress of the patient. In assessing and monitoring the condition of the patient, Manuel Hernandez employed evidence-based practices, which include temperature, blood pressure, and symptoms that the patient presented. As healthcare-associated infections cause organ failure, evidence-based research requires healthcare providers to assess blood pressure, temperature, and appropriate symptoms (Mathur, 2011). The doctor defended her position by citing that high temperature relates to appendicitis and the rashes were due to the scratch from the cat as noted in the patient’s history.
Conclusion
A review of the video effectively portrays how healthcare-associated infections occur among patients. What is interesting in the video is that healthcare providers, family caregivers, and visitors play a central role in the prevention of nosocomial infections. Simple acts, such as contaminating services and improper use of gloves, resulted in the death of the patient. To prevent the occurrence of healthcare-associated infections, Nathan Green should have initiated prevention efforts, Dena Gray should have washed her hands and used gloves appropriately, Janice Upshaw should have used approachable leadership skills in mobilizing healthcare providers, Kelly McTvish should have not contaminated surfaces using infected gloves, and Manuel Hernandez should have actively advised the doctor.
References
Ceballos, K., Waterman, K., Hulett, T., & Makic, M. (2013). Nurse-driven quality improvement interventions to reduce hospital-acquired infections in the NICU. Advances in Neonatal Care, 13(3), 154-163.
Landelle, C., Pagani, L., and Harbarth, S. (2013). Is patient isolation the single most important measure to prevent the spread of multidrug-resistant pathogens? Virulence, 4(2), 163-171.
Mathur, P. (2011). Hand hygiene: Back to the basics of infection control. Indian Journal of Medical Research, 134(5), 611-620.
Taran, S. (2011). An examination of the factors contributing to poor communication outside the physician-patient sphere. McGill Journal of Medicine, 13(1), 86-89.
Weber, D., Anderson, D., & Rutala, W. (2013). The role of the surface environment in healthcare-associated infections. Current Opinions in Infectious Diseases, 26(4), 338-334.