Analysis of a Pertinent Healthcare Issue

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. 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.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.

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.
The Assignment (3-4 Pages): Analysis of a Pertinent Healthcare IssueDevelop a 3- to 4-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.

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Analysis of a Pertinent Healthcare Issue

Introduction

There are various national healthcare issues or stressors that affect and impact healthcare organizations within the US. All these issues need to be addressed, even though some are more urgent than others. The selected healthcare issue is catheter-acquired urinary tract infections (CAUTI), which are among the most common hospital-acquired infections which the acute healthcare settings. CAUTIs occur due to multiple factors and interrelated behaviors done by numerous individuals. CAUTI can occur due to unnecessary use, poor insertion technique that introduces microbes, and prolonged stay of the catheter for a long time which allows bacteria to travel from the catheter to the bladder, and then to the blood (Ding et al., 2019).

National Healthcare Issue/Stressor

In spite of the current advances in healthcare, the prevalence of hospital-acquired infections (HAIs) continues to rise. HAIs are associated with an increased mortality rate among patients and they also cost the American healthcare system billions of dollars annually (Zhong et al., 2020). CAUTIs are among the most common kind of HAIs and they are associated with death and organ dysfunction. Even though CUAUTIs are preventable, they contribute to approximately 13,000 deaths every year in the US (Podkovik et al., 2019). CAUTIs occur from the biofilm (collection of microbes) that forms on the surface of the urinary catheter. This process starts immediately after the insertion of the catheter and the risk of CAUTI elevates, with the prolonged stay of the catheter (Pelling et al., 2019). CAUTIs have been shown to cause death, complications, prolonged length of hospital stay, and increase healthcare costs.

In my organization, the rate of HAIs and particularly CAUTIs is relatively high. The presence of CAUTIs leads to the organization experiencing punitive financial losses and a reduction in reimbursement for healthcare services. The rate of CAUTIs within the organization is relatively higher than the national benchmark. Moreover, the organization experiences increased healthcare costs due to the costs associated with the treatment of the infection as well as the prolonged length of hospital stay. According to the infection control nurse at the organization, even though the number of CAUTIs in the first and second quarter was negligible, the number of the CAUTI cases in the last 12 months was above the national benchmark. This indicates the importance of addressing the issue.

Summary of the Articles

According to Meneguet et al (2019) HAIs are a significant public health problem because they are associated with increased mortality and morbidity; prolonged length of hospital stay, increased healthcare costs, and additional suffering to the patients and their families. Urinary tract infections account for about 40% of all HAIs in the US and thus CAUTIs are among the most common HAIs in American hospitals (Meneguet et al., 2019). The use of an indwelling urinary catheter is the major risk factor for urinary tract infections. Accordingly, CAUTI is the most common type of UTIs, as they cause about 13,000 in the US annually (Meneguet et al., 2019). Because the majority of patients within intensive care units (ICU) are likely to have an indwelling urinary catheter, this patient population has an increased risk of developing CAUTI.

According to Atkins et al (2020) strategies that have shown efficacy in reducing the rate of CAUTI include removal of the catheter as soon as possible, training of the nursing staff, active surveillance on the incidence of CAUTI, and use of the suitable method to insert and maintain the catheter. Atkins et al (2020) explain that the key hindrance to the removal of a urinary catheter is the nurses’ perception that severely ill patients need to use the catheter. This perception can be changed through training and promoting the implementation of guidelines and protocols about the indications for use of an indwelling urinary catheter (Atkins et al., 2020). Healthcare organizations are not reimbursed for costs incurred during the treatment of CAUTI. According to the Centers for Medicaid and Medicare Services, CAUTIs are preventable when the guidelines are adhered to and when the proper techniques are used.

Strategies

One of the strategies to reduce the incidence of CAUTIs in the organization is to ensure the healthcare providers adhere to the CAUTI prevention bundle. This can be achieved by increasing surveillance and audits for CAUTIs and educating bedside nurses regarding the prevention of CAUTIs. The findings from Meneguet et al (2019) indicated that training and daily review of an indication for catheters significantly reduced the rate of CAUTIs in the hospital’s ICU. Nurses were also educated about the appropriate insertion techniques of urinary catheters. Atkins et al (2020) also indicate that educating the nurses about the latest CAUTI management guidelines and providing supporting materials to the nursing staff helps to reduce CAUTIs in healthcare organizations.

The positive outcomes in educating nurses about CAUTI and ensuring adequate surveillance and audit of CAUTI in the organization can help in improving patient outcomes, increase the organizational reimbursement from Medicare and reduce the organizational costs by decreasing out of pocket expenses associated with prolonged hospital stays that are not catered by insurance. In addition, there is a need to implement policies that support procedures to reduce CAUTIs in the organization. This ensures that all organizational staff follows the policies. Moreover, the reduced rate of CAUTI in the organization is likely to gain a positive score in the healthcare industry and also facilitate increased patient satisfaction. Positive improvements in the organization can improve the wellbeing of the nursing staff, resulting in more positive impacts like increased employee retention.

Conclusion

By educating the nursing staff about the reduction of CAUTIs and implementing policies to reduce the rate of CAUTI, the organization sends a message that quality of care and patient safety are priorities in the organization. Reduced rates of CAUTI will help the organization gain positive scores in the healthcare industry and reduce healthcare costs. Even though these investments are likely to cost the organization, the investments will in the long run lead to a significant reduction of healthcare costs. Striving to lower the rates of CAUTI is the first step towards attaining improvement at the organization.

References

Atkins, L., Sallis, A., Chadborn, T., Shaw, K., Schneider, A., Hopkins, S., … & Lorencatto, F. (2020). Reducing catheter-associated urinary tract infections: a systematic review of barriers and facilitators and strategic behavioral analysis of interventions. Implementation Science, 15(1), 1-22. https://implementationscience.biomedcentral.com/articles/10.1186/s13012-020-01001-2

Ding, R., Li, X., Zhang, X., Zhang, Z., & Ma, X. (2019). The epidemiology of symptomatic catheter-associated urinary tract infections in the intensive care unit: a 4-year single-center retrospective study. Urology Journal, 16(3), 312-317.

Menegueti, M. G., Ciol, M. A., Bellissimo-Rodrigues, F., Auxiliadora-Martins, M., Gaspar, G. G., da Silva Canini, S. R. M., … & Laus, A. M. (2019). Long-term prevention of catheter-associated urinary tract infections among critically ill patients through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheters: a quasi-experimental study. Medicine, 98(8). https://journals.lww.com/md-journal/Fulltext/2019/02220/Long_term_prevention_of_catheter_associated.22.aspx

Pelling, H., Nzakizwanayo, J., Milo, S., Denham, E. L., MacFarlane, W. M., Bock, L. J., … & Jones, B. V. (2019). Bacterial biofilm formation on indwelling urethral catheters. Letters in applied microbiology, 68(4), 277-293.

Podkovik, S., Toor, H., Gattupalli, M., Kashyap, S., Brazdzionis, J., Patchana, T., … & Wacker, M. R. (2019). Prevalence of Catheter-Associated Urinary Tract Infections in Neurosurgical Intensive Care Patients–The Overdiagnosis of Urinary Tract Infections. Cureus, 11(8).

Zhong, X., Xiao, L. H., Wang, D. L., Yang, S. W., Mo, L. F., He, L. F., … & Luo, X. F. (2020). Impact of a quality control circle on the incidence of catheter-associated urinary tract infection: An interrupted time series analysis. American Journal of Infection Control, 1(1). https://journals.lww.com/mdjournal/Fulltext/2019/02220/Long_term_prevention_of_catheter_associated.22.aspx