Directions:
Write a 1,900 word paper that provides the following:
1. Identify a quality, change, or safety theory you will use to support the implementation of your quality and/or safety program. Provide evidence that supports the use of this theory within the program you designed.
2. Provide the design of your evidenced-based quality and/or safety program that can be implemented to improve quality or safety outcomes in your identified entity.
3. Discuss expected outcomes of your implementation and how to ensure their sustainability.
Support your position by referencing at least five to six to eight scholarly resources. At least three of your supporting references must be from scholarly sources of not older than 5 years.
Implementation and Evaluation
Introduction
Implementation of a new quality or safety program in healthcare facilities has always been a big deal since most health care personnel prefer applying for the present programs rather than switching to new ones. As a result, many healthcare facilities in the world have failed to implement the newly discovered evidence-based programs. However, studies show that the cause of delayed implementation of new quality and safety progress is the application of unreliable approaches which cannot convince health care providers to adopt the new programs. Thus, health care professionals should make efforts to ensure that quality and safety programs are implemented and evaluated in the healthcare system so as to enhance good patient outcomes. In this case, different theories including change, safety, and quality theories can be used in the process of implementing a change program. Besides, the implementation of a new program is always accompanied by positive or negative outcomes. Therefore, this essay entails the theories used to come up with my design program, an explanation of the design program, and expected outcomes after implementing the program.
Everett Rogers’ Theory of Diffusion of Ideas and Innovations
In my case, I would prefer to use a change theory to support the implementation of my quality program in the healthcare facility. Everett Rogers’ theory of diffusion of ideas and innovations is one of the change theories that have been used to implement changes in healthcare programs. According to Rogers, four elements influence the diffusion of ideas. The elements include innovations, communication channels, time, and social systems (Kreps, 2017). Besides, the diffusion of innovations process occurs in five phases which include the followings:
Phase 1: Knowledge
In this phase, members of an organization are exposed to new ideas or innovation. This can happen through reading written materials, getting knowledge from conferences, or through benchmarking (Godin, 2016). The person who has accessed the knowledge about the new program can then share with other health care professional in an organization.
Phase 2: Persuasion
In this step, those who have accessed the knowledge about the new quality program develop an interest to know more about it. Investigation about the program includes researching on its merits and demerits (Godin, 2016). This helps those interested in it to adopt it or go for another option. Actual testing of the idea can also be done as it enables those interested in the program to practice and determine its efficiency.
Phase 3: Decision
After acquiring and verifying knowledge about the quality and safety program, the health care team can then decide on whether to adopt it or not. During the decision-making process, the individuals weigh the value of adopting the program. A program which improves patient healthcare outcomes can be adopted (Tola & Contini, 2015). In case of the decision to be made concerns the whole organization, members have to consult from the top management before making any progress. For example, nurses have to confirm from their management and even from the collaborative team before deciding to incorporate a certain program in healthcare.
Phase 4: implementation
Implementation involves taking up the idea after consulting with all the concerned parties. This is accompanied by putting in place all the requirements for the idea to work. For example, implementing an infection prevention and control program in a healthcare facility should be accompanied by the purchasing of waste segregation and personal protective equipment. Also, training of those who will be involved in fulfilling the idea is essential because it will enable them to practice effectively. As a result, the goals of the new program can be achieved.
Phase 5: Confirmation
Confirmation of the idea comes after it has been proved to be effective in delivering the intended services. After that, strategies on how to expand the program can be initiated to ensure that it is applied maximally. Also, the outcomes related to the program can be evaluated continuously to determine its consistency in being effective. In the healthcare setting, a program can be confirmed to be effective it gives out quality health outcomes such as a decrease in nosocomial infections.
Evidence of Use of Rogers’ Diffusion of in the Designed Quality and Safety Program
The theory discussed is majorly applicable where an individual or an organization wishes to bring change in existing functions. In a quality and safety program, this theory is necessary since it provides all the necessary steps needed to implement the designed program. A quality or safety program in a healthcare facility is not always acceptable to all health care professionals. Therefore, it has to undergo all the processes needed including, persuasion of those who have rejected it.
In my designed quality program, I applied all the initial steps which includedcoming across knowledge about the program and researching more about it. After weighing the importance of the program in patient care, I made a decision to inform address other health care workers so that we can collaborate and implement it. Since all healthcare workers were aware of the value of the program, they accepted to support it so that it can be implemented and be initiated in the healthcare practice. Thus, application of Roger’s diffusion of ideas theory was applied successfully in the initial stages of the program, and it can as well be relied on in implementation and evaluation of my program.
Design of the Evidence-based Quality and Safety Program
My evidence-based quality and safety design is about coming up with quality infection prevention and control measures that can help the healthcare facility to reduce the number of cases of healthcare-acquired infection. I was interested in this program because nosocomial infections have been diagnosed severally among inpatients. Following that, I came up with a design that could lead to a reduction in the cases of health-acquired infections in the healthcare facility if applied appropriately.
Firstly, the healthcare facility should set aside a well-secured waste-dumping side where infectious waste can be dumped immediately after being assembled in the waste bins. Immediate dumping of hospital waste reduces the chances of infectious microorganisms gaining access to patients (Herzig et al., 2016). Also, the dumping site should have an incinerator so that most infectious equipment such as used syringes andsurgical blades can be burned at high temperatures to avoid any accidental exposure to them. Also, burning infectious equipment at extreme temperatures kills the microorganisms hosted on them.
Apart from designing a dumping site with an incinerator, I thought about changing the positioning of waste segregation equipment such as sharps boxes and waste bins. Instead of placing them in dark corners, they should be placed some two or three feet from the patient. This way, health care professionals can easily access them when they want to discard used items such as gloves, syringes, and swabs. Besides, patients can also be in a position to discard wastes effectively. Since the dumping site already been established, frequent emptying of the waste bins can be initiated to avoid cases of reinfection.
Furthermore, my design included renovating the cleaning and sterilization departments. Such departments play a huge role in preventing infections in the healthcare facility. Firstly, the suite should have adequate space so that washed items can be separated from the dirty ones (Kaye et al., 2015). Also, sinks should always be draining to avoid overflows that may contain infectious microorganisms. In short, the room set aside for cleaning should be maintained clean all the time. Secondly, the central sterile supply department (CSSD) should as well be working as expected such that all the disinfectants should be available all the time to avoid delays in disinfection of equipment taken there. In addition, sterilization equipment should be examined frequently for any damages and to check if they are malfunctioning.
Since pathogens can as well be transferred directly from one person to another, I recommended that the facility should do space planning to avoid configuration of many patients in a common place. This can also include the establishment of enough isolation rooms for those patients suffering from airborne infections. Limiting the exposure of such patients to others will reduce cases of cross-transmission.Besides, more patient rooms should be constructed to avoid congestion in the existing ones.
Finally, I also addressed the issue of training all health care professionals about infection prevention and control. This was part of the design since the hospital cannot put all the necessary infection prevention materials in place without education those who will handle them. As such, training can entail the importance of applying new infection prevention and control design and how to use the equipment correctly (Drake et al., 2018). Those who are trained can disseminate the knowledge to others who could not turn up for the training. More so, the design demands that health care professionals from different departments should collaborate so that the program can be successful.
Having discussed the design of my quality and safety program for infection prevention and control in the healthcare setting, am confident that with support from other health care professional the program can be implemented. As a result, the rate of patients acquiring nosocomial infections will decrease. Thus, the hospital stay for admitted patients will be shortened.
Expected Outcomes after Implementing the Program
Introduction of a new program in a healthcare facility has some accompanying outcomes. Thus, I expect several outcomes in case my design program is implemented. Firstly, there will be reduced incidences of hospital-acquired infections in the hospital (Mody et al., 2015). Following the strict practice of infection prevention and control measures such as effective disposal of healthcare waste, the likelihood of infectious microorganisms shifting to patients or even health care workers will be reduced. As a result, patients who are admitted to the hospital will undergo primary treatment successfully up to discharge. This will reduce congestion in the hospital as most of the congested patients suffer from nosocomial infections.
Secondly, implementing my design program will enable the healthcare facility to save on the cash spend on transporting hospital wastes to external dump sites. As explained earlier, the designed program includes the establishment of an internal waste dumping site. Previously, the hospital had to transport wastes to the recommended dumpsites. It had to spend capital on fuel and for paying those who could load and offload the hospital wastes. Thus, having a dump site inside the healthcare facility will lower such coasts. Instead, the capital will be used to cover up other expenses for the facility such as purchasing more hospital equipment.
Another expected outcome is that health care personnel will gain more skills regarding infection prevention and control (Saint et al., 2016). As shown earlier, the design includes training health care workers on how to adhere to the infection prevention measures and guidelines. The knowledge gained through learning will help them improve their skills. Besides, the available infection prevention and control equipment will act as training tools for them. They will in return apply the new knowledge and skills to manage patients effectively with the goal of preventing hospital-acquired infections.
Finally, implementing the program will upgrade the hospital since the design suggested is aimed at initiating internal development. Firstly, creating a dumping site with an incinerator in the hospital is a remarkable development which can lift it to another level. Also, expanding the hospital by constructing more wards will increase the capacity of patients being admitted, and this also will be a positive change.
Conclusion
With the help of Everett Rogers’ theory of diffusion of ideas and innovations, the essay above has discussed the implementation and evaluation of a quality and safety program. In my case, the designed program was about establishing evidence-based infection prevention and control measures in the hospital. Among the major areas of the design was creating a dumping site in the facility and expanding wards to avoid consolidation of many patients in one ward. Based on my assessment of the expected outcomes of program implementation, the healthcare experiences many developments such as reduced cases of nosocomial infections.
References
Drake, M., Nailon, R. E., Tyner, K., Beach, S., Fitzgerald, T., Lyden, E., …& Ashraf, M. S. (2018). Frequently Identified Infection Prevention and Control Gaps in Critical Access Hospitals. American Journal of Infection Control, 46(6), S15.
Godin, B. (2016). Innovation and Imitation: Why is Imitation not Innovation? Project on the Intellectual History of Innovation.Working Paper, (25).
Herzig, C. T., Stone, P. W., Castle, N., Pogorzelska-Maziarz, M., Larson, E. L., & Dick, A. W. (2016). Infection prevention and control programs in US nursing homes: results of a national survey. Journal of the American Medical Directors Association, 17(1), 85-88
Kaye, K. S., Anderson, D. J., Cook, E., Huang, S. S., Siegel, J. D., Zuckerman, J. M., & Talbot, T. R. (2015). Guidance for infection prevention and healthcare epidemiology programs: healthcare epidemiologist skills and competencies. infection control & hospital epidemiology, 36(4), 369-380..
Kreps, G. L. (2017). Diffusion theory in integrative approaches.In Oxford Research Encyclopedia of Communication.
Mody, L., Krein, S. L., Saint, S., Min, L. C., Montoya, A., Lansing, B., & Rye, R. A. (2015). A targeted infection prevention intervention in nursing home residents with indwelling devices: a randomized clinical trial. JAMA internal medicine, 175(5), 714-723.
Saint, S., Greene, M. T., Krein, S. L., Rogers, M. A., Ratz, D., Fowler, K. E.,& Faulkner, K. (2016). A program to prevent catheter-associated urinary tract infection in acute care.New England Journal of Medicine, 374(22), 2111-2119.
Tola, A., & Contini, M. V. (2015). From the diffusion of innovation to tech parks, business incubators as a model of economic development: the case of “SardegnaRicerche.” Procedia-Social and Behavioral Sciences, 176, 494-503.