Essential Roles in Healthcare

This paper discusses the importance of healthcare providers and caregivers implementing evidence-based practices and guidelines using innovative technologies and research techniques to improve the patient’s quality of care. Specifically, it focuses on the significance of using chlorhexidine gluconate (CHG) bathing to reduce the rate of central line-associated bloodstream infections (CLABSI). The paper also highlights health disparities as a significant obstacle hindering healthcare practices and improvement.

Concept

Essential roles in healthcare include Research, evidence-based practice (EBP), and quality improvement (QI). Acquiring new knowledge involves peer-reviewed studies (Polit & Beck, 2017). EBP embraces the latest proven evidence to guide clinical decision- making (Melnyk & Fineout-Overholt, 2018).QI targets strengthening the healthcare processes and outcomes (Batalden & Davidoff, 2007). As a future Advanced Practice Nurse, it is an integral part of practice to include Research by continuing to be updated on current results in this area through peer-reviewed references and textbooks (Polit & Beck, 2017). EBP must be involved in healthcare practices by applying evidence-based guidelines and recommendations to patient care (Melnyk & Fineout-Overholt, 2018). In addition, QI principles should be utilized in continuity to assess further and improve the quality of care provided to patients (Batalden & Davidoff, 2007).

Disparities

Addressing healthcare disparities can be challenging as a charge nurse on a surgical floor. Health disparities in different populations and levels of poverty can significantly impact health outcomes. For instance, some studies found that individuals with lower socioeconomic status, such as those with limited or low incomes, are more likely to experience disparities in healthcare access and have higher rates of chronic diseases (Adler et al., 2016) for homeless patients who get discharged back to the streets, boats, tents, etc. CHG bathing is the last thing they worry about since they are just trying to survive with basic needs such as food, clothing, and shelter. Research has shown that impoverished individuals may face limited access to healthy food options, safe outdoor areas, and possible exposure to environmental toxins, contributing to adverse health outcomes (Diez et al., 2010).
Limited learning opportunities can lead to lower healthcare literacy, reduced
understanding of preventive measures, and less engagement in promoting healthy habits (Marmot, 2005).
Socially isolated individuals in unsafe environments may experience increased rates of stress, limited social guidance, and reduced access to healthcare resources, contributing to disparities in health outcomes (Williams & Mohammed, 2013).
Disparities in the healthcare system, such as inequality and culturally challenging access to healthcare services and insurance coverage, contribute to health disparities. Studies have shown that individuals without insurance or limited healthcare access are more likely to delay or refuse necessary medical care, leading to poor health outcomes (Buchmueller et al., 2016).
It is essential to be aware of these disparities and work towards promoting health equity. Providing culturally competent care, advocating for policy changes, continuing research and upgrades of EBP, and collaborating with interdisciplinary teams can tremendously reduce health disparities and improve health outcomes for all individuals.

Measures

Three specific measures are designed for healthcare quality improvement. Each step provides a straightforward and concise thought process for care delivery and patient outcomes.
Structure measures assess the physical and organizational characteristics of healthcare settings that can influence the quality of care. These measures focus on the resources, facilities, and systems to support care delivery. For the selected POI project of CHG bath to prevent infection, a structure measure could be the availability of CHG bathing supplies and equipment in healthcare facilities. This measure could be specific, such as ensuring that 90% of healthcare units have an adequate supply of CHG bathing products (Melnyk & Fineout-Overholt, 2018).
Process measures and evaluate the actions taken by healthcare providers during care delivery. These measures assess whether evidence-based practices and guidelines are followed. In the CHG bath project context, a process measure could be adherence to CHG bathing protocols. Most healthcare facilities monitor their daily compliance. For example, the effort could achieve a 95% compliance rate in correctly performing CHG baths according to established guidelines (Melnyk & Fineout-Overholt, 2018).
Outcome measures assess the impact of healthcare interventions on patient outcomes. These measures focus on the results of care and the overall effectiveness of interventions. An outcome measure for the CHG bath project could be reducing central line-associated bloodstream infections (CLABSIs) among patients receiving CHG baths. The standard could achieve a 50% reduction in CLABSI rates within six months of implementing CHG bathing protocols (Polit & Beck, 2017).
Applying all three measures to the CHG bath project allows for a comprehensive evaluation of the intervention. Structure measures ensure the necessary resources and framework are in place to support CHG bathing. Process measures assess the adherence to evidence-based guidelines and protocols during CHG bathing. Outcome measures evaluate the effectiveness of CHG baths in reducing CLABSIs and improving patient outcomes.
P: Patients with central lines I: CHG bath intervention
C: No CHG bath intervention O: Decrease incidence of Clabsi

Clinical Question: Does the use of a CHG bath for patients with central lines (P) compared to no CHG bath intervention (C) result in a decrease in the Clabsi rate(O)?

Conclusion

In conclusion, ongoing implementation of evidence-based guidelines and practices, vigilance awareness of health disparities, and this simple yet essential intervention, such as chlorhexidine gluconate (CHG) bathing, reduce central line- associated bloodstream infections (CLABSI). Incorporating it into overall improvement strategies can enhance healthcare practices to ensure safer and more efficient patient care.

References:
Batalden, P. B., & Davidoff, F. (2007). What is “quality improvement” and how can it transform healthcare? Quality and Safety in Health Care, 16(1), 2-3. https://doi.org/10.1136/qshc.2006.022046
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.).
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.).