Change Initiative: Implementation, Evaluation, and Sustainability

Change Initiative: Implementation, Evaluation, and Sustainability
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Change Initiative: Implementation, Evaluation, and Sustainability
The Need for Change
At the 800-bed capacity multi-specialty hospital where the researcher works, the most critical issues that need change are the high rate of catheter-associated urinary tract infections (CAUTIs) andventilator-associated pneumonia (VAP). These two issues are posing a great challenge to the management of the healthcare facility as they adversely affect patient care outcomes. The need for change is driven by the fact that CAUTI and VAPs are the primary reasons behind the prolonged stay of patients in the hospital’s Intensive Care Unit (ICU). Though preventable, these nosocomial infections have been linked to high mortality and morbidity, and the runaway healthcare costs at the hospital. There is need for preventive intervention to manage and reduce these infection rates and hence change at the hospital’s ICU department based on Kotter’s 8 Step model will be implemented. This change initiative will reduce the rate of the two infections from the current 14 cases in 1000 patients to less than 5 cases. The outcome of the change will be a decline in morbidity and mortality rates, as well as a reduction in departmental costs. The general outcome will be improved patient care outcomes and healthcare quality.
Description of internal and/or external driving forces
The internal driving forces for the growing prevalence of CAUTIs and VAPs are poor sanitary conditions and especially, the sanitation of catheter gadgets. The primary cause of CAUTIs is bacteria and fungi that infiltrate the urinary tract through the catheter(Clayton, 2017). Once these bacteria get into the urinary tract, they begin to multiply and subsequently cause fatal infection. These infections happen in different ways. For instance, during catheterization, the catheter gets exposed to contamination, and as a result, bacteria and fungi enter through the insertion. The second driving force for the infection is prolonged use of drainage bags without emptying or replacement(Clayton, 2017). This is largely caused by the shortage ofcatheterization gadgets and the need to manage the ICU department costs. These infections also result from the entry of bacteria during a bowel movement, which eventually enter into the catheter. Furthermore, the backward movement of urine from the catheter into the bladder is to blame for the rising cases of CAUTI infections in the ICU. On the other hand, Ventilator-associated pneumonia (VAP) infection often results from prolonged mechanical ventilation procedures and is transmitted through an endotracheal tube(Kalanuria, Zai&Mirski, 2014). In the hospital ICU, VAPs is commonly caused by an invasion by micro-organisms in the lower respiratory tract and lung parenchyma.As a result, gastric secretions get their way into the lower airways thus causing triggering the infection.
Evaluation of stakeholders
The successful implementation of the proposed change at the department will require multi-stakeholder collaboration. Firstly, members of the multidisciplinary team that attends to patients in the ICU will be involved in...