Quality Improvement Proposal

Quality Improvement Proposal
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Quality Improvement Proposal
Evidence-based practice uses the best available evidence to make clinical decisions for patient care. The road to evidence-based practice is a systematic process that healthcare providers use to achieve the best possible patient clinical outcomes. This paper aims to identify a quality improvement opportunity in my organization, describe the problem or issue, and propose a quality improvement initiative based on evidence-based practice. In particular, the paper applies the road to evidence-based practice process as outlined in Chapter 4 of the textbook by Melnyk and Fineout-Overholt (2018) to create the proposal.
Overview of the Problem and the Setting
The problem identified in my organization is the high rate of central line-associated bloodstream infections (CLABSI) in the neonatal intensive care unit (NICU). CLABSI is a serious complication affecting neonates in NICU. It can lead to mortality, increased length of stay, and healthcare costs. According to the Centers for Disease Control and Prevention (CDC) (2021), about 4,000 CLABSI cases occur annually in NICUs. The incidence rate ranges from 1.7 to 8.9 infections per 1,000 catheter days. The setting in which the problem occurs is the NICU, where premature and critically ill neonates are cared for.
The Need for Quality Improvement Initiative
A quality improvement initiative is needed because CLABSI is a preventable complication that increases morbidity, mortality, and healthcare costs. According to the CDC (2021), up to 27% of CLABSI cases can be prevented through evidence-based practices such as proper insertion techniques, catheter maintenance, and early removal of catheters (Milstone, Sengupta & Perl, 2016). The expected outcome of the quality improvement initiative is a reduction in the rate of CLABSI in the NICU by at least 50% within the next six months.
In addition to the significant impact on patient outcomes, there are financial implications of CLABSI for the healthcare system. The CDC (2021) estimates that the average cost per CLABSI case ranges from $34,000 to $56,000, which can result in increased healthcare costs and decreased hospital reimbursement rates (Milstone, Sengupta & Perl, 2016). A quality improvement initiative can help reduce the occurrence of CLABSI, improve patient outcomes, and ultimately save costs for the healthcare system and patients.
Furthermore, by implementing evidence-based practices, the quality of care in the NICU can be improved. It is essential to provide the best care possible to vulnerable neonates who are at increased risk of infection due to their underdeveloped immune systems. A quality improvement initiative can enhance the quality of care provided to neonates in the NICU, thereby improving their chances of survival and long-term health outcomes.
Support for the Quality Improvement Initiative
Several studies have established the effectiveness of evidence-based practices in preventing CLABSI in NICUs. For instance, a study by Akinboyo et al. (2020) found that the use of an evidence-based central line maintenance bundle was assoc...