Strong Nursing Leadership Is Essential to Reducing HAIs

It’s one of the hottest topics in health care right now: how to prevent hospital-acquired infections. Hospitals everywhere are adopting evidence-based policies to reduce HAI rates, and many are adding certified infection preventionists to the staff.

Yet, a recent study from the Columbia School of Nursing seems to indicate that the mere presence of these policies is not enough to lower the prevalence of HAIs – we must now work on increasing compliance with infection control policies. While the study itself did not identify methods of ensuring compliance, one of the researchers suggested, in an interview with HealthLeaders Media, that strong nursing leadership is a core strategy in any infection control initiative.

The study basically looked at a cross-section of infection prevention programs in ICUs across the country, with a focus on clinician compliance. Here are some of the study results:

• More than one-third of the hospitals studied did not have a certified infection preventionist (IP) on staff. The mean staffing ratio for IP was one preventionist per 100 beds. (An industry standard from 1985 suggests a ratio of one preventionist per 250 beds, which is equivalent to 0.4 per 100.)

CLABSI and VAP prevention policies have a high prevalence, while policies designed to prevent CAUTI have a relatively low prevalence.

• Regarding CLABSI, 92% of the ICUs had a policy requiring clinicians to use an insertion checklist, but only 52% of clinicians adhered to it.

• Regarding VAP, 74% of the ICUs used a ventilator bundle checklist, but only 52% of clinicians adhered to it.

• Regarding CAUTI, only 27% of ICUs had a policy for nurse-assisted catheter insertion, and compliance rates were equally low. Yet, CAUTI is the most frequently occurring HAI, and it was the first one to be singled out by Medicare for non-payment.

So what does this all mean?
The study’s lead author shared her thoughts in an interview with HealthLeaders Media. Patricia Stone, PhD, MPH, RN, FAAN, pointed out that while HAIs are considered a nursing sensitive outcome, many other health professionals share the responsibility of preventing infection – including physicians and respiratory staff. She believes an interdisciplinary approach is needed.

Nursing traditionally has put a huge focus on patient advocacy. Nurse leaders, even though they don’t provide bedside care, can advocate for patients’ safety and comfort by providing strong leadership when it comes to infection control and prevention polices. They can identify where policies are lacking, work to establish and promote needed policies, and take the lead on ensuring that every member of the multi-disciplinary care team complies with them. As HAIs remain a hot topic in health care, strong nursing leadership – including at the executive level – will be instrumental in reducing their incidence.

The industry-wide focus on HAIs is also expanding career opportunities for nurses who want to specialize or move into management. Hospitals are in need of infection preventionists as well as nurse executive leaders who can direct the policy making process. Higher education is the first step toward landing these rewarding jobs. American Sentinel University offers both MSN and DNP degree programs in a flexible, online format.

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