Knowledge of the Healthcare Environment
Executive Summary
In an Orthopedic Unit that houses 36 beds most of the patients are postoperative total hip replacement patients and over the age of 76 on average. Most of the causes of the hip fractures are falls, which are unfortunately more common in elderly patients. The length of hospitalization for these patients is usually 6.5 days before they are discharged and sent to rehabilitation services. The length of stay for these patients has decreased by 49% since 2003 and this is probably due to the more advance and less invasive procedures that are now performed. Also, postoperative complications of urinary tract infections have decreased by 28% since 2010, and the use of catheters for longer than 48 hours postoperative has decreased by 45% since 2009. With that being said, for the last 5 months’ nosocomial urinary tract infection numbers have gone up.
For patients with total hip replacements, statistics for contracting nosocomial urinary tract infections increased as the months went by. The mean length of stay increased from 6.5 days to 11.5 days in just 5 months. Interestingly enough, the percentage of patients admitted from the nursing facility reduced from 6.1% to 3.7%. The need to keep catheterization in after 48 hours postoperative was steady 3.6%, but this incidence has increased immensely in 5 months. The reason for this, looking at the highest percentage, is for “unknown” or undocumented reasons. Finally, the mean nosocomial urinary tract infection costs per patient have increase by four times in a month period from $3652.17 to $12173.
In conclusion, there is clearly something that has caused this change in the wards. The catheters are being left in too long and this is increasing the nosocomial urinary tract infections. Either the unit is understaffed or is not being managed efficiently and these details are falling through the cracks.
A Plan for the Infection Control Committee
For whom this may concern, it has come to our attention that there has been an increase in the percentage of nosocomial urinary tract infections in the Orthopedic Unit over the last 5 months. It has gone from 3% of patients only to 23.1%. This is of course quite worrying and a plan needs to be put into place. The plan will be directed at the Infection Control Committee for they are best fit to deal with reducing the number of this infection. The infection has made that the patients stay longer in the hospitals which increases the costs as an outcome. Which means a problem-solving strategy has to be put in place so the infection numbers can go back down to where they were.
Firstly, it is noteworthy to mention that it is the clinical decision- making model that will be used and its problem solving steps. It is clear from the data collected of the past 5 months that the management of the patients’ needs to be updates and better handled. One thing the Medical director can look into is the organizational climate. The levels …
