STAKEHOLDER ANALYSIS

Csilla Orban Bonacci

Main Response,

 

The FADE model (Spath, 2018) will be applied to suggest lowering the risks of developing CLABSI. First, the team will focus on what the problem is and why. We will address why documentation that central lines have been assessed is lacking. Why aren’t doctors and nurses bringing up the issue of the necessity of a line during rounds (as managers assumed this was happening). Focus on the fluctuating compliance percentage will be discussed.

 Next an analysis of the issue and what causes the risk of developing CLABSI to be high will be considered. Interviews with nurses, quality improvement personnel, and assistant managers show that CLABSI has not been an issue on some floors for years, however, the risk of developing CLABSI at any moment can be high if adherence to the CLABSI bundle is not performed. An analysis of how nurses can be helped to adhere to the CLABSI bundle will be done. A review of how the hospital has been doing in relation to CLABSI over the years will be studied. Trends will be discussed, and a root cause analysis will be performed.

The development of a plan to encourage nurses to comply with the CLABSI bundle will be assumed. The plan will include the nurse assistant manager, quality personnel, and educator. Educators check every Tuesday and Thursday the units where compliance is low and will meet with nurses to encourage adherence to the CLABSI bundle, timely documentation, execute performance improvement, and educate new nurses about the importance of all the above (Buetti et. al, 2022).

Nurses will be enlightened on the issue of the lack of reimbursement from insurance companies for such hospital-acquired infections. Money spent by a hospital on a patient’s treatment that we could have prevented could have been used for something else.

Meetings with nurses to suggest ideas on how to remind themselves to document central line assessment will be set up. Communication between nurses and doctors will be encouraged if a central line site is red, warm to the touch, or painful. A CLABSI checklist will be suggested for all nurses to use before they start their shifts and to prepare for rounds.

Motivating staff to be the best hospital can be a challenge. Incentives will be offered to those who comply regularly and consistently.

Finally, the plan will be executed by meeting with the nurses, managers, and educators to implement all the ideas and measures we will take to prevent CLABSI. A hindrance to our plan might be encountered due to not being sure everyone will use the checklist and if they will use it long-term. Alternative ways of task checklists might need to be established.

Motivation to follow through might be a difficulty we need to overcome. According to the quality department morale and motivation have been low since the covid pandemic, but it is just starting to pick up.

For our plan to succeed, we will use cost-effective resources such as interviews, and computers that will show us the stored information over the years, and staff who oversees monitoring quality in the hospital.

 

Our approach to change will be following the following steps:

 

1. Show empathy towards staff while implementing change.

2. Explain “why’ change is needed.

3. Explain how the change will be implemented.

4. Reward acceptance

5. Celebrate those who take the first step toward change.

6. Encourage anxious employees.

7. Be ready for resistance

 

 

References

Bravo. 2019. Helping Employees Deal with Change in the Workplace. https://www.bravowell.com/resources/helping-employees-deal-with-change-in-the-workplace

Buetti N, Marschall J, Drees M, Fakih MG, Hadaway L, Maragakis LL, Monsees E, Novosad S, O'Grady NP, Rupp ME, Wolf J, Yokoe D, Mermel LA.  2022. Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update.  Infection and Control Hospital Epidemiol. 2022 May;43(5):553-569.Cambridge University Press.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096710/Links to an external site.

Spath, P. (2018).  Introduction to healthcare quality management (3rd ed.). Health Administration Press