1 Using Rapid Access Multidisciplinary Palliative Assessment 2 The Problem/Issue The main problem addressed with this intervention is that patients with cancer-induced conditions such as bone pain often time wait for a long time to receive palliative radiotherapy treatment as well have an assessment by specialist palliative care services as well as other allied healthcare professionals (Dennis et al., 2017). The long wait may be detrimental to their health and they may develop psychological distress as well as other potentially debilitating health problems. In most healthcare settings, access to palliative care services for cancer patients is often subject to a separate referral pathway. On the same note, access to assessment by allied healthcare personnel is also limited and is subject to further separate referrals. The complexity involved in this case may create further health complications for the cancer patients. As such, using rapid access multidisciplinary palliative assessment can help improve the treatment modality that may further improve the experience of the cancer patients (Danjoux et al., 2018). Current research indicates the efficacy and feasibility of having a combined palliative assessment from different specialists with the entire radiotherapy pathway in one hospital visit. The setting The intervention will involve developing a rapid access multidisciplinary palliative assessment within clinical settings such as primary care facilities. This will help combine assessment by specialist professionals drawn from palliative care and clinical oncology to help improve the planning and delivery of palliative radiotherapy for cancer patients (Dennis et al., 2017). The combination of the palliative assessment by specialists and professionals will help improve the overall patient experience since the cancer patient will not have to wait for weeks to receive palliative radiotherapy treatment as well as have an assessment by specialist palliative care service providers (Fairchild et al., 2016). The hospital will conduct multidisciplinary 3 palliative assessment processes in a single half-day visit that normally takes weeks with at least three separate appointments. Description of the intervention Rapid access multidisciplinary palliative assessment helps improve access to care and can further foster the delivery of radiotherapy more efficiently and effectively. This intervention creates efficiency in access to care by cancer patients by ensuring a reduced number of patient visits to the healthcare facility. With this intervention program, the cancer patient can access palliative radiotherapy treatment, receive an assessment by specialist palliative care service providers as well as other allied healthcare professionals within a single hospital visit (Watanabe et al., 2020). This ideally helps reduce the number of visits as well as referrals that the cancer patient is expected to receive which normally takes 2-3 weeks. The longer wait time is not only detrimental to the health and wellbeing of the patient but may also affect the patient's level of treatment outcome and experience. Effects of the intervention Rapid access multidisciplinary palliative assessment will help improve cancer patients’ treatment outcomes and experience. This is because; it will shorten the treatment duration that is often characterized by a longer wait time. Ideally, the intervention encompasses a multidisciplinary palliative assessment approach which not only allows the patients to receive key treatment interventions at the same time but also allows the caregivers to minimize the number of referrals they make to the patient which is subject to a longer wait time. As noted by Freeman et al. 2018, rapid access multidisciplinary palliative assessment is critical in advancing cancer patient experience by fostering treatment outcome. The same notion is shared by Casson, Round and Johnson, 2019 in their study on the implementation and evaluation of a rapid access 4 palliative clinic in a New Zealand cancer center where they noted that rapid access palliative clinic is essential in improving patient treatment outcome since it allows the patients to receive comprehensive care without having to undergo several referrals. Significance of the topic to the nursing practice The topic of rapid access multidisciplinary palliative assessment is very significant to the nursing practice in the sense that it provides new knowledge of caring to cancer patients (Fairchild et al., 2016). To the nursing practice, this intervention improves cancer patients’ treatment timescale, helps in proper management of cancer patients, reduces the number of referrals and regular patient visits, minimizes non-elective admissions as well as the length of cancer patients’ admission timescale, most importantly, it helps improve patients’ mental health and wellbeing. LeGuerrier et al. 2019 noted that rapid access multidisciplinary palliative assessment fosters multidisciplinary approach to cancer care that further helps in improving cancer patient treatment outcomes. Similar notion is also shared by Kowalczyk and Jassem, 2020 in their study on multidisciplinary team care in advanced lung cancer where they noted that multidisciplinary care fosters effective patient treatment outcome since it draws a multidisciplinary team in caring for cancer patients. The team in this case is able to share knowledge within the practice and this allows them to create a more flexible model of treatment. 5 References Casson, C., Round, G., & Johnson, J. (2019). Implementation and evaluation of a rapid access palliative clinic in a New Zealand cancer centre. Journal of medical radiation sciences, 61(4), 217-224. Danjoux C, Chow E, Drossos A, et al. An innovative rapid response radiotherapy program to reduce waiting time for palliative radiotherapy. Support Care Cancer 2018; 14: 38– 43. Dennis, K., Linden, K., Balboni, T., & Chow, E. (2017). Rapid access palliative radiation therapy programs: an efficient model of care. Future Oncology, 11(17), 2417-2426. Fairchild, A., Pituskin, E., Rose, B., Ghosh, S., Dutka, J., Driga, A., ... & Severin, D. (2016). The rapid access palliative radiotherapy program: a blueprint for initiation of a one-stop multidisciplinary bone metastases clinic. Supportive Care in Cancer, 17(2), 163-170. Freeman, R. K., Van Woerkom, J. M., Vyverberg, A., & Ascioti, A. J. (2018). The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with lung cancer. European journal of cardio-thoracic surgery, 38(1), 1-5. Kowalczyk, A., & Jassem, J. (2020). Multidisciplinary team care in advanced lung cancer. Translational Lung Cancer Research, 9(4), 1690. LeGuerrier, B., Huang, F., Spence, W., Rose, B., Middleton, J., Palen, M., ... & Fairchild, A. (2019). Evolution of the radiation therapist role in a multidisciplinary palliative radiation oncology clinic. Journal of medical imaging and radiation sciences, 50(1), 17-23. Watanabe, S. M., Fairchild, A., Pituskin, E., Borgersen, P., Hanson, J., & Fassbender, K. (2020). Improving access to specialist multidisciplinary palliative care consultation for rural cancer patients by videoconferencing: report of a pilot project. Supportive Care in Cancer, 21(4), 1201-1207. 1 Infection Control in Healthcare Organizations 2 Introduction Hospital-associated infections sometimes called hospital-acquired infections present some of the major worrying conditions in healthcare organizations today. These infections cause patients and healthcare providers functional disability and mental stress, and in rare situations, they can progress to debilitating conditions that impede the patient's treatment outcome and quality of life (Arefian et al., 2016). Nosocomial infections are some of the major hospitalacquired infections in many healthcare organizations today. They are also the leading cause of death among many patients on a global scale. Reducing these infections is therefore critical as it will help reduce the emotional trauma associated with hospital visits and stay while at the same time reducing the number of deaths associated with hospital-acquired infections. Against this backdrop, this paper will analyze infection control in healthcare organizations. The problem/Issue Infections acquired in the hospital context, often known as healthcare-associated illnesses, which are infections that are neither present or incubating at the time of admission to the healthcare organization. Catheter-associated urinary tract infections, surgical site infections, central line-associated bloodstream infections, and ventilator-associated pneumonia or hospitalacquired pneumonia are some of the most common types of hospital-acquired infections. These infections are common within the healthcare setting, particularly among inpatients. According to the data provided by the CDC, about 1.7 million patients contract hospital-acquired infections every year. Out of this number, about 99,000 dies of hospital-acquired infections every year (Baker & Quinn, 2018). This is a shocking number that requires an immediate control mechanism to help save lives and bring safety within the hospital settings. Evaluation and management of HAIs are therefore critical within healthcare organizations. Interprofessional 3 teams in this regard have the greatest role in improving care for patients within the hospital setting (Boev & Kiss, 2017). The Setting/Context Healthcare-associated infections commonly occur within hospital settings. In most cases, the infections are contracted during the treatment process or when the patient is admitted within the hospital setting. It should be noted that hospital-acquired infections are not present or incubating at the time of admission rather, they are contracted during the treatment process. However, the majority of these infections are contracted by the patient during his or her long stay at the facility (Friedrich, 2019). They're obtained after being admitted to the hospital, and they usually show up 48 hours later. Healthcare organizations such as the National Healthcare Safety Network (NHSN) and the Centers for Disease Control and Prevention (CDC) are frequently monitoring these illnesses. Healthcare organizations have been paying attention to cases of hospital-acquired illnesses for decades. In order to assist reduce the occurrence of healthcare-acquired illnesses, several of these hospitals have developed infection tracking and monitoring systems as well as sophisticated infection prevention initiatives. Healthcare acquired infections continue to impact the reputation of many healthcare organizations since it tarnishes the name of the hospital and makes it appear unable to prevent the hospital-acquired infections that impact the overall patient treatment outcomes (Tajeddin et al., 2016). These infections also affect not only the individuals but also their communities as they have been linked to multidrug-resistant infections. Description of the issue The issue at stake in this analysis is infection control in healthcare organizations. Because of the impact of hospital-acquired infections not only on the patients but on the community and 4 the healthcare organizations in general, preventing these infections becomes the number one priority for most healthcare organizations (Moriceau et al., 2016). Today, many healthcare organizations have developed robust systems and guidelines to help monitor and prevent these infections. Moreover, the Infectious Disease Society of America also provides guidelines for managing these infections within primary care settings. These guidelines are available to both the nurses as well as other healthcare professionals including physicians. Some common guidelines that have been put in place including but not limited to an assessment of the need for isolation and screening all the ICU patients for conditions such as neutropenia and immunological disorder, known communicable diseases, skin rashes, diarrhea, and other known carriers of an epidemic strain of bacterium among other conditions. Effects of the problem Hospital-acquired infections are some of the common causes of death among patients not only in the United States but also in other parts of the world. The data from the CDC indicates that about 1.7 million patients in America contract hospital-acquired infections. Out of this number, about 99,000 patients die from hospital-associated infections (Baker & Quinn, 2018). Although the risk of hospital-acquired infections is dependent on the infection control guidelines and practices adopted by the hospitals as well the immune system of the patients and the prevalence of the pathogens with the community, these infections present a serious problem within the global healthcare systems and organizations. Immunosuppression levels, hospital length of stay, old age, frequent hospital visits, underlying conditions of the patient as well long stay in ICUs also present an increased risk of these infections (Erb et al., 2017). However, with proper guidelines and practices, healthcare organizations can minimize the incidences of these infections and help improve the overall patient treatment outcome. 5 Significance and implication for nursing practice Infection control in healthcare organizations is essential since it helps reduce the number of deaths associated with hospital-acquired infections. Within the nursing practice, the goal is to ensure greater treatment outcomes for patients; however, hospital-acquired infections prevent the achievement of this goal. In this case, nurses have the responsibility of ensuring they adhere to the control guidelines for them to be able to reduce infection incidences (Accardi et al., 2017). The nursing practice also must play a leading role in ensuring a high level of hygiene to help prevent infections associated with poor hygiene. Most importantly, infection control provides the foundation for understanding patient safety within healthcare organizations. Proposed Solution Hospital-associated infections are common causes of poor patient treatment outcomes, they increase the patient hospital length of stay, and increases the treatment cost. These infections also control about 49% of most deaths in healthcare organizations. In this case, developing proper guidelines including monitoring and surveillance and other infection control practices can help minimize the infection incidences thereby reducing the number of deaths and comorbidities. 6 References Accardi, R., Castaldi, S., Marzullo, A., Ronchi, S., Laquintana, D., & Lusignani, M. (2017). Prevention of healthcare-associated infections: a descriptive study. Ann Ig, 29(2), 101115. Arefian, H., Vogel, M., Kwetkat, A., & Hartmann, M. (2016). An economic evaluation of interventions for the prevention of hospital-acquired infections: a systematic review. PloS one, 11(1), e0146381. Baker, D., & Quinn, B. (2018). Hospital-acquired pneumonia prevention initiative-2: incidence of nonventilator hospital-acquired pneumonia in the United States. American journal of infection control, 46(1), 2-7. Boev, C., & Kiss, E. (2017). Hospital-acquired infections: current trends and prevention. Critical Care Nursing Clinics, 29(1), 51-65. Erb, S., Frei, R., Dangel, M., & Widmer, A. F. (2017). Multidrug-resistant organisms detected more than 48 hours after hospital admission are not necessarily hospitalacquired. infection control & hospital epidemiology, 38(1), 18-23. Friedrich, A. W. (2019). Control of hospital-acquired infections and antimicrobial resistance in Europe: the way to go. Wiener Medizinische Wochenschrift, 169(1), 25-30. Moriceau, G., Gagneux-Brunon, A., Gagnaire, J., Mariat, C., Lucht, F., Berthelot, P., & BotelhoNevers, E. (2016). Preventing healthcare-associated infections: Residents and attending physicians need better training in advanced isolation precautions. Medecine et maladies infectieuses, 46(1), 14-19. Tajeddin, E., Rashidan, M., Razaghi, M., Javadi, S. S., Sherafat, S. J., Alebouyeh, M., ... & Zali, M. R. (2016). The role of the intensive care unit environment and health-care workers in 7 the transmission of bacteria associated with hospital-acquired infections. Journal of infection and public health, 9(1), 13-23.
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