Factors influencing the implementation of an effective infection control process in a neonatal intensive care unit

Bernhardt, Lizelle (2000-03)

Thesis (MCur)--Stellenbosch University, 2000.

Thesis

ENGLISH ABSTRACT: Nurses are being held responsible and accountable for the quality of nursing care, which includes quality infection control nursing, they provide. This change in accountability has been brought about by the need to reduce the ever escalating costs of health care. During the 1980's, health care services created a demand for high-quality, efficient, cost-effective and competitively priced health services. In order to provide these services, health care organisations are forced to consider new strategies. This is a process that produces outcomes. Quality improvement methods, which include infection control, help organisations to produce these outcomes. Donabedian (1980) defined high-quality care as "that kind of care which is expected to maximise an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts" (Grossman, 1998: 43). Quality improvement in infection control relates to the activities employed to improve the performance of a process, and includes the process of planning and control. Management is responsible and accountable for providing resources In order to implement quality infection control nursing care. The purpose of the study was to identify factors influencing the implementation of an effective infection control process in aNICU. An exploratory and descriptive design with a qualitative orientation was implemented. It consisted of a narrative and a literature study by means of which factors have been identified to influence the implementation of an infection control process in a NICU. The case study design, an indepth analysis of a single unit of study, was utilised in this study as part of the data-gathering process. Recommendctions were made on the macro, meso and micro levels, which included quality circles, hand hygiene and antibiotic usage, in-service education, recognition of personnel, mission statement and the infection control manual. The shortage of human and physical resources in nursing is a global problem. In S.A. there has been no previous study to emphasise the importance of an effective infection control process, and therefore no solutions to the problem have been suggested. The Japanese view with regard to quality circles is recommended.

AFRIKAANSE OPSOMMING: Verpleegkundiges is verantwoordelik en aanspreeklik vir die gehalte van verpleging wat gelewer word, insluitende gehalte infeksiebeheer verpleging. Hierdie verandering in aanspreeklikheid het voortgespruit uit die behoefte om die voortdurende styging in gesondheidskoste te verminder. Gedurende die 1980s, het 'n aanvraag vir hoë gehalte, kosteeffektiewe en kompeterende gesondheidsorgdienste ontstaan. Gesondheidsorg dienste moes nuwe strategieë oorweeg om in hierdie dienste te kan voorsien. Uitkomste word op hierdie proses gebaseer. Om hierdie uitkomste te bereik, behoort organisasies gehalteverbetering metodes, wat infeksie beheer insluit, te implemeteer. Donabedian (1980) definieer hoë gehalte as "that kind of care which is expected to maximise an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts" (Grossman, 1998: 43). Gehalteverbetering in infeksiebeheer , verwys na die aktiwitieite wat geimplementeer word om die uitvoer van In proses te verbeter, insluitende beplanning en beheer. Bestuur is verantwoordelik en aanspreeklik vir die voorsiening van hulpbronne, om gehalte infeksiebeheer verpleegsorg te implementeer. Die doel van die studie was om faktore wat die implementering van 'n effektiewe infeksie beheer proses in 'n NICU beinvloed, te identifiseer. In Verkennende en beskrywende ontwerp, met 'n kwalitatiewe orientering, is geimplementeer. Dit het bestaan uit In narratief en In literatuur studie, waardeur faktore wat die implementering van In effektiewe infeksie beheer proses in 'n NICU beinvloed, geidentifiseer word. Die gevallestudie ontwerp, wat 'n in-diepte ondersoek van In enkele eenheid van studie is, is in hierdie studie gebruik as deel van die data-insamelings proses. Aanbevelings is gemaak of makro, meso en mikro vlak, en sluit in gehalte sirkels, handhigiëne en antibiotika gebruik, indiensopleiding, erkenning van personeel, In missieverklarin~ en ten opsigte van die infeksiebeheerhand- leiding in. Die tekort aan menslike en fisiese hulpbronne in verpleging is I n globale probleem. Aangesien daar nog nie voorheen In studie in S.A. gedoen is om die belang van I n effektiewe infeksiebeheerproses te beklemtoon nie, is daar nog nooit oplossings vir die probleem voorgestel nie. Die Japanese siening van gehalte sirkels word aanbeveel.

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