Date of Graduation

Spring 5-19-2017

Document Type

Project

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Abstract

Preterm infants in the Neonatal Intensive Care unit, are susceptible to hospital acquired infections due to their immature immune systems. To mitigate this occurrence a change project will be implemented to decrease the incidence of nosocomial infection in this population. The project will be focusing on preterm infants working on full nipple feeds. Our project is aiming to discharge this population home with a nasogastric tube to work on feedings, rather than remaining in the hospital. Chart Audits were conducted pre-program and found approximately 18 patients acquired blood stream infections and 2 acquired MRSA. The method used to assist in implementation of this project was Lewin’s Change Theory. This theory focuses on three stages to best help change projects. The first stage is unfreezing; the phase focuses on the recognition of a problem within the facility. The second stage is moving; this process involves in-depth discussion to cultivate this new project. The last phase is refreezing, in this stage the new process has begun implementation. This stage is vital in the sustainability of this project. A Root Cause Analysis was explored to substantiate the need for a project of this caliber. This analysis showed that our patients weakened immunity along with environmental factors and the hesitancy of several attendees were causative factors in our patients becoming ill. A cost analysis was conducted and found that hospitalization for a preterm infant with no complications is approximately $1,200,000 for a four month stay. Whereas an infant whom acquires an infection can remain in the hospital for an additional month at a cost of approximately $3,000,000. There was not an opportunity to evaluate this project due to many contributory factors in implementation. There have been many discrepancies in billing and registration, that has caused a delay in execution of this project. Further review of the billing and registration process is needed to best support this program. Once this project is fully functional it is anticipated that there will be a 30% decrease in nosocomial infections in this population and length of stay will be decreased my several weeks to months. Chart Audits will be conducted at the six-month mark to measure the success of this program. The summation of this project will be to decrease the incidence of nosocomial infections in the preterm infant. Which will decrease the length of stay that will correlate to costs savings.

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