This paper is about reducing Infection among Dialysis Patient with the Support of Inter-professional Team by utilizing the element of iCare of Compassion, Advocacy, Resilience, and Evidence Based Practice. In a typical dialysis setting, the center is operated with the help of inter-professional team such as facility administrator, medical director, nephrologists, nurse Manager, nurses, PCT, social works, dietitian, biomed, administrative assistants, and housekeeping staffs. It is safe to say that; dialysis center cannot operate effectively without existing inter-professional team. Having inter-professional team working together is a good thing.
However getting the team “work well” together is another thing. One thing that can improve team work is a clear, respectful and effective communication. Effective communication among the team is important to get the right message across. Without effective communication, patient care could be compromised. Needless to say, reducing infection among Dialysis Patient can be achieved with the help of all teammates.
According to Medical Dictionary, compassion can be defined as an “awareness of and feeling for the pain and suffering of others (sympathy), and also defined as a profound awareness of another’s suffering coupled with a desire to alleviate that suffering” (Medical-dictionary, n.
d) The culture of Compassion can positively influence patient outcomes and satisfaction. Interprofessional team can establish compassion by first and foremost listening to the patient and shows that they genuinely care for them. Patients are likely to open up when they sense that the teammates are genuinely concerned about their wellbeing. It will then be easier to educate them on how to reduce or prevent infection by asking the patient to frequently clean their access site as protocol.
In addition, the act of compassion also includes doing thing that contribute to the wellbeing of other. For instance, teammates should properly practice hand hygiene before dealing with patient especially when it involved their access sites. The culture of compassion in the organization will not only improve patient satisfaction but also making the work environment less stressful.
According to medical dictionary, advocacy is a “process whereby a nurse or other health care professional provides a patient with the information to make certain decisions, usually related to some aspect of the patient’s health care.” (Medical-dictionary, n.d) For example, if patient is currently using CVC as their main dialysis access, it is only right for the inter-professional team to advocate for AVF or AVG placement because it is the safer option for dialysis patient to have due to less infection rate (Lincoln, 2011). According to Grothe, Belasco, Vianna, Sesso & Barbos(2010) blood stream infection for patient with Central Venus System as their main dialysis access is very high at sixty one percent compare to AVG and AVF(Grothe, Belasco, Vianna, Sesso & Barbos, 2010). When advocacy is done right, infection can be reduced, and it will also reflex in the performance index of the dialysis facility. The infection performance index is especially important for Medicare and Medicaid reimbursement process.
Resilience is defined as the capability to deal with difficulty, and overcoming it with positive attitude (APA, n.d.). Resilience is especially important in nursing due to the nature of the job. In short, nursing is not for people with “a faint hearted”. Interprofessional teams, including nurses often deal with all type of patient with different personality and temperament. Patients can be nasty at times, and can make the working environment very tense and uncomfortable. This is the time when resilience is very important. Nurses have to be firmed, but also must be able to explain their action to the patient and their caregiver assertively, and stress that their well being and safety are the main priority. In dealing with infection control, nurses and the team mate must know how to firmly inform the patient and their caregiver about the importance of infection control especially when it comes to their access site.
EBP (Evidence Based Practice) is defined as the best practice or best demonstrated practice that is supported by evidence available from data collected through the years. In infection control, it is well known, that EBP proves that the most important practice to reduce infection is hand hygiene. Wilson & Wong (2012) mentioned that proper hand hygiene practice reduce both mortality rate and healthcare cost. Proper hand hygiene must be done correctly for it to be working. CDC recommends that proper hand hygiene include wetting the hands in clean, running water, rubbing hands with soap vigorously for 20 seconds, and rinsing the hand in clean, running water, and then finally drying the hands with clean towel (CDC, n.d.) EBP also shows that education concerning proper catheter care among nurses is important to prevent CVC infection among dialysis patient (Lincoln, 2011). Interprofessional team can greatly impact the rate of infection control in the facility by practicing the proper hand hygiene and correct catheter care.
As a conclusion, iCare elements of Compassion, Advocacy, Resilience, and Evidence Based Practice can be used by the Interprofessional teams to positively influence patient outcomes as described in the paragraphs above. Each of the elements in the iCare is important as it makes patient care be more whole and rounded. As a nursing leader, these elements should be used as a stepping stone to reach a greater goal in improving patient outcomes in any facility as well as personal satisfaction for job well done.