Located in Houston Texas, since 1978, Orbital Hospital is a public healthcare provider. The hospital’s major funding comes from donors who expect the best care provision to a patient who seeks medical attention. The board approves the strategic decisions of the hospital with emphasis on cost cutting measures that have influenced the level of patient care. Orbital Hospital administration runs the day-to-day operations regarding billing and legal issues. The operation of the various departments consists of management committees including nurses. A sharp rise in increased nosocomial infections within the hospital led the board to request a report on the matter from the nursing committee.
The chief nursing officer investigates the growth in the hospital related infections within the hospital. The nursing committee established a sub-committee for this activity. The goals of the committee included the developing of the infections rising from the condition in the hospital. Next, the subcommittee looks into the reasons for the decrease in patient care. The assessment of the impact of the hospital associated infections and carry out an evaluation of the solutions to bring the infections rates down.

Evidence-Based practices for reducing nosocomial infections

Health practitioner’s hands provide the single most source of infections within hospitals. Hand hygiene in hospital thus is the best way to reduce infections in the hospitals. Use of antibacterial soap as the practitioner meets patients, is vital to the bacterial prevention process in a healthcare setting. The practice of hand hygiene deterioration down at orbital hospital and measures to correct the problem established. Also, the staff exposed to body fluid should thoroughly wash their hands (Mehta, et al., 2014). Also, hand sanitizing when they touch patients surroundings spreads the infections. The guidelines put in place specify on hand hygiene by health professionals before, during, and after examination. This practice reduces cases of transmission of pathogens within Orbit Hospital. Appropriate waste disposal procedures in place reduce risks involved with used hand gloves fail to meet the requirement for patient safety.
Technology plays a significant role in reducing hospital-associated infections at Orbit hospital. The use of various devices in patient care provides a source of pathogens. Patients risk infections within hospitals because of improperly repurposed equipment. For instance, thermometers provide a high risk due to the use on different patients without undergoing through proper sterilization (Weston, 2013). Orbit Hospital intends to provide single use thermometers to reduce infections. At the same time, the hospital initiated an evaluation of the sterilization procedure used to sterilize equipment. However, the delayed implementation of technology such as fluorescent excitement and unveiling UV light screening contribute to unreliable patient testing.
Sick people and patient’s visitors contribute to infection and spread of diseases in the hospitals. Family members need constant monitoring to ensure minimum rates in the spread of infections within health facilities. At Orbital Hospital, extensive screening during patient admission limits the effects of diseases on the hospital population. For instance, epidemiology diagnosis at the admitting points to identify, monitor, and prevent the spread of illness (Foley, 2011). Patients admitted to the hospital receive educational materials on the ways to reduce infections to themselves, visitors and other patients.
The financial aspect for epidemiology within orbit hospital plays a significant role in establishing reliable preventive measures for hospital-associated infections. Implications of funding the screening efforts provide a guarantee of how well an institution reduces the infection and spread of microbial organisms. To accurately diagnose the diseases expensive measures often complicate the determination of the cost benefit associated with the provision of these resources (Foley, 2011). However, providing a cost benefit analysis of the impact of funding efforts and justifying the huge budgetary allocations provide a big challenge to the Hospital.
Involvement of the community in the management of hospital-associated infections is crucial to reducing the hospital-related infections. Apart from the medical personnel and support staff in hospitals, the public plays a vital role in providing a guard against infections in hospitals. In particular, the community outreach programs help hospitals manage the spread if infections. For example, the diagnoses and eventual containment of infectious diseases depend on the public’s level of awareness and preparedness. In most cases, the leadership within the community and education levels regarding emergency protocols provide guidance in reducing the severity of infections.

Transmission Routes

Pathogens within the hospital, transmission occur through direct or indirect contact. Direct situations such during physical examinations, pathogens from the host to vulnerable people happens. The health care worker provides a conduit through which pathogens move from the first patients to other people (A., Salkeld, & French, 2013). Blood transfusions make a good example for pathogens causing Hepatitis making their way to patients’ bloodstream because of improperly screened blood.
Indirect contact as means of pathogens transmission occurs in instances of use of medical devices. Also, poor hand hygiene leads to this communication in situations where a sick patient touches an object in the hospital, and a susceptible person handles the same purpose. This method of infection is standard in skin diseases such scabies.
Another means of spread is through the air within the hospital. Airborne diseases dangerously spread because of the pathogens ability to use air as a tool to move from on host to another. Cases of airborne diseases may escalate quickly if not handled first and protective measures taken to use masks. Tuberculosis is a case of a sickness that spreads through the air (James, 2013).
Other means of transmission include vectors and water droplets

Impact of nosocomial infections on patient care

The rising nosocomial infections observed at orbital hospital need urgent interventions. The assessment of the impact brings forward various issues in the hospital’s ability to care for the patients. Hospital-associated infections (HCAIs) result in reduced low public perception of the hospital (Scott II, 2016). The numerous cases of patients admitted to the hospital overstaying because of complications severe damages the opinion of the patients. The little public image manifests itself through the small bed occupancy. The hospital’s inability to utilize bed capacity of 1400 patients shows the limited public confidence. Current bed occupation stands at 900 a drop in comparison to two years back usage of 1400. This decrease represents a 35% decline in the patients served at the hospital.
Constrained budgetary allocation compromises the screening process quality. Patients admitted receiving necessary testing and consultation without a proper diagnosis of the underlying causes. The limited finances reduce the ability of the hospital to hire enough staff to manage the patients seeking treatments at the hospital (Scott II, 2016). Their new malpractice suit due to an overworked nurse resulted in hefty fines and compensation charges to the hospital.
Low staff morale lead to increase in HCAIs at Orbital Hospital. Long work hours by the nurses compromise the quality of care received by the patients (A., Salkeld, & French, 2013). Scheduling challenges in shift changes aggravate the situation with nurses and technicians unable to take enough rest. The current average change stands at 10 hours per day. Also, the nurses on longer shifts of more than 12 hours receive little benefits.
Families with patients at the Hospital have faced serious health repercussions because of infections after visiting their admitted family members. The poor hygiene at the hospital increases the risk of HCAs among visitors and the patients (Foley, 2011). The resultant financial constraints on the patients with complications due HCAs brings the willingness to seek treatment down. In the last six months alone, patient’s bills have gone unsettled resulting in withdrawing of patient care by the hospital.
Increased medical follow-up of discharged patients continues to manifest. Occasioned by frequent relapse, patients return to the hospital shows the low level of primary medical care provided by Orbital Hospital. In the past two months, patients suffering from acute pneumonia failed to respond to medication thereby forcing the hospital to readmit them.


Through engagement of the board, the proposals to reduce the infections from the hospital environment include various changes in policy in the management of the hospital programs. Reduction of diseases related to hygiene, the introduction of ultraviolet (UV) random light inspections to check staff hand cleanliness (Healey & Evans, 2015). Also, access to hand sanitizers by those visiting the hospital would promote overall hygiene within the hospital. Hospital cleaning staff motivation to work better and improve the cleanliness of the hospital will also reduce HCAIs.
Furthuremore, appropriating protective equipment to all the staff would reduce infections by a significant margin (Saber et al, 2013). Promotion of non-invasive procedures as an alternative to non-essential surgical procedures should reduce infections in the end. However, a balance ensuring the teaching continues smoothly (Mehta, et al., 2014). The hospital needs to reform the hiring capacity to improve the nurses and patients ratios. Increasing in the total number of nurses would lead to better staff morale and better patient care.
There is a need to improve the surveillance within the hospital to limit the interaction between patients. Proper monitoring of patients would ensure reduced infections, which result from these interactions. Also, the patient’s visits should make certain minimal risk from the visitors (Weston, 2013). Preserving the health of family members, the hospital, would do well to provide a clean environment and education to the visit procedures.
Enhancing corroboration between community leadership and the hospital would ensure the right management of nosocomial management. Raising public awareness through campaigns on effects of nosocomial infections would guarantee proper measures resolve risks in time (Scott II, 2016).

Emphasis on appropriate action would limit the spread of airborne diseases. An evaluation of air control system within the facility would heavily affect the air movements in the wards. Air regulators would remove the risk of air contamination thereby reducing the rates of infections within the hospital.


In conclusion, the speed with which the board moves to implements these recommendations is essential to reduce the hospital related infections at Orbital Hospital. The costs involved in implementing the recommendations are substantial, and the importance of a cost-benefit analysis suggest this is the way to go. Speedy actions to remedy the situation such as hand washing behavior correction should start immediately.
A decision on the implementation procedures remain at the discretion of the board, but the nursing committee would welcome the opportunity to spearhead the process. About specific short-term measures, the committee advises that the priority area includes staff motivation and improving the screening protocols. The medium term implementation suggestions include staff recruitment and patient education. Long-term deliverables should involve the community and the leadership.
The committee drives these recommendations from concerns gathered within and outside the hospital. If implemented, the hospital’s image will improve, bed capacity raised, the ability to attract medical specialists, sand students realized. With a focused implementation, the orbital hospital will rise again as a modern center for the best health care services in Texas.
This committee urges the board to actively engage the hospital sponsors to assist in the reforms proposed here to enhance patient care.

Foley, S. L. (2011). Molecular techniques for the study of hospital-acquired infection.
Hoboken, N.J: Wiley-Blackwell.
Healey, B. J., & Evans, T. M. (2015). Introduction to health care services: Foundations
and challenges. San Francisco, CA: Jossey-Bass & Pfeiffer Imprints, Wiley.
James, J. T. (2013). A new, evidence-based estimate of patient harms associated with
hospital care. Journal of patient safety. J.T, 122-133.
Mehta, Y., Gupta, A., Todi, S., Myatra, S., Samaddar, D. P., Patil, V., &
Ramasubban, S. (2014). Guidelines for prevention of hospital-acquired infections. Indian
Journal of Critical Care, 149–163.
Scott II, R. D. (2016). Center for Diseases Control. Retrieved from Center for Diseases
Control Web site:
Saber., Y., Salkeld, J. , & French, G. L. (2013). Evidence that contaminated surfaces
contribute to the transmission of hospital pathogens and an overview of strategies to address contaminated surfaces in hospital settings. American journal of infection control, S6 – S11.
Weston, D. (2013). Fundamentals of infection prevention and control: Theory and
practice. Chichester, West Sussex: Wiley-Blackwell.