Hospitalization complications or hospital-acquired complications are secondary infections patients acquire after initial admission to healthcare facilities. The most common hospitalization complication is a healthcare-associated infection known as Staphylococcus aureus bloodstream infection (SABSI). This infection is associated with prolonged hospital stays and results in death. Other hospitalization complications include pressure injuries, hospital falls, surgical complications, unplanned intensive care admission, respiratory complications, urinary tract infections, malnutrition, cardiac complications, neonatal birth trauma, third and fourth-degree perineal laceration, delirium, gastrointestinal bleeding, and medication complications.
Factors leading to hospitalization complications include increased workload and nurse interruptions, high-risk working environment, and high burn-out and nurse turnover rates. Hospitalization complication causes numerous problems to patients and their families. They affect patient recovery and overall care outcomes, leading to prolonged hospital stays. This increases healthcare costs and overutilization of healthcare resources. Nurses play an essential role in minimizing and avoiding healthcare-acquired complications. They provide appropriate patient care and take actionable steps to prevent hospitalization infections.
Understanding the factors contributing to hospitalization complications is essential. Knowledge of healthcare complications helps nurses understand the risks involved, developing effective measures to mitigate the elements and improve patient satisfaction and the overall quality and safety of care. This paper broadly explores factors contributing to hospitalization complications and their implications on nurses’ practices on an adult medical surgery floor.
Literature review
Current Research on Hospitalization Complications
Hospital-acquired complications are frequent events and variations in rates of events occurring during a patient stay in healthcare facilities. A study by Duke et al. (2021) noted that 9.7% of hospital-acquired infections were reported in South Australia and Victoria in 2015-2018. In 2020, coronavirus cases were significant among patients admitted to healthcare facilities once or multiple times during the coronavirus pandemic. Complications after the pandemic had long and short-term consequences for patients, healthcare utilization, healthcare system preparedness, and society (Drake et al., 2021). The complications were associated with reduced ability to self-care at discharge, worst functional outcomes, and substantial strain on health and social care.
In the adult medical surgery floor, patients may face various hospitalization complications depending on their underlying medical condition and surgery. Common hospitalization complications in the adult medical surgery unit include hospital-acquired infections such as pneumonia, urinary tract infection, and surgical site infection, life-threatening complications such as deep vein thrombosis and pulmonary embolism, pressure ulcers due to prolonged immobility, acute confusion and changes in mental status, and adverse drug interactions, medication interactions, or dosage error complications (Mudge et al., 2021). Cardiovascular, gastrointestinal, respiratory, and renal complications are additional complications on the adult medical surgery floor.
Key factors contributing to hospitalization complications on the surgery floor include poor healthcare environment, such as noise, disruptions, and poor lighting hindering the recovery process, inadequate communication and collaboration among healthcare providers leading to missed instructions, delayed actions, misunderstandings, and insufficient staff levels which makes it tiring and difficult to carry out all post-surgical instructions. Also, the patient’s nutritional status, surgical complexities, and underlying health conditions such as diabetes and heart disease weaken the ability to cope with post-surgery effects. Older patients are at increased risk of trips and falls.
Relevance of Hospitalization Complications on nurse practices on the adult medical surgery floor
Nurses working on the adult medical surgery floor are essential in hospitalization complications. They are required to provide better and improved patient care, monitor, and ensure patient safety. Understanding hospitalization complications in the care setting affects nurse practices by improving their patient monitoring practices. Nurses must carefully observe the patients, their vital signs, risks of infection, and the wound healing process. Careful observations ensure the timely detection of complications, leading to necessary care practices.
Enhancing complication prevention and control. Understanding hospitalization complications helps implement necessary prevention measures such as hand hygiene and adherence to infectious control protocols.
Promoting patient advocacy. Knowledge of hospitalization complications enables nurses to advocate for safety and care, ensuring they receive the best care and treatment with limited complication risks.
Promoting patient education. Nurses educate patient and their families on infection, prevention measures, wound care, complication signs, and medication management.
Enhancing collaboration and open communication. Nurses communicate with the patients about the risks of complications. They also document and record patient interventions and outcomes. They also collaborate to provide multidisciplinary care. Collaboration promotes care coordination, information sharing, and development of comprehensive care plans.
The relevance of hospitalization complications in nurse practice is enhanced by clear communication. This helps nurses fulfill their role as patient educators, advocates, and care coordinators. Knowledge of healthcare-acquired complications and factors related to their competency, expertise, and dedication to enhancing patient care and managing complications.
Healthcare system responses to hospitalization complications
Patients on the medical surgery floor are either preparing for or recovering from room surgery. Healthcare system responses to hospitalization complications aim at improving patient safety before and after surgery. They respond to hospitalization complications by developing policies and procedures to prevent, manage, identify, and minimize the effects of these complications (Mulu et al., 2020). Healthcare systems develop quality improvement initiatives to enhance patient safety and reduce complications. They ensure the implementation of evidence-based initiatives, improve regular training among staff, and continuously monitor health outcomes.
Healthcare systems also introduce patient safety guidelines to mitigate hospitalization complications. These guidelines include encouraging nurses to adopt a checklist of things that must be done before and after surgery, ensuring patient identity and type of surgery are confirmed before surgery, and coordinating with the surgical department to understand the after-surgery medication and care (Rodziewicz & Houseman, 2023). These promote patient safety before and after surgery.
Additionally, healthcare systems respond by developing specific protocols for each hospitalization complication on the surgery floor. For example, they develop medication management systems to manage medication errors, including barcode medication administration, electronic medication records, standardized units of measure, and weight-based dosing (Rodziewicz & Houseman, 2023). For hospital-acquired infections, they implement patient safety protocols such as hand hygiene programs and checklists (Mulu et al., 2020). The actions help minimize hospital-acquired infections and other complications.
Implications for practice
Research-based nursing interventions to promote better patient outcomes regarding hospitalization complications
Research-based nursing interventions promote better patient outcomes and prevent complication levels on surgery floors. Examples of evidence-based interventions on the surgery floor include strict hand hygiene and infectious control measures. The control measure ensures that the surgical floor implements rigorous hand hygiene measures and infectious control protocols. Proper hand hygiene has proven effective in reducing the spread of infections, including surgical site infections and other complications (CDC, 2020). During the COVID-19 pandemic, hand hygiene helped minimize the adverse effects of the condition.
Patient education. Patient education has been an effective evidence-based strategy for preventing hospitalization complications (Aslam et al., 2020). Patients are provided with comprehensive preoperative education and postoperative care. Education should be complete and easy to understand. This improves their preparedness before and after surgery, reducing their fear and anxiety, which minimizes complications.
Individualized pain management. Individualized pain is related to anxiety, depression, and disability. The pain management protocols are tailored to individual patients’ needs and preferences. The lack of consistent and mechanistic pain treatment protocols increases extended hospital stays and hospital readmission (Welch-Coltrane et al., 2021). Research-based pain management control minimizes complications related to inadequate pain management.
Continuous monitoring and quality improvements. Continuous monitoring practices entail the provision of better quality care after surgery. Improved tracking of patient outcomes and complications ensures early detection and management of risk factors.
Specific ways specialty nurses in the adult medical surgery floor implement the interventions
Specific ways nurses can implement the interventions in the adult medical surgery floor include;
In strict hand hygiene and infectious control measures, nurses play examples in practicing hand hygiene measures (CDC, 2020). They educate patients and their families on the importance of proper hand washing and oversee the implementation of sanitizers, washing detergents, and other necessities required.
For patient education, nurses provide knowledge and education to the patients. They educate them on various hospitalization complications, risk factors, and effective ways to mitigate them. This helps the patient stay educated and informed of the healthcare environment.
For individualized patient management, nurses ensure they provide patient-centred care and spend quality time interacting and communicating with patients (Welch-Coltrane et al., 2021). They also collaborate with other care teams to offer personalized pain management plans, regularly monitor patient pain levels, and adjust the interventions based on patient’s needs and preferences.
Lastly, in continuous monitoring and quality improvements, nurses actively participate in these practices. They report complications and contribute to quality improvements.
Relevance of research to my future nursing practices
Research on hospitalization complications and implications on nurse practices in the adult medical-surgical unit is essential for my future nursing career. It equipped me with knowledge and understanding of existing healthcare complications, factors leading to increased risk of complications, and their impact on nurse practices. It also helped me understand my role as a nurse and the role of healthcare systems in managing and mitigating healthcare complications. I understood different evidence-based interventions used to enhance care and safety and will apply them in my future nursing practices. I will ensure my patients are educated and informed of healthcare-acquired complications and how to mitigate them.
Conclusion
Hospitalization complications are common in healthcare, affecting patient care, patient outcomes, and numerous implications on nurse practices in the adult medical surgery floor. Common hospitalization complications in the adult medical surgery unit include hospital-acquired infections, deep vein thrombosis and pulmonary embolism, pressure ulcers, adverse drug interactions, medication interactions, or dosage error complications. Contributing to hospitalization complications on the surgery floor include poor healthcare environments, such as noise, disruptions, poor lighting hindering recovery, and inadequate communication and collaboration.
Healthcare systems and nurses have an essential role in mitigating healthcare complications. They must actively collaborate to enhance patient safety by promoting patient education, advocating for patient health risk mitigation measures, and acting at the forefront in implementing and practising measures such as hand hygiene protocols. This ensures that collaborative approaches in the management of healthcare complications are well-implemented.
References
Aslam, S., Simpson, E., Baugh, M., & Shill, H. (2020). Interventions to minimize complications in hospitalized patients with Parkinson’s disease. Neurology: Clinical Practice, 10(1), 23–28. DOI: https://doi.org/10.1212/CPJ.0000000000000709
CDC. (2020, February 25). Clean hands count for safe healthcare. Centres for Disease Control and Prevention. https://www.cdc.gov/patientsafety/features/clean-hands-count.html
Duke, G. J., Moran, J. L., Bersten, A. D., Bihari, S., Roodenburg, O., Karnon, J., … & Santamaria, J. D. (2022). Hospital‐acquired complications: the relative importance of hospital‐and patient‐related factors. Medical Journal of Australia, 216(5), 242-247. https://doi.org/10.5694/mja2.51375
Drake, T. M., Riad, A. M., Fairfield, C. J., Egan, C., Knight, S. R., Pius, R., … & Lefteri, D. (2021). Characterization of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study. The Lancet, 398(10296), 223–237. https://doi.org/10.1016/S0140-6736(21)00799-6
Mudge, A. M., McRae, P., Hubbard, R. E., Peel, N. M., Lim, W. K., Barnett, A. G., & Inouye, S. K. (2019). Hospital‐associated complications of older people: a proposed multi-component outcome for acute care. Journal of the American Geriatrics Society, 67(2), 352–356. https://doi.org/10.1111%2Fjgs.15662
Mulu, G. B., Kebede, W. M., Worku, S. A., Mittiku, Y. M., & Ayelign, B. (2020). Preparedness and responses of healthcare providers to combat the spread of COVID-19 among North Shewa Zone Hospitals, Amhara, Ethiopia, 2020. Infection and drug resistance, 3171-3178. https://doi.org/10.2147%2FIDR.S265829
Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2018). Medical error reduction and prevention. https://www.ncbi.nlm.nih.gov/books/NBK499956/
Welch-Coltrane, J. L., Wachnik, A. A., Adams, M. C., Avants, C. R., Blumstein, H. A., Brooks, A. K., … & Hurley, R. W. (2021). Implementation of individualized pain care plans decreases the length of stay and hospital admission rates for high-utilizing adults with sickle cell disease. Pain Medicine, 22(8), 1743-1752. https://doi.org/10.1093%2Fpm%2Fpnab092
write