ENGL 103 Formal Proposal

Formal Proposal Instructions

You are the chief operating officer (COO) of Training World, Inc., an international workplace training organization, located at 9476 Henderson Highway in Charlotte, North Carolina 28213.  With over 200 full-time and part-time employees, your company handles training and development in in the health care field. You have spoken with Ms. Jocelyn Hightower, director of Human Resources at Central Dallas Medical Center (CDMC) at 14763 Main Street in Dallas, Texas 75208, about a three-day training program for all employees at that medical facility. 

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Choose a topic with which you are most familiar that would be appropriate for the employees of CDMC and submit a 7-8 page formal proposal addressing the training you could offer, the purpose and benefits of that training, and the cost for the three-day training that you propose. 

Your proposal must include the following elements:

  • Title page
  • Executive summary
  • Table of Contents
  • Introduction
  • Headings throughout your proposal
  • Conclusion
  • References

Proposal for a Training on Hospital Acquired Infections


The primary purpose of a private healthcare institution is to provide quality healthcare services and to make profits while at it. Quality healthcare involves the provision of the best available diagnosis, medication, and follow-up. The cost is also a huge part of quality as costs impact heavily on the lives of patients. The hospital should also be able to prevent the transmission of infections to patients in the healthcare center. If patients are made to stay longer in the hospital due to infections that are acquired in the hospital, they are bound to give the institution a negative rating which could negatively impact on the reputation of the institution. This could significantly affect the hospital’s brand and lead to losses in the long-term as people would lack trust in the institution’s ability to provide them with quality care.

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Going by the fact that most of the hospital-acquired infections arise from poor handling by healthcare professionals, our company intends to provide quality training on how these infections can be minimized. The training provided by our company will help to reduce the number of this kind of infections in your institution. Our training will equip your employees with the necessary skills and knowledge of how to reduce the transmission of hospital-acquired infections in your facility. This will have a significant impact on the quality of your services, as well as play a part in assuring your facility of a sustainable and profitable future.


Hospital Acquired Infections are infections that patients acquire while in hospital. These are infections that the patients did not come with to the hospital. They are also known as healthcare-associated infections or nosocomial infections. They are infections that are not present or incubating at the time of the admission of the patient in the hospital. There are factors that increase a patient’s risk of contracting these infections. These risk factors include patient’s weakened immune status, prolonged hospital stays, the prevalence of infective agents in the community and the hospital, invasive procedures, use of indwelling devices such as catheters and valves, multiple underlying illnesses and old age (Cornejo-Juárez et al., 2015). Some of the leading hospital-acquired infections include urinary tract infections, hospital-acquired pneumonia, surgical site infections, gastrointestinal infections, and central line infections (primary bloodstream infections) (Khan, Baig & Mehboob, 2017). These infections have been blamed for prolonging patients’ hospital stays, as well as increasing mortality and morbidity. Lack of observation of proper hygiene by healthcare professionals that attend to patients on a regular basis is the leading cause of the transmission of these infections.

Factors that Increase the Risk of Nosocomial Infections

Use of catheters has been implicated as one of the main factors that increase the risk of hospital-acquired infections. It is apparent that it is impossible to avoid the use of catheters in the hospital setup. Many patients present in the hospital with such issues as urinary retention, especially old patients, and this requires drainage by use of catheters. Other patients with fluids in such areas as the chest may require insertion of drainage catheters. The administration of fluids through the blood vessels also necessitates the use of catheters. The main ways through which catheters predispose to infection include: when they are inserted to an area without disinfection of the external skin surface, the catheters coming into contact with infected material before being inserted into the body, as well as prolonged use of catheters among others.

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Surgery is another major cause of acquisition of nosocomial infections. This can happen when surgeries are not done in totally aseptic conditions. Surgery is an important issue because it leads to penetration of inner parts of the body, and, therefore, makes it easy for direct infection to occur. Post-operative wound infections normally occur from the first day going onwards. However, it normally happens between the sixth and the tenth day after surgery. Infections are the the most common complications that occur after surgery and should, therefore, be addressed as they lower health outcomes for those that undergo surgeries.

Considering that injections are very common in the hospital setup, they also play a big part in the transmission of nosocomial infections. Injections are used for such purposes as the drawing of blood for examination, administration of medications and fluids, fine needle aspiration of tissue for cytology, and the drawing of fluids that have accumulated in any given area of the body. Injections predispose to infections in many ways. Some of these include: reusing of needles, infection of the needles when they come into contact with dirty surfaces, lack of disinfection of skin surfaces before injections, and the injected surface coming into contact with infectious agents in hospital beddings.

Lack of thorough cleaning of the healthcare setup also increases the risk of infections. Such areas as the injection rooms, venipuncture rooms, catheterization area, and the admission wards require regular cleaning as they are used by many patients who may be harboring different kinds of infectious agents. Some chronic bacteria such as Pseudomonas aeruginosa may persist in a given area for a long time and infect many people. Regular cleaning and disinfection ensure a reduction in microorganisms as well as the elimination of many of them. This helps to reduce the number of infections acquired by patients in the hospital setup.

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Transmission of infections from healthcare professionals to patients is also widespread in the healthcare setup. When healthcare professionals like nurses and doctors are suffering from such illnesses as cholera, flu, hepatitis B, and staphylococcal infections, among others. It is easy for them to transmit these infections to patients. This is because these infections are highly infectious and thus pass from one person to another easily. Lack of proper measures to curb these kinds of transmissions increases the risk of patients acquiring them.

Common Nosocomial Infections

Urinary tract infections (UTIs) are the most common infections that are acquired by patients in the healthcare setup. Urinary tract infections are responsible for up to 40 percent of hospital-acquired infections. Hospital-acquired urinary tract infections are commonly associated with the use of urinary catheters in the hospital. Most hospitalized and bed-ridden patients require the use of urinary catheters and can therefore not avoid its use. This predisposes them to high risk of urinary tract infections as the catheter go deep into the bladder. The most commonly implicated organism in this category is the Escherichia coli bacteria.

Hospital-acquired pneumonia (HAP) is the second leading infection in the realm of nosocomial infections. Hospital-acquired pneumonia develops 48 to 72 hours after the admission of a patient to a hospital for a different health complaint. The patients with this kind of pneumonia present with difficulty in breathing, coughing up of purulent sputum, and chest pains, among others. Hospital-acquired pneumonia has been blamed for extending a patient’s hospital stay for up to two weeks, leading to an increase in the patient’s hospital costs. This infection also increases the costs of running a healthcare institution and overstretches its resources.

Methicillin-resistant Staphylococcus aureus (MRSA) infection is another major challenge as far as nosocomial infections are concerned. Methicillin-resistant Staphylococcus aureus infections are responsible for almost half of all deaths that result from infections with antibiotic-resistant microbes. Resistant strains of Staphylococcus aureus are very prevalent in hospital setups and are a significant cause of concern for healthcare institutions. These infections are commonly found in patients who have recently had surgery or those with open wounds that are still under management. Infection with this organism complicates treatment and prolongs stay in hospital.

Hospital-acquired Clostridium difficile infection is also another major issue that confronts healthcare setups. The infection is commonly implicated in patients who have had a prolonged stay in hospital. Infection with Clostridium difficile is widespread and affects patients of different characteristics (Leffler & Lamont, 2015). However, it mainly affects pediatrics and could hinder the normal progression of growth. The infection is associated with the use of certain antibiotics for prolonged periods. Based on this, it is the leading cause of antibiotics-associated vomiting and diarrhea in hospitalized patients.

Surgical site infections and central line bloodstream infections are also prominent hospital-acquired infections. Surgical site infections in the hospital setup occur following the carrying out of surgery in septic conditions, which leads to the introduction of infectious agents into the surgical wound.  Poor handling of wounds after surgery by healthcare providers also increases the risk of introduction of microorganisms. Injections introduce central line bloodstream infections into veins. This happens during such procedures as the administration of medications or drawing of blood for laboratory tests.

Content of the Training Course

The following outline provides the content that will be covered under each area:

  • Reducing Catheter-related nosocomial infections
    • Proper handling of catheters
    • Disinfection of catheters before insertion
    • Duration of catheters in the body
    • The catheterization area
  • Reducing Surgery-related nosocomial infections
    • Proper handling of the skin surface on surgery area
    • Surgery-related hygiene techniques
    • Patient-centered education on surgical site infections
    • Regular handling of surgical sites
  • Reduction of Healthcare setup infections
    • Hygiene in the healthcare setup
    • General disinfection
    • Surgical theatre hygiene management
  • Reducing injection-related nosocomial infections
    • Handling of injection sites
    • Proper syringe and needle usage
  • Reducing health care workers to patient infections
    • Institutional handling of ill workers
    • How healthcare workers can minimize transmission of infections to patients

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Proposed Training Schedule

Training Aspect Date and Time Trainers
Reducing Catheter-related nosocomial infections   July 1, 2019 – Morning Dr. Brooks and Dr Reddington
Reducing Surgery-related nosocomial infections   July 1, 2019 – Afternoon Dr. Jana and Dr. Anita
Reduction of Healthcare setup-related infections   July 2, 2019 – Morning Dr. Hussein and Dr. Kenya
Reducing injection-related nosocomial infections   July 2, 2019 – Afternoon Dr. Taarabt and Dr. Nasibu
Reducing health care workers to patient infections   July 3, 2019 – Morning Dr. Stevens and Dr. Darwin
Review of all of the above topics July 3, 2019 – Afternoon All the trainers


The cost of our three-day training program is very cost-effective and competitive. We hope that the prices that we provide will be desirable to you based on the assurance of quality that we offer. Our content is well-researched and up to date based on the latest research on the science and impact of hospital-acquired infections. The total cost of the three-day cost is US$ 50,000.

Benefits of the Training to your Facility

The training should be able to improve services in your facility and significantly impact the facility’s future.  Your workers will be equipped with invaluable skills and knowledge that they will apply at all times while in service. Reduction in nosocomial infections in your facility will help to reduce the length of hospital stays of your patients. This will make it possible to attend to many patients without overstretching of resources. The bigger picture is that this should be able to translate to higher profits and positive reviews for your facility. It is therefore apparent that this training is immensely necessary and holds great potential for Central Dallas Medical Center.

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In conclusion, it is evident that nosocomial infections are a serious challenge to the success of a medical institution. Based on the fact that your facility’s success is based on the provision of quality healthcare services, it is essential that minimization of these transmissions is prioritized. Training of healthcare workers is an essential step in this aspect. Through the provided schedule and cost, we hope that we can work together in this project to the benefit of both parties.

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