solved Hi, Please, read and respond to Peer 1 and 2

Hi, Please, read and respond to Peer 1 and 2 (100 words minimum). References should be in APA style.Peer 1: According to Olson, B.D., evidence-based research indicates that patient survivorship dramatically improves when antibiotics are given antibiotics within one hour of surgery (Olson, 2016). About 500,000 infections occur each year in surgical facilities. These infections cause over 4 million hospital days and contribute to more than $2 billion in added health care costs. The prevalence of these infections has been identified as one of the factors that contribute to healthcare costs. For most patients undergoing a clean-contaminated surgical procedure, a cephalosporine is the recommended antibiotic (Salkind & Rao, 2011). There are about 2,000 preventable deaths each year in hospitals, according to a report released by the Leapfrog Group. When hospitals score low on infection rates, it generally means they are not following clinical best practices. If an organization is having difficulties managing post-operative surgical infections, they should consider performing an independent accreditation of the day-to-day processes to evaluate the quality of their work. Typically when performing quality assessments, the organization is able to demonstrate continuous improvement in its operations (Olson, 2016). Deaths from medical mistakes and infections are rising at the worst hospitals in the US. The findings reinforce Americans’ need to check hospital ratings regularly. The study analyzed data collected from over 2,000 US hospitals since 2016. It found that many of the country’s most dangerous medical facilities have become even more dangerous for patients (O’Connell, 2019).Hospital infection rates have been a part of the healthcare industry for a long time. They are calculated by various public health agencies and healthcare facilities by collecting infection data and metadata. A hospital-acquired infection rate is a number that shows the rate of infections that occurred during a hospital stay. It is usually calculated for the entire hospital, though it can also be calculated for each unit. The rate of postoperative infection is a good indicator of quality care. It can also be used to evaluate the level of surgical care (Olson, 2016).ReferenceO’Donnell, J. (2019). Low-rated US hospitals are deadlier due to mistakes, botched surgery, infections. USA Today.Olson, B. D. (2016). Chapter 27: Project Management. Health Information Management: Concepts, Principles and Practice. 5th Edn. AHIMA press.Salkind, A., Rao, K. (2011). Antibiotic prophylaxis to prevent surgical site infections. American Family Physician. Peer 2:Why is it clinically important for patients to receive antibiotics within one hour of surgery?There is a growing amount of data that can be found which supports the use of antibiotics in a prophylactic manner in timely ways following surgery. For example, Crader & Varacallo (2021) highlight a benchmark 2008 study conducted by Hind & Hutchinson which found that after knee and hip replacement surgeries those who were given a prophylactic antibiotic saw an 80% reduction in infection when compared to the controlled group, which was not given antibiotics following their procedures.Jonge et al., (2017) quantitatively examined 14 papers, which included over 54,000 patients, all with the purpose of attempting to determine whether a prophylactic antibiotic given between 120-60 minutes was less effective than if the antibiotic was given between 60-0 minutes of surgery. Additionally, this study searched whether after 120 minutes, post-surgery infections were more likely. Although Jonge et al., (2017) did not find any support that an antibiotic given 120 minutes after surgery increased the likelihood of infection versus if it were administered 60 minutes or less, this quantitative study did shown rather definitively that prophylactic antibiotics given inside of a 120 minutes after surgeries does dramatically reduce post-surgery infection. Beyond the chief importance of insuring that patients heal successfully, infections lead to increased hospital stays, costs, etc., that can lead to all kinds of macro-level issues for hospitals, and even communities. For example, there is some evidence that higher levels of hospital-based infections leads to higher overall antibiotic-resistant infections in the surrounding communities (Monegro, Muppidi, & Regunath (2020). In clinical documentation what would be reviewed to report on hospital performance of this quality measure or which portion of the record would provide the most accurate information to confirm the administration of antibiotics and its time?Both Crader & Varacallo (2021) and Jonge et al., (2017) both emphasize in their respective studies that consistency in regards to when the antibiotic was given, what antibitotic was given, and in what the results were, are all key areas of study pertaining to accurate representation of outcomes.If hospital consistently scores low on this measure, what does this indicate?Earlier this year (2021), the Centers for Medicare and Medicaid Services (CMS) penalized 774 hospitals for having high rates of patient infections and/or other potentially avoidable medical complications. The top 25% of all hospitals in the U.S. responsible for the highest rates of infections, and other preventable complications during a hospital stay, had their funding reduced by CMS.Generally speaking, as evidenced throughout this post, hospitals with higher rates of infection are providing less effective care. Also important to note, as the studies cited throughout this response indicate, there are many direct correlations between increased costs and complications during hospital procedures and/or stays.However, Cedars-Sinai Hospital makes a counterargument that just because a hospital has higher infection rates, that does not necessarily correlate to lessor care. A representative for Cedars-Sinai argued that “[punishing hospitals for higher infection rates] disproportionally punishes academic medical centers due to the “high acuity and complexity” of their patients” (Sullivan, (2021). Therefore, higher infection rates observed does not automatically equate to worse care.If a hospital is scoring low on this quality measure, which clinical quality management process could be used to help the hospital understand why the performance is low? Clinical quality improvement is no easy task in most regards. There are a number of proven, best-practice ways that both government and private-industry has established to improve on less-than-desired outcomes in a health provider context.If a hospital’s post-surgical infection rates are too high, one method outlined by the Agency for Healthcare Research and Quality (AHRQ) to approach a quality improvement process is to implement an improvement cycle. Simply put, an improvement cycle generally follows a P.D.S.A (plan; do; study; act) formula. All staff should be involved so that from the bottom-up to develop new and better ways to approach ongoing problems.References:Crader MF, Varacallo M. (2021, July 18). Preoperative antibiotic prophylaxis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442032/#de Jonge, S. W., Gans, S. L., Atema, J. J., Solomkin, J. S., Dellinger, P. E., & Boermeester, M. A. (2017). Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection: A systematic review and meta-analysis. Medicine, 96(29), e6903. https://doi.org/10.1097/MD.0000000000006903 Please reply to Peer 3: According to Platt, et al . (1990). Electronic health records are typically utilized to improve quality because they provide the most exact detail and efficiency, and they do not allow for considerable manipulation of the reports.Many hospitals export data from the EHR into a different data set with more analytic capability, and some combine data from multiple categories. This necessitates the creation of manual reports. Additionally, it was mentioned appropriately that EHRs cannot meet all reporting standards due to the granularity of metrics.On that score , EHR is also dependent upon the implementation of patient health literacy initiatives concerning self-reporting of medication allergies (Moskow, et al . , 2016). This is particularly relevant for populations most at-risk for low health literacy, including patients with linguistic and cultural differences(Moskow et al. ,2016). Just as patients with low health literacy may need addition support understanding labeling and dosage, patients with low health literacy may also need support in differentiating between true drug allergies versus side effects of medications to ensure that this information is documented accurately in the patient chart.References.Platt, R., Zaleznik, D. F., Hopkins, C. C., Dellinger, E. P., Karchmer, A. W., Bryan, C. S., … & Segal, M. R. (1990). Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery. New England Journal of Medicine, 322(3), 153-160.Moskow,J., Cook,N., Lippmann-champion, C. , Amofah ,S.A. & Garcia A.S.(2016) Identifying opportunities in EHR to improve the quality of antibiotic allergy data Journal of the American Medical Informatics Association, Volume 23, Issue e1, April 2016, Pages e108–e112, https://doi.org/10.1093/jamia/ocv139