ASSIGNMENT

Title

 

           (Introduction – not labeled ‘Introduction’) Introduce your topic of interest for practice change (
Hand Hygiene to Control Health Acquired Infections
) and its general area of either (a) clinical outcomes, (b) safety and quality, (c) leadership or (d) health policy. Tell the reader what the purpose of the paper is and present a preview of what the paper will include.

Project Topic and Question Formats

Remember to use the MEAL plan to organize your paragraphs. Start with your Main point and follow with Evidence, Analysis and Links.

            Introductory paragraph

In this section of the paper, describe the background and development of this clinical practice issue that you propose to address (
Hand Hygiene to Control Health Acquired Infections-SEE ATTACHED DOCUMENTS
). Show how you derived at your problem statement (problem/etiology) your assessment (consisting of personal experience, observation, stated patient values, literature, organizational needs and other validated). Complete the section by stating the practice problem in two distinct sentences (problem and etiology), stating why this statement format is important (in other words, why does it matter that you have etiologic statements)?; and then state the problem in PICOT format and tell your reader about the purpose of using this format to describe the problem

Reflection on Nursing Science Underpinnings for Practice Change

            Introduce your reader to the main ideas related to application of theory to guide development of knowledge and understanding of your particular interest in leading practice change. Articulate your original application and evaluation of specific academic frameworks.

Metaparadigm

            Identify the major concepts of nursing’s metaparadigm and describe these concepts as they are defined in the context of your interest in practice change (specific problem and area).

Ways of Knowing  

            Describe how the concepts in the theory of Ways of Knowing (SEE ATTACHED) are related to your practice change idea. Provide an example from the theorist’s work and your practice to support your assertions.

Nursing Theorist (SEE ATTACHED DOC)

            What are the major assumptions of the theory and how do they relate to nursing’s metaparadigm and your practice issue? Remember to illustrate with examples from the theorist’s work that support your assertions.

Development and Discussion

Tell your reader where you stood on your clinical concern before you studied it in light of theory, Ways of Knowing and the literature. What values, background and other factors influenced your thinking. Use personal experience or previous knowledge to support your understanding.

Supporting Literatures

Summarize one article that influenced your thinking on this issue. Describe the author’s purpose, what their main argument was and which of their ideas you found most influential. Which ideas supported your original thinking and which advanced your understanding beyond what you originally thought? In other words, show readers how what you have learned both validated or challenged your own thinking. Complete this section by stating what you anticipate next regarding your progress in developing a practice change project.          

 

Conclusion

            Identify the main ideas and major conclusions from the body of your manuscript. Do not add new information in the conclusion. 

 

 

References (centered, not bold)

Type your references in alphabetical order here using hanging indents (under “Paragraph” on the toolbar ribbon).  See your APA Manual and the resources in the APA folder in Course Resources under Course Home for reference formatting.

 

NOTE THAT THE PRACTICE CHANGE I CHOSE IS:

Hand Hygiene to Control Health Acquired Infections

Purpose

The purpose of this paper is to present the story of your inquiry process thus far on the road to developing your DNP project. An inquiry essay differs from other traditional academic essays in that its purpose is not to argue for a specific idea, but rather to illustrate your inquiry and thinking process, and to demonstrate your understanding of how theoretical and process models guide your DNP project development

 

Course Outcomes

This assignment provides documentation of student ability to meet the following course outcomes:

 

CO2: Identify practice problems at the microsystem, mesosystem and macrosystem levels of health care systems (PO #3).

 

CO3: Assimilate nursing’s ways of knowing and the development of nursing science (PO #3).

 

CO7: Analyze the implementation of selected theoretical perspectives into evidence-based practice. (PO #5)

 

CO11: Summarize scientific knowledge to determine the nature and significance of a practice problem (PO #3)

 

Points

This assignment is worth 275 points.

Requirements

1.     To complete this application, you will need to access to the following databases: CINAHL, MEDLINE, Cochrane Library, and the Joanna Briggs Institute. You may access these databases through the Chamberlain College of Nursing Online Library. The PDF tutorials for database searches are in the “Need Help?” box on every library page. To ask for assistance from a librarian, use one of the contact methods in the “Ask A Librarian” box at the top right of every page.

2.     When clicked, it reveals a list of “Tools” or PDFs on how to do conduct various searches of the required databases (CINAHL, MEDLINE, Cochrane, and JBI) through the portals (EBSCO and OVID) provided. 

3.     The Inquiry Paper is worth 275 points and will be graded on the required components as summarized in the directions and grading criteria/rubric.

4.     Create your manuscript using the version of Microsoft Word required by Chamberlain College of Nursing. You can tell that the document is saved as a MS Word document because it will end in “ x”

5.     Follow the directions and grading criteria closely. Any questions about this paper may be posted under the Q & A Forum.

6.     The length of the paper will be 5 pages excluding title page and reference pages.

7.     A minimum of 5 scholarly references (not your text books but primary sources of theory and research).

a.     The textbook required for this course may be used as a reference for this assignment but does not count towards the required minimum number of scholarly references.

8.     APA format and effective writing is required for the paper. Use your APA manual or Purdue Owl to check and correct your formatting. Use Grammarly, Tutor.com found under General Resources on the Course Resources page or in the student portal, the grammar and spelling check on your Word Processor and criteria for effective writing (available through the Writing Call and Coaches) to assure that your paper well written.

 

Preparing the Paper

The following are best practices for preparing this paper:

1.     Outline your paper at the beginning of the term and begin adding notes to the content headings as you read critically and begin to synthesize and as insights occur in your mind. Following your outline will help you establish and maintain context throughout the paper.

2.     Review your studies, discussion and exercises from week 1 forward in this class. Keep the MEAL plan in mind as you begin drafting paragraphs.

3.     Create purposeful structure throughout your paper and in your paragraphs, having a sense of introduction, development and conclusion. Your outline and notes will facilitate this purposeful structure.

4.     Be sure that your content is original and appropriate to the topic as assigned. Validate your ideas with substantiated thinking and appropriate use of valid sources. In other words, provide evidence and examples to illustrate your statements.

5.     Assure proper conventions and content: Check the usage, spelling, punctuation, sentence structure, format, citing and so on using tools such as Grammarly, Word Spell and Grammar Check, APA manual, Purdue Owl, Listening to the Writing Calls, Contacting your faculty or using a writing coach if necessary.

6.     An effective conclusion should include the main ideas and major conclusions. Do not add new information in the conclusion.

Directions and Grading Criteria

Category

Points

Description

Introduction

20

Introduces your topic for practice change and it’s general area of either (a) clinical outcomes, (b) safety and quality, (c) leadership or (d) health policy.. Tell the reader what the purpose of the paper is and present a preview of what the paper will include.

Assessment and resulting project topic and PICOT questions

30

In weeks 1 and 2 you began articulating your interest in being a doctoral prepared clinical leader for practice change. From your existing clinical expertise, reflection, study and beginning organizational assessment within your planned clinical site; you derived and described a clinical problem. In this section of the paper, describe the background and development of this clinical practice issue that you propose to address. Complete the section by stating the practice problem in two distinct sentences (problem and etiology), stating why this statement format is important; and then state the problem in PICOT format and tell your reader about the purpose of using this format to describe the problem.
 
 

Reflection on Nursing’s Metaparadigm, Theory and Ways of Knowing  as frameworks guiding practice and study

45

Introduce your reader to nursing’s metaparadigm and discuss how your chosen theory and the Ways of Knowing have guided development of ideas you have for practice change.
Use examples from the theorist’s work that relate to your study of nursing phenomenon. In other words, describe your practice problem and explain the ways in which the theory applies to your topic. Use relevant examples to illustrate and support your ideas. Describe your practice problem within the context of nursing’s meta-paradigm and the theoretical insights.

Development and Discussion

45

Tell your reader where you stood on your clinical concern before you studied it in light of theory, ways of knowing and the literature. What values, background and other factors influenced your thinking? Then summarize one literature that influenced your thinking on this issue. Describe the author’s purpose, what their main argument was and which of their ideas you found most influential. Which ideas supported your original thinking and which advanced your understanding beyond what you originally thought? In other words, show readers how what you have learned both validated or challenged your own thinking. Complete this section by stating what you anticipate next regarding your progress in developing a practice change project.

Conclusion

20

Includes the main ideas and major conclusions. Summarizes the benefits of the selected theory for an eventual DNP Project.

Clarity of writing

75
 

 Demonstrates (a) Appropriate use of language, (b) setting and maintaining context, (c) organization given a sense of overall introduction, development and conclusion as well as paragraphs organized by main point with supporting evidence and analysis and (d) support for a position and development of ideas.

References

20

A minimum of five scholarly resources used including at least one ‘primary’ source written by the theorist.  The course textbook may be used but does not count towards the required minimum number of scholarly references.

APA format

20

1. All information taken from another source, even if summarized, must be appropriately cited in the manuscript and listed in the references using APA (6th ed.) format.
2.     Correct APA (6th ed.) format for document setup
3.     Correct APA (6th ed.) format for title and reference pages.

Total:

275 pts

A quality paper will meet or exceed all of the above requirements.

 

 

 

Grading Rubric

Assignment Criteria

Meets Criteria

Partially Meets Criteria

Does Not Meet Criteria

Introduction

(20 pts.)

Introduces topic for practice change and it’s general area of either (a) clinical outcomes, (b) safety and quality, (c) leadership or (d) health policy. Clearly articulates relationships between ideas and concepts. Tell the reader what the purpose of the paper is and present a preview of what the paper will include.
18 – 20 points

Throughout the writing, provides and maintains a sense of focus and purpose
 

 

 

 

 

 

 

 

 

 

 

13–17 points

Gives audience some sense of focus and purpose, telling what the paper is about.
 

 

 

 

 

 

 

 

 

 

0–12 points

Assessment and resulting project topic and PICOT questions

(30 pts.)

Maintains a refined sense of structure in relation to the academic framework and professional nursing process
 

 

28-30 points

Consistently articulates relationships between points of development but may be missing transitions, main points, evidence or analysis
 

22-27 points

Shows ability to use some examples or evidence but does not support most generalizations with evidence nor develop ideas through appropriate content
0-21 points

Reflection on Nursing’s Metaparadigm, Theory and Ways of Knowing  as frameworks guiding practice and study

(45 pts.)

Effectively integrates academic frameworks/theories into the context of nursing and thoughtfully challenges existing frameworks and approaches.

42-45 points

Demonstrates appropriate application of designated ideas but does not synthesize or evaluate or validate them with substantiated thinking or use of valid sources.
34-41 points

Does not articulate ideas accurately, nor identify key elements that indicate understanding of frameworks and theories.
 

 

0 – 33 points

Development and Discussion

(45 pts.)

Relates any of own relevant work and develops ideas with appropriate depth, variety and sufficient interest to engage the reader.
 

 

 

42-45 points
 

Supports most generalizations with examples and or evidence meaningful to the audience but does not develop ideas with appropriate depth, variety or sufficient interest to engage the reader.
34-41 points

Articulates some ideas accurately but misses key elements or is inaccurate, does not demonstrate understanding of the content.
 

 

 

0 – 33 points

Conclusion

(20 pts.)

Excellent understanding of theory. Conclusions are well evidenced and fully developed.
 

18 – 20 points

Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.
13–17 points

Little understanding of theory. Little to no original explanation; inappropriate emphasis on an area.
 

0–12 points

Clarity of writing

(75 pts.)

Excellent understanding of criteria for effective writing.
Persuasively develops thesis (central idea) with specific and compelling evidence.
Demonstrates ability to introduce and support original ideas.
Evaluates, analyzes, and synthesizes information from sources.
Effectively and consistently establishes clear and logical connections between ideas.
Flows smoothly and effectively from introduction to conclusion.
Includes clear topic sentences and fully-developed, well-organized paragraphs.
Demonstrates accurate, fluent grammar, mechanics, and spelling.
 

 

70 – 75 points

Basic understanding of criteria for effective writing.
While the reader can understand the writer’s general purpose, the focus is slightly blurred by inconsistent response to the issue or by lack of originality.
An appropriate organizational plan is generally followed, with only minor inconsistencies present. 
Support for the central idea is adequate, and most details and examples contribute to unity and help achieve the writer’s purpose. 
The style is competent but not distinctive. 
A few minor errors in sentence-level grammar, punctuation, capitalization, or spelling are present, but they do not significantly distract the reader and do not interfere with meaning.             67-69 points

Writing needs development.
The paper is unfocused and the reader is confused about the writer’s purpose.  Ideas show little insight or analytical ability.
The connections between sentences and paragraphs are often loose, and the reader has difficulty following the relationships among ideas.
Not enough detail has been included to support the central idea.  Details typically do not relate to the paper’s purposes. 
Problems such as wordiness, excessive passive voice, awkward constructions, weak verbs, repetitive structure are common. 
Errors in grammar, punctuation, capitalization, or spelling are pervasive and frequently distract the reader and interfere with the meaning.
0-66 points

References

(20 pts)

Minimum of 5 scholarly references used.
At least one ‘primary’ source written by the selected theorist.
References are current – within a 5-year time frame unless a valid rationale is provided for use of older references.
 

 

 

 

 

 

 

18 – 20 points

Only 4 scholarly references used.
 
At least one ‘primary’ source written by the selected theorist.
References are current – within a 5-year time frame unless a valid rationale is provided for use of older references.
 

 

 

 

 

 

 

 

13–17 points

Less than 4 scholarly references used.
 
OR
Did not use one ‘primary’ source written by the theorist.
 
OR
References not current –
within a 5-year time frame unless a valid rationale is provided for use of older references.
0–12 points

APA format

(20 pts)

APA format correct with no more than 1-2 minor errors.
 

18 – 20 points

3-5 errors in APA format and/or 1-2 citations are missing.
 

13–17 points

APA formatting contains multiple errors and/or several citations are missing.
0–12 points

Total Points Possible = 275   points    

 

Running head: HAND HYGIENE TO CONTROL INFECTIONS 1

HAND HYGIENE TO CONTROL INFECTIONS 6

Hand Hygiene to Control Infections

Name:

Institution:

Hand Hygiene to Control Infections

In most of the healthcare facilities throughout the country be it the doctors’ offices, hospitals, home health facilities and various skilled care facilities, there has been notable lack of hand hygiene not only among the patients but also among the healthcare workers. The problem of hand hygiene is not limited only to some facilities but its known worldwide. Most infectious diseases spread through the hands since being one of the most useful parts of the body. Therefore, hand hygiene in healthcare can be one of the most effective ways to reduce the spread of infectious diseases.

Healthcare-acquired infections (HAI) are infections that are acquired in hospitals after being established by patients within two days after there are admitted or some few days once they have a surgical operation and some few days after discharge. The nurse usually transfers HAI from one patient to another as they provide to them. Low Submission to hand hygiene is due to lack of training or qualification, work overload and lack of knowledge (Fox et al.., 2015).

Healthcare-acquired infections are transmitted to the victim via healthcare provider’s contaminated hands, and therefore the healthcare organization is financially obligated for the diagnostic testing and extended long stay of the patient (Huis et al. 2013). HAI also affected the number of nurses unavailing them for their duty in the process limiting the time they should spend on the patients (Landers, Abusalem, Coty & Bingham, 2012). Additionally, HAI causes a rise in the rate of mortality and morbidity among the patients. Considering the high numbers of deaths brought about by HAI, the world health organization set up guidelines stipulating when healthcare should wash their hands that is before a procedure, once they touch a patient’s environment, after a procedure, after touching a patient and before touching a patient.

HAI infects millions of patients every year, and approximately 1.8 million patients are infected by HAI where over 110,000 of them die (Mathur, 2011). This significantly increases healthcare system financial liability as the numbers keep on increasing. HAI is opposite to what the healthcare facilities are meant to do since instead of creating a safer environment, due to this condition many people suffer in these facilities. The nurse is the largest staff in hospitals and can, therefore, assist in decreasing the number of HAI most especially by practicing hand washing (CDC Foundation, 2017).

To find a solution, the first step would be to get all the doctors, supervisors and administrators involved. Being the leaders, they will find reasons why the staff members are not complying with the set guidelines. However, some reasons may include insufficiency of the hand washing equipment, work overload or general lack of knowledge. The moment the leasers know and understand the particular reasons, they will then have the chance to correct primary issues (Fox et al.., 2015). Additionally the doctors and the entire management can approach the issue of washing hands in their facilities is by following regulations and rules themselves.

Getting the staff and the nurses involved to find a solution has in the past yielded positive results by significantly reducing HIA and improving compliance. Putting in mind that the nurses are the staff who mostly get involved with the patients, they, therefore, have ideas and chance to find ways to control the issue. Allowing the nurses to make and form visual aid may allocate a more efficient reminder since they will feel they were involved in the problem analysis and implementation (Mathur, 2011).

Getting the patients involved is also another way of ensuring that HAI is addressed through hand hygiene. One way to address this is by educating the patients on ways to promote good hand hygiene and also letting them know they have a right to ask the healthcare provider if they have washed their hands before attending to them (Huis et al. 2013).This will alert the healthcare professionals always to wash their hands. Insisting on the compliance of washing hands is important and should be a must at all times.

Etiology of low hand hygiene in hospitals

Hand hygiene compliance rates have reduced due to some reasons, and as a result of hand hygiene being strikingly very low, there has been so many readmissions and too much uncoordinated care for patients. Some of the etiological causes of hand hygiene non-compliance are: the presence of broken sinks or dispensers in the hospitals thus the nurses and doctors avoid using them. Similarly, empty dispensers discourage the nurses from bothering to use whichever dispenser they come across in the hospital. There are also inconveniently positioned hand hygiene dispensers and sinks. Bearing in mind that they should be strategically positioned for any nurse going to attend to a patient and that would reduce readmission rates. Incorrect hygiene products in the dispenser is also a factor. Sometimes the nurses and doctors are too busy or get distracted, and they forget to clean their hands. Sometimes as they pass the sinks their hands are full thus not able to clean them (Chassin, Mayer & Nether, 2015). However, ignorance of nurses is also a cause of low hand hygiene that may be due to ineffective education and some assume that putting on gloves negate the need for hand hygiene.

References

CDC Foundation. (2017). Hand Washing: A Simple Step To Prevent Hospital Infections.

Chassin, M. R., Mayer, C., & Nether, K. (2015). Improving hand hygiene at eight hospitals in the United States by targeting specific causes of noncompliance. The Joint Commission Journal on Quality and Patient Safety, 41(1), 4-12.

Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Jones, L., Bennett, Y. P., & . .. Bader, M. K. (2015). Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses’ hand washing. American Journal Of Critical Care , 24 (3), 216-224.

Huis, A; et al. (2013). Impact of a team and leaders-directed strategy to improve nurses’ adherence to hand hygiene guidelines: A cluster randomised trial. International Journal of Nursing Studies . Philadelphia, Pennsylvania, 50, 4, 464-474.

Landers, T., Abusalem, S., Coty, M., & Bingham, J. (2012). Patient-centered hand hygiene: The next step in infection prevention. American Journal Of Infection Control , 40 (s1), S11-7.

Mathur, P. (2011). Hand hygiene: back to the basics of infection control. The Indian Journal Of Medical Research , 134 (5), 611-620.

Running head: DISCUSSION 2 1

DISCUSSION 2 2

Discussion 2

Student’s Name

Institutional Affiliation

Discussion 2

PICOT: Infection Control: Hand Hygiene

(P): Population: hospitalized patients, visitors, healthcare workers

(I): Intervention: Hand hygiene interventions. This will include education as well as training for the existing patients, visitors coupled with the underlying healthcare employees, reminders, audits, team association, and decisive intervention. Also it will include convenient and strategic location of sinks and dispensers which are in good condition and working properly. All dispensers should be filled to encourage the nurses, patients and other professionals to wash their hands always after an activity.

(C): Comparison intervention: no hand washing; supplementary solution; masks

(O): Outcomes: decreased infection

Implementation plan

Methods for Approval

The first fundamental step in executing pan would be reviewing the problem with the existing infection control (IC) supervisor. Moreover, this will enable presenting the plan to the primary contributors that ought to give authorization as well as funding for several HH intervention program (Srigley et al., 2015). After IC is involved, and a presentation to the underlying stakeholders of the organization incorporating a PowerPoint coupled with handouts for the intervention is finished, the information and evidence will be first be presented to the corporate, managers and supervisors such as Chief nursing officer, director of nursing, directors coupled with charge nurses in meeting (Ellingson et al., 2014).

After funding and approval are given, a presentation of the program to the underlying staff is undertaken in a bid to obtain their respective approval and views, which is fundamental to success. Srigley et al., (2015) proved that staff involvement results typically to escalated compliance of HH as communication with staff were massively enhanced, barriers were tackled, and there was an escalation regarding social influence among the existing peers (Ellingson et al., 2014). Moreover, the information would be presented to staff within meeting in the form a PowerPoint as well as handouts in a bid to illustrate program ideas but also permitting them to give feedback to squeeze the program to be efficient.

Description of Problem

Roughly 1.4 million individuals are anguished by an HAI at any specific duration worldwide. Approximately 40% of the infections are deemed to be preventable thus a more efficient way of preventing HAIs is appropriate had washed. Often patients are infected with bacteria from their normal flora as HCW, visitors, as well as patients touching the surfaces and items around them devoid of without performing HH (Srigley et al., 2015).

Present policy and procedure entail the method of hand washing with alcohol disinfectant technique (Ellingson et al., 2014). Nevertheless, the current strategy does not incorporate patients and visitor training of HH.

References

Ellingson, K., Haas, J. P., Aiello, A. E., Kusek, L., Maragakis, L. L., Olmsted, R. N., … & VanAmringe, M. (2014). Strategies to prevent healthcare-associated infections through hand hygiene. Infection Control & Hospital Epidemiology, 35(8), 937-960.

Srigley, J. A., Corace, K., Hargadon, D. P., Yu, D., MacDonald, T., Fabrigar, L., & Garber, G. (2015). Applying psychological frameworks of behaviour change to improve healthcare worker hand hygiene: a systematic review. Journal of Hospital Infection, 91(3), 202-210.

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