Week 4: Nursing Theories and Middle-Range Theories
Considering the nursing theory you discussed last week (
Legacy of Florence Nightingale environment theory
)(or a new one if you desire) describe how you would apply that nursing theory as a basis for nursing actions related to your practice change idea (that you developed in a problem statement and PICOT in weeks 1 and 2. SEE THE ATTACHED PROBLEM STATEMENT.
Specifically relate theoretical concepts to the elements of your problem statement — how does the theory guide your ideas about the problem, etiology, population, intervention and outcomes?
An example would be to explain how Roy’s adaptation model describes the victim of lateral violence in the work place. How does the model recommend assessing a victim’s adaptation range and what modes of assessment (physiologic, self concept, role and interdependence) would the nurse use to determine how positive coping can take place?
1 PAGE, 2 REFERENCES, APA
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.
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.