Capstone Project Change Proposal Essay Discussion Paper
Create a professional presentation of your evidence-based intervention and change proposal to be disseminated to an interprofessional audience of leaders and stakeholders. Include the intervention, evidence-based literature, objectives, resources needed, anticipated measurable outcomes, and how the intervention would be evaluated. Submit the presentation in LoudCloud for feedback from the instructor. Julie Marshall has created a new thread in the Questions to Instructor Forum for NRS-493-O501 that started on Sep 20, 2021. PICOT question: Will adherence to handwashing guidelines by healthcare staff over a 60-day period reduce the risk of nosocomial infection in patients during hospital length of stay compared to the improper hand hygiene? Hello! Heres some tips for success for your ppt presentation: -you may submit as voiceover ppt (loom), video of yourself presenting the ppt, or ppt with your notes typed below the slides -present to your preceptor at a minimum, prefer to your preceptor and an audience -keep slides simple, a good rule is: 6 bulletpoints max per slide, 6 words max per bulletpoint. -include a cost/benefit analysis slide (see below); how much is your PICOT implementation going to cost and also how much money will it save in the long run, or maybe it doesn’t save money, but it increases quality outcomes Capstone Project Change Proposal Essay Discussion Paper.
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-I recommend a “questions” slide at the end to offer your audience an opportunity to ask questions -for week 10, you then can submit a short paper on how your presentation and feedback went overall-see the rubric. When you complete your week 9 PPT presentation a Cost/Benefit slide is REQUIRED. This is not in the rubric, but we as nurse leaders know that health care is expensive, top nursing talent is expensive, and patients and taxpayers have limited funds. We as change agents need to consider how much change costs and be prudent and good stewards of finances. Suppose one of you wants to build a tower. Won’t you first sit down and estimate the cost to see if you have enough money to complete it? Luke 14:28 Please consider how much your project costs. How much time (salary) will cost to pull data, educate staff, complete audits, ongoing sustainability and change management. Other considerations: if you are increasing staffing (turn team, safe staffing ratios) how much will this cost? An estimate is acceptable. But change can also save money! Example: If you are increasing your staffing, yes this is a huge cost, but the benefit of less patient harm will save money. Example: increasing staffing costs versus how much will be saved with less error, increase in patient satisfaction, increase in retention, and less hospital acquired events (Pressure injury, fall w/injury, CLABSI, CAUTI…etc). An estimate is acceptable if you dont have exact numbers, but most of this information I have listed is available through literature Capstone Project Change Proposal Essay Discussion Paper.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. Literature Evaluation Table Student Name: Sharron Lewis-Garrett Change Topic (2-3 sentences): Health care workers hands are the primary way infection is transmitted from patient-patient. This emphasizes the need to educate healthcare workers on hand hygiene compliance and the effects of improper hand hygiene to reduce hospital acquired infections of patients in hospital settings. Bio vigil electronic hand hygiene solution: A reminder an awareness system, when used effectively, leads to higher patient satisfaction. A badge clipped to the uniform or lab coat worn by hospital staff members. It has a green light indicating hands have washed or sanitized. When admitted every patient is educated about the Bio vigil badge drawing their attention in their hospitalization duration. http://www.biovigil.com Patient handheld posters to remind healthcare workers of the 5 moments of hand hygiene guidelines by World Health Organization, clean your hand screen savers, how to properly use alcohol based hand rubs and handwashing technique, stating the importance in meetings and huddles. Incentives: interdepartmental competitions to engage workers and motivate them to be accountable for hand hygiene compliance. Winning gifts such as 5 moments of hand hygiene t-shirts and/or insulated cups, gift cards, or lunch which will result in the safe healthcare of the patient. Inaccurate Hand Hygiene Causes Nosocomial Infections The cost of ineffective hand hygiene can be staggering. Improper hand hygiene disrupts health promotion and disease prevention, increases healthcare-associated infections (HAI’s), and contribute to unhealthy microorganisms results in greater spread of harmful, viral disease. (CDC, 2020) Capstone Project Change Proposal Essay Discussion Paper.
Healthcare-associated infections are preventable infections that patients can get in a healthcare facility while receiving medical care for another condition such as bloodstream infections, pneumonia, surgical site infections, and urinary tract infections. This problem causes extended hospitalization days, prolonged medical equipment usage, and weakened immune systems makes the patients more vulnerable to infection. Therefore, nurses’ providers, and staff have a duty to utilize hand hygiene guidelines constantly to prevent healthcare-associated infections. “Healthcare providers are susceptible to infection while they are caring for patients. It is a necessary to prevent the spread of germs in hospitals and rehab nursing homes” (CDC, 2020). HAI’s can be from a patient’s flora or from outside the patient’s flora, or surgical site infections, but often from the hands of healthcare workers. Healthcare-associated infections places a serious disease burden on millions of people worldwide that cause increased health care costs and many deaths. These infections primarily exist because healthcare workers simply do not follow basic infection control guidelines such as hand hygiene compliance. For this reason, there is a need for a more integrated approach to the reduction of HAI’s. Good hand hygiene is a simple task of cleaning hands at the right times and in the right way, can save lives. The PICOT question, (P) will healthcare workers’ (I) adherence to handwashing compliance guidelines (C) compared to improper hand hygiene (O) reduce the risk of nosocomial infection in patients (T) during hospitalization? The goal is to encourage healthcare workers to clean their hands, save lives, and avoid fines. This research paper will propose a solution to boost hand hygiene compliance rates in healthcare workers to reduce and prevent HAIs in patients during hospital duration with direct observation, education, and role modeling. Criteria Article 1 Article 2 Article 3 Article 4 Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article Center for Disease Control and Prevention Capstone Project Change Proposal Essay Discussion Paper
https://www.cdc.gov/patientsafety/features/clean-hands-count.html#:~:text=CDC%E2%80%99s%20Clean%20Hands%20Count%20campaign%20aims%20to%20improve,or%20reminding%20healthcare%20providers%20to%20clean%20their%20hands Geberemariyam, B.S., Donka, G.M. & Wordofa, B. https://doi-org.lopes.idm.oclc.org/10.1186/s13690-018-0314-0 Hor, S., Hooker, C., Iedema, R., et al https://qualitysafety.bmj.com/content/26/7/552 Santosaningsih, D., Erikawati, D., Santoso, S. et al. https://doi.org/10.1186/s13756-017-0179-y Article Title and Year Published Patient safety: clean hands count for safe healthcare Assessment of knowledge and practices of healthcare workers towards infection prevention and associated factors in healthcare facilities of West Arsi District, Southeast Ethiopia: a facility-based cross-sectional study. Year published 2018 Beyond hand hygiene: A qualitative study of the everyday work of preventing cross-contamination on hospital wards. Year published 2017 Intervening with healthcare workers’ hand hygiene compliance, knowledge, and perception in a limited-resource hospital in Indonesia: a randomized controlled trial study Year published 2017 Research Questions (Qualitative)/Hypothesis (Quantitative) Will adherence to handwashing guidelines by healthcare staff over a 60-day period reduce the risk of nosocomial infection in patients during hospital length of stay compared to the improper hand hygiene? Will adherence to handwashing guidelines by healthcare staff over a 60-day period reduce the risk of nosocomial infection in patients during hospital length of stay compared to the improper hand hygiene? Capstone Project Change Proposal Essay Discussion Paper
Will adherence to handwashing guidelines by healthcare staff over a 60-day period reduce the risk of nosocomial infection in patients during hospital length of stay compared to the improper hand hygiene? Will adherence to handwashing guidelines by healthcare staff over a 60-day period reduce the risk of nosocomial infection in patients during hospital length of stay compared to the improper hand hygiene? Purposes/Aim of Study CDC’s Clean Hands Count campaign aims to improve healthcare provider adherence to hand hygiene recommendations, address myths and misperceptions about hand hygiene, and empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands. The aim of this study was to assess the knowledge and practices of healthcare workers with respect to infection prevention and associated factors in healthcare facilities The importance of considering the primary vector of pathogen transmission are the most adverse events for inpatients worldwide. This study aimed to evaluate the effect of three different educational programs on improving hand hygiene compliance, knowledge, and perception among healthcare workers in a tertiary care hospital in Indonesia. Design (Type of Quantitative, or Type of Qualitative) A type of Qualitative Study Quantitative Facility-Based Cross-Sectional Design Qualitative Study interventionist video-Reflexive ethnography study Quantitative Pilot Cluster Randomized Controlled Trial Setting/Sample Healthcare Providers and Patients Multi-stage sampling was employed to select 680 healthcare workers from 30 randomly selected healthcare facilities Population: Healthcare workers Three wards in two hospitals in New South Wales, Australia. 46 semi structured interviews, 24 weeks of fieldwork (observation and videoing) and 22 reflexive sessions with a total of 177 participants (medical, nursing, allied health, clerical and cleaning staff, and medical and nursing students) The study was performed from May to October 2014 and divided into a pre-intervention- 196 participants, intervention, and post-intervention phase- 88 participants. Hand hygiene compliance was observed during 2,766 hand hygiene opportunities, and knowledge-perception Methods: Intervention/Instruments Everyone should know the truth about hand hygiene and alcohol-based hand sanitizer: Alcohol-based hand sanitizer kills most of the bad germs that make you sick and is the preferred way to clean your hands in healthcare settings. Alcohol-based hand sanitizer does not kill C. difficile, a common healthcare-associated infection that causes severe diarrhea Capstone Project Change Proposal Essay Discussion Paper.
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Patients with C. difficile should wash their hands with soap and water and make sure their healthcare providers always wear gloves when caring for them Data was collected using a self-administered structured questionnaire. Descriptive statistics were computed on the healthcare workers at the selected facilities. Interventionist video-Reflexive ethnography study A modified grounded theory approach, to account for the range of infection prevention control (IPC) practices identified by participants. Three interventions to the departments, including role model training-pediatrics, active presentation-surgery, a combination of role model training and active presentation-internal medicine, and a control group-obstetrics-gynecology. Both direct observation and knowledge-perception survey of hand hygiene were performed using WHO tools Analysis Germs that cause serious infections are in healthcare facilities Inadequate infection prevention knowledge and unsafe hand hygiene practices were frequent among study participants There is inadequate understanding during routine clinical practice in identification of transmission risks, and comprehension of the design and promotion of a wider range of preventive strategies and solutions. Based on healthcare profession, hand hygiene adherence improved among doctors and nurses in general, although it was not significant in the surgery department. Key Findings Hand hygiene should be a topic of conversation between healthcare providers and patients. Healthcare providers can explain how and why they clean their hands before, after, and sometimes during patient care, and let patients know it’s ok to ask about hand hygiene. This study helps healthcare workers to improve the quality of healthcare delivery services and infection prevention activities. There is a need for new approach with healthcare workers when performing aseptic procedures in the examination of patients to reduce Healthcare Associated Infections. Hand hygiene improved after intervention. In the departments with an intervention of role model training ( pediatrics and internal medicine), the hand hygiene compliance improved, but only pediatrics department with the sole intervention of role model training was significantly better than the control group. Recommendations Healthcare providers should clean their hands before and after every patient contact to protect themselves as well as their patients from infections Healthcare providers might need to clean their hands as many as 100 times per 12-hour shift, depending on the number of patients and intensity of care Preventing and reducing the risk of HAIs and using infection prevention principles are in the control of healthcare workers; therefore, healthcare workers must have corrected, up-to-date and appropriate scientific information and practice accordingly Nurses are advocates in the prevention of disease transmission in patient care during hospital stay. After intervention, wearing gloves without indication decreased but shifted to hand rubbing while using gloves during patient care. Healthcare workers (HCW) did not change gloves between patients or between contacts of different sites on the same patient Capstone Project Change Proposal Essay Discussion Paper.
Explanation of How the Article Supports EBP/Capstone Project This article supports the need for the most current hand hygiene practices and infection prevention methods to improve quality health care to patients. This article supports the need for the most current hand hygiene practices and infection prevention methods to improve quality health care to patients. This article supports the need for daily interventions to prevent hospital acquired infections in the hospital. This article supports the need for hand hygiene compliance which can reduce rates of health care‐associated infection. Methods such as observed hand hygiene compliance and visual cues such as posters and signs, education, and hand hygiene at every bedside, and feedback indicates the most effective way to promote hand hygiene compliance and reduce HAIs Criteria Article 5 Article 6 Article 7 Article 8 Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article Pham, T. M., Kretzschmar, M., Bertrand, X., Bootsma, M. https://pubmed.ncbi.nlm.nih.gov/31461450/ DOI: 10.1371/journal.pcbi.1006697. Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., Taljaard, M. https://doi.org//10.1002/14651858.CD005186.pub4 Woodard, J., Leekha, S., Jackson, S & Thom, K. https://doi.org/10.1016/j.ajic.2018.10.026 Ignatavicius, D., Workman, M. & Rebar, C. ISBN 9780323444194 Elsevier/Elsevier.com Article Title and Year Published Tracking Pseudomonas aeruginosa transmissions due to environmental contamination after discharge in ICUs using mathematical models. Year published 2019. Interventions to improve hand hygiene compliance in patient care. Year published 2017 Beyond entry and exit: Hand hygiene at the bedside. Year published 2018 Care of patients with infection. Year published 2018 Research Questions (Qualitative)/Hypothesis (Quantitative) Will adherence to handwashing guidelines by healthcare staff over a 60-day period reduce the risk of nosocomial infection in patients during hospital length of stay compared to the improper hand hygiene? Will adherence to handwashing guidelines by healthcare staff over a 60-day period reduce the risk of nosocomial infection in patients during hospital length of stay compared to the improper hand hygiene? Will adherence to handwashing guidelines by healthcare staff over a 60-day period reduce the risk of nosocomial infection in patients during hospital length of stay compared to the improper hand hygiene? Will adherence to handwashing guidelines by healthcare staff over a 60-day period reduce the risk of nosocomial infection in patients during hospital length of stay compared to the improper hand hygiene? Purposes/Aim of Study The aim is inform healthcare workers and patient that bacterial loads shed during a patient’s hospital stay (which may then be transmitted via HCWs to other patients) is assigned to cross-transmission as in practice To assess the short‐ and long‐term success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of health care‐associated infection Capstone Project Change Proposal Essay Discussion Paper.
The aim is to assess compliance, knowledge, and attitudes regarding the World Health Organization (WHO) 5 moments for hand hygiene (HH). The purpose of this study is to educate healthcare workers on the importance of performing proper hand hygiene practices to reduce healthcare associated infection. Design (Type of Quantitative, or Type of Qualitative) Quantitative Systematic Review/Quantitative 14 Randomized trials (RCTs), 2 non‐randomized trials, controlled before‐after studies (CBAs) and 10 interrupted time series (ITS) studies meeting the most recent explicit entry and quality criteria used by the Cochrane Effective Practice and Organization of Care (EPOC) Group (EPOC 2013b) Qualitative Study Three hundred two HH opportunities were observed in 104 unique HCP-patient interactions. A type of Qualitative Study Setting/Sample In total, 13,065 patients (6,061 admitted to ICU A and 7,004 to ICU B) and 37,738 screening results (14,631 in ICU A and 23,107 in ICU B) were included in the analysis Population was Healthcare Workers: Cluster Randomized Controlled Trials 4 Random Controlled Trials, 1 interrupted time studies: Hand hygiene compliance: 24 long-term care facilities, 10 hospitals, 11 ICU’s and 11 primary healthcare units. Infections Rates We assessed hand hygiene (HH) compliance from July-August 2016, using a modified WHO HH observation form. This study was performed at the University of Maryland Medical Center, a 750-bed tertiary care hospital in Baltimore, Maryland. Health care workers in the care of patients Methods: Intervention/Instruments A mathematical transmission model that differentiates between three modes of transmission based only on longitudinal routine surveillance data. Data from two ICUs of the University hospital in Besancon to estimate the parameters that characterize the transmission routes Six studies assessed different types of performance feedback, two studies evaluated education, three studies evaluated cues such as signs or scent, and one study assessed placement of alcohol-based hand rubs, and multimodal interventions with some but not all strategies recommended by WHO compared to no hygiene promotion Capstone Project Change Proposal Essay Discussion Paper.
A 26-question survey was used to assess health care personnel (Healthcare personnel (HCP) knowledge, opinions, and barriers to hand hygiene (HH). A subgroup of HCPs participated in a 2-round focused survey (multiple choice survey) to assign priority to the moments. Infection Control Prevention in health care worker Analysis Every admission was treated separately (as a new patient) resulting in 14,403 admissions (6,659 admitted to ICU A and 7,744 to ICU B). For each patient: day of admission day of discharge screening days and results. Traditionally hand hygiene has been considered the single most important way of reducing health care‐associated infections, many of which are spread by direct contact, especially by the hands of healthcare workers Opportunities for hand hygiene are frequent at the bedside. Compliance with WHO 5 moments of hand hygiene in ICUs was poor, 35%. Few healthcare workers recall the WHO 5 moments. Health care workers’ hands are the primary way in which infection is transmitted from patient -patient or staff to patient. Hand hygiene refers to both handwashing and alcohol-based hand rubs (ABHRs). Key Findings Cross-transmission usually caused by temporarily contaminated hands of health-care workers (HCWs) has been identified as a source of transmission. It is furthermore known that moist environments (soil and water) may serve as natural reservoirs of P. aeruginosa and that it can persist for months on dry inanimate surfaces. Key messages A variety of single intervention strategies and combinations of strategies, many based on current recommendations from the World Health Organization (WHO), led to increased hand hygiene compliance in most studies, regardless of setting. This study will inform development and implementation of new educational strategies aimed at improving HH awareness and compliance during patient care at the bedside. Handwashing is still an important part of hand hygiene, but it is recognized that in some health care settings, sinks may not be readily available. Despite years of education, healthcare workers do not wash their hands or perform hand hygiene on a consistent basis. Recommendations while the effect of cleaning improvement after discharge might be limited for the two considered ICUs, general cleaning improvement of the environment might be important to reduce permanent reservoirs for environmental contamination. Increasing the availability of alcohol‐based hand hygiene products, different types of education for staff, reminders (written and verbal), different types of performance feedback, administrative support and staff involvement. HH compliance may also be related to glove use. We observed that gloves were used in place of HH for 26% of opportunities. Further prioritization of moments may guide educational strategies. Soiled, visibly dirty or sticky hands must be washed instead of ABHRs. ABHRs are ineffective against spore-forming organism such as C-Diff, a common cause of healthcare- associated diarrhea Capstone Project Change Proposal Essay Discussion Paper.
National Patient Safety Goals require health care agencies monitor handwashing practices and the use of ABHRs to make sure that health care workers are performing hand hygiene on a regular basis. Explanation of How the Article Supports EBP/Capstone This article supports the statement: cross-transmission usually caused by temporarily contaminated hands of health-care workers (HCWs) has been identified as a source of transmission. Hand hygiene compliance can reduce rates of health care‐associated infection. Methods such as observed hand hygiene compliance and visual cues such as posters and signs, education, and hand hygiene at every bedside, and feedback indicates the most effective way to promote hand hygiene compliance and reduce HAIs. This is supported by our survey results in which HCP perceived HH as not necessary when gloves were continuously worn this study will inform development and implementation of new educational strategies aimed at improving HH awareness and compliance during patient care at the bedside. This article is to influence health care workers that the CDC recommends infection control within a health care facility to reduce the risk for HAIs and thus reduce morbidity and mortality to create a culture of safety for our patients Capstone Project Change Proposal Essay Discussion Paper