Discovery: Topic and Practice Issue
The topic and the nursing practice issue related to this topic
The identified topic is hand hygiene issues among practicing nurses at hospitals. Because hand hygiene is critical for preventing spreading infections within care environments, failure to comply may lead to adverse patient outcomes. Therefore, the absence of systematic measures of ensuring hand hygiene is a nursing practice problem that needs attention from the management, clinicians, and researchers.
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The rationale for the topic selection. The scope of the issue/problem
Hand hygiene is taught not only to medical students but also to young children and school students. It is a part of primary education, and it is shameful that even healthcare institutions, places that should feature cleanness and infection-free environment have challenges related to hand hygiene. Nonetheless, because the problem exists, it needs to be solved. This concern is present in most hospitals around the United States; therefore, the scope of the issues is broad.
Summary: Evidence to Support Need for a Change
The practice problem and the PICOT question
Hand hygiene issues arise when hospital workers, including nurse practitioners, fail to adequately wash and disinfect their hands before interacting with objects the patients will be exposed to. For instance, a nurse may touch the patient’s water cup without washing the hands after checking with another patient with a skin disease. In this circumstance, the infection may spread to other patients even if they do not directly interact with the person that has a skin disease.
The PICOT question is, “In practicing nurses in the United States, how do routine and documented monitoring and appropriately placing hand hygiene products affect compliance with hand hygiene standards?”
The main findings from the systematic review and the strength of the evidence
Despite research and intervention attempts from many researchers and practitioners, non-compliance to hand hygiene continues to be a challenge for healthcare providers (Smiddy, O’Connell, & Creedon, 2015). Current research indicates that a lack of knowledge and motivation, workplace burnout, and absence of organizational culture are significant factors of non-compliance (Manomenidis, Panagopoulou, & Montgomery, 2019).
Evidence-based solutions for the trial project
- Routine and documented monitoring of compliance to hand hygiene.
- Appropriately placing hand hygiene products.
Translation: Action Plan
Care standards, practice guidelines, or protocols to support the intervention planning
Carefully selecting hand hygiene products is critical to ensure that they are compliant, effective, and safe for patients and nurses.
Motivational factors are also critical; the management should ensure that nurses are provided adequate working conditions (Jeong & Kim, 2016).
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Workplace burnout decreases motivation; the management should be aware of the adverse effects of forcing nurses to overwork (Manomenidis, Panagopoulou, & Montgomery, 2019).
Stakeholders, their roles and responsibilities in the change process
Hospital President – should establish an overall strategy of how the training is provided to the staff. The president is responsible for gathering the related department heads and informing them about the importance of hand hygiene in the hospital.
Supply Manager – is responsible for the provision of hand hygiene products. The manager should compare and contrast the various types of products and propose the most suitable ones.
Nurse (Me) – should engage in training and stay compliant with the hand hygiene requirements. If the nurses detect non-compliance on behalf of their co-workers, they should inform them about the importance of hand hygiene in hospital settings.
The nursing role in the change process
Engage in staff and patient education.
Stakeholders by position titles important to the project
Human Resources Manager – is responsible for developing and distributing training materials necessary for staff education on hand hygiene.
Director of Nursing – should organize monitoring activities. Also, the director is responsible for assessing the nurses for any signs of workplace burnout.
The type of cost analysis that will be needed prior to a trial
The cost of staff training and the overall cost of hand hygiene products should be analyzed. The HR manager and supply manager are responsible for this task.
The process for gaining permission to plan and begin a trial
The change process should be cleared by the administration of the hospital.
The plan for educating the staff about the change process trial
Daily meetings can be used to inform staff. Also, informational stands are also one of the options for delivering education to employees.
The implementation timeline for the change process
- February 2020 – start.
- April 2020 – evaluation of preliminary results.
- May 2020 – end and final evaluation.
The measurable outcomes based on the PICOT
Data from monitoring activities will be used to make a conclusion. The final results will be compared with the data from the initial test. The percentage of employees that comply with hand hygiene will be evaluated.
The forms that might be used for recording purposes during the pilot change process
No specific forms.
The resources available to staff during the change pilot
Informational booklets and access to other online training resources.
The meetings of certain stakeholders throughout the trial
Every month, the Hospital President, Director of Nursing, Supply Manager, and HR Manager will meet to discuss the progress.
Reporting the outcomes of the trial
Results will be summarized in an academic article.
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The next steps for the use of the change process information
Comparing the efficacy to other documented methods and making alterations to fill any gaps.
Jeong, S. Y., & Kim, K. M. (2016). Influencing factors on hand hygiene behavior of nursing students based on theory of planned behavior: A descriptive survey study. Nurse Education Today, 36, 159-164.
Manomenidis, G., Panagopoulou, E., & Montgomery, A. (2019). Job burnout reduces hand hygiene compliance among nursing staff. Journal of Patient Safety, 15(4), e70-e73.
Smiddy, M. P., O’Connell, R., & Creedon, S. A. (2015). Systematic qualitative literature review of health care workers’ compliance with hand hygiene guidelines. American Journal of Infection Control, 43(3), 269-274.