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Hospital-Acquired Infections: Project Change

Cases of hospital-acquired infections (HAIs) in the clinical environment are an acute public health problem because they not only complicate the treatment process but also create a negative reputation for medical institutions. To minimize this threat, a special plan needs to be thought out based on the available information regarding this issue. As a basic methodology for intervention, Nightingale’s environmental theory will be utilized. Despite potential barriers and challenges, active work to maintain a high level of hygiene and, in particular, antiseptic protocols can reduce the likelihood of HAIs in the clinical environment and educate healthcare personnel.

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Nursing Theory Utilized

As a nursing theory used for the intervention in question, Nightingale’s concept will be applied. According to Mitchell, Boisvert, Wilson, and Hogan (2017), the author of this model considers a clean environment one of the main components of an effective care process. The relevance of this theory in the context of the proposed intervention plan lies in similar principles of influence, in particular, hand hygiene procedures.

As Mitchell et al. (2017) note, during her work on the development of this theory, Nightingale managed to minimize mortality rates from non-compliance with basic sanitary standards among her patients “from 42% to 2%” (p. 1985). This indicator is significant to put this model into practice. The provisions of the theory imply promoting favorable conditions for recovery, in particular, the cleanliness of the room, and this principle corresponds with the declared intervention plan.

Implementation Plan and Outcome Measures

To implement the plan under consideration, a specific clinical environment will be applied, in particular, the intensive care unit. As a basic tool, a hand hygiene protocol will be applied, which, as Reilly et al. (2016) state, is a universal algorithm used in many developed countries. In addition, this is the main nurses’ obligation provided in Nightingale’s theory. The plan itself will include the following steps:

  • Educational work with the staff of the ICU on the importance of compliance with sanitary standards when interacting with patients.
  • The familiarization of employees with a special hand hygiene protocol.
  • The appointment of those responsible for monitoring staff compliance with protocol rules.
  • Three-month medical practice based on following the established sanitary standards.
  • The comparison of the results before and after the intervention.

When analyzing outcome measures, cases of HAIs will be considered as key factors. If this indicator decreases, an appropriate assessment will be given to this program. The results of the intervention can be disseminated to the medical community, and other medical institutions may be offered to implement the hand hygiene protocol project as part of a three-month change plan. These measures will make it possible to expand such an effective practice and improve patient outcomes.

Potential Barriers and Their Overcoming

Although the use of the hand hygiene protocol is an unambiguous strategy, some barriers may arise during the implementation phase of the plan. Mitchell et al. (2017) cite a WHO report and note that skin problems can be a factor that impedes the normal realization of the plan conditions. To solve this issue, wearing gloves and adhering to protective measures against chemical components are important tasks. Another potential difficulty is the lack of nurses’ awareness of the importance of working in this direction (Mitchell et al., 2017). This gap may be corrected by comparing the current results of the intervention with previous ones, which can encourage personnel to follow the protocol more effectively.


The plan to prevent HAIs in the clinical setting and, particularly, in ICUs, can be accomplished by using a special hand hygiene protocol that is a valuable mechanism to minimize this problem and educate staff. Nightingale’s nursing theory is a successful model for the implementation of this project. After all stages of the plan have been performed, the outcomes should be summed up to compare the results before and after this practice. As barriers, nurses’ skin problems and the lack of employee awareness of this work importance can be noted.

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Mitchell, A., Boisvert, E., Wilson, T., & Hogan, S. (2017). Hand hygiene: A quality improvement project. Biomedical Journal of Scientific & Technical Research, 1(7), 1985-1988.

Reilly, J., Price, L., Lang, S., Robertson, C., Cheater, F., Skinner, K., & Chow, A. (2016). A pragmatic randomized controlled trial of 6-step vs 3-step hand hygiene technique in acute hospital care in the United Kingdom. Infection Control & Hospital Epidemiology., 37(6), 661–666.

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