The nursing theory that can be utilized as the basis of this intervention is Orlando’s Deliberative Nursing Process. According to this philosophy, introduced in the 1970s, the nurse-patient relationship lies at the center of all activities that a nurse performs (Smith & Parker, 2015). The nursing process is directed by patients’ needs, and it reflects the dynamic patient behavior. It is a duty of professional nurses to assist patients in identifying the reasons for their health-related distress and responding to their issues with deliberative action. The theory is focused on immediate problems and on the ways in which nurses perceive and interpret people’s individual cases.
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The concentration on patient assessment and timely response makes this theory a suitable framework for preventive initiatives. During their work, nurses need to be aware of their influence on patients and their ability to construct action plans for each particular situation (Smith & Parker, 2015). In the case of sepsis prevention, all hospitalized patients are at risk of contracting an infection through the engagement with medical services (Forde & Scullin, 2017).
Therefore, nurses have to evaluate their practices and their interaction with patients to prevent problems before their progress. Orlando’s theory encourages nurses to constantly explore their interaction with patients, which can help them stay mindful of the risks related to medical care.
The project for sepsis prevention is based on the Plan-Do-Study-Act (PDSA) cycle. The first cycle of action will determine the effectiveness of initially proposed steps, and each subsequent cycle will modify the activities and broaden the scope of involved participants (Forde & Scullin, 2017). The first part of the project involved nurses as primary stakeholders. Proper hand hygiene, including hand antisepsis and sterile gloves, should be introduced to departments as a primary measure of preventing sepsis (Kilpatrick, Saito, Allegranzi, & Pittet, 2018).
According to the World Health Organization (WHO), the focus on hand hygiene is vital since the issue of antimicrobial resistance continues to become more severe globally (Kilpatrick et al., 2018). The chosen location for the project’s implementation will establish new guidelines about hygiene, including the use of hand antiseptic before and after nurse-patient interactions and the use of sterile gloves when appropriate.
The second part of the intervention deals with the use of preventive antibiotics. In the case of neonatal patients and their parents, for example, intrapartum antimicrobial prophylaxis is advised- a dose of penicillin or ampicillin will be administered 4 hours before parturition (Shane, Sánchez, & Stoll, 2017). This measure has an effect on early-onset sepsis in newborns (Shane et al., 2017). Antibiotics can also be used for sepsis prevention in patients recovering from or at risk of infection. Here, the decision to administer drugs should rely on individual cases.
This project will monitor and record two types of measures – process and outcome. Process-related results include the adherence of stakeholders to the outlined steps. The first measure is the volume of antiseptic used by nurses for the monitored area. Second, the volume of hand hygiene soap used before and after patient interaction will be documented. Patients will be involved in the data gathering process as well – they can be asked whether nurses washed their hands before and after visits.
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The combination of these numbers should reveal any changes in hygiene-related procedures performed in the department under investigation. If the volume and patients’ answers indicate the increase and consistency in the use of hand hygiene tools, the researcher may conclude that the intervention’s guidelines were followed.
The number of administered antibiotics can be measured separately for appropriate groups of patients. In regards to outcome measures, the central indicator is the incidence of sepsis occurrence in patients in the selected department. Incidence percentages are calculated by dividing the number of new cases by the total number of the chosen population (Johnson, Akinboyo, Curless, Milstone, & Coffin, 2019). If the incidence of patient cases decreases after the intervention’s implementation, one may conclude that hand hygiene and antibiotic preventive treatments are effective.
In some settings, the proposed intervention may encounter a number of obstacles. For example, the existing infrastructure of the organization can limit nurses’ ability to participate in the project. The lack of available financial resources or tools makes the suggestions challenging to follow. In clinics that do not have sinks and soap dispensers in the patient’s view, patients’ participation in the data gathering process is impossible.
Moreover, the low level of adherence to the initiative’s steps is another issue. If the staff-to-patient ratio is low, for instance, nurses may overlook the instructions due to time constraints, stress, and overburden (Johnson et al., 2019). Similarly, shortages in supplies, lack of education, poor organizational culture, and other factors can lower nurses’ desire to participate.
To overcome these barriers, organizations need to evaluate and recognize possible issues. Concerns related to nurses’ low adherence when tools are available should be resolved with training and awareness programs. The WHO’s campaign “It’s in your hands – prevent sepsis in health care” is an example of an educational project that teaches people about the importance of hand hygiene (Kilpatrick et al., 2018, p. 106).
Patient advocacy groups, infection and prevention control leaders, and other influential persons can also distribute knowledge about hygiene. Staff-to-patient ratios, insufficient tools, and other financial issues can be overcome with funding and redistribution of resources.
Forde, C., & Scullin, P. (2017). Chasing the Golden Hour–Lessons learned from improving initial neutropenic sepsis management. BMJ Open Quality, 6(1), u204420.w6531.
Johnson, J., Akinboyo, I. C., Curless, M. S., Milstone, A. M., & Coffin, S. E. (2019). Saving neonatal lives by improving infection prevention in low-resource units: Tools are needed. Journal of Global Health, 9(1), 010319.
Kilpatrick, C., Saito, H., Allegranzi, B., & Pittet, D. (2018). Preventing sepsis in health care – It’s in your hands: A World Health Organization call to action. Journal of Infection Prevention, 19(3), 104-106.
Shane, A. L., Sánchez, P. J., & Stoll, B. J. (2017). Neonatal sepsis. The Lancet, 390(10104), 1770-1780.
Smith, M., & Parker, M. E. (2015). Nursing theories and nursing practice (4th ed.). Philadelphia, PA: F.A. Davis Company.