Capstone Project Change Proposal Portfolio
The issue of hand hygiene is important in healthcare due to the benefits associated with proper hand hygiene (Chavali, Menon, & Shukla, 2014). Compliance with hand washing measures has been indicated to improve patient safety by preventing the spread of disease-causing agents to other admitted patients. However, non-compliance with hand washing measures has negative effects on healthcare delivery by affecting patients’ safety in diverse aspects (Chavali, Menon, & Shukla, 2014). This may lead to the spread of disease-causing germs to other patients ultimately affecting the healthcare goals of having positive patient outcomes. Based on this information, it is important to determine effective strategies that will enhance compliance with hand washing measures to help improve patient outcomes by decreasing healthcare-associated infections (Chavali, Menon, & Shukla, 2014).
BackgroundHand hygiene has been a crucial aspect in healthcare in an effort to prevent the spread of health-related infections. This is due to the fact that nurses attend to different patients admitted in a healthcare facility which may increase the chances of spreading disease-causing agents among patients (Chavali, Menon, & Shukla, 2014). The main reason why patients are admitted at healthcare facilities is to improve their health status by addressing any illnesses currently affecting them. Acquiring other diseases while admitted in healthcare facilities is a negative effect towards achieving this goal (Chavali, Menon, & Shukla, 2014).
There are many reasons why nurses may fail to comply with hand washing measures such as lack of adequate information on the importance of hand hygiene and lack of the necessary resources required in hand hygiene (Zhao, Yang, Huang, & Chen, 2018). Implementing effective strategies to increase compliance with hand washing measures will be beneficial to patients by preventing the spread of disease-causing germs which may lead to other infections negatively affecting the health status of the patient. Healthcare goals are also affected through poor patient outcomes while the healthcare facility may have a negative reputation within the community (Zhao et al., 2018). Problem StatementNon-compliance with hand washing measures has negatively contributed to poor patient outcomes with an increase in the spread of healthcare-related infections. Hand washing measures have been developed to ensure that patient safety is improved during the time of hospitalization (Zhao et al., 2018). This is aimed to help healthcare practitioners in adopting these measures in their practice since they are solely responsible for taking care of patients during the time of hospitalization (Zhao et al., 2018).
Some of the reasons why healthcare practitioners do not comply with hand washing measures include inadequate hand washing resources and lack of adequate knowledge affecting their awareness on the importance of hand hygiene (Zhao et al., 2018). This makes it important for all healthcare stakeholders to implement effective strategies that will improve compliance with hand washing measures by healthcare practitioners. This will prevent the spread of disease-causing agents that negatively affect patient outcomes (Zhao et al., 2018). Purpose of the Change ProposalThis change proposal will be beneficial to healthcare practitioners in achieving healthcare goals which are to provide quality healthcare services aimed at improving the health status of patients (Sickbert-Bennett et al., 2016). Non-compliance with hand washing measures has resulted in negative effects that have affected the achievement of healthcare goals.
The spread of disease-causing agents has led to increased costs in addressing these illnesses as well as affected the quality of healthcare services provided (Sickbert-Bennett et al., 2016). This change process will identify effective techniques meant to improve compliance with hand washing measures among healthcare workers. This can be through the provision of the necessary resources required in hand hygiene as well as improving the healthcare workers’ perception and knowledge about hand hygiene (Sickbert-Bennett et al., 2016). This will minimize healthcare-associated infections that may be spread during the time of hospitalization ultimately resulting in improved patient safety. PICO(T)Due to the roles played by direct care staff in a hospital setting, it is important to comply with hand washing measures because of the benefits associated with this aspect.
However, non-compliance with hand washing measures will have a negative effect on the achievement of healthcare goals (Lawal et al., 2018). Compliance with hand washing measures will help healthcare practitioners in improving patient safety by decreasing healthcare-associated infections during the time of hospitalization. During this time, nurses who are responsible for providing direct care to patients play a big role in ensuring that patients are safe from any harm which may negatively affect their health (Lawal et al., 2018). Literature Search Strategy EmployedMany research articles have been published to provide more insight on the importance of the change process. This is meant to provide adequate knowledge on some of the major concerns affecting compliance with hand washing measures (Bottomley, Pryjmachuk, & Waugh, 2018). This includes the reasons behind non-compliance with hand washing measures, the role of decision-makers in motivating healthcare workers in complying with hand washing measures, and the importance of complying with hand washing measures (Bottomley, Pryjmachuk, & Waugh, 2018).
Most of the literature about the issue of hand hygiene in patient care can be accessed in the school library where there are peer-reviewed articles. Other articles can also be accessed using the internet on academic sites which are meant to help students with different learning materials (Bottomley, Pryjmachuk, & Waugh, 2018). The school library was the most useful since it contains literature from credible and approved sources which can be used for research purposes (Bottomley, Pryjmachuk, & Waugh, 2018). Some of the challenges encountered in search of credible articles having evidence-based information as some of the articles had inconclusive information related to the topic. Other articles provided data which had to be analyzed to provide a clear meaning which can be understood by all readers (Bottomley, Pryjmachuk, & Waugh, 2018). Evaluation of the LiteratureThe first article by Bittner et al (2017) focused on explaining the importance of educating patients and families as a way of increasing the rate of compliance with hand washing measures.
The second article by Chavai, Menon, and Shukla (2014) examined the use of the multimodal technique as a way of improving hand hygiene compliance among direct care staff. The third article “Knowledge and perception of hand hygiene among health care workers of a tertiary care military hospital: A descriptive study” by Iqbal, Zaman, and Azam (2018) provided information about the knowledge and perception of healthcare workers about hand hygiene. The fourth article by Lawal et al (2018) supports the Capstone project by providing information on the importance of hand hygiene to nurses in providing patient care. The fifth research article “Hand dermatitis: Hand hygiene consequences among healthcare workers” by Longuenesse, Lepelletier, Dessomme, Le Hir, & Bernier (2018) explains how hand dermatitis may affect healthcare practitioners in complying with hand washing measures. The sixth article by Oliveira and Pinto (2018) investigates the perception and attitude of healthcare staff in regards to patient participation in hand hygiene. Zhao, Yang, Huang, and Chen (2018) provide strategies to motivate nurses in complying with hand washing measures. The last research article is “Reduction of healthcare-associated infections by exceeding high compliance with hand hygiene practices” by Sickbert-Bennett et al (2016) which investigates how complying with hand washing measures results in positive health outcomes.Applicable Change or Nursing Theory UtilizedThe nursing theory utilized is the Watson theory of human caring which aims at improving the relationship between nurses and patients which is important in having positive health outcomes (Butts & Rich, 2018).
Compliance with hand washing measures is aimed at benefiting patients as well as healthcare practitioners. Having a good relationship with patients can enable patients to participate in hand hygiene by reminding healthcare practitioners on the importance of observing hand hygiene measures (Butts & Rich, 2018). Complying with hand washing measures is one way of showing care to patients since this safeguards the welfare of patients by ensuring that they are safe from any harm which may negatively affect their health status during the time of hospitalization (Butts & Rich, 2018). Proposed Implementation Plan with Outcome MeasuresAn implementation plan will be helpful in directing healthcare stakeholders who make important decisions in the healthcare sector. The implementation plan will contain the strategies and directions to achieve the desired goal which is having an increased compliance rate with hand washing measures (Iqbal, Zaman, & Azam, 2018).
The first step will involve determining the reasons behind the high rate of non-compliance with hand washing measures. These include the lack of adequate knowledge and inadequate hand washing resources (Iqbal, Zaman, & Azam, 2018). The implementation plan will include strategies on how to address these issues which can involve training healthcare staff on the importance of hand hygiene in improving patient outcomes (Iqbal, Zaman, & Azam, 2018). Other parties can be involved in this change process to help in providing financial resources and other support that will enable healthcare facilities to provide the necessary materials required in ensuring hand hygiene. A program can be developed to include patient participation in the change process (Oliveira & Pinto, 2018). Since patients regularly interact with healthcare practitioners, they can be involved in the change process to remind nurses on the importance of adhering to hand hygiene measures.
This will provide healthcare practitioners with the necessary resources to comply with hand washing measures (Oliveira & Pinto, 2018).Identification of Potential Barriers to Plan Implementation, and a Discussion of How These Could Be OvercomeOne of the barriers to plan implementation is limited financial resources which are important in the training programs to improve nurses’ awareness on the importance of hand hygiene in their profession (Lawal et al., 2018). This can be addressed by looking for private sponsors as well as engaging the government which is the main financier of healthcare services to provide more funding in order to enable organizations to achieve this objective (Lawal et al., 2018). Another barrier to plan implementation is uncooperative staff members which may affect the implementation process. This can be addressed by using a collaborative approach where healthcare practitioners are involved in the decision-making process and in the implementation process (Lawal et al., 2018). The third potential barrier to plan implementation may include administrative challenges where qualified personnel should be engaged to help in successfully implementing the plan (Lawal et al., 2018).
Due to the diverse functions of healthcare administrators, additional functions may affect their performance in other important areas. This barrier can be addressed by delegating these responsibilities to other nurse leaders in other departments to ensure a successful implementation of the plan (Lawal et al., 2018).
Bittner, M. J., Routh, J. M., Folchert, M. D., Woessner, N. E., Kennedy, S. J., & Parks, C. C. (2017).
Hand hygiene among health care workers: Is educating patients and families a feasible way to increase rates? WMJ: Official Publication of the State Medical Society of Wisconsin, 116(2), 79–83.Bottomley, J., Pryjmachuk, S., & Waugh, D. (2018).
Studying for your education degree: Critical study skills. St Albans: Critical Publishing.Butts, J. B., & Rich, K. L. (2018).
Philosophies and theories for advanced nursing practice. Burlington, Massachusetts: Jones & Bartlett Learning.Chavali, S., Menon, V., & Shukla, U. (2014).
Hand hygiene compliance among healthcare workers in an accredited tertiary care hospital. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine, 18(10), 689-693.Iqbal, M., Zaman, M., & Azam, N. (2018).
Knowledge and perception of hand hygiene among health care workers of a tertiary care military hospital: A descriptive study. Pakistan Armed Forces Medical Journal, 68(5), 1372–1377.Lawal, T., Monsudi, K., Zubayr, B., Michael, G., Duru, C., Ibrahim, Z., & Aliyu, I. (2018).
Hand hygiene practices among nurses in a health facility in a semi-urban setting. International Journal of Health & Allied Sciences, 7(3), 191–195.Longuenesse, C., Lepelletier, D., Dessomme, B., Le Hir, F., & Bernier, C. (2017).
Hand dermatitis: Hand hygiene consequences among healthcare workers. Contact Dermatitis, 77(5), 330–331.Oliveira, A. C., & Pinto, S. A. (2018).
Patient participation in hand hygiene among health professionals. RevistaBrasileira De Enfermagem, 71(2), 259–264.Sickbert-Bennett, E. E., DiBiase, L. M., Willis, T. M. S., Wolak, E. S., Weber, D. J., & Rutala, W. A. (2016).
Reduction of healthcare-associated infections by exceeding high compliance with hand hygiene practices. Emerging Infectious Diseases, 22(9), 1628–1630.Zhao, Q., Yang, M. M., Huang, Y.-Y., & Chen, W. (2018).
How to make hand hygiene interventions more attractive to nurses: A discrete choice experiment. PLoS ONE, 13(8), 1–11.Appendix Review of Evidence-Based Research Articles Supporting Compliance with Hand Washing MeasuresBittner et al (2017) focused on how cognitive impairment could affect patients’ efforts of reminding healthcare practitioners to disinfect their hands. Although patients can play an important role in increasing the rate of compliance with hand washing measures, certain considerations should be taken into account which includes the mental health of the patients. Patients may also have a negative attitude towards their participation in implementing hand measures strategies (Bittner et al., 2017). The main participants are the decision-makers and the healthcare providers who must come up with an effective process to increase compliance with hand washing measures among healthcare practitioners (Iqbal, Zaman, & Azam, 2018). It is worrying to discover the perception and attitude of healthcare workers about hand washing. Since healthcare workers are mainly involved in providing patient care, it is important that they are adequately educated on the importance of complying with hand washing measures as a way of improving patient outcomes (Iqbal, Zaman, & Azam, 2018).
It is important to use a collaborative approach where healthcare practitioners are involved in the decision-making process. Decision-makers in the past have not involved healthcare practitioners in decision-making process which may have contributed to the high rate of non-compliance with hand washing measures (Lawal et al., 2018). Involving healthcare practitioners in the decision-making process will enable them in airing any concerns affecting their compliance with hand washing measures. This will also motivate them to participate in the implementation plan by being good examples to other workers (Lawal et al., 2018)
Immersion Hours ComponentInclude your immersion hours for each week and the domains that they apply do. You should have this already in your journal. You will not have completed your hours for Week 10, but you can list them as: Projected Hours for Week 10