Nursing: The Compliance With Handwashing

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Table of Contents

Implementation plan
Evaluation plan
Evaluation data collection
References

Implementation plan

Implementation of the proposed solution

The study proposes the use of comprehensive education to enhance compliance with handwashing among nurses. The nurses are not the only target group that shows a lack of handwashing compliance, also physicians in a hospital setting. Therefore, the chosen solution for the problem is ideal. This solution is adopted in other nursing problems like caring for people with diabetes. Concerning people with a diabetic foot, Corken supports the approach of comprehensive education (2009, p.7) asserts it is the most effective way of change. In the same light, therefore, this approach can support the changes in the disinfection habits of the nurses. The objectives of the study are to enhance compliance among the nurses concerning hand washing. Meeting this objective can only be achieved through the proposed solution. The target groups for this education program are nurses, physicians, and patients. Compliance levels must be of a high degree to stop infections to patients due to practices of dire negligence from the nurses and other caregivers. Study books on nursing suggest routine training of nurses and other caregivers in a hospital setting. Edwards (2008, p.65) put such suggestions forward as the best way to remind nurses of handwashing compliance.

Resources for the implementation

Resources for implementation of the proposed solution were evaluated in the view of the target groups; the extent of the problem and the significance of the objectives of the study. In the first place, the target groups are the nurses (main target), patients, and other nursing physicians. As a result, each of the mentioned in the study has a specific need in terms of resources for the success of the comprehensive education program. Besides, nurses and physicians share the lack of compliance in hand washing. Consequently, their education resources are relatively similar. This study coins resources such as notebooks, subordinate staff, patients’ medical databases, professional health care educators, and health institutions. Besides, questionnaires will be a requirement during the program. To begin with, professional health care educators are handy for the transfer of handwashing knowledge to both patients and nurses. Emphasis is put on professional health care educators since they are better placed to spell out handwashing guidelines to the nurses. To the patient, the intention is he /her act as an immediate reminder of the nurse’s hand washing. Questionnaires would be used as tools for collecting compliance data among the nurses. Subordinate personnel help in the distribution of materials and venue preparation for the program.

Methods for monitoring implementation

The methods of monitoring implementation would objectively measure attendance trends of both patients and nurses. Consequently, the best measure would be an attendance record. Since the turn-up of both patients and nurses is an important indicator of the success of the solution, attendance registers would be used to monitor the implementation. Another method of monitoring implementation is assessment. Assessment is relative in the context of patients and nurses. The nurses will assess using a written test at the end of the education program (Joint Commission Resources, 2005, p.121). On the contrary, the assessment design for patients would involve oral questions, recorded for analysis of implementation monitoring. In addition, questionnaires will be used to assess overall progress for both patients and nurses; at the end of the program. Poljicanin, Pavlich-Renar, Metelko, and Code (2005, p. 45) propose this approach of frequent assessment as ideal for monitoring the progress of implementation, in their analysis of comprehensive education for handling diabetes complications. This is also applicable in the monitoring of the implementation of this program for handwashing compliance. Besides, the study has an aspect establishing the relationship between workload and lack of handwashing compliance (Edwards, 2008, p. 65). This will be done by isolating some nurses subjecting them to less work and monitoring their behavior about hand washing.

Theory of planned change

The study makes use of Havelock’s theory of planned change in the implementation plan. The basic arguments in this theory identify intensive planning as the first stage of causing change. In addition, the theory separates several change players in the change system. The first player is the nurse, in our comprehensive education program. The theory identifies the nurse as a client and the educators as change agents (Swansurg, 1996, p.291). Consequently, there is a sense of empowerment of change agents, in this case, the educators to a large extent and subordinate staff to a lesser extent. Clients targeted for planned change using the comprehensive education program are nurses and patients. Therefore, the overall planned change is only possible through the collaborative interaction of educators, patients, and nurses.

Feasibility of the implementation plan

Resource availability for the implementation of the proposed plan dictates feasibility. Luckily, the resources required for the implantation plan are minimal. Professional educators, health care institutions, and patients are readily available for the implementation plan. The only immediate challenge would be to design suitable education material and content suitable for the nurses and the patients. However, the expertise of the research team offsets the effectiveness of the challenges. On an average scale of judging feasibility, the availability of resources renders the plan attractively feasible.

Evaluation plan

Outcome measure

Evaluation of project objective

The project objective is to enhance hand-washing compliance among nurses in a health care institution. Therefore, meeting this project object comes because of a successfully implemented comprehensive education program. Compliance changes will be reflected in two aspects in a nursing institution change. In the first place, nurses and other physicians must be observed to practically use hand washing during their work hours. Secondly, the rate of reported infection cases of patients must be observed to decline. These two outcomes must be conditionally met for any measure to be discerned as “achieved”. Therefore, patients’ past infection trends will be retrieved from their database. A comparison of the past and present rates is a measure of change impact (McGuire, 2004, p165).

Validity, reliability, and sensitivity to change

This outcome measure proposes the usage of patient-database assessment to ascertain and evaluate the effects of a comprehensive education program. The only way to tell the change due to a comprehensive education program is to compare parametrically present infection trends and the records of the same infections. The reduction in patient infections is a direct indicator of compliance to hand washing. Besides, chosen nurses put under conditions of low work are expected to validate an allegation that workload contributes to non-compliance to hand hygiene (Mallik, Hall & Howard, 2009, p. 101).

Evaluation data collection

Methods for data collection

Discoveries related to handwashing have to be put forward through ideal means of data collection. The study identifies two ideal data collection tools: questionnaires and patients’ medical databases. Questionnaires will be issued periodically to the nursing staff. The information collected from questionnaires would be carefully collected and critically analyzed. Patient databases will provide the most accurate information about infection trends. Evaluation can be feasibly extended by the inclusion of several health care institutions that did not utilize the comprehensive education program. These health centers perform the role of a control experiment in the research (Stanzak, 2006, p. 155-156).

Resources needed for evaluation

Accuracy of information collection affects to choice and usage of an evaluation resource. This research employs the use of questionnaires and patients’ medical databases for data collection. The questionnaire monitors the progress of the nurses. Since the information collection process is highly reliable, statistical packages can be used. A statistical package like SPSS (Statistical Package for Social Sciences) will be used to establish correlation levels between handwashing and infections. This shall be conclusive of the comprehensive education program. The results of correlation found by use of the SPSS package will be used to establish the impact and effectiveness of the comprehensive education program.

Feasibility of the evaluation plan

The evaluation plan relies on the accuracy of patient databases and questionnaires. The accuracy of information provided by the two methods assures the usage of an assortment of statistical packages. Since this evaluation plan endorses the use of questionnaires and patients’ databases, the usage of statistical packages is feasible. Due to the feasibility of using SPSS for analytical treatment of the information gathered, there is reliability and validity in the conclusion, regarding comprehensive education programs and changes due to hand washing. The feasibility found in the usage of the statistical package, SPSS makes it possible to make generalization statements about handwashing reduction in infections (Friedman & Petersen, 2004, p. 8).

References

Corken, A. (2009). Prevention and Early Intervention for Diabetes Foot Problems: A Research Review. American Association of Diabetes Educators, 1-13.

Edwards, M. (2008). The informed Practice Nurse. West Sussex: John Wiley &Sons.

Friedman, C. & Petersen, K.H. (2004). Infection control in ambulatory. London: Jones & Bartlett.

Edwards, M. (2008). The informed Practice Nurse. West Sussex: John Wiley &Sons.

Joint commission Resource. (2005). Issues and strategies for nurse leaders: meeting hospital challenges today. New York: Joint Commission Publications.

Mallik, M., Hall, C., & Howard, D. (2009). Nursing knowledge and practice: foundations for decision-making. London: Elsevier Publishers.

McGuire, M.R. (2004). Steps towards a universal patient medical record: a project plan to develop one. Florida: Universal Publishers.

Poljicanin, T., Pavlic-Renar, I., Metelko, Z., & Coce, F. (2005). Draft Program of Prevention of Diabetic Foot Development and Lower Extremity Amputation in Persons with Diabetes Mellitus. Diabetologia Croatica, 34(2), 43-49.

Swansburg, R. C. (1996). Management and leadership for nurse managers. London: Jones & Bartlett.

Stanzak. R.K. (2006). Bottom line Medicine: a layman’s guide to evidence-based medicine. New York: Algora Publishing.

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