Category: Hygiene

Abstract

Hand hygiene has been with us for ages. This notwithstanding, its application in the medical sector has remained quite low. For the idea to be fully embraced, it is imperative to create avenues through which health care practitioners can be educated and sensitized on the importance of hand hygiene practices.

This paper examines six articles on the subject of hand hygiene and the use of alcohol-based sanitizers as a way of controlling infections. Evidently, and as revealed in this study, effective hand hygiene practices help to prevent the transmission of infections from one patient to another. In addition, hand hygiene makes it possible for health care practitioners to safeguard the lives of patients.

Introduction

An important consideration for all health care practitioners is the need to ensure the safety of all patients under their care. To a large extent, patients undergoing surgical operations are often exposed to risks that can cause them to develop serious medical conditions that can be very costly to treat (Hand Washing: What is the Solution?, 2014). Usually, infections find their way into a patients body through open wounds or other weak body points. Apparently, most nurses and doctors are aware of the risks involved and make every effort to see to it that patients are protected.

The use of surgical scrubs is thus popular among doctors and other health care practitioners who are cognizant of their importance in preventing infections during surgical operations. Three options are available for ensuring hand hygiene including the use of soap and water, antiseptic solutions, or alcohol-based hand rubs or sanitizers (Hand Washing: What is the Solution?, 2014). Some of these are, however, less effective and may not prevent the transmission of microorganisms into a patients body.

Despite efforts to ensure that patients undergoing surgical operations are not affected by acts of negligence on the part of health care practitioners, there are some instances where due diligence is not exercised, subjecting patients to serious medical risks. In order to protect patients, physicians in some countries are required to take an oath compelling them to handle all patients with care, without causing any harm (Nazarko, 2013). As a consequence, the importance of hand hygiene should be reinforced among health care practitioners.

However, this did nothing to ensure the safety of patients and some patients even refused to visit hospitals to seek treatment because of fear of being infected. They would thus look for alternative ways of treatment which, to a large extent, may be costly and less effective. According to Chen et al. (2011), infections as a result of healthcare are prioritized among the challenges faced to ensure the safety of patients. This paper presents a discussion on hand hygiene practices and the use of alcohol-based sanitizers as a way of controlling infections.

History and Importance of Hand Hygiene

According to findings by Mathai, Allegranzi, Kilpatrick and Pittet (2010), effective strategies are critical for dealing with the challenges associated with healthcare infections. Seemingly, many people have lost their lives as a result of health care associated infections. Drawing from a study by Canham (2011), the practice of hand hygiene started in the early 19^th century. In the year 1961, all health care practitioners in the United States were expected to thoroughly clean their hands using soap and water before and after coming into contact with a patient.

Hand hygiene practices in the United States were later standardized by the Centers for Disease Control (CDC) in 1975 and 1985. As noted by Mathai et al. (2010), it is only recently that the association between hand hygiene and prevention of health care related infections started making sense among health care practitioners. While some people have fully taken up the idea and are making every effort to practice, some have a long way to go and probably need to be trained and sensitized.

Generally, hand hygiene is regarded as the most critical component of any strategy meant to protect infections that arise during the operation period. Evidently, hand hygiene is simple and less costly when compared with other options that may be used for a similar purpose (Chen et al., 2011). There is, however, a laxity among healthcare providers to comply with recommended guidelines.

In the study carried out by Chen et al. (2011), it emerged that clinical staff rarely washed their hands during operations. It is thus essential to ensure that health care practitioners understand the importance of hygiene when taking care of patients. Despite being helpful for improving the safety of patients, hand hygiene also lessens the burden of caring for patients and reduces the overall associated cost.

The importance of hand hygiene springs from the fact that infections are normally passed from one patient to another through the hands of health care practitioners (Nazarko, 2013). Ostensibly, this is because human hands are prone to contamination by microorganisms which can easily be transmitted from one patient to another by health care practitioners. However, they usually do not pose a big threat unless an individual has a skin that is damaged or has a weak immune system.

Evidently, effective hand washing can help to drastically lower the rate of infection. For this reason, health care practitioners should understand the benefits associated with hand hygiene practices. Ideally, recommended guidelines for hand hygiene practices should be followed keenly by all health care practitioners as they attend to patients.

Hand Hygiene Practices and the Use of Alcohol-Based Sanitizers

Citing the challenges associated with hand hygiene, alcohol-based hand rubs or sanitizers were introduced. For sometime, however, some people felt that alcohol-based sanitizers could not be used in places where sinks were lacking. Subsequent guidelines by Centers for Disease Control cleared the confusion by advocating for the use of alcohol-based hand rubs to clean hands before and after any surgical procedure.

In general, the use of alcohol-based hand rubs or sanitizer was meant to reduce instances of infections during operations as a result of health care practitioners failing to clean their hands properly. Ordinarily, alcohol-based hand rubs play an important role in preventing micro-organisms from being passed from one patient to another through the health care practitioners hands. In the study by Chen et al. (2011), they made use of a quasi experimental study design that involved the close monitoring of health care associated infections in order to determine the effectiveness of hand hygiene using alcohol-based hand rubs.

Based on their study, strict adherence to hand hygiene was found to be less costly. Besides, adherence to hand hygiene seemed to help with the reduction of health care associated infections. Apparently, some concerns have been raised regarding the use of alcohol based solutions. Although findings from different studies point to the fact that alcohol based solutions are more effective in dealing with microorganisms unlike the use of soap and water, they tend to have a less powerful effect on some viruses such as rotavirus as well as on some bacteria such as clostridium difficile (Hand Washing: What is the Solution?, 2014). As a result, the use of alcohol based solutions when dealing with patients with such infections should be encouraged.

While comparing the effectiveness of different hand hygiene solutions, Canham (2011) argued that while the use of plain soap and water is good, antimicrobial soap presents a better solution. However, the use of alcohol based hand rubs offers the best solution. It is worthwhile noting that the use of alcohol based sanitizers is inappropriate where hands are soiled or contaminated. The effectiveness of alcohol based solutions also depends on the percentage of alcohol used. Bacteria are better destroyed by alcohol based solutions that contain between 60 and 95 percent alcohol.

According to Stephen-Haynes (2014), health care practitioners can use various approaches to prevent infection. Using antimicrobial therapy, for example, it is possible for nurses and doctors to eliminate the possibility of infections being transmitted from patient to patient. The patient may also be safeguarded through immunization and personal hygiene. It is also advisable for health care practitioners to use the correct clinical equipment and protective clothing for the sake of patients.

Arguably, a patients personal hygiene also plays an important role in preventing the spread of microorganisms (Stephen-Haynes, 2014). Consequently, efforts should be made to ensure that patients take a bath on a regular basis. Health care practitioners should also ensure that patients do not share personal hygiene items such as toothbrushes and towels. In some cases, nurses are required to use different clothes to clean different parts of a patients body. In addition, it is necessary for every patient to have his or her own bowl.

The effectiveness of hand hygiene depends on proper selection of hand hygiene products. Moreover, the procedure to be undertaken and the extent of contamination also affect the success of hand hygiene to some extent. Accordingly, health care practitioners must take time to carefully choose the best products to be used for sanitization. In general, the articles reviewed indicate that alcohol-based sanitizers are more effective. While this may be true, there are concerns that alcohol based sanitizers are limited in some ways and may fail to produce the desired results in some cases.

Conclusion

Following from the discussion presented in this paper, it is obvious that hand hygiene plays a very important role in ensuring the safety of patients. Throughout the world, many people have lost their lives as a result of health care related infections and it is thus imperative for health care practitioners to be familiar with different mechanisms for dealing with such challenges. As suggested by various authors, health care practitioners should consider having guidelines for effective hand hygiene.

Although it appears like a simple problem, many people may lose their lives due to negligence and lack of knowledge among health care practitioners. However, it is possible to control the damage caused by health care related infections and stakeholders should come together and devise effective intervention strategies. As earlier explained, guidelines should be provided to ensure that health care practitioners adhere to best practices. In most cases, having guidelines in place is usually meant to ensure that all those taking care of patients get to do what is expected of them.

Arguably, the idea of hand hygiene seems to be a foreign one to some health care practitioners. As a consequence, health care practitioners should be trained and sensitized on the need for effective hand hygiene. Efforts should be made to encourage health care practitioners to embrace the concept of hand hygiene in order to improve the safety of patients. In addition, guidelines should be provided to health care practitioners to guide them on ensuring the effectiveness of hand hygiene in the medical sector. In the absence of such guidelines, there is a likelihood that health care practitioners will use their own judgment which may lead to serious problems.

References

Canham, L. (2011). The First Step in Infection Control is Hand Hygiene. Dental Assistant, 80(1), 42  46.

Chen, Y., Sheng, W., Wang, J., Chang, S., Tien, K., Hsu, L., Tsai, K. & Lin, H. (2011). Effectiveness and Limitations of Hand Hygiene Promotion on Decreasing HealthcareAssociated Infections. PLoS ONE, 6(11), 1  9.

Hand Washing: What is the Solution? (2014). Journal of Perioperative Practice, 3(2), 8  10.

Mathai, E., Allegranzi, B., Kilpatrick, C. & Pittet, D. (2010). Prevention and Control of Health Care-Associated Infections through Improved Hand Hygiene. Indian Journal of Medical Microbiology, 28(2), 100  106.

Nazarko, L. (2013). Putting Patient Safety at the Heart of Healthcare. British Journal of Healthcare Management, 19(9), 422  427.

Stephen-Haynes, J. (2014). How to Ensure Better Infection Control in the Patients Home. Journal of Community Nursing, 28(3), 76  80.

Situation

• J.D. is a 25-year-old patient.
• He survived an appendectomy successfully.
• The nurse should take postoperative blood tests.
• Hand hygiene practices were neglected.
• An infection was developed but managed in time.

In one of the local hospitals, a 25-year-old man, J.D., was delivered for an urgent appendectomy. The patient survived the surgery successfully, but additional postoperative tests were required because of hypertension that was suddenly developed during an operation. In the morning, the nurse entered the room, and the patient was eager to communicate, which resulted in the nurses inattentiveness and neglect of simple hand hygiene rules. Neither wearing on protective gloves nor washing was done, but the blood was taken. Within the next few hours, an infection was developed, causing fever and rash around the injection. It was managed by taking antibiotics in time and following all postoperative recommendations. The patients well-being was stabilized, and he did not officially report the mistake.

Response

• I was out of the room during blood test taking.
• I was not responsible for checking nurses hands.
• I had to remind the nurse about hand hygiene.
• There were several similar cases but no infection outcomes.
• I should care about following hand hygiene guidelines.

Unintentional neglect of responsibilities and the development of friendly relationships could challenge the quality of care. I was asked to bring another pillow to the patient and left the room when the blood test was taken. Although I was not obliged to follow if the nurse used protective gloves or washed her hands, I could remind her about this simple step before leaving. I observed several cases when nurses forgot to wash their hands as soon as they started working with a new patient; however, no serious complications were reported. Unfortunately, the lack of my response to such mistakes could be defined as one of the triggers for infection development because of hand hygiene neglect.

Thoughts and Feelings

• Regret.
• Concerns about not following hand hygiene rules.
• Fear.
• Compassion.
• Future improvements.

One of the obvious feelings in this situation was regret that I was not attentive enough to identify a problem in a hospital. I was overfilled with concerns about why nurses, even being aware of the threats of not following hand hygiene rules, continue neglecting this practice from time to time. I was also afraid of the patients condition and my participation in this situation. I demonstrated my compassion to the family and tried to explain everything to the young mans family. I decided to improve my behavior and now consider hand hygiene as a priority in nursing practice.

In the Patients Place

• I would enjoy the surgerys outcomes.
• I would need some entertainment.
• I would have interest in the nurse and want to talk.
• I would be concerned about my well-being.
• I would always pay attention to nurses hands.

If I were the patient, I would enjoy the outcomes of my surgery and tried to find some entertainment because my well-being was good. As soon as I saw an opportunity to talk to a nice person, I would use this chance, without knowing how attentive a nurse should be. When I felt bad, my concerns about my health would change, and I would like to know what happened. Being explained about hand hygiene, I would never allow a healthcare provider to touch me without gloves.

Ethical Principles

• Beneficence:
  • the patients well-being;
  • no patients responsibility;
  • the nurses neglect of duties;
• Non-maleficence:
  • harm avoidance;
  • no patients awareness;
  • no hand hygiene.

Not following simple hand hygiene rules in clinical settings leads to a variety of problems, and one of them is a poor understanding of ethical principles. In this case, two core issues, beneficence and non-maleficence, could be questioned. First, any nurse knows about the importance of beneficence as the necessity to promoting the patients well-being. It is never the responsibility of a patient but the obligation of a healthcare provider. The nurse neglected her task to do everything that could support the mans health. Non-maleficence is another ethical aspect that was not followed in the hospital. Instead of avoiding harm, and because of the patients unawareness of the outcomes, the nurse did not wear protective gloves and put the patient at risk of infection.

Future of Nursing

• Lack of water and poor hand hygiene are observed;
• Nurses should support improvement initiatives;
• Patients well-being and care are the priorities;
• Ethical principles and obligations are enhanced;
• Hand-washing and gloves could save patients.

My future as a nurse has to be built around several important aspects. First, I should remember that poor hand hygiene and water problems still challenge many hospitals. Therefore, I have to consider improvement initiatives as a solution for clinical settings. Second, my primary responsibility is the promotion of patients well-being and high-quality care. Attention to the existing ethical principles is a good opportunity to understand what is expected from me as a nurse. Finally, I will never forget that such simple steps and hand-washing and wearing protective gloves could influence treatment and even save human life.

Summary

Infections acquired in the hospital are currently one of the major causes of mortality and morbidity. Proper hand hygiene (HH) practices, in turn, are considered to be an effective way to prevent the transmission of infections during communication and interaction between patients and medical staff. Despite the fact that health professionals are aware of the importance of HH, compliance levels remain low in many facilities, including the organization in question.

Objective

Evaluate the impact of using the PDSA model and Lewins three-step model in interdisciplinary teams on HH compliance. It is expected that the level of compliance in the given organization will increase as a result of the changes introduced. If achieved, this objective will have a significant positive impact on both organizational and patient outcomes, as it will reduce the spread of hospital-acquired infections (HAIs).

Questions and Predictions

• What tools will be used to collect data?
  • Data collection tools will include a standard HH observation form, WHOs Data Collection Tool, and a researcher-made HH questionnaire (Alper, 2021).
• What resources are likely to increase the participation of health personnel and patients?
  • The resources used will include interventions recommended by the WHO concerning HH compliance and Electronic Message Boards, which will provide workers with the means to receive daily reminders and updates (Sands & Aunger, 2020). In addition, different types of HH signage, such as flyers and posters will have to be posted in various places, including bathrooms, nurses rooms, hand sanitizing stations, etc.
• How will compliance be ensured and maintained among health professionals?
  • Compliance can be ensured through regular discussions held for the workers to gain their feedback regarding the implementation of the change; health professionals will be asked to assess their own compliance with HH requirements.

Change Theories and Leadership Strategy

The PDSA model, Lewins model, and transformational leadership will be used to implement the change, as they are likely to help interdisciplinary teams in the interviewees organization to collaborate and implement the plan proposal. The PDSA model will allow the teams to identify areas for improvement, while Lewins model of change will allow them to evaluate current processes together and gain buy-in from employees and leadership (Burnes, 2019). Finally, transformational leadership is chosen as the most efficient strategy because it provides focus on the concept of collaboration of all employees and a common goal they aim to achieve.

Team Collaboration Strategy

• The change managers in all teams will be responsible for assigning the activities to the members and ensuring their regular participation;
• The administrator will gather the results of each interdisciplinary team, analyze them, and develop a sequence of actions to take further;
• Hospital managers will use the outcomes of the teams work to introduce policies and practices that will increase HH compliance.

Collaboration in regard to this project can be defined as the participants assumption of the roles that are complementary and help them to cooperate in achieving a common goal. The best type of collaboration in this project would be involving doctors, nurses, and other health professionals working in the given organization to consider each others specific abilities and skills. By exploring and combining these inputs, the efficiency of the approach will increase, which will help to meet the teams needs using all its human resources. This collaboration approach is relevant to the teams needs and will help to drive success because it contradicts workers negligence and aims to involve all of them in the problem-solving process.

Required Organizational Resources

The staffing needs of the project are minimal, as the interviewees organization already has competent professionals willing to implement the change. The teams will thus require about 30 doctors, nurses, and other employees working in the facility. Equipment and supplies needed include hand-washing stations and sanitizers, as well as Electronic Message Boards, which the organization has in sufficient amount. Access to the facility departments is required and easily available as well. Therefore, funds will mostly be required to cover staff time and will amount to 600$ for each team. If the change is not implemented, patient outcomes will be affected as the rates of HAIs will continue to grow.

References

Alper, P. (2021). Best practices for measuring hand hygiene compliance. Medline.

Burnes, B. (2019). The origins of Lewins three-step model of change.The Journal of Applied Behavioral Science, 56(1), 32-59.

Sands, M., & Aunger, R. (2020). Determinants of hand hygiene compliance among nurses in US hospitals: A formative research study.PLOS ONE, 15(4), e0230573.

Introduction

Novant Health is an organization with a comprehensive and developed management. The organization includes a network of clinics in four US states, which have various subspecialties. The company has a multi-stage structure, including a board of directors, which reports to the heads of each of the clinics that manage the rest of the hospital staff. The board of directors is focused on solving the problems of investment and logistics, intervening in the management of hospitals only through regulatory documents. Then, the heads of each institution have subordinate managers responsible for managing departments and divisions within each clinic. These department managers coordinate the work of doctors, nurses, and technical and IT staff.

Novant Health hospitals have specializations in the areas of therapeutic services, pediatrics, and traumatology. Trauma clinics are a model for successfully integrating IT into workflows, including diagnostic and care tools. Pediatric clinics focus on highly qualified specialists with education in several fields. Notably, Novant Health provides horizontal interaction between clinic managers for joint learning, sharing of experience, and professional development. This approach distinguishes the network of clinics and allows for providing a consistently high quality of services and a unified approach common to all institutions.

Identifying the Healthcare Problem

In most cases, Novant Health clinics follow the guidelines and have no difficulty complying with regulations submitted by the board of directors. Recently, however, clinic leaders have drawn attention to the urgent need to improve hand hygiene compliance. Hand hygiene, by definition, is a system of practices that clinics perform to meet the generally accepted standards for ensuring the safety and health of patients. Hand hygiene terminology considers concepts of hand-washing schedule and prevention of transmission of infections. Notably, Herzbergs Motivation-hygiene two-factor theory could be applied to address the problem. This theory implies that job satisfaction comes from success in the performance of duties, while job dissatisfaction can be associated with barriers to career or professional development. Therefore, the development of policies to motivate health workers maintaining hand hygiene should consider the ideas associated with this management model.

So far, employees are showing low levels of handwashing for several related reasons. According to studies, these reasons include the need to frequently change locations when entering and leaving rooms and a short time spent with patients (Clancy et al., 2021). Wearing gloves reduces the tendency to wash hands, as many workers perceive them as a sufficient means of protection. Just as importantly, the logistics of alcohol dispensers and sinks, as well as breakdowns and late refills, result in reduced compliance rates. Some employees may have allergies or skin irritations caused by disinfectants. Healthcare workers often move items around the clinic, such as medications, instruments, or notepads, and their hands can be constantly full, while sinks and dispensers lack shelves for such items.

Stakeholders Most Impacted by the Problem

Remarkably, even a small number of employees who do not follow the rules of handwashing endanger the health of patients and healthcare workers. Poor handwashing practices can lead to the spread of infections within the hospital. The first group of stakeholders to suffer from hand hygiene non-compliance are hospital patients and healthcare workers who may be contaminated with infectious diseases. In addition, non-compliance with handwashing practices leads to economic losses due to patient dissatisfaction and deterioration in the image of the clinic. Therefore, clinic leaders and the board of directors are the second group of stakeholders who will suffer from non-compliance. The third potentially vulnerable group of stakeholders are family, acquaintances, and friends of employees and patients who are equally exposed to the spread of infectious diseases.

Socio-Ecological Principles Applying to Healthcare Management Decision-Making

The socio-ecological principles help determine how health care practices affect broader ecosystems, such as local communities, the environment, the urban community, and state and federal health care. The socio-ecological model provides a framework for applying the understanding of a multi-level society and the interaction of people in social systems (The social-ecological model, 2022). Therefore, the prevention, intervention, and control of various policies must consider different socio-ecological levels. Interestingly, the Centers for Disease Control and Prevention require introducing new policies and management decisions with a social-ecological model in mind.

The missions associated with the introduction of new practices within the framework of the model include improving the quality of services provided and the health of patients, which entails improving the health of local and wider social groups. Notably, tolerance and awareness of human rights violations, gender values, socio-cultural norms, attitudes, hopes, and beliefs strengthen the motivation for change (Olden, 2019). Therefore, the application of a social-ecological model in the implementation of changes positively affects complex ecosystems such as local communities and improves the environment.

The Role of Managements Responsibilities in the Change Process

Some critical resources will be needed to implement the plan of hand hygiene compliance successfully. Notably, clinic leaders will have a primary role in making decisions about implementing change. In particular, clinic leaders will develop a common strategy in collaboration with the healthcare administrators. Then, this strategy will be presented to the board of directors and delegated to subordinates through the hierarchical and horizontal chains of command processes.

Clinic leaders will be responsible for overall strategy implementation and change, and the quality of the strategic plan. Clinic department heads will be responsible for implementing the changes at local levels and for overseeing the quality of the implementation. Heads of departments and subordinates who will be affected by the changes will make proposals for strategic and tactical decisions. Subordinates, including nurses, doctors, technical staff, and IT workers, will be responsible for implementing the requirements and practices recommended. Patients, upon admission to the hospital, will also be required to familiarize themselves with the rules of handwashing.

Health administrators will have a special role in assisting clinic and departmental leaders in strategy development and oversight. Notably, healthcare administrators are typically responsible for ethical issues and are involved in strategic planning, decision-making, and change management (Barr & Dowding, 2019). Healthcare administrators at Novant Health will also subsequently evaluate the strategy and refine some of the tactical steps to implement it (Duffy, 2018). Mid-level and lower-level administrators will be responsible for more detailed development of tactical steps to implement the change strategy within day-to-day operations and functions.

Why the Resolution of the Issue is Sufficient

The implementation of the solution will rely on the use of various techniques and control tools to reduce the level of non-compliance. In particular, the healthcare administrators will ensure that the progress of strategic change is adequately measured and evaluated. From there, administrators will distribute weekly questionnaires to staff, with questions about the frequency of handwashing, and reasons for non-compliance with the rules. Within a month, shortcomings in the strategy may come to light, and it is good if the staff can report them. At the end of the month, the level of the spread of infectious diseases among patients who stay or have left the clinic will be recorded to compare with the level of diseases before the implementation of the strategy.

The first concern is that questionnaires about the handwashing schedule are not enough to check the hygiene state. It is possible to introduce a plan of handwashing in every hospital room where the physician or the nurse should write down their surname and time after washing hands. Even though this action is additional work for the healthcare personnel, it might help them develop the habit in several weeks. After the pattern is established, it is possible to disregard writing surnames in the schedule after washing hands.

The second initiative that might increase the positive motivation of the employees to wash hands regularly is establishing a ritual that is obligatory for everyone who approaches the patient. For instance, every employee should know that the first action they should take when communicating with the patient is washing hands. When every person in the hospital is aware of this ritual, there is no space for variations in this case.

As mentioned in the paper, healthcare professionals can disregard alcohol dispensers and sanitizers because of hand allergies and irritation. It is critical to give healthcare personnel enough options to wash their hands using warm running water and soap. Moreover, hand sanitizers are less effective in preventing infection from spreading than handwashing with soap. Every room in the hospital should have convenient sinks, hand driers, and shelves to put papers and medical tools to facilitate this process and make it an integral part of the employees daily routine.

Conclusion

Thus, a report on coping with the problem of hand hygiene in the Novant Health clinics was presented. The positive outcomes of the strategic changes addressing the hand hygiene issues will include lower infection levels, while the negative outcomes may feature dissatisfaction among employees. To implement and adapt the solution, the strategy will be developed by clinic leaders with input from the healthcare administrators. This strategy will be approved by the board of directors and presented to all employees. The success will be monitored and evaluated by the healthcare administrators.

References

Barr, J., & Dowding, L. (2019). Leadership in health care. Sage.

Clancy, C., Delungahawatta, T., & Dunne, C. (2021). Hand-hygiene-related clinical trials reported between 2014 and 2020: A comprehensive systematic review.Journal of Hospital Infection, 111, 6-26. Web.

Duffy, J. R. (2018). Quality caring in nursing and health systems. Implications for clinicians, educators, and leaders. Springer Publishing Company.

Olden, P. (2019). Management of healthcare organizations: An introduction. (3rd ed.). Health Administration Press.

The social-ecological model: A framework for prevention. (2022). CDC. Web.

Introduction

Setting the right health-related career goals requires identifying the professional field that causes the greatest degree of fascination. Due to requiring honesty and the analysis of the initial assumptions feasibility and potential in the long-term perspective, self-exploration linked with career field choices has never been an easy process to complete. In this essay, I justify my decision to choose dental hygiene as a profession with reference to experience-based and security-focused factors and explain the professions meanings, including promoting happiness and the culture of self-care.

Dental Hygiene: The Reasons for Selecting the Field

The various reasons that have informed my decision could be divided into two large groups, with the first set of factors incorporating some personal or experience-related considerations. A personal history of teeth issues in childhood, including hypersensitivity, tooth decay from high sugar intake, and plaque accumulation, made dental visits and receiving patient education common occurrences in my life before adolescence. Instead of instilling any fears, these experiences have filled me with an inspiration to address dental exacerbation early by providing high-quality preventive dental care and assisting others in maintaining good oral health habits. Interestingly, as per dentistry students career choice motivation profiles, over 20% of dental hygienists cite inspiration from their own dental experiences as the key rationale for choice (Shaikh & Inglehart, 2018). Increases in the quality of life achieved due to post-treatment self-care recommendations from dental hygienists, including dietary guidance, have been strong enough to make me willing to continue their mission.

The second type of motivators refers to factors that are more pragmatic in nature, including job security, demand, and having an appropriate skill set to succeed in the field. Despite the advancements in oral care products for clients with dissimilar need profiles and such products affordability, the job outlook for the profession is still positive, adding to my determination to enter the field. The U.S. Bureau of Labor Statistics (2022) predicts the change in employment between 2020 and 2030 to exceed 10% for the dental hygiene field, which is higher than the average growth rate for all occupations. These security and demand projections add to the possibility of finding stable employment and having a range of potential employers to choose from, resulting in optimal job satisfaction. Another decision-making factor pertains to the presence of adequate skills that will aid in fulfilling the dental hygienists responsibilities with both pediatric and adult clients. My key competencies relevant to the profession include manual dexterity, fine motor skills, and eye-hand coordination. Finally, certain psychological assets, for instance, attention to detail in problem-solving and cooperation/communication skills, could facilitate ongoing learning in my case.

The Meaning of Dental Hygiene and a Discussion of the Professions Aspects

Regarding the personal meaning of dental hygiene, my definition of the fields importance would stress the professions links to public health, oral cavity disease prevention, and fighting the culture of dental neglect. In other words, although engagement in diagnostic and cleaning procedures is paramount, in my perception, dental hygiene is about working with a culturally diverse clienteles health-related mindsets. From my perspective, along with consisting of safe and effective care based on the clients actual health condition, each dental hygiene visit should be perceived as an opportunity for spreading the philosophies of self-care. With an emphasis on oral health, professionals should make the clients recognize that health is a finite resource. Every early sign of pathological processes in the mouth that gets ignored might progress into serious concerns years later, sometimes even leading to life-threatening systemic diseases starting in the oral cavity (Coppola et al., 2022). Therefore, I see efforts to raise patients awareness of dental health from the systems-level perspective and the need for early intervention in case of concerns as the professions critical meaning.

At an individual level, aside from disease prevention, I also see the professions aspects, ranging from the initial assessment to patient education, as endeavors to prevent clients psychological discomfort from aesthetic flaws. Dental hygienists can engage in assessments, documentation, decision-making peculiar to preventative care, oral cancer screening, administering local anesthetics, collaborating with dentists, and providing nutrition and oral hygiene counseling to diverse populations (Coppola et al., 2022). In addition to tooth loss prevention, these dimensions of practice, despite being different in nature and the involved skills, aid in addressing certain visible flaws and supporting individuals dental health without invasive treatments. By means of aesthetic improvements, including tartar and stain removal, professionals in the field can help their patients to feel more attractive and cope with some of the barriers to expressing emotions. In certain cases, a more pleasant-looking smile can even change a persons life and create more opportunities for successful personal and professional relationships, making the effects of dental hygienists work all-encompassing. With that in mind, these specialists promote holistic well-being by means of administering the right preventative interventions.

Conclusion

To sum up, my career decision is rooted in the idealistic goals of maximizing happiness and some more utilitarian arguments, including the professions alignment with my assets and security-focused expectations. The selected career options meanings for public health, shifts in peoples attitudes to health, and mental well-being have also been influential in personal decision-making. Hopefully, these attitudes will support me in developing specialized skills and seeking professional excellence.

References

Coppola, N., Rivieccio, I., Blasi, A., Ferrigno, R., Baldares, S., Mignogna, M. D., & Leuci, S. (2022). Current knowledge, attitude and practice among dental hygienists in oral cancer awareness: Systematic review. International Journal of Dental Hygiene, 20(2), 249-261.

Shaikh, M. A., & Inglehart, M. R. (2018). Dental and dental hygiene students career choice motivations in 200917: A mixed methods approach. Journal of Dental Education, 82(8), 848-856.

U.S. Bureau of Labor Statistics. (2022). Dental hygienists: Summary.

Introduction

Hygiene is something which man should give importance to. It is an aspect of ones life which reflects ones personality. It is through hygiene that a man acquires his cleanliness and safety from threats that pose potential harm to him. More than that, through hygiene, man can socialize with others without proper hygiene, interacting with others is a very intricate and annoying task. There are different aspects of hygiene and two of the most common are personal and environmental hygiene.

In talking about personal hygiene, Filipinos are known to be good at it. There had been comparisons and studies which compared Filipino hygiene and the practice of other cultures. Filipinos ranked first in the latest Google-Trends wherein the different hygiene terms were mentioned, and following the Philippines are the countries India and the USA (Google Trends, 2007).

Also, compared with other nations, the everyday hygiene that Filipinos practice is one of our edges compared to other nationalities. In fact, in an article published, it was found out that Filipinos are recognized for their exceptional hygiene and personal grooming [&]. This was released by the TESDA as they disclosed the feedback of passengers regarding Filipino seamen and seafarers from other countries (Philippine Daily Inquirer, 2007).

This aspect of Filipinos indeed is an edge since many employers external to the country prefer Filipino workers because of their presentable grooming and exceptional priority regarding everyday hygiene. Perhaps, this is one aspect that contributed to the title of the Philippines as the Manning capital of the World.

Environmental hygiene

Though Filipinos excel in this certain type of hygiene, a very concerning fact comes when we talk of environmental hygiene. Filipinos greatly fail on this side because of the unhealthy practices they exhibit like passing out urine in the streets (especially for the males), the throwing of garbage everywhere, spitting on the streets, and other sorts of unhygienic practices. Because of this, being personally hygienic would still be overcome.

The worse thing, in this case, is that when these Filipinos migrate or work in other countries which are very strict in their environmental sanitation, they successfully conform to the rules. For example, a person who is fond of spitting in the streets of the Philippines finds it hard and controls himself to do so when in Singapore. This fact is very saddening since it shows that although Filipinos can control themselves into doing such things, they do not try to because of the lax rules that are being implemented if there are.

Perhaps this is one weakness of the Filipinos against Americans since in America; people practice sanitation and environmental friendliness. This is one reason why it is hard for the Filipinos to be assimilated into mainstream American culture because the attitudes of Filipinos when it comes to environmental hygiene show off though they try to conceal it. Also, although Filipinos try to conform to the rules in America, for example, assimilating is rather an intricate task since discrimination is still a large and would never cease to exist. The image that Americans see of themselves as the superior race is a big barrier. Likewise, the image of Filipinos as an inferior race also serves as a barrier. Another is that Filipinos have no strong voice in a place strange to them. Because of this, they wont be able to express their concerns and problems since they are strangers struggling for their lives in a place where they deem before as a place for extravagance. The never-ending xenophobic attitude which some Americans show to immigrants and non-natives is also another threat that inhibits the immigrants to get along with the mainstream culture of America. The blame that these immigrants crowd up the city, consume government welfare and corrupt the society with uncivilized and foreign practices (Johnson, n. d.) turns the supposedly amicable relationship into a hostile one.

Conclusion

With these facts shown, it would be ideal to initiate a scientific inquiry on why Filipinos act in a behaved manner (in terms of environmental hygiene) in other countries and do otherwise on their native land. Another is that why these Filipinos prioritize everyday hygiene among other things, despite their problems in other aspects of their lives.

References

Blogspot.com. (2007). Filipinos lead the world in personal hygiene. Web.

Google.com. (2007). Google-Trends On-line. Web.

Johnson, Diarra. (n.d.). Coming to America: The Opportunities and barriers of Assimilation. 2007. Web.

Ortiz, Margaux. (2007). Filipino seamen smell better than othersTESDA. The Philippine Daily Inquirer Online. Web.

The source published by authors affiliated with the American Dental Hygienists Association (ADHA) summarizes essential barriers to dental care optimization in the U.S. Basically, the document aims to apply systems thinking to propose viable paths toward positive change. From my perspective, the change-driver chart created by Rhea and Bettles (2011) identifies the central topics of interest for the dental hygiene profession in a successful manner. Notably, the discussion is not limited to patients issues and covers workforce-related challenges, such as educational opportunities, professional standards, and the long-term outcomes of workforce aging. Therefore, it can be said that all areas of critical importance have been listed.

At the present moment, it seems that the profession is prepared to work in healthcare and community settings. Particularly, as the report indicates, advanced practice dental hygienists have numerous opportunities for collaboration with community health professionals for the optimization of disease prevention initiatives (Rhea & Bettles, 2011). At the same time, further resources and teamwork-related education might be required to propel this readiness to the next level.

Increasing workforce diversity and intercultural competence is another critical objective to inform further developments in the field. To achieve the stated goal, it is essential to plan and implement diversity recruiting practices and popularize dental hygiene as a career choice among high school students in racially diverse neighborhoods. The completion of competence training programs promoting at least basic intercultural knowledge as it pertains to dental self-care should become mandatory in diverse settings where dental hygienists work.

Finally, exploring the current social and legal landscape to identify ADHAs potential partners is another priority. In the healthcare field and the non-profit sector, such partners may include community dental service staff and school-based dental services. As for the government and business, engaging in collaboration with the U.S. Department of Health and Human Services and prominent dental care product brands that are popular in the U.S. might be productive.

Reference

Rhea, M., & Bettles, C. (2011). Dental hygiene at the crossroads of change: Environmental scan 2011-2021. American Dental Hygienists Association. Web.

Recommendations and Justifications

From the data presented, it is recommended that dental hygiene students receive additional training to enhance their skills in applying dental sealants to school children. The training should specifically target how dental sealants are applied on the distal fossa and the lingual grove as these are the two important areas where the students performed dismally, leading to low retention rates. With targeted training and exposure, dental hygiene students should be allowed to continue applying dental sealants in the State Sealant Program as they provide the service at a low cost compared to licensed dental hygienists.

Additionally, it is recommended that dental hygiene students focus on areas that they are able to achieve a higher retention rate. The findings suggest that the students achieved a reasonable retention rate in applying sealants to the central fossa region. Focusing on one specific area, in my view, will not only ensure a high retention rate but also enable the students to increase their speed in applying sealants. The data shows that only 518 children received dental sealants from dental hygiene students compared to 3,443 children who received the service from registered dental hygienists. The slow rate of service exhibited by the students may be a result of their inexperience in other areas that require sealants, as demonstrated by the low retention rates of dental sealants applied by the students in the distal fossa and lingual grove regions. Consequently, it is important for the students to focus on one area where their efforts show promising results.

Secondary Issues

The key partners that should be included in making this decision final include state and local health department officials, contracted dental hygienists and assistants, dental hygiene students, school heads and education officials, parents, community-based religious organizations, and school children. The criterion for inclusion of the stakeholders is based on participation in the program and use of the evaluation results (Lobo, Petrich, & Burns, 2014). The communication of key findings to the mentioned key partners will be done using personal contacts and community forums. Specifically, state and local health officials, contracted dental hygienists and assistants, dental hygiene students, and education officials will be contacted via personal emails to ensure the findings reach the intended audience, while school heads, parents, religious organizations, and school children will be contacted via community-based forums. The responses of key partners are likely to be in support of the recommendations and conclusions made based on the objective techniques used to conduct the evaluation. Due to the worrying retention rates, it is suggested that parents and children be educated on proper oral health behaviors. Effective tooth brushing and dietary habits can form the basis of the education plan (Horowitz, Kleinman, & Wong, 2013).

From the review of the data presented, it is evident that there are other evaluation issues that need to be considered. First, a significant number of children who received dental sealants from licensed dental hygienists reported retention problems, particularly in the distal fossa and lingual grove regions. Additionally, the cost per sealant retained seems higher for some registered dental hygienists than for others despite the fact that the program targeted a homogeneous population. These issues can be addressed by retraining the licensed dental hygienists and ensuring that the appropriateness of materials and technologies used to apply the dental sealants. Lastly, program staffing costs and the nature of dental hygiene school attended by the students form important pieces of information that can be used to determine the effectiveness of the program.

References

Horowitz, A.M., Kleinman, D.V., & Wong, M.Q. (2013). What Maryland adults with young children know and do about preventing dental caries. American Journal of Public Health, 103(6), 69-76.

Lobo, R., Petrich, M., & Burns, S.K. (2014). Supporting health promotion practitioners to undertake evaluation for program development. BMC Public Health, 14(1), 1390-1406.

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.

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 patients 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, OConnell, & 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).

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.

Implementation

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.

Evaluation

Reporting the outcomes of the trial

Results will be summarized in an academic article.

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.

References

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., OConnell, 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.

Dental hygiene is crucial for peoples health, and self-assessment is an essential part of hygiene. It is worth mentioning in the curriculum because hygienists must have these skills for self-improvement and personal growth in the profession. The value of that practice will help to monitor both their health and their performance at work. Self-assessment skills meet ADEA Competencies and ADHA Standards as they both require professional growth and development. Thus, they aim at reviewing the already acquired knowledge. This practice is excellent for enhancing critical thinking, which is the clinical courses priority because it is vital to maintain professional interaction with patients, and assessment of decision-making process.

As for ADEA competencies that self-assessment meets, we can mention the following topics: health promotion and disease prevention. If hygienists monitor their dental health, they can understand the factors that help the patients to maintain hygiene and prevent various diseases. Moreover, this practice for self-management and critical thinking is high-priority in terms of recording data and analyzing risks. ADHA Standards also have some core values that correspond with self-assessment. For instance, planning standards require the establishments of goals for a patient to maintain their dental hygiene. Furthermore, self-assessment helps to monitor the results of patients and changing the strategies if necessary.

I believe that self-assessment should be both in the clinical and the didactic courses because this is a skill that needs to be learned and studied in theory and practice. Particularly, making a questionnaire for other hygienists is one of the tools that can point out the gaps in knowledge; thus, it promotes to review challenging topics. The techniques and basics of critical thinking urge them to gain knowledge in a particular sphere and promote better work performance. Eventually, this practice is an excellent example of personal growth and a key element in the decision-making process.