Category: Infection

Professional Practice Description

Various nursing practices, such as assessment of pain, nurse-to-nurse shifts, effective patient care, improving patients’ satisfaction, and infection control, occupy an important place within the healthcare industry. Nurses must perform at their best level and seek to deliver excellent service and care. Careful analysis and evaluation of nursing practices are essential in developing clear instructions and objectives, as well as in achieving great results through the implication of those practices. The purpose of this paper is to analyze the infection control or prevention nursing practice and observe the necessity of change and possible alternatives based on prior researches.

Within the analyzed facility, infection control is an integral concept that implies dangers and problematic issues. The primary point in infection prevention lies in the extensive existence of healthcare-associated infections (HAI) that can be caught by the patients while getting their treatment. The WHO defines infection prevention and control (IPC) as “a specific approach and practical solution designed to prevent harm caused by infection to patients and healthcare workers” (“Infection prevention and control,” 2017, para. 1).

Different infectious diseases, social sciences, epidemiology, and the enhancement of the health practices lie in the foundation of infection control practice (“Infection prevention and control,” 2017). Besides, infection control practice has a unique position, because each encounter of the health professional and a patient has a threat of infection development (“Infection prevention and control,” 2017). Consequently, one can see the significance of proper techniques to prevent possible infections within the healthcare organization and not to expose anyone to unfavorable outcomes.

The analyzed healthcare facility possesses weaknesses in infection control practice. Firstly, there is a lack of handwashing dispensers, which creates burdens to the timely access to the infection prevention procedures for the professionals. Besides, the chosen organization does not have enough cleaning personnel and environmental safety employees, which decreases the effectiveness of the current ICP practice. The analyzed facility also lacks in the strength of the organizational culture, which creates limitations for successful infection control. The chosen healthcare organization has a limited budget, while the ICP practice improvements require investments. Thus, it is crucial to find practical implementations and emphasize the advantages of the change to the board.

Within the last decades, more hospitals have become aware of infection control and aim to strengthen their position in this field. Healthcare-associated diseases represent a severe complication of modern medicine internationally. Several reasons, such as the utilization of the devices, older population, or incorrect use of antimicrobial practices, contribute to the emergence of this problem (Al-Tawfiq & Tambyah, 2014). Today, medicine is full of new complicated procedures that might put the immune system at risk (Nelson & Williams, 2014).

The wide use of invasive devices and the complexity of the treatment techniques can compromise the health of the patients and increase the possibility of infection. Nelson and Williams (2014) claim that within the nearest future, the number of HAIs will increase due to the reasons described above. Moreover, weak ICP methods imply high costs for a healthcare organization. Therefore, infection control practices require a change to keep up with the developments of healthcare procedures and to be able to provide an appropriate level of safety for the patients and workers.

Key Stakeholders

It is essential to identify the stakeholders, the parties who are influenced by infection control and prevention practice, and its change. Firstly, the patients are at a higher risk and, therefore, the members of the society, where every single individual can become a patient, are the integral stakeholders in this field. Invasive devices are used during clinical procedures and treatment, which has a chance to cause infection directly for the patient.

Consequently, it is within the interests of the community to pursue effective ICP practices because they play the primary role within the possible impact of healthcare techniques and methods. As an influential stakeholder group, the patients can contribute to the change by providing feedbacks on their experiences within the facility. Besides, the recommendations and expectations for the services from the community can be beneficial to the strengthening of the current ICP practice.

Another essential group to consider is the healthcare industry professionals. Infections can have a rapid spread in a wide area within a short period. HAIs occur in various health organizations that are full of patients, but also doctors, nurses, and medical assistants. Interesting, that healthcare professionals have two different roles within the investigated concept. From one perspective, they, just like patients, can catch an infection after specific procedures.

In this way, they represent a group that is at risk of being infected. From another perspective, doctors and nurses can compromise themselves by being the ones who performed the procedures on a patient who got the infection later. Due to the diversity of reasons for the HAIs, it is difficult to determine the causes of related diseases. However, the professionals performing operations or having contact before the infection period, are at stake of carrying the blame and having legal and social consequences.

The healthcare professionals must take the ICP practice change seriously because it directly involves their awareness and participation. The medical workers will be responsible for the specific stages of change implementation. Besides, it is fundamental for them to follow all the guidelines carefully, evaluate their performance, stick to the regulations, and maintain the proposed company’s culture. Encouragement among colleagues will also be an advantage for successful change integration.

Besides the stakeholders described in this section, patients’ relatives and friends, non-medical healthcare employees and visitors, and a specific health organization’s board of directors can be influenced by ICP practices. Healthcare-associated infections might be spread to people, with whom the infected ones interact before the detention of the disease. Also, HAIs imply costs for the healthcare facility, which puts the board of directors at stake.

The role of this stakeholder group with the ICP practice change process is to conduct the objective analysis of the proposed strategies and ensure the participation of all the parties involved. Raising awareness among the visitors, conducting continuous checks on the new implementations, and offering incentives to the other stakeholder groups is essential. Changes to improve infection control practices require significant investments, making more influence on the private hospitals’ shareholders or the chefs of the organizations. However, to make a positive impact on the stakeholders and increase the level of their satisfaction, it is essential to undertake specific measures.

Evidence Critique Table

Evidence Summary

The concept of nurses’ behavior plays a role when it comes to infection control practice. Jackson, Lowton, and Griffiths (2014) claim that healthcare professionals often present self-defensive behaviors in case of inappropriate HAIs prevention. The primary goal of their analysis was to understand the fundamental reason for the complex behaviors of the nurses in response to infections among their patients (Jackson et al., 2014).

The findings revealed that despite the focus on the rules for compliance with the existing ICP practices, different factors like individual perception, motivation, or pressure might influence professional’s behavior (Jackson et al., 2014). Thus, the integration of “reflective sessions or clinical supervision programs” can become a useful change for the existing infection control practices (Jackson et al., 2014, p. 407). From this article, one can withdraw the problematic issues and proposed strategies to implement a change.

Hand hygiene is another crucial aspect of ICP practice, which is directly connected to the emergence of HAIs. The researchers suggest that hand-rub dispensers and hand-hygiene facilities play an essential role in the effectiveness of infection prevention (Zingg et al., 2015). The systematic review concluded that several critical components make ICP practice effective. Among them, there are availability and access to the materials, use of guidelines, bed occupancy, and auditing and feedback (Zingg et al., 2015).

According to Zing et al., positive OC also favorably contributes to the success of infection control (2015). Besides, limited access to the hand-hygiene equipment within specific hospitals becomes “a source of frustration” for the professionals, which harms various levels of the organization, including behaviors and satisfaction (Zing et al., 2015, p. 214). Consequently, this study shows the connection among the elements of the healthcare facilities, highlights the importance of hand hygiene and the necessity in creating easy access to the related equipment.

The organizational culture occupies a significant spot within healthcare facilities. The researchers argue that organizational culture (OC) is a mirror of the professionals, services, activities, and patients (De Bono, Heling, & Borg, 2014). Throughout time, the essence of the company’s culture transformed into the norms of behavior and expectations (De Bono et al., 2014). Today, positive organizational beliefs and thinking can portray the legitimacy and desirable attitudes towards the patients. In such a way, focusing on modifying organization culture “appears to be promising, albeit challenging target for IPC improvement campaigns” (De Bono et al., 2014, p. 1). Thus, another study emphasized that alterations in OC can have a positive impact on the effectiveness of ICP performance.

It is crucial to take a look at the effectiveness of ICP practices. Mitchell, Hall, MacBeth, Gardner, and Halton (2015) conducted a cross-sectional study among Australian hospitals. The findings have revealed that private hospitals possessed lower levels of infection control, in comparison with the publicly funded healthcare facilities (Mitchell et al., 2015). Moreover, the analysis showed that in smaller hospitals, the professionals had identified the need for “increased access to infectious diseases or microbiology support” (Mitchell et al., 2015, p. 612).

Besides, the researchers have concluded that the most significant change would be implementing information technology within the practice (Mitchell et al., 2015). Therefore, one can see that this research portrays the lack of ICP in small and private healthcare institutions and emphasized the usefulness of the further integration of improved technologies.

One more study focused on investigating the cost-effectiveness of the investments in fighting HAIs within intensive care units. Dick et al. (2015) have examined five years of data and concluded that current ICP strategies proved themselves to be cost-effective. However, besides the analysis of the financial side of infection control, the researches emphasized that HAIs remain to be a severe issue and impose high social costs (Dick et al., 2015). Consequently, although changes in ICP will require higher investments, “efforts to develop new prevention strategies” are integral for the healthcare industry (Dick et al., 2015, p. 9). Thus, this article highlights the importance of integrating the change to reduce the problems and costs associated with HAIs.

Evidence-Based Practice Recommendation

From the summary of various studies in the previous section, one can claim that the focus of change in ICP practice lies within the organizational culture, employees’ behaviors’ evaluation, and hygiene equipment access. OC improvement implies investing in education and knowledge of the professionals, as well as maintaining positive relationships among the leaders and their subordinates. Also, the behavioral concept goes deep into infection control performance.

As the studies indicate, despite knowledge in ICP regulations, nursing professionals often portray inappropriate behaviors, which is also the issue in the analyzed healthcare facility. Thus, integrating more self-assessment tools, implementing audit and feedback from both nurses and patients, and emphasizing the individual’s value among all the parties involved can have a positive impact on the organization.

Another crucial recommendation, based on the evidence summary, is the investments in hand-rub dispensers, hand-hygiene facilities, and related information technology. For instance, automatic reminders of the system for the professionals to perform infection prevention procedures can make the practice more efficient. Hence, the change in ICP practice requires careful attention to various levels within the healthcare organization, including OC, and investments into physical equipment and technologies.

Practice Change Model

Havelock’s theory of change is a great model for the implementation of changes in infection control and prevention practice within the analyzed healthcare facility. Integrating a specific model aims to create a planned and positive change within the organization, which is crucial in improving nursing practices. Havelock’s theory developed from Lewin’s initial change model that included unfreezing, moving, and refreezing stages (Kearney-Nunnery, 2016). Havelock’s approach broadens the three phases and offers detailed steps for the implementation of modifications. This model fits the chosen recommendations for the ICP because it “reflects the empirical-rational nature of humans” (Kearney-Nunnery, 2016, p. 185). The list below represents Havelock’s theory’s stages and provides details for the ICP changes within the analyzed organization:

1. Perception of need: despite proper knowledge and education, as well as investments in ICP, HAIs keep occurring within the organization, which requires change.
2. Problem’s diagnosis and identification: careful analysis of the current ICP practice reveals that it needs to be more effective to maintain a positive image, meet the patients’ expectations, and respond to desired safety levels.
3. Devising a plan of action: the company will emphasize the major recommendations, as well as specific details on the change plan. The first integral part is investing in new technologies and establishing more hand-hygiene facilities within the organization. The next step is integrating proper auditing and evaluation techniques for the professionals and focusing on creating positive OC through teambuilding, special seminars, and educational sessions.
4. Gaining acceptance of the plan: communicating the need for change for ICP practice among nursing professionals, discussing the planned actions with them, and earning their approval through emphasizing advantages that the moves will bring.
5. Stabilization: implementing the action plan and working on stabilizing the new approach to ICP practice within the organization.
6. Self-renewal: maintaining the improved ICP practice within the facility by sustaining the implemented measures and techniques.

Potential Barriers

Every change strategy implies the presence of possible barriers either for its full realization or the burdens for sustaining the improvements. In the case of the proposed recommendations through Havelock’s model of change, a potential obstacle can be the reaction and misunderstanding of the employees. Modifications in the OC involve active interactions with the professional and their aspiration for positive change and development. As far as ICP practice change implicates the evaluation of behaviors, it might generate discontent or unwillingness to participate. Another potential barrier is the financial cost of the change.

As far as the new strategy means investing in new equipment, new technology, seminars, and education, the analyzed healthcare facility should carefully design an action plan considering the current budget. Consequently, the perception of the transformation, its communication to the organization, and financial implications represent possible obstacles for the ICP change.

Ethical Considerations

Ethics is in the core of nursing practices and plays a significant role in ICP in particular. The Code of Ethics was developed by the American Nurses Association to highlight the importance of integrity and morality when it comes to healthcare activities (Haddad & Geiger, 2019). This code includes nine provisions that serve as guidance for the professional nurses to perform at their best levels (Haddad & Geiger, 2019). One of the parts related to the suggested changes in ICP practice is the fact that the patient represents a primary concern and commitment for the professionals (Haddad & Geiger, 2019).

Another integral one is that the nurse “has authority, accountability, and responsibility for nursing practice” (Haddad & Geiger, 2019, para. 10). Those points require thorough consideration for the chosen recommendations for ICP change. Thus, one can claim that throughout the implementation of change within the analyzed healthcare facility, it is crucial to remember the Code of Ethics and carefully examine each action.

In conclusion, the chosen healthcare organization needs to integrate changes into the current infection control and prevention practice to enhance its operations, improve patients’ experience, and minimize the chance of HAIs’ occurrence. Careful analysis of various researches provides the foundation for the recommendations. Working towards positive organizational culture, conducting professionals’ evaluations, and investing in new equipment and techniques based on Havelock’s model of change can have a positive impact.

References

Al-Tawfiq, J. A., & Tambyah, P. A. (2014). Healthcare-associated infections (HAI) perspectives. Journal of Infection and Public Health, 7(4), 339-344.

De Bono, S., Heling, G., & Borg, M. A. (2014). Organizational culture and its implications for infection prevention and control in healthcare institutions. Journal of Hospital Infection, 86(1), 1-6.

Dick, A. W., Perencevich, E. N., Pogorzelska-Maziarz, M., Zwanziger, J., Larson, E. L., & Stone, P. W. (2015). A decade of investment in infection prevention: A cost-effectiveness analysis. American Journal of Infection Control, 43(1), 4-9.

Haddad, L. M., & Geiger, R. A. (2019). Nursing ethical considerations. Web.

Infection prevention and control. (2017). Web.

Jackson, C., Lowton, K., & Griffiths, P. (2014). Infection prevention as “a show”: A qualitative study of nurses’ infection prevention behaviours. International Journal of Nursing Studies, 51(3), 400-408.

Kearney-Nunnery, R. (2016). Advancing your career: Concepts in professional nursing (6th ed.). Philadelphia, PA: F.A. Davis Company.

Mitchell, B. G., Hall, L., MacBeth, D., Gardner, A., & Halton, K. (2015). Hospital infection control units: Staffing, costs, and priorities. American Journal of Infection Control, 43(6), 612–616.

Nelson, K. E., & Williams, C. M. (2014). Infectious disease epidemiology. Burlington, MA: Jones & Bartlett Learning.

Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L.,… Pittet, D. (2015). Hospital organization, management, and structure for prevention of health-care-associated infection: A systematic review and expert consensus. The Lancet Infectious Diseases, 15(2), 212-224.

Hepatitis A, also commonly known as Hep A, is a transmittable liver infection caused by an agent known as the hepatitis A virus. The causative agent is one of the different forms of hepatitis viruses that trigger inflammation and affect the proper functioning of the liver. The disease is manifested in two different cases. One of these cases is reflected in mild symptoms that last for a number of days. The other one is characterized by severe symptoms that may last for more than a month. The prevalent forms of acquiring the infection include the use of contaminated water or food alongside getting into contact with an infected person. Therefore, maintaining cleanliness is one of the ideal approaches that can help mitigate the likelihood of susceptibility to the virus. Vaccines are available for severe illnesses.

There are many symptoms of the disease, most of which are noticeable a few days after contracting the infection. Some of the most common ones include fatigue, loss of appetite, nausea and vomiting, joint pain, dark urine, and abdominal discomfort or pain (Sanchez, 2013). It is advisable to immediately seek medical attention on the realization of any of these symptoms in order to avoid infection. There are specific categories of people who are more vulnerable to the virus infection, including international travelers, users of illegal drugs, and those living with an infected person.

The predominant cause of the infection is the ingestion of contaminated water or food. The fecal matter moves along the digestion system to the liver where it infects the cells, consequently leading to inflammation. These inflammations can affect the normal functioning of the liver and trigger other symptoms of the disease. The body’s immune system plays an integral role in keeping the body safe from disease. The presence of a pathogen is first detected by the innate immune system through specialized cells dubbed dendritic cells. This triggers production of lymphocytes that helps the body to destroy the infected cells and invaders.

On the other hand, the treatment of the illness remains a mystery. The body clears the virus automatically. In most reported cases of Hep A, the liver takes six months to heal with no lifelong damage. Treatment largely focuses on coping with symptoms. People affected by the disease, for instance, need to take a rest. Moreover, it is important to take snacks and high-calorie foods in order to cope with nausea. It is also important to give the liver a rest mainly through avoiding medications and alcohol. People who have been exposed to the virus are recommended to have immunoglobulin therapy or vaccine within a fortnight of exposure in order to protect the body from infection.

Environmental, as well as individual methods and precautions, can go a long way in protecting the body from the disease. Practicing good hygiene is one of the highly effective precautions. Besides, those infected with the virus should keep away from sexual activities. The Hepatitis A vaccine is also a good antidote for the disease. It is normally administered in two doses – initial immunization and a booster shot after half a year.

The disease is rife in most parts of the world. The U.S., for instance, has reported numerous outbreaks of the disease. In 2014, for instance, the country reported 165 casualties in at least 10 states. The spread of the virus resulted from the consumption of “Townsend Farms Organic Antioxidant Blend” sourced from Turkey (Center for Disease Control and Prevention 2014). Among the confirmed cases, 55% (91) were females while 11 were children below 18. Conversely, 95 of the reported cases involved people in their midlife. The best way to prevent further outbreaks is constant sensitization of the citizenry on the importance of practicing good hygiene and having immunization.

References

Center for Disease Control and Prevention. (2014). Multistate outbreak of hepatitis A virus infections linked to pomegranate seeds from Turkey (Final Update). Web.

Sanchez, G. (2013). Hepatitis A virus in food: Detection and inactivation methods. New York, NY: Springer.

Taking the nursing course NUR 479DE was useful as it provided information about ways that nurses can have an impact on health outcomes in particular groups and populations. The healthcare context in which nurses operate today is rather complicated, and so is the nurses’ role in it. While nurses have to provide high-quality care to individual patients, they also take part in improving the health outcomes of specific groups and communities. Working closely with patients, as well as other care providers, enables nurses to identify potential problems that could be addressed through interventions. Their unique position in the healthcare industry also allows nurses to plan and implement interventions aimed at improving community and public health. Overall, the content of this course and the assignments included in it were helpful in exemplifying the practical role of nurses in identifying and addressing the health concerns of communities.

The fieldwork experience proved to be helpful because it enabled me to study and apply the processes used by nurses to influence public and community health. As part of the fieldwork experience, I identified potential health concerns in a particular community, which included child patients in the Medical Daycare program. Observations and assessments conducted as part of the fieldwork experience were instrumental for highlighting problems in infection control. Further research included discussing the findings with other specialists involved and consulting scholarly resources. The information gathered as a result of the fieldwork experience allowed me to design an educational intervention that could improve infection control and patient health outcomes. The components of the fieldwork experience mirror those involved in community nursing practice. Thus, completing this project assisted me in developing and improving the skills and abilities that I could apply to improve my future nursing practice.

Observations, assessments, and research are crucial to nursing interventions aimed at improving community health. Community health assessments are particularly valuable in nursing practice since they help to identify the needs, health problems, and concerns of people in a particular community. According to the Centers for Disease Control and Prevention (2018), community health assessments add value to nursing care by supporting health improvement planning. They provide comprehensive and reliable information that allows planning nursing care interventions that would benefit communities. The inclusion of community health assessments in educational programs also provides future nursing leaders with knowledge and experience necessary to ensure that their practice helps not just individual patients but also communities and the general public (Evans-Agnew, Reyes, Primomo, Meyer, & Matlock-Hightower, 2017). Hence, conducting a community assessment as part of the course helped me in gaining practical knowledge that would benefit my future work in healthcare.

One particular aspect of the course and the fieldwork experience that stood out to me was the role of different stakeholder groups in community health improvement. Both the theoretical information provided and my practical work as part of the course highlighted the importance of involving different stakeholder groups in health improvement efforts. For instance, my fieldwork experience focused on infection control practices of care providers. However, the educational intervention was aimed at various stakeholders, including care providers, patients, and their caregivers. Involving different groups of stakeholders in health improvement projects increases their potential efficiency (Albritton et al., 2014). Therefore, this new learning will assist me in planning and implementing health improvement initiatives more effectively in the future.

References

Albritton, E., Edmunds, M., Thomas, V., Petersen, D., Ferry, G., Brach, C., & Bergofsky, L. (2014).Engaging stakeholders to improve the quality of children’s health care.Web.

Centers for Disease Control and Prevention. (2018).Community health assessment & health improvement planning.Web.

Evans‐Agnew, R., Reyes, D., Primomo, J., Meyer, K., & Matlock‐Hightower, C. (2017). Community health needs assessments: Expanding the boundaries of nursing education in population health. Public Health Nursing, 34(1), 69-77.

Required information

This paper is a research proposal aimed at drafting the information about the purpose of the research, the strategies, and techniques used for the research. The research is aimed at considering the nosocomial infections transmitted by all staff within the Skilled Nursing Facility with the help of quantitative research after the consideration of the medical journals and some sources on the Internet.

Appropriateness of approach

The research is important, and it should be conducted as nosocomial infections are easily transmitted and may be a cause of a serious epidemic if the specific measures are not considered in detail. This research aims to check two specific ways of how to combat the disease in case it is already spread in one particular environment. The research is appropriate as it corresponds to the requirements of the course, and all the necessary procedures are followed, including the literature review, the methodology, the results, and the discussion of the research results. Nosocomial infections are considered a serious problem for hospitals, which requires more financial support and more time of hospitalization (Baghaei, Mikaili, Nourani, & Khalkhali, 2011).

Purpose of the research proposal

The research is aimed at considering the measures which may be taken when the nosocomial infections are transmitted by all staff within the Skilled Nursing Facility. Particularly, the research is directed at checking whether the implementation of the preventive alert and pause system is effective in the situation. The purpose of the research is based on measuring the number of the occurred cases and considering how many cases were treated by means of the mentioned techniques.

Researcher

The main role of the researcher is to create the sample for the research, to describe in detail the methodology and the research procedure, and to observe the research by noting all the results. Having quantitative research as the method used in this case, the researcher should gather all the data, systemize it, and after a detailed consideration to structure the results to make those easy for consideration. The role of the researcher, in this case, bears practical importance along with the theoretical participant who is responsible for the research procedure and results in analysis.

Sampling techniques

Quantitative research is based on the number of occurrences of the cases of nosocomial infections, and the strategies for decreasing the number of cases are going to be considered.

Appropriateness of sampling techniques

This type of research is the most appropriate as being aimed at considering the most effective strategy for dealing with nosocomial infections; the number of cases should be explored with the observation of the strategies used with the consideration of the most effective measures taken.

The target audience of participants

The target audience is the medical staff, nurses, doctors, and other participants of the treatment process who may deal with nosocomial infections at the workplace. The research may also be interesting for organizations that should accept many people. The measures for preventing infectious disease are going to be useful for the medical staff in schools, kindergartens, and other organizations where many people are gathered.

Hypothesis statement

Nosocomial infections transmitted by all staff within the Skilled Nursing Facility may be successfully prevented if the staff implements the preventive alert and pause system during the predicted peak of the disease.

Reference List

Baghaei, R., Mikaili, P., Nourani, D., & Khalkhali, H. R. (2011). An epidemiological study of nosocomial infections in the patients admitted in the intensive care unit of Urmia Imam Reza Hospital: An etiological investigation. Annals of Biological Research, 2(5), pp. 172-178.

Introduction

The purpose of this paper is to provide a critique of a quantitative research paper dedicated to reducing hospital-acquired infection in hospital patients. One of the ways to fight hospital-acquired infections in patients is through handwashing. The reviewed article is titled “Patients’ Hand Washing and Reducing Hospital-Acquired Infection,” written by Haverstick et al. (2017) and published in June’s issue of Critical Care Nurse, which is a peer-reviewed journal. The study sought to understand if there is a correlation between increased access to hand hygiene and patient education with the rate of infection and transmissions of hospital-acquired infections (HAI) (Haverstick et al., 2017). The bio-organisms of interests included methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, as well as Clostridium difficile, which are some of the most frequent causes of HAI (Haverstick et al., 2017).

The article does not feature a dedicated literature review section, instead focusing on the components of experiment and its results. The data pulled from other literature sources was used generally to set up the background, citing that out of 72,200 HAI patients in 2011, over 75,000 died, showing a mortality rate of over 10% (Haverstick et al., 2017). Additional literature sources were used to formulate the experiment’s framework and its hypothesis, as well as to serve as points of comparison for the results. The researchers hypothesized that the outcomes of the study would mirror other similar experiments, and result in moderate-to-significant reductions in bacteria populations as well as risks of acquiring infections (Haverstick et al., 2017). Since the article does not feature extensive literature review, it is hard to determine whether any biases towards predicated sources is present.

Summary of Methods

The study was experimental, as the researchers introduced an intervention, which constituted of handwashing and patient education, into a hospital setting, and studied its effects. The research used a convenience sampling method, including all of the patients of the 36-bed cardiothoracic surgical step-down unit at the University of Michigan Health System (Haverstick et al., 2017). Participants were chosen based on their availability either as patients of the surgical unit or as doctors and nurses working in it. Prior to conducting research, a staff questionnaire was conducted in order to determine the levels of knowledge and attitudes of nurses and doctors in regards to handwashing (Haverstick et al., 2017). A similar question was also introduced to patients.

Data about the infection rates after the intervention was recorded post-factum. Researchers validated their chosen instruments for data collection by citing other researches with similar methods of data collection and analysis. In order to compensate for the relatively low number of patients participating in the study, the research design justified the use of parametric Wilcoxon rank sum test (Haverstick et al., 2017). Due to the relatively small size of the article, they did not directly address the issues of validity and reliability of their findings beyond comparative analysis with other articles and findings. This constitutes a weakness to the research.

Summary of Results

Statistically significant results included drastic reduction in median infection rates from Vancomycin-resistant enterococci and Methicillin-resistant Staphylococcus aureus. The former went down from 0.82 to 0.50, while the latter saw a more than three-times decrease in incidence rate, going from 1.60 to 0.50 (Haverstick et al., 2017). Clostridium difficile showed no significant changes, indicating that this type of bacteria may be more resistant to handwashing and alcoholic solutions applied to the skin as part of the intervention. The article claimed practical significance in reducing the number of incidents involving at least two types of bacteria found in generic hospital settings. The authors connect their conclusion to these findings, indicating that hand hygiene should be used before and after most essential practices, such as moving in and out of rooms, using the restroom, and taking meals (Haverstick et al., 2017). They did not directly cite the reduction of infection rates achieved in the scope of their study.

Ethical Aspects

The article has a dedicated section to various ethical aspects of the research. Since the intervention was conducted at Michigan university, it is safe to assume the institutional review board gave the researchers a go-ahead prior to the study being conducted (Haverstick et al., 2017). In order to protect patient and nurse confidentiality, distributed questionnaires were anonymous. In addition, the data regarding numbers of individuals acquiring hospital infections was anonymized. Patient consent to participate was waved for this intervention, as the project met the criteria for quality improvement. The University of Michigan provided a grant of 2350 dollars, which was mentioned in this paper. That money was spent on purchasing alcohol-based hand sanitizer and wipes (Haverstick et al., 2017). No ethical issues with this study were reported.

Evaluation of Study

The study implemented an experimental research design, which is the primary method of generating new quantitative data in a medical setting (Newman, 2016). It accounted for various dependent and independent variables by evaluating the amount of knowledge and the intensity of handwashing practice in the hospital from the patient and nurse perspectives, in order to establish discrepancies and justify the use of educational intervention in addition to the physical provision of alcohol-based solutions and handwipes (Haverstick et al., 2017). In that regard, researchers used appropriate methods in order to investigate research questions.

The strength of the study lies in its straight-forwardness of implementing the intervention and in the simplicity and economic viability of it (Newman, 2016). It proved to be relatively low-cost, with only 2,350 dollars spent on handwipes and alcohol solution for the entire duration of the intervention, while significantly reducing the number of hospital-acquired infections and saving the hospital money, while protecting patients from negative outcomes (Haverstick et al., 2017). In addition, the study featured a robust statistic framework in order to compensate for some of the weaknesses of the study.

Weaknesses are many, however, as the article does not feature a dedicated literature section, making certain claims made in the scope of the research doubtful (Ratelle, Sawatsky, & Beckman, 2019). Some of the limitations acknowledged by the authors include small sample size, homogeneity of the participants, the issues with self-reporting nature of questionnaires, and general levels of busyness of the staff, which could have distorted the effectiveness of the intervention (Haverstick et al., 2017). The authors also did not mention the lack of a longitudinal follow-up in order to see if the situation remained stable after the intervention was finished. The authors made suggestions to further investigate the practice of handwashing with alcohol-based solutions as means of reducing the number of HAIs, only in a larger setting with more heterogeneous population in order to account for the limitations of the present article. I think that the research design could be improved by utilizing handwashing methods that are effective on all three types of bacteria. As this research proved, alcohol-based solutions seemed to have no effect on Clostridium difficile, and no other information presented suggested otherwise.

Conclusion

The article presented offered a simple experiment design. Its findings correlated with other research in the same area. The article had some limitations regarding literature background and the number of patients participating. Its results cannot be easily extrapolated to other locations and larger settings. Utilizing handwashing solutions effective against all three types of bacteria is necessary, and additional research is required.

References

Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection. Critical care nurse, 37(3), e1-e8.

Newman, M. (2016). Research methods in psychology. (2nd ed.). San Diego, CA: Bridgepoint Education.

Ratelle, J. T., Sawatsky, A. P., & Beckman, T. J. (2019). quantitative research methods in medical education. Anesthesiology, 131(1), 23-35.

Introduction

The high prevalence of sexually transmitted infections (STIs) is an issue that has to be addressed in patient education. The diagnosis of these conditions is further complicated by the fact that they are mostly asymptomatic or similar to each other in the presentation. In the first case study, a 19-year-old Asian-American female comes to the office for a checkup and states that she had a sore on her labia that resolved on its own. The physical examination does not reveal any other signs, except from maculopapular rashes on different parts of her body. This combination of symptoms can be indicative of a variety of STIs as well as other disorders.

Differential Diagnosis

The first differential and most likely diagnosis is secondary syphilis. Syphilis is an STI caused by bacteria Treponema pallidum, and it progresses in several stages. Primary syphilis presents with painless sores on or around the genitals, mouth, or rectum (Schuiling & Likis, 2017). At the end of the stage, the sores heal, and maculopapular rashes manifest on extremities. Latent syphilis may have a debilitating effect on one’s cognition, eyesight, as well as cardiovascular and nervous systems (Gnann & Whitley, 2016). Diagnostic tests include a Rapid Plasma Reagin (RPR) or a Venereal Disease Research Laboratory (VDRL) and a treponemal analysis (such as fluorescent treponemal antibody absorption) (Tharpe, Farley, & Jordan, 2017). The patient’s preliminary and current symptoms align with the typical presentation of syphilis, thus suggesting the onset of the condition’s second stage.

The second possible diagnosis is an infection caused by the herpes simplex virus (HSV). In this case, as genital sores are present, the strain HPV-2 (genital herpes) can be considered (Workowski & Bolan, 2015). The primary symptom of HPV is sores – they may appear on or around one’s genitals and rectum (Workowski & Bolan, 2015). While the patient had a sore on her genitalia, it was not painful. Moreover, the development of maculopapular rash is not consistent with this diagnosis, thus lowering its priority.

The last differential diagnosis is pityriasis rosea – a rash the exact cause of which is unknown. It is possible that some herpes virus strains may lead to this condition. Pityriasis rosea is characterized by a rash that begins on one’s back, chest, or abdomen (Drago, Ciccarese, Rebora, Broccolo, & Parodi, 2016). Later, the rash spreads to the extremities; it may itch, but it usually goes away on its own. In this particular case, the location of the rash (arms, feet, neck) does not align with the typical presentation of pityriasis rosea. Moreover, the patient does not report an itch or other minor symptoms such as headaches, fever, or fatigue.

Treatment, Management, and Education

It is vital to treat the infection as soon as it is confirmed. The preferred treatment for all stages of syphilis is Penicillin G (Workowski & Bolan, 2015). For the first and second stages of syphilis, Penicillin G Benzathine can be prescribed as a single intramuscular shot in a dosage of 2.4 million units (Workowski & Bolan, 2015). The patient’s current and previous partner or partners have to be evaluated and treated as well. Apart from pharmacological treatment, the patient has to receive education regarding common STIs. The patient should avoid sexual activity before the treatment is completed, and the tests show the absence of an infection. Moreover, the patient needs to use preventive measures – have sex with uninfected partner or partners, use latex condoms to reduce the risk of infection, and get screened for STIs regularly (Schuiling & Likis, 2017). Testing for other STIs is necessary to detect possible conditions.

Conclusion

In the first case study, the patient’s symptoms suggest the development of syphilis – an STI caused by bacteria. The patient’s treatment includes antibiotics, and patient education has to focus on sexual hygiene. The most common ways of reducing the risk of STIs is protection with condoms and sexual activity with one long-term partner. Nonetheless, sexually active people are recommended to get screened for various STIs regularly to avoid missing the infections’ escalation.

References

Drago, F., Ciccarese, G., Rebora, A., Broccolo, F., & Parodi, A. (2016). Pityriasis rosea: A comprehensive classification. Dermatology, 232(4), 431-437.

Gnann Jr, J. W., & Whitley, R. J. (2016). Genital herpes. New England Journal of Medicine, 375(7), 666-674.

Schuiling, K. D., & Likis, F. E. (2017). Women’s gynecologic health (3rd ed.). Burlington, MA: Jones and Bartlett Publishers.

Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th ed.). Burlington, MA: Jones & Bartlett Publishers.

Workowski, K. A., & Bolan, G. A. (2015). Sexually transmitted diseases treatment guidelines, 2015. Morbidity and Mortality Weekly Report (MMWR): Recommendations and Reports, 64(RR3), 1-137.

Methicillin-resistant Staphylococcus aureus (MRSA) can cause a wide range of infections. Such infections can result in mortality and morbidity. Staphylococcus aureus is “a common pathogen widely common in prosthetic joint infections” (Ng & Awad, 2015, p. 2). The purpose of this study is to understand how an effective preoperative MRSA screening protocol can be used as a powerful strategy to minimize orthopedic surgical site infections (Alexander & Wang, 2015).

Search Method

A rigorous strategy was used to select the most desirable peer-reviewed journal articles for this study. The major databases used to collect the required information included Science-Direct, the British Medical Journal (BMJ), and Evidence-Based Nursing (EBN). Several keywords were also used to select quality articles for the study. The keywords used are presented below.

• Methicillin-resistant Staphylococcus aureus (MRSA)
• MRSA screening
• Orthopedic site infection
• Quality improvement
• Quality healthcare delivery

On top of that, a powerful criterion for exclusion and inclusion was used. For instance, articles published within the last five years were considered for inclusion. The other consideration was to ensure the articles addressed the issue of MRSA infection. The selected articles presented evidence-based ideas and arguments. A total of 10 peer-reviewed journal articles were selected for the study.

Summary of Research Studies

Akhtar, A., Kadir, H., & Chandran, P. (2014). Surgical site infection risk following pre-operative MRSA detection in elective orthopedic surgery. Journal of Orthopaedics, 1(1), 11117-11120.

This article indicates that patients undergoing orthopedic surgery have higher chances of MRSA infection. Over 80 percent of the targeted patients had been colonized with MRSA. The study shows clearly that a preventative or screening strategy can minimize the risk of MRSA infection. Patients should therefore “be sensitized about the increased surgical site infection if colonized with MRSA pre-operatively” (Akhtar, Kadir, & Chandran, 2014, p. 11117). However, the article fails to propose adequate solutions to deal with this problem.

Alexander, C., & Wang, L. (2015). Infection control: methicillin-resistant Staphylococcus aureus. American Journal of Infectious Diseases, 11(3), 74-82.

The scholars conducted an extensive literature review to understand the problem of MRSA infection. After conducting the study, the authors indicated that early isolation and identification for the pathogen could deal with the health problem (Alexander & Wang, 2015). This should also be done at the point of entry. The main strength is that the study offers new approaches towards dealing with various healthcare-associated infections (HAIs).

Charles, K., Nathan, L., Blake, B., Maureen, S., Gary, S., & David, L. (2016). Is staphylococcal screening and suppression an effective interventional strategy for the reduction of surgical site infection? Surgical Infections, 17(2), 158-166.

The study analyzed the current use of topical mupirocin in many hospitals as the best procedure for nasal decolonization. According to the authors, the screening methods were selective and controversial. However, studies have indicated that suppression and screening reduce SSI infections. The scholars proposed that the best surveillance strategy should be based on the risk-levels of patients undergoing surgical procedures (Charles et al., 2016). The study, however, fails to offer the best alternative for dealing with MRSA infections.

Duerden, B., Fry, C., Johnson, A., & Wilcox, M. (2015). The control of methicillin-resistant Staphylococcus aureus bloodstream infections in England. Open Forum Infectious Diseases, 2(2), 1-12.

A powerful research approach was used by the scholars. This was done by analyzing the major campaigns that managed to reduce MRSA infections. That being the case, the study also explains how the implementation of national infection prevention directions and expert improvement teams can deliver positive results. However, the authors fail to outline new screening strategies for MRSA (Duerden, Fry, Johnson, & Wilcox, 2015).

Jokinen, E., Laine, J., Huttunen, R., Arvola, P., Vuopio, J., Lindholm, L.,…Syrjanen, J. (2015). Combined interventions are effective in MRSA control. Infectious Diseases, 47(11), 801-807.

This study entailed the use of various infection prevention measures and screening protocols. The scholars wanted to understand how the MRSA pandemic could be minimized. They concluded that the use of universal screening methods was effective in containing the epidemic (Jokinen et al., 2015). As well, they indicated that the Pirkanmaa epidemic (PE-MRSA) was becoming a major challenge.

MacFadden, D., Elligsen, M., Robicsek, A., Ricciuto, D., & Daneman, N. (2013). Utility for prior screening for methicillin-resistant Staphylococcus aureus in predicting resistance of S. aureus infections. CMAJ, 185(15), 725-730.

The purpose of the study was “to evaluate the effectiveness of MRSA screening in predicting the resistance of clinical isolates of S. aureus” (MacFadden, Elligsen, Robicsek, Ricciuto, & Daneman, 2013, p. 726). The method can be used to minimize MRSA infection in every healthcare setting. The main weakness of the study is that it fails to describe how medical professionals can improve the nature of screening for MRSA to minimize nosocomial spread (MacFadden et al., 2013).

Mehta, S., Hadley, S., Hutzler, L., Slover, J., Phillips, M., & Bosco, J. (2013). Impact of preoperative MRSA screening and decolonization on hospital-acquired MRSA burden. Clinical Orthopaedics and Related Research, 471(7), 2367-2371.

The authors used a power study design to come up with their findings. They wanted to understand the best ways to decolonize the MRSA burden. The study showed conclusively that “the implementation of a staphylococcal decolonization protocol at a single specialty orthopaedic hospital decreased the prevalence density of MRSA” (Mehta et al., 2013, p. 2367). The ideas can be replicated elsewhere to address this health concern.

Ng, W., & Awad, N. (2015). Performance improvement initiative: prevention of surgical site infection (SSI). BMJ Quality Improvement Programme, 4(1), 1-3.

Hospitals performing numerous surgical procedures should have safety measures to prevent SSIs (Ng & Awad, 2015). Mafraq Hospital, therefore, developed a multidisciplinary team to implement the best measures to eliminate surgical site infections (SSIs). The authors, therefore, show that the continued use of proper medical practices can help prevent the major causes of SSIs. These evidence-based ideas are applicable in many hospitals.

Thompson, P., & Houston, S. (2013). Decreasing methicillin-resistant Staphylococcus aureus surgical site infections with chlorhexidine and mupirocin. American Journal of Infectious Diseases, 41(7), 629-633.

The authors outlined the best ways that can be used to eliminate MRSA SSIs. The authors used past studies to examine how various hospitals used different strategies to deal with the MRSA epidemic. The analysis showed that “intranasal mupirocin and non-rinse 2% chlorhexidine gluconate cloths were beneficial in preventing MRSA infections in the non-general surgery population” (Thompson & Houston, 2013, p. 630).

Al-Mulhim, F., Baragbah, M., Sadat-Ali, M., Alomran, A., & Azam, M. (2014). Prevalence of surgical site infection in orthopedic surgery: a 5-year analysis. International Surgery, 99(3), 264-268.

This outstanding article explains why emergency surgical operations carry the greatest share of MRSA risk. Many patients record new health problems and death due to such infections. The scholars, therefore, propose the use of proper measures to control MRSA infection (Al-Mulhim, Baragbah, Sadat-Ali, Alomran, & Azam, 2014). The article also shows clearly that the use of antibiotics may not be sufficient for dealing with the problem.

List of References

Akhtar, A., Kadir, H., & Chandran, P. (2014). Surgical site infection risk following pre-operative MRSA detection in elective orthopaedic surgery. Journal of Orthopaedics, 1(1), 11117-11120.

Alexander, C., & Wang, L. (2015). Infection control: methicillin-resistant Staphylococcus aureus. American Journal of Infectious Diseases, 11(3), 74-82.

Al-Mulhim, F., Baragbah, M., Sadat-Ali, M., Alomran, A., & Azam, M. (2014). Prevalence of surgical site infection in orthopedic surgery: a 5-year analysis. International Surgery, 99(3), 264-268.

Charles, K., Nathan, L., Blake, B., Maureen, S., Gary, S., & David, L. (2016). Is staphylococcal screening and suppression an effective interventional strategy for reduction of surgical site infection. Surgical Infections, 17(2), 158-166.

Duerden, B., Fry, C., Johnson, A., & Wilcox, M. (2015). The control of methicillin-resistant Staphylococcus aureus bloodstream infections in England. Open Forum Infectious Diseases, 2(2), 1-12.

Jokinen, E., Laine, J., Huttunen, R., Arvola, P., Vuopio, J., Lindholm, L.,…Syrjanen, J. (2015). Combined interventions are effective in MRSA control. Infectious Diseases, 47(11), 801-807.

MacFadden, D., Elligsen, M., Robicsek, A., Ricciuto, D., & Daneman, N. (2013). Utility for prior screening for methicillin-resistant Staphylococcus aureus in predicting resistance of S. aureus infections. CMAJ, 185(15), 725-730.

Mehta, S., Hadley, S., Hutzler, L., Slover, J., Phillips, M., & Bosco, J. (2013). Impact of preoperative MRSA screening and decolonization on hospital-acquired MRSA burden. Clinical Orthopaedics and Related Research, 471(7), 2367-2371.

Ng, W., & Awad, N. (2015). Performance improvement initiative: prevention of surgical site infection (SSI). BMJ Quality Improvement Programme, 4(1), 1-3.

Thompson, P., & Houston, S. (2013). Decreasing methicillin-resistant Staphylococcus aureus surgical site infections with chlorhexidine and mupirocin. American Journal of Infectious Diseases, 41(7), 629-633.

Abstract

The purpose of this project is to explore the measures for the control and prevention of an infectious disease outbreak that can result in a pandemic. The focus is the hospital setting and the target is medical-surgical nurses. In the hospital setting, the spread of infection is extremely likely due to many contributing factors including exposure rate, patient load, and frequent contact with ill people. Nurses are at a high risk of contracting the disease and spreading it if appropriate infection control protocols are not followed strictly. This project examines the current outbreak of the COVID-19 virus also referred to as the Coronavirus.

COVID-19 is spreading rapidly, and the Centers for Disease Control and Prevention (CDC) have declared a state of emergency. Mainly, this project reinforces the infection control and prevention of spread measures that are suggested by the CDC. It also goes in-depth on the role of the nurses and how they can assist in disease containment by using such tools as a simple checklist to help educate and spread awareness.

Introduction

Highly infectious diseases such as the one that develops with the novel coronavirus, otherwise known as COVID-19, put additional pressure on the healthcare sphere. The risk of a pandemic increases the patient load of every hospital and clinic, and healthcare personnel (HCP) have to adapt to the new standards of care. At present, the pandemic of COVID-19 is the central problem that concerns the whole world. The urgent need for changes is clear – according to the latest findings, most hospitals and countrywide healthcare systems are not adequately prepared to handle the growing rate of new cases (World Health Organization [WHO], 2020). Thus, this project aims at looking at the existing evidence and investigating guidelines that are based on evidence and should be included in the intervention.

Problem Statement

The nursing staff is among the first responders that are affected by this outbreak. HCP does not know much about COVID-19, and many of its features and risks are underexplored. The current strategy is symptom treatment and control of spreading, which implies that nurses and other healthcare professionals are under great pressure to prevent the growth of cases. Nonetheless, the lack of awareness about proper crisis responses is evident when analyzing the speed of the infection in the United States and other countries. The focus on nurses’ actions, as a result, is essential to ensuring that the industry is prepared to meet the challenge of COVID-19.

Purpose

The purpose of this project is the development of an intervention for HCP and medical-surgical nursing staff, in particular, that would help them respond to the pandemic and cap the number of cases in the US. Therefore, it is necessary to consider how nurses should prepare to control the spread of the disease, including measures for prevention and containment. For this purpose, one has to research the latest information about the infection and explore the nursing responses to previous outbreaks similar to the novel coronavirus. Furthermore, the contemporary guidelines from the Centers for Disease Control and Prevention (CDC) need to be reviewed to see which of them have to be included in the plan for the hospital and unit under investigation.

The Nature of the Project

The project has an investigative purpose – thus, its design is based on the review of the literature and the synthesis of knowledge. Several research papers are considered to see how this particular outbreak is characterized, including the features of the disease, its spread patterns, and potential treatments. Next. Scholarly resources appraising the effectiveness of responses to previous epidemics as well as COVID-19 are analyzed to reveal the possible pitfall in nurses’ behavior and actions. Finally, the CDC guidelines are taken as the basis for the intervention, making the final product of this project a plan that can be used by nurses to respond to the novel coronavirus disease’s spread.

Background

To determine what steps are the most important for the intervention, one has to understand what is currently known about the virus and the disease it causes. Furthermore, it is vital to assess its progression in the world, previous responses to similar outbreaks, and the current state of the selected hospital. The first cases of pneumonia of unknown origin were identified in December 2019 in Wuhan, China (Chen, Tian, Li, & Li, 2020).

The researchers identified that the disease was caused by a new enveloped RNA beta coronavirus that bared resemblance to other coronaviruses. This version is named SARS-CoV-2, or “severe acute respiratory syndrome coronavirus 2,” and it leads to the development of the coronavirus disease 2019 (COVID-19) (Guan et al., 2020, p. 1). It is believed that the virus has a zoonotic origin, having spread from bats to humans.

Other types of coronavirus infections generally present with mild symptoms, although there have been several instances where the number of cases reached the level of an epidemic. For example, both Middle East respiratory syndrome-related coronavirus (MERS-CoV) and SARS-CoV could be considered as major outbreaks of a similar nature (Alfahan, Alhabib, Abdulmajeed, Rahman, & Bamuhair, 2016).

Nonetheless, the present virus seems to have an even stronger impact on the world population, as the number of infected people grows every day. Currently, there are more than 120 thousand cases in the US alone, and the global numbers are much higher (WHO, 2020). This amount is notable as the infection was identified in December of the last year in China, thus showing that the disease spread significantly in less than four months. Another important fact is that the majority of reported cases started appearing at the beginning of March – the first case quickly grew into a large number of new infections.

This acceleration in the speed of the virus spreading is indicative of its highly infectious nature. According to the latest findings, SARS-CoV-2 is most commonly transmitted during person-to-person contact when infected individuals sneeze or cough. Respiratory droplets that are produced during these actions travel from one person to another, being inhaled into the lungs or landing on one’s eyes, mouth, or nose (Huang et al., 2020). The current investigation does not confirm that the virus can travel long distances while airborne, and some concerns are raised over SARS-CoV-2 being transmitted through fecal matter (Huang et al., 2020). Nevertheless, the fact that SARS-CoV-2 easily spreads through close contact is enough to make the disease extremely contagious.

Another problem is that SARS-CoV-2 does not cause one to develop symptoms immediately. A person may not know that they have the virus while spreading it further (Millar, 2020). The incubation period may last anywhere between two to seven days, during which the infected individual is as contagious as when they have symptoms. COVID-19 is a respiratory disease, but the first signs may differ from one person to another. For example, the most common symptom is fever, but it is present in less than half of all cases during the first days of the infection (Guan et al., 2020). Cough is another usual sign, with almost 70% of all people having it (Guan et al., 2020).

Other characteristic symptoms are dyspnea, chest pain, diarrhea, fatigue, and myalgia, but their presence without cough and fever does not signify the presence of the virus (Guan et al., 2020). The description of the coronavirus disease does not define it as an easily identifiable condition. In contrast, COVID-19 resembles a variety of respiratory infections, which could have contributed to its rapid uncontrolled spread.

Furthermore, it is vital to note that the disease affects certain populations in different ways. Older adults and people with underlying health problems are at increased risk of suffering from a severe case of COVID-19. In particular, lung problems and asthma, heath disease, diabetes, renal or liver failure, and compromised immune system are among the factors that put people at the highest risk of difficult recovery (Chen et al., 2020). Moreover, pregnant persons and people who cannot access high-quality care are exposed to additional dangers. Therefore, a response to this outbreak should consider the effect of the infection on different communities.

The comparison of SARS-CoV-2 with previous infections caused by other types of coronavirus (MERS-CoV and SARS-CoV) reveals that the current pandemic is even more impactful. According to Patel, Bell, and De Perio (2020), both of the older infections caused more than 10 thousand cases in the span of two decades. To compare, SARS-CoV-2’s rates have surpassed 100,000 cases in one country (the US) in less than four months (WHO, 2020). This great difference between the epidemics demonstrates the danger of SARS-CoV-2, although its mortality rate is much lower than that of previous coronaviruses.

COVID-19 is possible to diagnose using laboratory testing or imaging. According to the CDC, Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panels are the main tests that can be performed to confirm the presence of the virus. These diagnostics usually take up about four to six hours to show results. Analyzing radiologic findings, ground-glass opacity seems to be the most indicative of the infection, and no other abnormalities are as conclusive (Guan et al., 2020). However, not all people are currently tested to lower the burden on the hospitals and to encourage self-isolation to control the number of new cases. Therefore, most clinicians are encouraged to disseminate self-checkers that list major symptoms for individuals to seek appropriate treatment after they have concluded whether they have COVID-19.

This decision to prioritize self-testing is one of the measures included in the CDC’s interim infection prevention and control recommendations. Overall, the organization acknowledges the highly contagious nature of the virus and the current shortage of personnel, protective equipment, and testing capabilities in the US. Thus, its guidelines are based on these factors, and they focus on the restrictions that HCP have to establish to limit the spread of the disease. Notably, the center of the advice provided by the CDC is the shortage of personal protective equipment (PPE). PPE includes such items as masks, respirators, goggles, gowns, and gloves. It is stated that.

At the present moment, the US and other countries have shortages of such equipment, as reported by local distributors (Centers for Disease Control and Prevention [CDC], 2020). While this level of protective measures is the least effective, this problem signifies a larger issue of health care professionals and the system being unprepared for the crisis. Therefore, the background of this investigation shows that nurses have to take additional steps to protect patients and themselves from contracting and spreading the virus.

Finally, it is essential to show why the chosen hospital needs this project. As can be seen from the previous paragraphs, medical establishments in the country are largely unprepared for the crisis. Apart from the lack of necessary protection, the rapid spread of the disease implies that the hospitals and government organizations did not succeed at detecting and containing the virus on its initial entrance to the country.

As a result, the medical sphere is overwhelmed with the continuously growing number of cases, and crisis measures now impact all hospital departments, including the chosen medical-surgical unit. Thus, nurses in this unit, who usually deal with pre-and post-operative patients, now have to focus their time and attention on COVID-19 cases and the protection of existing patients. This response is the reason why a consistent crisis plan and additional knowledge are vital and why this project was developed.

PICO Question and Lewin’s Change Theory

Based on the background of the problem and the purpose of this research, one can determine that the PICOT question has to consider a nursing intervention in the unit to control the infection’s spread. According to Lewin’s Change Model, there exist three major steps in which any new initiative is implemented – Unfreeze, Change, Refreeze (Hussain et al., 2018). The first activity is to motivate people and prepare them to embrace the new process.

A change agent has to analyze the problem and create a plan as well as show others why change is necessary and beneficial. Next, all involved entities enter a transition state, during which they overcome barriers and implement new processes. Finally, during the refreezing stage, people get accustomed to the new routine. Based on this theory, one may propose the following PICO question. “In medical-surgical nurses, is the implementation of a crisis plan with awareness materials, compared to no crisis strategy, more effective for preparing them to deal with the COVID-19 outbreak?” While the time frame is not explicitly discussed, the progression of COVID-19 suggests a quick project to be implemented in the next month.

Summary

The issue under investigation deals with the presently evolving COVID-19 crisis that was caused by a coronavirus SARS-CoV-2. This virus was identified in December 2019, and, in less than four months, it has penetrated most countries in the world, leading to hundreds of thousands of infected people. While the initial symptoms of the novel coronavirus disease are similar to most respiratory conditions, the virus is highly contagious and dangerous to the elderly, immunocompromised individuals, and persons with underlying health concerns.

Currently, not much is known about the treatment or vaccination for COVID-19, and most clinicians are only able to address symptom relief. Thus, the combination of the virus’ speed of spread, its risks, and the lack of a cure, outbreak containment is the primary choice of action. Healthcare professionals are at the center of disseminating this knowledge and controlling the pandemic – thus, an advanced change plan is necessary to raise awareness among nurses and ensure their preparedness.

Literature Review

Introduction

The sources used above provide an overview of the virus and the disease, as well as some details about how it is being handled by the CDC in the US. However, one also has to consider how such outbreaks were controlled previously as well as review the current guidelines with a focus on medical care. Therefore, the literature for this project was chosen on the basis of these research questions. The literature matrix provided below contains scholarly sources that discuss the previous experiences of HCP in regards to such epidemics as MERS-CoV and SARS-CoV. Moreover, it shows how COVID-19 was handled in China during the first weeks, and what steps nurses consider necessary to be included in the intervention.

Literature Matrix

Historical Overview

Several studies were chosen to showcase how the previous outbreaks of coronaviruses were handled and what knowledge nurses can use for this intervention. Interestingly, one can observe the same issues during the epidemics of MERS-CoV and SARS-CoV that nurses encounter now – the lack of information about hand hygiene, absent training for crisis situations, and unclear optimal control measures for the infection’s spread.

For instance, Wiboonchutikul et al. (2016) investigate the MERS-CoV infection that was first reported in 2012. They describe the disease as transmitted during contact and droplets released during one’s coughing or sneezing (Wiboonchutikul et al., 2016). Moreover, the symptoms are close to those of the novel coronavirus disease. The authors consider how HCP who come into contact with infected patients control the spread by using protective measures. Their guidelines suggest that full compliance with the hand hygiene routine, as well as proper techniques for wearing protective equipment, are crucial. Thus, these two elements can be considered as the basis for protecting both HCP and patients from increasing the number of cases.

A similar historical finding is presented by Al-Dorzi et al. (2016), who examine another hospital’s response to MERS-CoV. Nonetheless, it appears that, along with hand hygiene and PPE, there exists a need to control patients’ interactions with visitors, the location of their hospitalization, and the nurse-to-patient ratio. Here, one can see that, although protective measures are important for keeping the rates of new infections down, they cannot fully shield nurses from outside influences and high workload.

It is also vital to consider how nurses are educated about these measures and whether the hospital has any problems with staffing or organizational environment that may disrupt the adherence to guidelines. The research by Alfahan et al. (2016) is especially notable as it examines which factors negatively or positively impact HCP’s adherence to hand hygiene standards. The hospital’s nurses have to address a variety of aspects, including the environment, social interactions, fear of punishment, and individual beliefs.

Overall, the guidelines seem to focus on the lower levels of protection that are directly related to nurses’ protective wear and their ability to separate infected patients from other individuals (uninfected patients and visitors). Nevertheless, while hospitals under study were able to deal with the outbreak with a small number of cases, the necessary nurse-to-patient ratio to achieve such success is nearly impossible for other organizations. Another important detail is that the previous crises were not regarded as a precaution to fix the issue with PPE supplies – a problem that is at the center of the contemporary guidelines.

Current Findings

The chosen literature about COVID-19 describes its features as well as the crisis response that should be implemented by all healthcare organizations in the US. As shown in the Background section of the project, COVID-19 is similar to the previous coronaviruses, but the inconsistency of symptoms creates a need for a stricter response. For example, a large portion of all infected persons do not show symptoms immediately, and fever is not the first sign of the disease (Guan et al., 2020). Therefore, the crisis response should be based on the presumption that all individuals that enter the facility are already infected. This measure is vital to control the spread of the virus further.

This approach can also be described as proactive planning – the anticipation of the worst-case scenarios by medical professionals. Crisis Standards of Care (CSC) are a response to major epidemics, and they are based on the limits of HCP’s abilities (Hick, Hanfling, Wynia, & Pavia, 2020). This means that the emergency plan devised for each unit has to be adjusted for its staffing, capacity, and equipment. However, such basic principles as fairness, transparency, consistency, and duty to care have to be the foundation for each choice (Hick et al., 2020). Hick et al. (2020) propose six main steps – prepare, conserve, substitute, adapt, re-use, and re-allocate. This strategy seems to be in line with the current instructions provided by the CDC.

The CDC recommendations encourage hospitals to focus on resource conservation due to the shortages and the limited capacity of the healthcare system. This decision is viewed by nurses as a lack of support for the HCP in times of crisis. According to Mason and Friese (2020), such a lack of success in establishing local sources of PPE is a failure to prepare for unpreventable emergencies. Nonetheless, nurses have to advocate for adequate resources while also adhering to conservation practices. Millar (2020) suggests that nurses should prevent the intrahospital spread, protect patients and themselves, reassure patients, quarantine infected persons, adhere to proper hand hygiene, limit visitations, and support HCP through material and psychological measures.

Conclusion

The analyzed literature suggests a crisis plan that is based on the CDC guidelines, but that is also updated to fit the unique capacity of the selected unit. Conservation, focus on the infected, and hygiene seems to be the main aspects of the plan, which shows the importance of the current project in preparing medical-surgical nurses for the crisis. The evidence from previous outbreaks shows that low adherence is detrimental to the success of controlling the virus. Furthermore, it also demonstrates a lack of preparation on the organizational and governmental levels, which calls for strict measures to be implemented.

Summary

The response of the HCP to previous epidemics was based on proper hand hygiene, PPE, staff reallocation, and visitation control. COVID-19 is more challenging to diagnose than the previously detected coronaviruses. At the same time, it is highly contagious; thus, HCP are urged to focus on preventive measures, assuming that all incoming patients are infected. Current guidelines are developed with such issues as PPE shortage and the limited hospital capacity in mind. Nurses have to protect themselves and patients while also conserving resources.

Intervention

The research explored above outlines the main steps that nurses and other HCP have to take to control the outbreak. It should be noted that the majority of the patients report to the emergency department, while the intensive care unit (ICU) seems to be the most equipped to handle the infected persons. Nevertheless, the capacity of these units has its limits, and the size of the crisis would likely affect all parts of the hospital. Therefore, medical-surgical nurses must prepare to accommodate patients with COVID-19. At the same time, it is clear that the unit’s patients have to be protected from the infection.

The first part of the intervention deals with training for proper hand hygiene and PPE donning and doffing. Although all HCP need to follow these guidelines daily, the outbreak requires additional precautions – frequent handwashing and the use of alcohol-based hand rub have to be enforced (Patel et al., 2020). Respirator and facemask use guidelines need to be updated to fit in with the current shortage of PPE supplies. In essence, these resources have to be allocated to HCP that interact with infected patients or perform procedures requiring direct contact.

Second, the unit needs to cancel all elective procedures and reschedule as many visits as possible. The patients that have to come to the hospital have to be assessed for COVID-19 symptoms, using a checklist provided by the CDC. Before visitations, nurses have to determine which rooms or parts of the unit can be used to separate infected individuals from other patients. Negative pressure rooms seem to be the preferred placement for patients with COVID-19 to control the flow of air (CDC, 2020). Isolation is necessary to limit patients’ exposure to the virus.

Additional education may be necessary for some nurses who do not possess the skills to deal with the infection. As the workload of the unit is likely to increase and shift toward COVID-19 patients, nurses have to know how to treat the infection and what procedures are performed. To achieve this, a combination of posters, pamphlets, and task-specific training has to be implemented. While all staff members have to receive refresher training, they may not respond to completely new information (Millar, 2020).

Thus, nurses have to learn only those activities that do not require extensive learning. Nurses with the most experience and specialized knowledge necessary for the surgical unit may be appointed to look after non-COVID-19 patients. Moreover, cleaning, bathing, and other regular, but unspecific tasks can be delegated to other HCP or appointed caretakers.

Information channels for the unit and other parts of the hospital have to be established to quickly report the presence of symptoms or any news related to the infection inside the facility. Reporting to public health authorities is important as well, as communication is the key to controlling the outbreak (CDC, 2020). Before transferring any patient to another department, appropriate HCP have to be made aware. Additionally, all nurses have to know who they have to contact in case they develop symptoms.

Nurses working in a crisis are under significant stress, and they often cannot seek help or deal with burnout. Thus, another part of the intervention deals with mental support – nurses can allocate a short period daily to meet and discuss existing problems, obstacles, and solutions (Millar, 2020). A conversation not focused on specific tasks is vital to relieving stress without taking away much of the nurses’ time. Nurses should be reminded that they are not alone in this crisis and that their work is appreciated by the community. Colleagues can assist each other through conversation and psychological support.

Finally, the unit can create a standardized list of the procedures and protection measures. Each nurse has to perform them before, during, and after a patient visit to assist HCP in adhering to the recommendations. This list should include hand hygiene, PPE, cough etiquette, symptoms and questions for patients, precautions and patient transportation routes, and equipment sanitization. This checklist is a measure that includes all previous steps and presents them in a simple way for nurses to refer to when they are unsure of their actions.

Conclusion

The present crisis is unfolding quickly, and all HCP are under great pressure to contain the virus and treat the infection. The overloaded healthcare system requires medical staff to deal with COVID-19 patients, even if they usually work in other departments. The previous crises did not affect the preparedness of the organizations for SARS-CoV-2, and, as a result, the US suffers from resource shortages and a growing number of cases. Therefore, nurses must educate themselves and adopt crisis standards of care. The proposed intervention covers training, resource conservation, proper hand hygiene, and support networks for nurses, offering guidelines and checklists for high adherence.

References

Al-Dorzi, H. M., Aldawood, A. S., Khan, R., Baharoon, S., Alchin, J. D., Matroud, A. A.,… Arabi, Y. M. (2016). The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: An observational study. Annals of Intensive Care, 6(101), 1-11. Web.

Alfahan, A., Alhabib, S., Abdulmajeed, I., Rahman, S., & Bamuhair, S. (2016). In the era of coronavirus: Health care professionals’ knowledge, attitudes, and practice of hand hygiene in Saudi primary care centers: A cross-sectional study. Journal of Community Hospital Internal Medicine Perspectives, 6(4), 32151. Web.

Centers for Disease Control and Prevention. (2020). Coronavirus disease 2019 (COVID-19): Interim infection prevention and control recommendations. Web.

Chen, X., Tian, J., Li, G., & Li, G. (2020). Initiation of a new infection control system for the COVID-19 outbreak. The Lancet Infectious Diseases. Web.

Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X.,… Du, B. (2020). Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine, 1-13. Web.

Hick, J. L., Hanfling, D., Wynia, M. K., & Pavia, A. T. (2020). Duty to plan: Health care, crisis standards of care, and novel coronavirus SARS-CoV-2. National Academy of Medicine Perspectives. Web.

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y.,… Cheng, Z. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497-506.

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127.

Mason, D. J., & Friese, C. R. (2020). Protecting health care workers against COVID-19 — And being prepared for future pandemics. JAMA Health Forum, 1(3), e200353-e200353. Web.

Millar, R. C. (2020). Nursing a patient with Covid-19 infection. Tasman Medical Journal, 1(1), 4-8.

Patel, A., Bell, M, & De Perio, M. (2020). CDC 2019 novel coronavirus response: Strategies for ensuring healthcare systems preparedness and optimizing N95 supplies. Web.

Wiboonchutikul, S., Manosuthi, W., Likanonsakul, S., Sangsajja, C., Kongsanan, P., Nitiyanontakij, R.,… Puthavathana, P. (2016). Lack of transmission among healthcare workers in contact with a case of Middle East respiratory syndrome coronavirus infection in Thailand. Antimicrobial Resistance & Infection Control, 5(21), 1-5. Web.

World Health Organization. (2020). Infection prevention and control during health care when COVID-19 is suspected. Web.

Introduction

According to the Center for Disease Control (CDC), Georgia has one of the highest rates of Sexually Transmitted Infections in the United States. For instance, the region is ranked third for syphilis rates, sixth for gonorrhea rates, and seventh for Chlamydia rates. In 2010, more than 52,000 cases of STIs were reported while more than 18500 people were living with HIV. Further, the ‘15-24’ age group has the highest risk of infection in the region, as it accounts for 50% of all newly reported infections.

Another major risk factor for infection is evident among ‘Men who have Sex with Men’ (MSM) and among the minority groups. In light of the increasing health problem concerning sexually transmitted infections in Atlanta, there is a need for an effective community health intervention program to control or eliminate the health issue. The main aim of this paper is to propose a community health intervention program that is targeted at reducing the prevalence of sexually transmitted infections in Atlanta.

To accomplish the task, the paper will prove the appropriateness of the proposed intervention programs using the existing peer-reviewed research that has supported the various intervention programs for STIs. The health intercession plan will focus on preventing the transmission of STIs through awareness and behavioral change initiatives. The outline of the awareness and behavioral change initiatives toward STIs prevention will be as follows:

• A summary of the status of STIs in Atlanta
• An overview of the proposed awareness and behavioral change initiatives
• Peer-reviewed support for the initiative
• Implementation of the initiative in Atlanta

Methodology

The main goals of the intervention plan are as follows:

• To propose education programs towards the prevention of STIs
• To propose education programs for specific groups in the population
• To propose an education program on behavior change

There is a need to have an education program that focuses on reducing the prevalence of sexually transmitted infections in Atlanta, Georgia, which has one of the highest prevalence of STIs and HIV in the state. With 50% of all new infections that are recorded among young people of 15-24 years, there is a need to have more effective programs that will ensure that the current trend is reduced to safeguard the future of young people in the state. The health program will focus on creating awareness on the various approaches to preventing STI and HIV among all the populations, although more focus will be on the groups that have the highest risk.

To achieve the intended goals of the program, the health awareness and behavioral change initiatives will center on the creation of relevant messages that are effective among each specific age group and target populations. Further, such messages will be conveyed through effective mediums. For instance, to young people in the 15-24 age bracket, the use of social media and other digital platforms will be of a great priority since research has shown that such a medium is more effective in this specific age group.

The program will also involve the creation of awareness on the ways of STI and HIV prevention among the target groups. Such consciousness will majorly focus on the promotion of condom use among the target population, especially the youths, to reduce the risk of infection and hence greatly reduce the current trends of STIs in Atlanta. The use of the Partner Notification (PN) program will also be a central program that will be used to ensure better health outcomes for the infected and those at risk as a way of reducing the risk of re-infection.

To evaluate the success of the program, the education program will focus on identifying the level of awareness among the target groups on the prevention measures of STI and HIV. Further, the education plan will utilize data from health care institutions such as CDC to identify the changes in trends of infection in the target population.

The ethical issues that arise from the program include the privacy of the people who will be actively involved in the research. The three key stakeholders of the program will be local communities, local health institutions, and the state government. The proposed program will focus on administering and managing health education, which is a responsibility of the Certified Health Education Specialist (CHES). In this case, the focus of the program is to create awareness in a specific area of health concern.

Hence, it will require adequate management to ensure the best outcomes for the target population. Lastly, the program brings about positive social change since it advocates the change that promotes healthy behaviors and thus longer living for all people in the population. The creation of awareness on the various sexually transmitted diseases that are prevalent among the young people is also a major positive social change scheme that will lead to positive behavioral change, as well as ensuring that the target population takes informed choices of protecting themselves from the risk of infection.

Reference List

Crosby, R., Charnigo, R., Salazar, L., Pasternak, R., Terrell, I., Ricks, J., Smith, R., & Taylor, S. (2014). Enhancing Condom Use among Black Male Youths: A Randomized Controlled Trial. American Journal of Public Health, 104(11), 2219-2225.

Guse, K., Levine, D., Martins, S., Lira, A., Gaarde, J., Westmorland, W., & Gilliam, M. (2012). Intervention using new digital media to improve adolescent sexual health: A systematic review, implications and contribution. Journal of Adolescent Health, 51(6), 535-543.

Lee, Y., Dancy, B., Florez, E., & Holm, K. (2013). Factors Related to Sexual Practices and Successfully Transmitted Infection/ HIV Intervention Programs for Latino Adolescents. Public Health Nursing, 30(5), 390-401.

LeFevre, M. (2008). Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine, 161(12), 894-902.

Rahman, M., Khan, M., & Gruber, D. (2015). A low-cost partner notification strategy for the control of sexually transmitted diseases: A case study from Louisiana. American Journal of Public Health, 105(8), 1675-1680.

Yzette, L., & Madeline, S. (2013). Reframing the context of preventive health care services and prevention of HIV and Other sexually transmitted infections for young men: New opportunities to reduce racial/ethnic sexual health disparities. American Journal of Public Health, 103(2), 262-269.

Introduction

Every practitioner wants to develop new skills. Training in nursing is an endless process. Caregivers should be ready to gain new skills and competencies in order to provide the best support to their patients. One of the best practices is working with other professionals. In this essay, I will reflect on my experience in a visit to an external organization to improve my skills. The practice made it easier for me to achieve the objectives of my project. I am planning to build better relationships and offer the best care to my patients. This paper uses Gibbs Model to reflect on my experiences gained during the planning stage of my project (Gibbs’ (1988) Reflective Cycle 2014).

Description

My project focused on every issue associated with infection control. I needed some help in order to review every educational resource for my project. I also wanted to gain new skills in order to come up with the best project (Vargas 2007). The organization had already formed an infection control committee recently. I was unable to get the best support from this new committee. Our readings encouraged every learner to seek the best support from experts in different organizations.

The above scenario encouraged me to contact the head of an infection control committee in one of the biggest hospitals in our city. The first thing was to request a visit. The manager advised me to send an official request. The second step was to meet with the manager. I explained to him why my visit was relevant to the success of my project and the dental department. I was happy to interact with the head of the infection control committee. The meeting was informative, cooperative, and interactive. The head of the committee answered most of my questions. The person also reviewed my questions and educational materials. This approach was relevant for supporting my project (Vargas 2007). My team also interacted with the committee in order to gain new skills and competencies.

Feelings

I was anxious and uncomfortable at the beginning of this project. I was not happy with the idea to get help from an external organization. I was also not very enthusiastic. I am not very intrusive. I have always encountered difficulties whenever contacting powerful people or building new relationships. The experience changed my views completely. I gained new ideas and skills from this organization. This experience made it easier for me ‘to form new relationships with experts’ (Vargas 2007, p. 38). I have greatly benefited from this experience. I have also gained new ideas from this experience. I am planning to interact with more professionals and experts throughout my project.

Evaluation

This exercise was successful because I gained the best support from the head of the committee. I was happy because the head of the infection control committee answered most of my questions. This hospital also equipped me with the best educational materials. I also gained new training in order to make my project successful. The good thing about the experience was that it equipped me with practical ideas. I will use these ideas throughout the project. I also established meaningful relationships with different professionals in the hospital. I also visited different departments in order to improve my competencies. The ‘best approach towards the success of every project is using proper leadership’ (Heldman 2011, p. 67). Every team leader should present the best standards and follow every policy (Heldman 2011). It is also appropriate to train every member and monitor the operations of the team. According to Heldman (2011), every project requires the best decision-making skills and preparation. I gained new ideas from this exercise. I now understand how to share information and ideas. I also understand the relevance of positive relationships in every organization.

Analysis

The decision to cooperate with different organization widened my skills. I also formed new relationships with different experts. I also improved my communication skills. These practices will improve the quality of healthcare in every organization. Communication can improve the quality of care in every hospital (Vargas 2007). This practice was relevant towards improving my writing skills. I will get better marks from this reflective writing. This practice is necessary for eliminating every geographic or organizational boundary. Every hospital or organization should form the best relationships with other firms. This collaboration will ensure every company improves its business practices (Vargas 2007).

The decision to cooperate with different organizations widened my ideas. I also improved my communication skills. These practices can improve the quality of care in every healthcare organization. This practice was relevant towards improving my writing skills. I will also get better marks from this reflective writing. This exercise explains why both collaboration and conferencing are essential whenever conducting a project (Vargas 2007).

Conclusion

Every person can gain new skills from different organizations. The best thing is to consider the best strategies in order to learn from these organizations. I have formed new relationships with different leaders and experts. This collaboration will make me successful. Every student should use this strategy in order to achieve his or her goals.

Action Plan

I am looking forward to interacting with this infection control team. I am also planning to visit more organizations in order to gain the best support and ideas. I will improve my communication skills and build new relationships in the future. This practice will make me successful in my current project and future career.

Reference List

Gibbs’ (1988) Reflective Cycle 2014, Web.

Heldman, K 2011, Project Management Jumpstart, Wiley, New York.

Vargas, R 2007, Practical Guide to Project Planning, Auerbach Publications, New York.