Evidence Based Practice Analysis

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Introduction

Evidence based practice is application of behavioral and mental health intervention to solve particular problem for which systemic empirical research has shown prove of possible effectiveness as a therapy (Dale,2005). Recently, use of evidence based practice has been supported by various professional associations. For instance American nurses association. It advocates the use evidence based practice amongst its member in formulating their interventions (Mitchell, 1999).

Nosocomial infections are acquired from health care units during treatment. For infection to be considered nosocomial, it has to appear after 48 hours or more hours after admission or within 30 days after discharge. These infections become rampant when the health care personnel become contented and fail to observe health hygiene practices (Black, 1996).

A theoretical framework which is a collection of interrelated concepts like a theory but not necessarily so well worked-out guided me in determining what things I will measure, and what statistical relationships I will look for. I came up with theoretical framework related to developing infection control and management program for licensed nurses in long term care facility.

This infection control program included Objectives, Content outline resources, Power point presentation, Handouts, Case Scenarios. Often I went through collected information and gave out my views to curb the infections. Over the entire program is a system to monitor and investigate causes of infection and manner of spreading.

Describe the development of the project

To begin my project, I completed Literature review on Evidence based practice (EBP) so as to become familiar with resources that are available to synthesize the information. I met with mentor and other Key staff members to discuss findings of literature review. I did theoretical review framework related to infection control to measure, and determine what statistical relationships I was to look for. I initiated house wide audit for last three months on nosocomial infections and the origin of the infection for all residents at Burien long term care facility.

I continued with data collection process and administered needs assessment as to licensed nurses at facility nurses meeting. I reviewed federal and Washington State Regulations on nosocomial infections.

I then met with infection control program coordinator to determine key issues to address in infection management program. I developed infection management program which included objectives, content outline resources, power point presentation, handouts, case Scenarios. Over the entire program was a system to monitor and investigate causes of infection and manner of spreading. I reviewed surveillance data routinely and made recommendations for the prevention and control of additional cases. The written infection control program is to be reviewed periodically by the facility.

I reviewed infection management program and the power point presentation with mentor and infection control coordinator.

I identified a conceptual basis for educational program and scheduled meeting with licensed nurses educational specialist to review the infection management program in-services and presentation. I the developed a pretest/posttest to measure the knowledge of Licensed nurses.

I set up date and time to implement infection management program for licensed nurses.I delivered an in-service infection management program using a power point presentation with content, objectives, outline, resources, handouts, and case scenarios.

The mentor completed written feedback report and developed evaluation tool on success of the infection management program.

I administered evaluation tool to licensed nurses and analyzed the percentage of infection one month after implementation of infection management. I met with mentor and infection control coordinator to review all evaluation results

Analysis of learning experiences

I identified that there is a needs for developing infection control and management program for health care facilities since the current infection control system may not be effective.

There is need for health care unit to develop proper communication tool to staff or families /visitors in efforts to control nosocomial infections.

Evidence based practice application is appropriate in carrying out systemic empirical research in order to achieve accurate intervention. This fact was evidenced by staff realizing that some of the resident current infection was avoidable after report was presented to them. In addition, the health care personnel agreed that this new program was friendly and easy to follow. Also Staff verbalized it was an excellent system and so far no confusion had been noted.

Nosocomial infections preferences are high in most health care units due to failure by staff to follow health hygiene practice. This is backed up by the fact that after the new infection management program was implemented on November 01, 2010; the Facility infection rate dropped down by 42 percent. Infection rate for January 2011 was 2.9%. This results indicate tremendous percentage reduction in nosocomial infection hence the infection management program was effective.

One of the barriers to Evidence based practice that nurses often cite is the time it takes to search and find research evidence. Often nurses are either not familiar with how to search the literature or they are overwhelmed by the amount and variety of evidence that is available.

Describe the implementation of the Practicum Learning Agreement

Literature search on needs for developing infection control and management program for licensed nurses in long term care facility: A literature review of 15 peer reviewed journal article on EBP was completed. By completing the literature review, I was able to have an important part of EBP is to become familiar with resources that are available to synthesize the information met with mentor and other Key staff members to discuss findings of literature review. I learnt that the facility usually doesnt use that much EBP. The usual practice for the facility was random controlled trail. After much discussion, we concluded that the literature review summary was appropriate for utilization with the patient population in the facility clinical setting.

Review theoretical framework; I was able to understand a theoretical framework is a collection of interrelated concepts, like a theory but not necessarily so well worked-out. A theoretical framework guided me in determining what things I was to measure, and what statistical relationships I was to look for. I submitted this summary of the theoretical framework related to developing infection control and management program for licensed nurses in long term care facility.

Initiation of house wide audit for last three months on nosocomial infections and the origin of the infection for all residents at Burien long term care facility; currently the facility has 102 residents in long term setting. I started every single active chart to audit for the last three months nosocomial infections and the origin of the infection and then compared the collected data to standard written definitions or criteria of infections. At the end of chart review I was able to determine that the facility did not have specific system on regular basis to identify new cases during defined time periods.

Review of the audit finding and conclusion with the facility infection control coordinator/ mentor; I discussed with Mentor and infection control coordinator findings of charts audit and the last three months nosocomial infections in the facility. I had broken down my report by units and types of infection. After much discussion, we all agreed that the facility did not have specific system to enhance infection preventions and minimize the potential for transmission of infections.

Administration of needs assessment as developed to licensed nurses at facility nurses meeting; I planed very carefully and cautiously, before I implemented a solution, to improve current performance. I made four items questionnaires with six matching quizzes. This was delivered to licensed nurses at different shifts at the facility.

Review of federal and Washington state Regulations nosocomial infections: I reviewed and summarized current federal and Washington state regulations F441. The facility must establish and maintain an infection control program designed to provide a safe, sanitary and comfortable environment.

I met with infection control program coordinator at Burien long term care facility to determine key issues to address in infection management program. I discussed with infection control program coordinator key issues such as recognizing infection control practices while providing care, hand hygiene, handling and processing of linens, use of standard precautions, and appropriate use of transmission based precautions and isolating or separating residents.

Development of infection management program; I developed infection control program which include Objectives, Content outline resources, Power point presentation, Handouts, Case Scenarios. Over the entire program is a system to monitor and investigate causes of infection and manner of spread. Surveillance data was routinely reviewed and recommendations made for the prevention and control of additional cases. The written infection control program is to be reviewed periodically by the facility.

power point presentation for licensed nurses at the facility for preventing the spread of infection; I developed power point presentation for licensed nurses to illuminate the importance of implementing effective and consistent infection control measures in the facility which included processes that could contribute to better outcomes for the residents in the facility to maintain health and well-being of residents and staff. The lesson covered the guideline developed by the U.S. centers for disease control (CDC).

Review of Infection management program and the power point presentation with mentor and infection control coordinator. I discussed with infection management program and the power point presentation with mentor and infection control coordinator. After much discussion and some additional lesson plan, we all agreed the material is ready to be presented for licensed nursing staff.

Identification of a conceptual basis for educational program; my goal of building the system and teaching staff was to prepare nurses and empower them. I realized that empowerment is a concept that adds present and future quality of life. An empowered mind enables a nurse to utilize knowledge at higher levels and apply it to real-life situations. An empowered mind permits a nurse to successfully maneuver the path to self-actualization.

Development of Pretest/Posttest to measure the knowledge of Licensed nurses; I prepared Pretest/Posttest to administer during in-services for licensed nurses at Burien long term care facility to measure the knowledge of Licensed nurses of the current status and after the in-service /presentation of infection control and management program. I understand that it is important to be able to determine the extent to which each and every nurse met the objectives. Clearly, I wanted to know if nurses learned what I taught them. In order to assess learning, I had baseline or pre-assessment of what nurses know prior to in-service as well as an indication of what they know after in-service.

Set up date and time and implemented infection management program for licensed nurses. Set up in-service date by the staff development coordinator for Nov 10^th 2010 in different shifts, and also set up the new infection management program implementation for November 15^th, 2011. Staff development coordinator to post sign at employee lounge and common areas the in-service poster.

Delivery of an in-service infection management program using a power point presentation with content objectives, outline, resources, handouts, and case scenarios; I started at 6am for night shift nurses, then 10 AM for day shift nurses, and 3 pm for evening shift nurses. I was prepared well for the presentation. I was ready with ideas for in-services/ meetings that would make it fun and interesting. I know from my own experience that to sit in a room listening to someone talk and talk and talk or put on a video gets very boring after the first 10 minutes. We had fun with it, I was able to get interaction with the class and the learning objectives were met. I did start with a mystery and conclude with a fact. In each session at the middle, I had a proper hand washing techniques exercise.

Completion of written feedback report by the mentor; I requested the mentor to complete written feedback report on the implementation of the infection management program. I received both verbal and written report. My mentor was extremely happy about the overall program and presentation. I also received good compliment from the nurses.

Evaluation tool on success of the infection management program; I developed a one page survey tool to collects feedback from nurses on how they feel about the program. This one-page survey inquired about nurses satisfaction with the program and the impact of the program on minimizing infections. It also implied to me if the program is happening the way they are supposed to, how to improve the program as we go along and if the program helped the nurses. The results of this survey were shared with mentor and infection control coordinator.

Administration of evaluation tool to licensed nurses; I administered the survey tool to licensed nurses. I made myself thoroughly familiar with the survey scale before attempting to interview the nurses. The survey was administered in a private and quiet environment. And also the nurses were prepared for the survey.

Analysis of percentage infection; It has been about a month since the new infection control program established. I did talk to many staff members regarding the program in addition I calculated the nosocomial infection rate. It came up 6.4 % for one month since the program established. There was a 20% improvement from the last month.

Review of all evaluation results with mentor and infection control coordinator. I was able to evaluate the program with mentor and infection control coordinator to review all evaluation results. The infection rate for the month of the month of January so far was 4.64%, which is 42% down from the usual monthly rate. Everyone was happy to see an improvement in minimizing nosocomial infections. Thus it made me to believe that the new infection control program is effective.

Evaluation of the value practicum had on my learning carrier path

I realized the importance of evidence based practice in solving problem; calculated the nosocomial infection rate. It came up 6.4 % for one month since the program established. There was a 20% improvement from the last month. The infection rate for the month of the month of January so far was 4.64%, which is 42% down from the usual monthly rate.

Realized the importance of team working in coming with proper intervention; this research program was made successful by the adequate support portrayed by the staff, the coordinator, mentor and the patients.

Application of infection management program is effective in controlling nosocomial infections. This was evident after the program yielded results and proved effective in nasocomial infection control.

Made me appreciate simple measure are required to control nososomial infection in health units. In addition, it created a plat form for knowledge discovery, trough developing the infection control program which was efficient in controlling nasocomial infection.

Highlight professional relationships developed during the project and the value of those relationships

In the course of the project, I was keen on our professional relationships with colleagues as we collaboratively focused on a Commitment to Excellence and our partnership. This relationship was guided by values, structures, and processes that support registered nurse control of the delivery of nursing care and the environment in which care is delivered.

Professional relationships focus on giving the quality services and related care in health facilities.

Professional relationship focused on appreciating personnel contribution toward attaining anticipated objectives.

Open communication is key for considering every individual during the program development.

Conclusion

Evidence based practice application is appropriate in carrying out systemic empirical research in order to achieve accurate intervention.

Nosocomial infections preferences are high in most health care units due to failure by staff to follow health hygiene practice.

One of the barriers to Evidence based practice that nurses often cite is the time it takes to search and find research evidence.

References

Black, J.G. (1996). Microbiology principles and applications. NJ: Prentice Hall.

Dale, A. (2005). Evidence-based practice: compatibility with nursing. Nursing Standard Journal, 12 (40) 48-53.

Mitchell, G. (1999). Evidence-based practice: critique and alternative view. Nursing Science Quarterly journal, 12 (1) 30-35.

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