Disseminating Results and Advancement of the Profession

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Developing an Intervention and Determining its Impact

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Developing an Intervention and Determining its Impact

Infections acquired by patients within the healthcare setting are a significant problem affecting the United States health care system. Healthcare-acquired infections mainly occur when the pathogens are transferred to the patients. Therefore, a significant intervention to reduce infections is one that limits the transfer of pathogens. The following is a hand-washing intervention for nurses that can help to reduce the transmission of germs to patients; hence, reducing the acquisition of infections.

Outline of the Intervention

The proposed intervention for healthcare-acquired infections is a handwashing education program for nurses. Nurses play an essential role in the continuum of care. There are various instances when the nurses come into contact with the patients in the process of administering care. During the process of patient caring, there is a possibility of the transfer of pathogens from one patient to another or from the general health care environment to a patient. Therefore, this intervention includes an education program that teaches nurses the vital information on handwashing so that they can have a better chance at sterilizing when taking care of the patients. There are many nurses' education programs that have already been carried in a significant number of healthcare institutions, but there are still some cases of infection that have been presented. Therefore, this education program will be specifically altered to include factors that will enhance its effectiveness in improving nurses' hygiene.

First, the education program will be carried out for six months. It is expected that nurses' undergoing an extended period of training will enable better results by enhancing the possibility of maintaining the lessons that have been learned in training. Additionally, this training program will focus mainly on compliance rather than spreading the knowledge on handwashing. This component of the intervention training has been included on the assumption that the nurses already understand the knowledge of hand hygiene and the techniques of hand washing. Hand hygiene is a big part of nursing training and also training for other medical professions. Medical professionals are often taught the importance of maintaining sterility when dealing with patients to minimize transfer of pathogens. In spite of this training, there is a significant percentage of healthcare professionals who still fail to maintain the required standards of hand washing. Thus, this handwashing training program will mainly focus on training the nurses on compliance to the standards of handwashing. The training will be offered in the practice setting rather than in a theoretical model so that it can be easier to identify the mistakes that the nurses make in the handwashing process and develop strategies to improve them.

Review of Literature Supporting the Intervention

A multitude of literature has been written on the effect of training healthcare professionals on handwashing hygiene on the spread of infections within the healthcare setting. According to Al-Khawaldeh, Al-Hussami & Darawad (2015) nurses beliefs, attitudes, and knowledge on handwashing compliance directly affects their hand sanitation practices. This conclusion was made based on a cross-sectional study done with nursing students as the subjects. The study found that knowledge, attitudes, and beliefs on hand sanitation were significant variables affecting the nurses' compliance with the hand washing guidelines provided to them. Therefore, this study recommended that training is used as a technique for promoting hand washing knowledge and promote positive beliefs and attitudes on sanitation among the nurses. Sopjani, Jahn, and Behrens (2017) evaluated the impact on handwashing training on the knowledge and practices of undergraduate nurses on Kosovo. This study analyzed the knowledge level for the participants before and after they underwent an education program for hand cleanliness in the healthcare setting. The study results showed that there is a significant difference between the nurses' knowledge level before and after the training. After the training, the subjects were more likely to understand more about the importance and techniques of maintaining sanitation in the healthcare setting. The study maintained that training could help to maintain a satisfactory level of knowledge that will improve nurses' practices with regards to hygiene.

The effectiveness of training nurses on handwashing has been established by many studies. However, some researchers have questioned the sustainability of this intervention, transfer of germs is still an issue even though many training programs have been conducted. A study by Doronina et al. (2017) evaluated the effectiveness of interventions that have been used to improve handwashing compliance among nurses working in healthcare institutions. The researchers, in this case, conducted a systematic review of six studies evaluating different types of interventions that have been used to promote hand hygiene in healthcare institutions. Among the studies assessed, three were randomized control trials, one was a controlled before-after study, and one was an interrupted time series. In the studies that evaluated the impact of education as an intervention technique to promote hygiene, it was found that the teaching was effective. However, this meta-analysis shows that education was effective but not sustainable because most healthcare professionals fail to maintain the compliance for a long time after the intervention.

A study by Gould et al. (2017) evaluated the impact of observing hand hygiene in the practice setting. Instead of just theoretically training nurses on maintaining hand cleanliness, this study investigated the effect of practically watching the nurses' hygiene behaviors while they practice. In a literature review, this study examined the impact of the Hawthorne effect, which is the alteration of behavior due to the understanding that they are being observed. This study suggests that most positive results of the positive interventions in investigations of the effectiveness of handwashing interventions have been affected by this effect. Therefore, the research indicates that the researchers investigate the efficacy of interventions for an extended period after the intervention has been administered. This helps to take into account the practices of the subjects after the Hawthorne effect is no longer in occurrence. Based on the suggestions of Gould et al. (2017) it is likely that having an intervention based in the practice setting for an extended period will have a better chance at determining the actual effect of the intervention.

Luangasanatip et al. (2015) conducted a meta-analysis comparing the efficiency of various hand hygiene interventions for nurses. This study evaluated 41 types of research on hand hygiene intervention. Among various other factors, time was found to be one of the variables that affect the effectiveness of these interventions. The interventions that were applied over an extended period were more likely to yield positive results. Therefore, this study demonstrates that conducting an education program for an extended period is more likely to have a more significant impact on improved hand sanitation by nurses.

The Impact of the Intervention

The proposed nurses' education program is expected to have a positive impact on improving nurses' practices when delivering care. The nurses who will undergo this intervention will be trained for six months on knowledge and compliance of hand washing while their methods are observed to identify the possibility of limitations that reduce the sanitation in the healthcare environment. It is expected that by the end of the training, the nurses will have learned the proper application of hygiene standards as part of their daily practices and not just for the study. This intervention focuses on compliance more than the knowledge, even though both components are included. The focus on compliance will help to enhance the sustainability of the intervention. The nurses are expected to maintain the changes caused by the training for an extended period because the intervention requires them to practice for six months.

The change in the nurses' behaviors is expected to have a positive impact on the reduction of the risk of healthcare-acquired infections. With more nurses being hygienic, there will be reduced transfer of disease-causing pathogens, which cause the life-threatening infections that are currently a population health issue. Patients in the process of receiving care will have a higher chance of having positive outcomes because of the reduced risk of getting infected by germs available in the healthcare environment. In general, the effectiveness of this intervention strategy will help to improve the overall quality of care.

Conclusion

Healthcare-acquired infections are one of the top ten population health issues affecting the United States. A majority of the infections in the healthcare setting are caused by problems that could have been avoided. The nurses are the health care professionals who spend the most time with the patients. Therefore, they have a high risk of being agents transferring pathogens to the patients under their care. This is why an intervention on training for hand-hygiene compliance is recommended as the best strategy for reducing the occurrence of infections. Studies have shown that improved education on hand hygiene has been an excellent strategy for improving nurses' practices. However, maintaining compliance for an extended period is still a problem. This intervention attempts to address this problem to enhance the effectiveness of training programs.

References

Al-Khawaldeh, O. A., Al-Hussami, M., & Darawad, M. (2015). Influence of nursing students handwashing knowledge, beliefs, and attitudes on their handwashing compliance. Health7(05), 572.

Doronina, O., Jones, D., Martello, M., Biron, A., & Lavoie‐Tremblay, M. (2017). A systematic review of the effectiveness of interventions to improve hand hygiene compliance of nurses in the hospital setting. Journal of Nursing Scholarship49(2), 143-152.

Gould, D. J., Creedon, S., Jeanes, A., Drey, N. S., Chudleigh, J., & Moralejo, D. (2017). Impact of observing hand hygiene in practice and research: a methodological reconsideration. Journal of Hospital Infection95(2), 169-174.

Luangasanatip, N., Hongsuwan, M., Limmathurotsakul, D., Lubell, Y., Lee, A. S., Harbarth, S., ... & Cooper, B. S. (2015). Comparative efficacy of interventions to promote hand hygiene in hospital: a systematic review and network meta-analysis. BMJ, 351, h3728.

Sopjani, I., Jahn, P., & Behrens, J. (2017). Hand Hygiene Training and Its Impact on the Knowledge of Undergraduate Nursing Students in Kosovo. Global Journal of Health Science9(4), 142.