Concept of Analysis of Compliance - Assignment Example

? Concept of analysis of Compliance Introduction Compliance is the degree to which behavior is in accordance to physicians’ health care advice or instructions. It is either a status of being in accord with established specifications, guidelines, or legislation and the process of becoming so. It is to adapt an individual’s action to another’s wishes, rule or a necessity. It is controlled or influenced by many factors like economic, culture, lack of knowledge and social factors. Nurses define compliance in different ways and in a manner that fits the philosophy of the discipline of nursing as different individuals react differently in a similar situation. Nurses can embrace a transactional or interactive process in order to form a client partnership, which allows a client to make choices in decision making about a prescribed behavior. Rationale The purpose of the study is to show the attributes and factors that influence nurses compliance in relation with standard precautions in order to shun occupational exposure to bacteria and pathogens, by using a qualitative research methodology. These are the set of guidelines aimed at protecting nurses from exposure to infectious pathogens since nurses can acquire infection during nursing care provision due to exposure to microorganisms, and this can be through needle sticks or exposure to air-borne transmitted micro-organisms. Compliance is of interest to nursing in order to avoid microorganisms’ exposure. It is a legal obligation for the nurses to adhere to the laid down guidelines in the profession. On hand hygiene, use of hand gloves is a requirement by law to prevent exposure to body fluids (Taylor 2006). Nurses should implement every component of standard precaution while conducting a clinical practice and take measures to keep away from exposure to pathogens. All nurses are also obliged to use the necessary means to protect their health by use of face masks and gloves. To prevent vulnerability to diseases, some nurses need to take preventive measures since their immune system is weak thus easy for them to be infected due to regular contact with sick persons. This is aimed at reducing risk of infection since nurses are continuously exposed to pathogens. Several nursing procedures such as giving bed bath require patients contact thus very easy to be infected (Baker & Feder, 1997). The risk is not only to the nurses, but also the individuals they come into contact with, more so the family members. Reason for compliance is to prevent occupation exposure. This can occur in different ways; it can be by direct or indirect transmission, airborne transmission and mucus membrane exposure. In the late seventies, the first preventive legislation was issued to help health care practitioners and protect them from microorganisms (Baker & Feder, 1997). It required nurses to treat each patient potentially infectious. It was revised requiring all nurses to use preventive and protective equipment in every case of exposure anticipated. Compliance creates a practitioner-patient partnership. Research has shown the importance of creating a relation in determining compliance level with prescribed treatment (Taylor, 2006). It describes a shared process, which leads to an agreement between prescriber and patient about the aim of drug treatment and how to achieve them. It enables the patient to participate fully and to influence the outcome ultimately. Information by patients informs the decisions made thus information leaflets are given with medicine supplied to each patient. This makes it essential for patients to discuss any information with the appropriate practitioner. Attributes to compliance are important in relation with standard precautions. Effective recommendations for nursing practice should be compatible with values among target groups and less controversial (Kanouse, Kallich & Kahan, 1995). It should not require much change to the already existing routine and have a precise definition, with specific actions and advice in different cases. They should also be compatible with routine and current values. Literature Review Findings In a research conducted by Grimshaw et al, (2000) on the attributes of implementation of guidelines, he provides insight on why some are more effective than other guidelines. He used observed data from clinical practices and the findings to show that guideline developers need to take attributes like demand changing normal routines, based on scientific research and demand new skills and knowledge into account. They show the importance of carrying out tests in clinical practices to show effectiveness and feasibility of guidelines and importance of performing scientific literature analysis. The findings are consistent on the attributes of implementation of guidelines and good guidelines, which states that compliance is the degree to which behavior is in accordance to physicians’ health care advice or instructions. Taylor (2003) research shows that policy makers have to understand attributes that relate to guidelines implementation in decision making in routine practices. It argues that guidelines have to be compatible with existing values in target groups and should not be controversial. They should demand fewer changes to existing routines and have a precise definition with specific decisions and actions in different scenarios. Indeed, recommendations expressed what practitioners were focusing to do. They were adhered to when description of scientific evidence was straight forward with no conflicting factors. The assessment of the suggestion by a panel of general practitioners of nurses could be improved as the reliability of its evaluation was modest. Lomas research (1995) on compliance guidelines explains the high and low of variance stating that 17 percent accept change in using guidelines, but many aspects have to be taken into account to determine using a guideline. He argues that setting of guidelines is primarily the initial step in a process of making and implementing patient care effectively. Further research shows guideline implementation needs to provide sight into the effectiveness of some guidelines over others. The findings are consistent with theory model on good guidelines, which states that compliance is the degree to which behavior is in accordance to physicians’ health care advice or instructions. This is the time in the research study that the influence of attributes guidelines has shown using experimental data from clinical practice. The findings illustrate that guidelines developers need to take these attributes in consideration. They show the importance of performing an analysis of the scientific literature. They show the significance of a specific definition of the recommended presentation in clinical decisions. The health belief model shows the attributes of compliance in two axes, the perceived threat of disease acquiring and the factors triggering the behavior. The perceived threat incorporates susceptibility and severity constructs which creates individual pressure for an action, nevertheless the action may not occur. The enabling factor triggering behavior includes the benefits and barriers perceived. Additional constructs like cues to action and self efficacy are supplemented in order to overcome limitations by the model. Theoretical and Operational Definition Theoretical definition of compliance It is the correspondence of a patient in relation to prescription by a physician. It can be unintentional whereby the victim simply forgets taking prescribed medicine or intentional whereby the patient ignores taking the prescription. It is to adapt an individual’s action to another’s wish; rule or a necessity. It is either a status of being in accord with established specifications, guidelines, or legislation and the process of becoming so. It shows correspondence to an action or reaction, example, show the attributes and factors that influence nurses compliance in relation with standard precautions in order to shun occupational exposure to bacteria and pathogens. Operational definition of compliance It is the manner by which nurses view fit to administer an action to a patient as different individual react different in a similar situation (Lomas 1995). They can either embrace transactional or interactive process in order to form a client partnership which allows client make choices in decision making about prescribed behavior. It is more practical in accomplishing of activities like physical administering of medicine and wearing of facemasks and gloves while conducting a process with an infected party. Application of the Concept Application of compliance is administered in hospital environments to assure certainty that medicine consumption and giving by patient intended to take (Carter and Taylor, 2003). This assures prescriptions are not wasted, and the intended patient is following the rule of the physician. In the community, however, certainties may not exist, and the major drawback of reliance on pharmacotherapy in treating ill health is either unintentionally or intentionally, high proportion of patients do not use their medicines in the appropriate way that is intended. Compliance has a set of guidelines aimed at protecting nurses from exposure to infectious pathogen since nurses can acquire infection during nursing care provision due to exposure to microorganisms via needle sticks or exposure to air-borne transmitted micro-organisms (Russel & Grimshaw, 2007). This reduces the risk of infection not only to the nurses, but also to their surrounding and people they associate with. Value Value analysis of compliance allows hospitals to involve both nurses and patients on allocation of medicine and create a patient-doctor partnership. By working together to meet and identify goals of the hospital while ensuring patients receive better and high-quality care. The aim of value analysis is to acquire transparency by sharing information, costs and effective utilization of products (Field & Lohr, 2002). This helps to grow the patient-nurse relation by reciprocating to transparency by the patient. It empowers clinicians and suppliers to work together to gain knowledge with access and visibility to transparent data and these lead to informed decision making. Through this process, nurses can become better educated on cost from total delivered to total utilization. Supply professionals can learn about how supplies get utilized, and the particular features are quite important more than others in care delivery. As a result, barriers may be bridged through working together and understanding to accomplish their goals. Conclusion Compliance has a wide field of definitions and each field defines it according to the manner of fitness. It involves adapting an action that one is obliged to undertake and may be influenced by economic, culture, lack of knowledge and social factors. An individual's behavior is guided by certain guidelines, and to understand them, one has to explain the reasons for compliance in their behavior. Nurses can embrace a transactional or interactive process in order to form a client partnership, which allows a client to make choices in decision making about prescribed behavior (Cluzeau et al, 2001). Compliance shows the attributes and factors that influence nurses in relation with standard precautions in order to shun occupational exposure to bacteria and pathogens, by using a qualitative research methodology. These set of guidelines are aimed at protecting nurses from exposure to infectious pathogen and the environment surrounding them. The findings and conclusion illustrate that guideline developers need to take attributes in consideration since they show the importance of performing an analysis of the scientific literature (Rogers, 1993). They show the significance of a specific definition of the recommended presentation in clinical decisions. References Baker, R, & Feder, G. (1997). Clinical Guidelines: Where Next? In J Qual Health Care 9: 399– 404. Cluzeau F, Littlejohns P, Grimshaw, J, & Hopkins A. (2001). Appraising Clinical Guidelines And Development of Criteria. Journal Of Inter Professional Care. Carter & Taylor, (2003). Guidelines For The Administration Of Medicines. London : NMC. Field, M & Lohr, K. (2002) Guidelines for clinical practice: from development to use. Washington, DC: National Academy Press. Grimshaw, J., Freemantle N, Wallace S, Russel I, & Hurwitz B, Watt. (2000). Developing And Implementing Clinical Guidelines. Quality in Health Care. 53–64. Kanouse, D, Kallich J, & Kahan J. (1995). Dissemination of effectiveness and outcome research. Health Policy. Lomas, J. & Grilli, R. (1995). The Relationship between Compliance Rate and the Subject Of A Practice Guideline. Med Care. Rogers, E. (1993). Diffusion of innovations. New York: Free Press. Russel, G. J. & Grimshaw, J.M. (2007). Effect Of Clinical Guidelines On Medical Practice: A Systematic Review Of Rigorous Evaluations. The Lancet, Volume 342, Issue 8883, Pages 1317 – 1322. Taylor, C. D. (2003). Compliance in Medicine Taking. Journal of Medicine Partnership. Read More