Outcomes of the EBP Project in Nursing - Essay Example

? EB Outcomes in nursing       and   Introduction This EBP project will utilize the Stetler model of evidence based planning and the practice implementation. The model uses the experiences of daily practice to inform the planning and the implementation of the change program (Stetler, 2010). In the current case, the change program will use the evidence collected from research studies, towards identifying areas of change and implementing the proposed changes in the area of nursing care. During the planning and the implementation of the change, the practitioners covered by the program will use the findings of previous research studies and other evidence-bases towards improving nursing practice (Stetler, 2010). This paper will discuss the implementation of a change program covering poor hand washing among healthcare service providers at Veema center, which has been found to cause adverse outcomes, during service delivery (Titler, 2008). Planning for Change This stage will cover the phases of preparation (Phase I), Validation (Phase II), and Decision making/ Comparative Evaluation (Phase III) From the evidence given studies, including Garrette (2013) and Canham (2011) hand hygiene is acknowledged by control experts and infection prevention personnel, as the single and most effective measure that helps in reducing the spread of infections in the community and at health care settings (Garrette, 2013). This is the case, because the hands are transmission areas between individuals and the objects, as well as the surfaces within the healthcare environment. Some of the objects that can transfer infections in the healthcare setting include blood pressure cuffs. The means of hand hygiene include that of using soap and water, and using alcohol-based products, in the cases where water and soap cannot be used. The World Health Organization (WHO) and the CDC (Center for Disease Control and Prevention) maintain that hand hygiene can aid healthcare providers to uphold quality practice, and patient safety (Pittet, Allegranzi & Boyce, 2009). The practice of extensive hand washing will lessen the risk of infection between patients, lessen the infection of healthcare personnel, and lessen the cases of morbidity, mortality and the costs incurred during the treatment of infection-based conditions (Garrette, 2013). In preparation for the change, a survey was administered to the personnel at the health care center, aiming at realizing the factors limiting hand hygiene. Some of the factors explained as causes of poor hand hygiene at the health center and from studies like Garrette (2013) and Pittet, Allegranzi and Boyce (2009) include that hand washing agents leads to dryness and the irritation of the skin; sinks are not available in convenient areas and there is also a lack of soap, water, and disposable towels for drying hands. Others include understaffing, giving priority to patient care needs, disagreement with hand hygiene directives and the low risk of getting infected by patients (Cambell, 2010). Towards ensuring that the factors affecting hand hygiene at the Veema health center are addressed through consulting the medical personnel at the center, when developing the best recommendations on hand hygiene. Secondly, the materials required for hand hygiene, which may not be available should be supplied at all times and hand washing areas should be available at all areas, including wards, casualty and admission centers. From the evidence of studies like Garrette (2013) and Pittet, Allegranzi and Boyce (2009), alcohol-based agents should be used for hand washing, before and after patient contact, after removing gloves, and in emergency situations where water is not available. Implementing the EBP Project (Phase IV Translation/ Application) Towards the implementation of the project, a team will be formed, comprising of staff nurses and doctors, clinical nurse specialists, departmental nurse administrators, nurse and doctor researchers and infection control nurse and doctor. The team will oversee the implementation of the project, and the evaluation of its success. The outcomes of the EBP project on hand hygiene include that all personnel at the health care center should comply with the hand washing practice for 15 seconds or more, at the different times of practice, as well as during other critical times at the center. Additionally, gloves should be worn at all times, because they limit the communication of micro-organisms from the patient or hospital surfaces, to the medical personnel. The 5 times for mandatory hand hygiene Source: (Garrette, 2013) The macro systems that may inhibit the implementation of the strategies and the resolution of the issues include the need to renovate hospital grounds and facilities, including the construction of sinks at the different areas of the hospital. The second is the availability of the new medical facilities required for hand washing, including disposable towels and alcohol-based detergents for patients and personnel (Garrette, 2013). Third is the training and education of medical staffs, in the areas of requiring further hand hygiene, which are aimed at quality improvement in service delivery. The Microsystems that can inhibit the implementation of the hand hygiene project include subjecting patients to hand washing and requiring family and visitors to wash hands before visiting wards (Garrette, 2013). The second Microsystems area that can inhibit the resolution of the issues is the distribution of the inputs required for hand hygiene and the communication of new strategies across different departments on hand washing (Canham, 2011). Through the improvement of hand washing among patients and health personnel, the risk of microorganism transmission will be reduced. Due to the reduction in the transmission levels, patient infection following contact with doctors or other medical personnel and implements like blood pressure cuffs, infection levels will reduce. Through observing the guidelines of the EBP project, the risk of personnel colonization will be reduced, and as a result, infection levels among medical personnel and visitors will be reduced (Garrette, 2013). Due to the reduction in infection levels and the transmission of microorganisms, hospital readmission cases will reduce, service outcomes will improve, and the costs associated with the management of infection-related cases will be reduced. Further, mortality levels will be reduced (Cambell, 2010). Evaluating EBP Projects (Phase Evaluation) The evaluation strategies used to check the success of the project will include the collection of empirical and non-empirical evidence in support of the change process. The empirical evidence collected at the health center will include non-experimental research, clinical trials, and the systematic reviews of the infection and transmission levels registered. The second evaluation model will entail the surveying of the effectiveness of the center’s hand hygiene, from the patients and the personnel at the health center (Canham, 2011). Some of the information collected during the survey include the number of times they wash their hands, whether alcoholic based detergents – for hand hygiene – and sinks are available at all areas requiring hand hygiene. These areas may include at the wards, casualty centers, surgery centers and physiotherapy centers. Based on the results of the evaluation of the outcomes of the EBP project, new practice guidelines and new standards of care will include the following: the oversight team should administer a feasibility study of the project, so as to ensure that funds for sustaining it will be available and a timeline should be drawn for the implementation of the project, and the outcomes predicted in advance. All medical personnel and patients should be required to sign – prior to contact – that they engaged in hand hygiene, using alcohol-based detergents or soap and water. All personnel should be taken through an educational workshop on the importance of hand washing in healthcare settings, and finally, rewards should be offered to the best ranked personnel in hand washing. Conclusion The EBP project will be administered according to the Stetler model of EB practice. The project will rely on the evidence collected from studies, during the planning of the change project, where the benefits of hand washing in healthcare will be explored. In the implementation stage, an oversight team will be formed, and it will be responsible for checking that patients and personnel adhere to the guidelines. At the evaluation stage, the success of the project will be evaluated, and future implementation strategies developed. Some of the future-looking strategies that include personnel that abide by the directives fully, will be rewarded. References Cambell, R. (2010). Hand-washing compliance goes from 33% to 95% steering team of key players drives process. Healthcare Benchmarks and Quality Improvement, 17,1, 5-6. Canham, L. (2011). The first step in infection control is hand hygiene. The Dental Assistant, 42- 46. Garrette, H. (2013). Evidence-Based Approaches to Hand Hygiene: Best Practices for Collaboration. Henry Schein, Inc. Retrieved from http://www.henryschein.com/us- en/Medical/ResourceCenter/HandHygiene_EvidenceBasedApproaches.aspx Pittet, D., Allegranzi, B., & Boyce, J. (2009). The World Health Organization Guidelines on Hand Hygiene in Health Care and their consensus recommendations. Infect Control Hosp Epidemiol, 30(7), 611-22. Stetler, C. (2010). Chapter 3: Stetler Model. In J. Rycroft-Malone & T. Bucknall (Eds.) Evidence-based Practice Series. Models and frameworks for implementing evidence- based practice: Linking evidence to action. Oxford: Wiley-Blackwell. Titler, M. G. (2008). The Evidence for Evidence-Based Practice Implementation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. 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