Strategies and Effectiveness of School-Based Education Session on Hand Washing Practices - Report Example

Assignment two: Designing and implementing an evaluation of the quality of a clinical Teaching Report Title: Evaluation of the strategies and effectiveness of school based education session on hand washing practices Word Count: 1,968 Table of Contents 1.0.Introduction 2 2.0.Evaluation Design 4 3.0.Significance of the Evaluation 6 4.0.Outcome of the Evaluation 6 5.0.Evaluation Results based on the Mean Score 8 6.0.Discussion and Reflection 9 7.0.Appendices 12 7.1.Appendix 1: Prescribed Tests and Evaluation on Teaching Hand Washing Effectiveness and Strategies 12 7.2.Appendix 2: Feedback/Comments Questionnaire 13 8.0.References 15 Figure 1: Results for Mean Score from Rating Scale based on the evaluative questions 6 1.0. Introduction Hand hygiene is one of the first basic skills of a patient safety that is taught to undergraduate nursing students. However, these skills are not carried by students into clinical practice or further into the careers. As Boscart and McGilton (2008) note, both students and healthcare providers’ compliance to proper hand hygiene or hand washing is unacceptably low. Due to Boscart and McGilton’s statistics and observations, evaluation of strategies and effectiveness of hand washing is essential as it contributes to the students’ and health providers’ performance management. The essentiality of evaluating hand washing strategies and effectiveness also translates to enhancement of environment where there is professional accountability. On the other hand, carrying evaluation on school based environment creates what Smith (2008a) had explained as “enhancement of practices and the actual course design of what learners mingle with in day to day activities” (p. 28). Though Smith does not address hand washing, his research on evaluation creates standing point that evaluation of hand washing strategies and effectiveness creates a variety of nursing education strategies that Polifroni (2008) also advise to be included within simulation and such has shown to increase hand hygiene compliance..Since patients’ quality and safety of healthcare is correspondent to the competence of healthcare professionals, the evaluation, design and implementation will contribute to the simulations as a successful teaching and evaluation strategies. To conceptualise the objective, results of the study will be availed and subsequent discussion and self-reflection presented based on the data and literature materials reviewed. 2.0. Evaluation Design The evaluation was a one day interactive session where students and healthcare staff within school were invited. Being a session to teach students and remind healthcare staff on the importance of hand washing strategies and effectiveness, the evaluation provided the following for the activity: Water Alcohol Basin Hand towel Soaps The objective of the target group, materials provided and venue for the evaluation was to instill the best way to enable nursing students to consistently incorporate appropriate hand hygiene into their clinical practice. (What does this means?) On the one hand, this report finds that there are a number of evaluation strategies suggested by authors. For instance, Fisher & Miller (2008) postulate that for value to be added and correct feedback generated in an evaluation, there should be adoption of reiterative process in evaluations. Contrariwise, scholars such as Pittet (2001) have suggested the adoption of summative evaluation especially when evaluator would like to avoid instances of a single retrospective feedback. Based on the multiplicity of approaches that can be used for evaluation, this report integrated both the single retrospective and summative evaluation so as to ensure that there is more than value and interactive process. In addition to this, researchers such as Boulet and Roche (2011) have stated the reliability and validity of evaluation process increases with increase in number of methods that have been adopted. Based on authors reviewed thus far, it is important to note that there is no single methodology or approach to effective evaluation instead, there is need to integrate varied approaches. Based on this findings, this report seeks to rate the effectiveness of the evaluation process by developing questions and ratings that seeks to provide teaching methods used in the evaluation. For instance, one of the registered health workers in a nearby health centre was invited to give directions on how best s/he think the process of hand washing should be. All materials was provided and s/he demonstrated this within three (3) minutes. After the completion of the task, the health worker was evaluated and oral questions presented as the report was made based on the evaluation and response given. The purpose of including a registered health worker alongside other learners (number of students taken within the school for evaluation) was to assess the method component and learning component of the evaluation process. As scholars such as Fitzpatrick (2011) note, including a registered health worker create dynamism thus giving an insight in creating the correct evaluation tool (the tool as tested on the registered health worker has been included as Appendix 1). Teaching and Learning Objectives The teaching and learning objectives of the evaluation have been aligned with the specific needs of leaners and course outcomes and such linked with Appendix 2 as included below. To contextualise this approach, the objectives identified are; Assessing whether students are using the recommended sanitizer Understanding the procedures used by learners in hand washing The level of consistency in the use of hand hygiene after patient care How often in hand washing strategies linked with nursing practices learnt 3.0. Significance of the Evaluation There is need to re-evaluate current practices of hand washing as part of hand hygiene. The importance of the evaluation will be to integrate findings of Al Kadi & Salati (2012) where good practices of hand washing encompass a nursing fundamental didactic and laboratory course. Based on this premise from Al Kadi & Salati, the process of evaluation as detailed above will use its generated report to assess hand hygiene compliance in the clinical setting. The observation as will be generated from design will use Kolb’s Experiential Learning Theory to understand the effectiveness of hand hygiene (MacDougall, 2011). Since the evaluation and subsequent report aims to promote effectiveness and compliance in hand hygiene in the clinical setting, the evaluation intends to integrate Friedman’s model where learning objectives should be communicated to participating staff before the evaluation process so that learning behaviours as observed, will benefit process of teaching and learning within classroom context (Friedman, 2009 as cited in Palmer, 2012). 4.0. Outcome of the Evaluation The evaluation process adopted both qualitative and quantitative approaches so as to provide in depth learning experience and information on the evaluation objective identified as well as identification of the aspects of hand washing strategies and effectiveness that were successful and areas where participants needed improvement. The adoption of registered health worker would inform the study about the effects of the response on clinical setup. Before analysis of the outcome, the qualitative and quantitative data that were presented were as follows; Figure 1: Results for Mean Score from Rating Scale based on the evaluative questions Rating Scale/Numerical Value Student self-evaluation questionnaire Strongly Disagree 1 Disagree 2 Not Sure 3 Slightly Agree 4 Agree 5 Strongly Agree 5 I use appropriate recommended sanitizer Mean score 3.5 I follow procedures for hand washing regularly Mean score 2.5 I am consistent in the use of hand hygiene after patient care Mean score 4.5 I only wash my hands after dealing with ‘real patient’ Mean score 5.5 I would perform hand washing after the evaluation process Mean score 5.5 5.0. Evaluation Results based on the Mean Score Based on the data presented above, evaluation realized that students evaluated had not mastered the corrected strategies and effectiveness of hand washing techniques thus inappropriate hand hygiene. To understand Kirkpatrick’s model of evaluation as cited in Webb-Corbett (2010), the students were given “I only wash my hands after dealing with ‘real patient’” question so as to assess their reaction, learning and behaviours on common issues within their areas of practice. Based on this evaluation, it has been noted that students do not use hand sanitizers before patient. In addition to this, most students requested that the evaluation be aligned with strategies of hand hygiene after visiting washrooms and toilets. Along with this request, evaluation reported highest number of participants being conversant with hygienic ways of exiting public toilets but little attention to the same when dealing with patients or in clinical practices, an observation that was also noted by (Rose & Best, 2005). In determining the extent to which learning had occurred during evaluation process, their sills and strategies of hand washing had developed as more and more respondents participated in the practice and new dynamics of hand hygiene within clinical setting introduced to them. During these observations, the process would interject the simulation and ask respondent(s) to stop and reflect on the hand washing deficit. Some of the anecdotal responses showed a recurring theme such as, “I would have washed my hands and used recommended soaps, detergents or sanitizers if it would have been a real dirt or patient.” This and other similar responses showed that there low compliance of proper hand hygiene within clinical settings. This was a stopping point to engage students in critical reflection of the thoughts so as to commit the change or actions and improvements on the current behavior (Rose & Best, 2005; Carmel, 2006). 6.0. Discussion and Reflection The discussion and reflection as detailed below is premised on three critical issues; the observation of the process as performed by students and the registered health care worker. Secondly, theoretical framework in this case, Reflective Cycle as postulated by Gibbs (Rose & Best, 2005; Bissett, 2007). The third premise is the results and comments as directly obtained from students’ comments. Basing on the mean score from rating scale based on the evaluative questions, it has been realised that repeated hand washing practice within the appropriate environment are deliberate action. Every task involved by the group should be fully demonstrated and not just verbalised. This is what Balliro (2005) also suggests by arguing that it is important to detail to participant about the procedure of evaluation prior to commencement so that maximum participation and relevant responses are obtained. Connecting findings by Balliro (2005), the evaluation process showed positive trend, the whole process of hand washing still need to be followed and verbal responses gathered for effectiveness of the evaluation. Based on the responses that students were giving when they were asked about “I follow procedures for hand washing regularly” I realised that hand washing and hygiene should be reinforced in all case scenario. Latest research by scholars such as Balliro (2005) agree that the best way to get outcome from evaluation or practice is to expose the process of learning in a restrained way so that the targeted group get accustomed to the process. Based on mean score obtained when students responded to “I use appropriate recommended sanitizer”, the realisation is that the evaluation simulation conducted support effective tools that can be used to measure how skills and strategies in hand washing can be translated into the clinical and career paths. This particular finding concurs with what researches such as Biggs & Tang (2007), Radhakrishnan et al. (2007), Polifroni (2008), Weaver & Lubomksi (2013); Smith (2008b) have discussed before. The improvements that this evaluation suggests should be premised on the discussions and data presented. First, this evaluation was my first interactive session with adult learners and educators. As a result, there were emerging challenges such as management of the learning environment and directing attention. Therefore my first area of improvement is to work with the suggestion made by Carmel (2006) that the learning environment should be made formal by availing the needed learning materials so that what is anticipated can be achieved conveniently. Based on this model, future evaluation will ensure careful management of classroom so to avoid problems such as misdirected responses as they were noticed with my evaluation. This study brings one suggestion; that there is need to establish or determine proper technique for performing hand washing. The point is that most students were accustomed to the techniques that this study provided and the difference my evaluation presented was more of a reminder to what they have been doing. In bringing such improvements, the techniques of improving hand washing should be aligned with Biggs & Tang (2007) and Smitt (2008b) suggestions that materials presented for evaluation should provide cynical and reoccurring outcomes. More research is also required to identify the most effective evaluation strategies and concepts that can integrate effecting learning and theoretical models in hand washing strategies. The suggestion for more research is also premised on three issues; that I appreciate the fact that the evaluation and teaching session gives an insight in improving personal reflection when it comes to clinical practices. Secondly, Centers for Disease Control and Prevention (2013) have strongly founded that critical and creative evaluation must be based on variety of sources so that its validity contributes to the already myriad knowledge. Lastly, in as much as my evaluation can guide my reflection and help in tailoring teaching, it can give inaccurate information if further research is not conducted. 7.0. Appendices 7.1. Appendix 1: Prescribed Tests and Evaluation on Teaching Hand Washing Effectiveness and Strategies Instructions for students: Please TICK your responses in the BOXES provided according to the guideline underneath. Key: SD: Strongly Disagree D: Disagree NT: Not Sure AS: Slightly Agree A: Agree AS: Strongly Agree Student self-evaluation Questionnaire Please TICK your responses in the BOXES provided I use appropriate recommended sanitizer SD D NT AS A AS I follow procedures for hand washing regularly SD D NT AS A AS I am consistent in the use of hand hygiene after patient care SD D NT AS A AS I only wash my hands after dealing with ‘real patient’ SD D NT AS A AS I would perform hand washing after the evaluation process SD D NT AS A AS 7.2. Appendix 2: Feedback/Comments Questionnaire Feedback/Comments Questionnaire from Learners Area(s) of Concern Response from Learners If hand hygiene was to be stressed on one most important thing that healthcare workers could do to prevent infections what would it be? 1………………………………………………………………………………………………………. 2………………………………………………………………………………………………………. 3………………………………………………………………………………………………………. Based on both the qualitative and quantitative data gathered specific to hand Hygiene, which area(s) need improvement(s). 1………………………………………………………………………………………………………. 2………………………………………………………………………………………………………. 3………………………………………………………………………………………………………. Which sections and occasions of evaluation could be improved? And why and or how? 1………………………………………………………………………………………………………. 2………………………………………………………………………………………………………. 3………………………………………………………………………………………………………. How would you advise educators and evaluators on current practices so as to help determine adherence to guidelines for best practice 1………………………………………………………………………………………………………. 2………………………………………………………………………………………………………. 3………………………………………………………………………………………………………. 8.0. References Al Kadi, A., & Salati, S. (2012). Hand hygiene practices among medical students. Interdisciplinary Perspectives on Infectious Diseases: Volume 2012. http://dx.doi.org/10.1155/2012/679129 Balliro, L. (2005). Clues to classroom management in ABE. Feild Notes, 15(2), 1-3. Biggs, J., & Tang, C. (2007). Teaching for Quality Learning at University. Maidenhead: McGraw-Hill/Society for Research into Higher Education & Open University Press. Bissett, L. (2007). Skin care: an essential component of hand hygiene and infection control. British Journal of Nursing, 16(16), 976-981. Boscart, V., & McGilton, S., (2008). Acceptability of a wearable hand hygiene device with monitoring capabilities. Journal of Hospital Infection. 70(3): 216-222. PMid: 18799234 http://dx.doi.org/10.1016/j.jhin.2008.07.008 Boulet, J. & Roche, P. (2011). Research regarding methods of assessing learning outcomes. Simulation in Healthcare 6(7): S48-S51. PMid: 21705967 http://dx.doi.org/10.1097/SIH.0b013e31822237d0 Carmel, A. (2006). Models for reflective practice. Practice Nurse, 32(10), 28. Centers for Disease Control and Prevention (CDCP) (2013). Guideline for hand hygiene in health-care settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee. Morbidity and Mortality Weekly Report 5 (RR-16), 1-45 Fisher, R. & Miller, D. (2008). Responding to student expectations: a partnership approach to course evaluation. Assessment and Evaluation in Higher Education, 33(2), 191-202.’ Fitzpatrick, A. (2011). Novel Educational Programme to improve knowledge regarding health care-associated infection and hand hygiene. International Journal of Nursing Practice. 2011; 17: 269-274. PMid:21605267http://dx.doi.org/10.1111/j.1440-172X.2011.01934.x http://dx.doi.org/10.7326/0003-4819-158-5-201303051-00002 MacDougall, C. (2011). Evaluation-the educational context. British Medical Journal, 95, 28-32. DOI: 10.1136/adc.2008.142240 Palmer, S. (2012). Student evaluation of teaching: keeping in touch with reality. Quality in Higher Education, 18(3), 297-311. Pittet, D. (2001). Improving Adherence to Hand Hygiene Practice: A Multidisciplinary Approach, Emerging Infectious Diseases. http://dx.doi.org/10.3201/eid0702.010217 Polifroni, C. (2008). Evaluating teaching strategies: a blended perspective. Journal of Nursing Education, 47(3), 95-97. Radhakrishnan, K., Cunningham, H. & Lubomksi, L. (2007).Measuring clinical practice parameters with human patient simulation: A pilot study. International Journal of Nursing Education Scholarship. 4(1). Rose, M. & Best, D. (2005). Transforming Practice Through Clinical Education, Professional Supervision & Mentoring. Sydney: Churchill Livingstone Elsevier. Smith, C. (2008a). Design focused evaluation. Assessment and Evaluation in Higher Education, 33(6), 631-645. Smith, C. (2008b). Building effectiveness in teaching through targeted evaluation and response: connecting evaluation to teaching improvement in higher education. Assessment and Evaluation in Higher Education, 33(5), 517-533. Weaver, S. & Lubomksi, L. (2013). Promoting a Culture of Safety as a Patient Safety Strategy A Systematic Review. Annals of internal medicine. 158(5_Part_2): 369-374. PMid: 23460092 Webb-Corbett, R. (2010). Using simulation to teach patient safety behaviors in undergraduate nursing education. Issues with Nursing Evaluation Higher Education, 21(2), 497-511. Read More