PNUR124 Practical Nursing Theory 2
Question:
Part A
This purpose of this assignment is to integrate newly introduced knowledge and research terminology with a student-identified, contemporary patient-focused clinical topic of interest within the nursing domain. The submission for this assignment has a maximum word count of excluding the cover page and references. Total word count must be identified on the title page of the assignment submission. Copies of the two literature articles described in the submission must be submitted in printed copy at the beginning of the class immediately following the assignment submission deadline. The structure of the submission is a written response to each of the prompts outlined in Table 1 below.
To help define a topic of interest, students are strongly encouraged to review two documents:
- NCLEX-RN Activity Statements from NCLEX Concept framework
Select client focused activity statements that would inform your practice at the nurse/client interface
- Peterson, S.J. Bredow, T.S., Middle range theories: application to nursing research. 3rd Ed. Wolters Kluwer Health/Lippincott Williams & Wilkins. 2013
Focus on chapters 3 to 16 plus chapter 18
Electronic submission of this assignment via the course Blackboard site is required.
Part B
Focuses on the outcome of an evidence search in relation to the student’s, contemporary patient-focused clinical topic of interest within the nursing domain from the first assignment. Based on the outcome of the first assignment the wording of the topic may be modified. The submission for this assignment has a maximum of five (5) pages including both narrated and tabulated text but excluding the cover page and references. A one page appendix is also required. Each of the ten (10) selected research articles must be submitted on an USB memory drive labeled with the student’s name. The articles must be submitted in the order that the articles appear in the literature table and must be clearly identified with all APA reference information.
The assignment submission must include:
- identification of the contemporary, patient-focused clinical topic/question of interest within the nursing domain
- a narrative description of the literature search and the search outcome; a one page appendix with a graphic depicting the search process and results must be provided
- a literature chart detailing the ten (10) selected research studies. Both quantitative and qualitative research studies must be include within the selected articles. Table 2 provides the required format and content requirements for the literature table.
- a concisely worded descriptive synthesis of the evidence regarding the topic of inquiry.
- a concisely worded conclusion regarding the specific nursing research problem needing investigation to inform nursing practice
Electronic submission of this assignment via the course Blackboard site is required. The USB memory drive must be submitted at the beginning of the class immediately following the assignment submission deadline.
Answer:
PICOT:
|
Population (P) |
Health care workers |
|
Intervention (I) |
Using hand hygiene guidelines |
|
Comparison (C) |
Unhygienic practice |
|
Outcomes (O) |
Reduction in healthcare associated infections |
|
Time (T) |
6 months |
PICOT:
Does the use of hand hygiene guidelines reduce the risk of healthcare associated infections as compare to the unhygienic practice within a time period of 6 months?
Before conducting the preliminary research of academic literature on the effectiveness of hand hygiene on the reduction of health care associated infections my personal perception regarding the issue was health care associated infections only develops for the patients undergoing major surgery. I believed that, maintaining proper dressing and medication is the only process of managing surgical infection. However, I was aware about the importance of using aseptic process during surgery and surgical infection management, but the transmission of infection through unhygienic process such as lack of hand hygiene was not fully understood. I considered the hand washing or hygiene process as a common process but was unaware about its effectiveness in reducing health care associated infection. However, during the research of academic papers I gathered information about health care associated infection and demonstrated the importance hand hygiene. Furthermore, I have learned about different factors related to health care associated infection such as infection associated with wound, intravenous channel related infection, infection due to the transmission of microbial agents and others and understand the importance hand hygiene compliance of the health workers (Smiddy, O’Connell & Creedon, 2015). I have realised that, hand hygiene is not only important during surgery or surgical infection management but also for reducing risk of other health care associated infections and its importance in usual care. In addition importance of hand hygiene of patients is also understood during the research (Haverstick et al., 2017).
The significance and relevance of hand hygiene in reducing health care associated infection in nursing is high. Research has identified health care associated infections as the reason of morbidity and mortality across the world, thus become one of the major threat for patient safety (Luangasanatip et al., 2015). Hence, it is required to implement effective strategy in order to reduce the risk of health care associated infections in an effective manner. In this regards, hand hygiene compliance has been identified as an effective technique to reduce the transmission of health care associated infections (Monistrol et al., 2012). However, health care workers have found to be poorly complies with hand hygiene factors due to lack of information and understanding regarding the importance of hand hygiene.
Thus, it is important to provide adequate information to the health workers about the effectiveness of hand hygiene in reducing health care associated infections and it is important to make them understand that it is the safety belt for them as well, so that they could comply with the hand hygiene guidelines (Niyonzima, Brennaman & Beinempaka, 2018). Hence, research on this topic would help to reduce the risk of health acre associated infection and improve the quality of life by ensuring patient safety. This position is also supported by the recent study conducted by Smiddy, O’Connell & Creedon, (2015) who suggest that research is required to explore the factors that influence hand hygiene compliance to use them to encourage the health workers to comply with hand hygiene guidelines in order to reduce the risk of healthcare associated infection and improve patient safety.
In a preliminary research of academic papers, two peer reviewed articles have been identified using database such as Google Scholar. Relevant key terms such as healthcare associated infection, hand hygiene, patient safety has been used with inclusion criteria such as English language, current year, relevancy and full text articles. As mentioned before, it is important to educate the health workers about the effectiveness of hand hygiene compliance in order to motivate them to follow the guidelines. The article by Monistrol et al., (2012) has focused on hand hygiene educational program and used interventional methods to derive the result which has provided basic ideas about the strategies that could be taken to implement educational program, thus, the study has been found to be relevant to the research topic and the article has been selected for the research. On the other hand, the article by Niyonzima, Brennaman & Beinempaka, (2018) has provided evidence based practice related to hand hygiene and examined its effect on different medical wards such as surgical ward, ICU, ED and general ward as well, thus, wide range of area has been undertaken. Due to such reason this article has been selected for the research.
The identified purpose of the article by Monistrol et al., (2012) is to evaluate the effect of a multimodal intervention on hand hygiene compliance, alcohol-based hand rub consumption and incidence of health care associated infection and hospital-acquired methicillin-resistant Staphylococcus aureus in medical wards. On the other hand the identified purpose of the article by Niyonzima, Brennaman & Beinempaka, (2018) is to assess the availability and suitability of required hand washing facilities, hand washing practice and compliance among healthcare workers in surgical ward, emergency department, ICU, and general wards.
The two articles have shaped my original understanding. My original understanding was that, hand hygiene is maintained only in surgical ward to reduce the risk of surgical infection and it is only performed by the health workers, however, the articles have contradicted my knowledge and informed that it is important to comply with the hand hygiene guidelines for health workers and patients as well in every medical wards such as surgical ward, ED, ICU and general ward to reduce the risk of health care associated infection and reduce the transmission of infection (Niyonzima, Brennaman & Beinempaka, 2018). Beside the safety of the patients, hand hygiene provides safety to the health workers as well. Behaviour of the health workers, work environment and cognition of individual have been found to impact the compliance with hand hygiene, hence social learning theory and cognitive theory would be helpful to initiate an educational program. In addition alcohol based hand rub consumption has been indicated as effective technique as compare to using soap. Furthermore, five moments of HH of WHO is also an effective tool to inform about the hand washing practice and improve patient safety (Monistrol et al., 2012).
References:
Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection. Critical care nurse, 37(3), e1-e8.
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: systematic review and network meta-analysis. bmj, 351, h3728.
Monistrol, O., Calbo, E., Riera, M., Nicolás, C., Font, R., Freixas, N., & Garau, J. (2012). Impact of a hand hygiene educational programme on hospital-acquired infections in medical wards. Clinical Microbiology And Infection, 18(12), 1212-1218. doi: 10.1111/j.1469-0691.2011.03735.x
Niyonzima, V., Brennaman, L., & Beinempaka, F. (2018). Practice and compliance of essential handwashing among healthcare workers at a regional referral hospital in Uganda: A quality improvement and evidence-based practice. Canadian Journal Of Infection Control, 33(1), 33-38.
Smiddy, M. P., O’Connell, R., & Creedon, S. A. (2015). Systematic qualitative literature review of health care workers’ compliance with hand hygiene guidelines. American journal of infection control, 43(3), 269-274.
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