Description
Assessment DescriptionDiscuss what it means for an intervention to be sustainable. Determine two methods used to promote sustainability of evidence-based interventions. Discuss what the next steps would be for your project.
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Reducing Hospital
Acquired Infections
(HAIs) through Hand
Hygiene Compliance
Presented By:
Antwanetta Boswell
HCA-650
Benchmark –
Evidence-Based
Project
Date: 10/05/2023
Reducing Hospital Infections (HAIs)
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Hospital Infections (HAIs) endanger patients and raise healthcare expenses.
Healthcare workers’ hand hygiene (HH) compliance is a top HAI prevention
strategy.
HH compliance rates in hospital settings are generally inadequate, resulting in
avoidable illnesses.
Approximately 1 out of 31 patients admitted to the hospital are affected by HAIs.
Studies have shown that most healthcare practitioners do not adhere to HH
compliance.
Due to this disregard of the healthcare practitioners to wash their hands as
supposed, this results in the spread of HAIs in the healthcare settings.
Hand hygiene serves as a cornerstone in infection prevention and control
programs.
Objective of this proposal
Hand hygiene serves as a cornerstone in infection prevention and control
programs.
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In the context of reducing HAIs through improved hand hygiene compliance,
evidence-based practice objectives are essential to guide interventions and
evaluate their effectiveness.
● Objectives
i)
Achieve a minimum of 90% compliance with hand hygiene protocols among
healthcare workers within the next 12 months.
ii)
Reduce the overall incidence of HAIs in the healthcare facility by 20% within
the next 24 months.
iii)
Increase the proportion of healthcare workers who receive regular hand hygiene
education and training to 100% within the next 6 months.
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Method Used in Gathering Research
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When searching for the articles to be used for this research, several databases
were used, including PubMed, CINAHL, Cochrane Library, and Scopus.
PubMed has a vast collection of peer-reviewed articles, making it a valuable
resource for research studies related to hand hygiene and HAIs.
CINAHL is also particularly useful for accessing research studies related to
healthcare practices, including hand hygiene.
The Cochrane Library also provides access to individual research studies that are
included in these reviews.
Scopus provides access to a substantial number of research articles, including
those related to hand hygiene and HAIs.
Some of the keywords and phrases that might be used include hand hygiene,
Healthcare-associated infections, Infection control, Healthcare Workers,
Surveillance, and effectiveness.
Proposed Solution
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Evidence-based hand hygiene programs improved healthcare professionals’
compliance with hand hygiene recommendations and decreased HAIs.
Hand hygiene promotion programs are more cost-effective than HAI therapy in
the American Journal of Infection Control.
The suggested approach complies with current research and standards, but its
deployment in a hospital setting must be considered.
Consideration must be given to resource availability, training requirements, and
organizational support to adopt and improve hand hygiene compliance.
To aim for a minimum 20% increase in hand hygiene compliance and a
minimum 15% decline in HAIs within a year, track progress, and assess the
effectiveness of the intervention.
Organizational or Community Culture
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The effectiveness of a healthcare intervention is contingent upon factors such as
the organizational culture and the availability of resources.
They may be exemplified by the improvement of hand hygiene to mitigate the
occurrence of HAIs.
Healthcare facilities need to embody the cultural values and principles of the
organization.
Cultures of continuous improvement can be effectively aligned with evidencebased approaches.
The enhancement of organizational leadership commitment and accountability
serves to reinforce the responsibility for patient outcomes.
The alignment of resources is paramount in ensuring sustainability and
usefulness.
Integrating these components increases the probability of a hand hygiene
intervention being efficacious and aligning with the organizational culture and
available resources.
Stakeholders
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The effectiveness of the project depends on the varied groups of stakeholders
participating in the implementation of evidence-based hand hygiene treatments to
minimize HAIs.
The success of the intervention is directly impacted by the implementation of
hand hygiene practices by healthcare personnel.
The hospital administration is essential in allocating funds, establishing
guidelines, and promoting a hand hygiene-friendly culture.
Teams dedicated to infection control and prevention create, oversee, and assess
infection control procedures to ensure the longevity of the intervention.
Families and caregivers must be educated and encouraged to participate in hand
hygiene practices while engaging in patient care.
At the same time, hospital support employees, such as janitors, are crucial for
keeping a clean and infection-free environment.
Expected Outcomes and Goals
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The hand hygiene intervention is designed to provide several distinct and
quantifiable results.
With regular monitoring and comparisons to baseline data, it first aims to raise
hand hygiene compliance among healthcare personnel by at least 15% within six
months.
By introducing evidence-based hand hygiene practices and monitoring infection
rates against historical data, the intervention seeks to reduce HAIs by 90% within
a year.
Improved patient safety and satisfaction are a secondary but crucial result of
decreased HAIs, resulting in fewer complications, shorter hospital stays, and
higher patient satisfaction ratings.
By lessening the cost of treating HAIs and demonstrating a return on investment,
the intervention also attempts to show cost savings.
Method to Achieve Outcomes
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Programs for education and training to healthcare professionals and support
employees must be implemented first.
This training should stress the importance of hand cleanliness, offer precise
instructions, and refute prevalent myths.
Monitoring and feedback systems need to be put in place to track hand hygiene
compliance.
Technology-enhanced reminders and prompts incorporated into processes and
strategically positioned around healthcare facilities help ensure hand hygiene is
routinely maintained.
Leadership support is necessary to establish an example and preserve an
infection prevention culture.
Data-driven decision-making, patient involvement and feedback gathering are
essential elements.
Activities for cultural change and adequate resource allocation complete the
approach.
The ideal project evaluation method
The cost-benefit analysis (CBA) is the ideal one for the proposed project.
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The project recommends adherence to evidence-based hand hygiene techniques
to reduce hospital-acquired infections.
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The CBA was selected over other methods for several reasons.
i) It will provide a clear picture of the costs the healthcare organization will incur to
not only educate healthcare professionals about these evidence-based hand hygiene
techniques.
ii) It will install supportive infrastructure and materials to support the use of these
techniques.
iii) It will show the monetary benefits associated with implementing these
techniques, such as reducing patient lawsuits due to hospital-acquired infections.
iv) It will allow for the inclusion of non-monetary benefits, such as improved patient
outcomes and satisfaction.
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Evaluation and adjustment plan
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To leverage the cost-benefit approach to assess the proposed project, the
healthcare organization will have to first identify the costs associated with
implementing it.
The healthcare organization will have to compare these costs against the
monetary and non-monetary benefits associated with implementing the project.
The Trans Theoretical Model of Behavioural Change (TTM) will be leveraged to
implement the proposed evidence-based hand hygiene improvement initiative.
Creating a culture of compliance with the hand hygine techniques might be
challenging and regular training is required.
As such, an adjustment should be made during the maintenance stage of the
selected change model.
Change Model
● The Trans Theoretical Model of Behavioural Change (TTM) is a useful change
model for implementing an evidence-based hand hygiene improvement initiative
in a hospital context.
● The TTM outlines the many phases of change that people go through while
acquiring new behaviors.
Stage 1: Precontemplation Educating the public about the dangers of HAIs and the
advantages of good hand hygiene.
Stage 2: Contemplation Give them evidence-based knowledge on efficient hand
hygiene practices to inspire them to take action.
Stage 3: Preparation Ensure a sufficient supply of soap, PPE, and hand sanitizers.
Stage 4: Action Celebrate your minor victories and thank your team for their efforts
in reinforcing good behavior.
Stage 5: Maintenance Continue monitoring compliance, conduct regular audits, and
provide ongoing education and support.
Implementation Plan
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The project will be implemented over a 12-month, allowing for flexibility in
starting at any time.
The budget for implementing the hand hygiene improvement project is estimated
at $500,000 over the 12-month implementation period.
This budget is designed to cover various expenses related to personnel, supplies,
equipment, computer-related costs, and other project-related expenses.
The contingency fund provides a buffer for unexpected expenses during the
implementation process.
The Human Resource Department should provide project oversight and
monitoring, conduct hand hygiene training sessions and analyze compliance data
and identify trends.
The fiscal resources should be used to development, printing of hand hygiene
educational materials, purchase hand sanitizers, soap, and PPE and provide
salaries and benefits for project staff.
References
● Chavali, S., Menon, V., & Shukla, U. (2014). Hand hygiene compliance among healthcare
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workers in an accredited tertiary care hospital. Indian Journal of Critical Care Medicine,
18(10), 689–693. https://doi.org/10.4103/0972-5229.142179
Koopmans, C., & Mouter, N. (2020). Cost-benefit analysis. In Advances in Transport
Policy and Planning (Vol. 6, pp. 1-42). Academic Press.
Haque, M., Sartelli, M., McKimm, J., & Abu Bakar, M. B. (2018). Health care-associated
infections – an overview. Infection and Drug Resistance, Volume 11(11), 2321–2333.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245375/
Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., & Taljaard, M. (2017). Interventions
to improve hand hygiene compliance in patient care. Cochrane Database of Systematic
Reviews, 9(9). https://doi.org/10.1002/14651858.cd005186.pub4
Toney-Butler, T. J., & Carver, N. (2019). Hand Washing (Hand Hygiene). Nih.gov;
StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470254/
Wang, Y., Yang, J., Qiao, F., Feng, B., Hu, F., Xi, Z., Wu, W., Ni, Z., Liu, L., & Yuan, Y.
(2021). Compared Hand Hygiene Compliance among Healthcare Providers before and after
the COVID-19 Pandemic: A Rapid Review and Meta-analysis. American Journal of
Infection Control, 50(5). https://doi.org/10.1016/j.ajic.2021.11.030
References
● Basu, M., Mitra, M., Ghosh, A., & Pal, R. (2021). Journal of Family Medicine and Primary
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Care,
10(9), 3348. DOI: 10.4103/jumps.jfmpc_742_21
https://www.sciencedirect.com/science/article/pii/S0196655321004831
Sands, M., & Aunger, R. (2020, June 13). Developing and Evaluating A Novel Intervention
to Improve the Hand Hygiene Behaviour of Nurses In Acute Care Hospital Units in the
United States. Researchonline.lshtm.ac.uk.
https://researchonline.lshtm.ac.uk/id/eprint/4657204/
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