Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal Point.docx

Rubic_Print_FormatCourse CodeClass CodeAssignment
TitleTotal PointsNRS-490NRS-490-O500Benchmark - Capstone
Project Change Proposal300.0CriteriaPercentageUnsatisfactory
0-71% (0.00%)Less Than Satisfactory 72-75%
(75.00%)Satisfactory 76-79% (79.00%)Good 80-
89% (89.00%)Excellent 90-100%
(100.00%)CommentsPoints
EarnedContent60.0%Background5.0%Background section is not
present.Background section is present, but incomplete or
otherwise lacking in required detail.Background section is
present. Some minor details or elements are missing but the
omission(s) do not impede understanding.Background section is
present and complete. The submission provides the basic
information required.Background section is present, complete,
and incorporates additional relevant details and critical thinking
to engage the reader.Problem Statement5.0%Problem statement
is not present.Problem statement is present, but incomplete or
otherwise lacking in required detail.Problem statement is
omission(s) do not impede understanding.Problem statement is
present and complete. The submission provides the basic
information required.Problem statement is present, complete,
to engage the reader.Change Proposal Purpose5.0%Purpose of
change proposal is not present.Purpose of change proposal is
present, but incomplete or otherwise lacking in required
detail.Purpose of change proposal is present. Some minor
details or elements are missing but the omission(s) do not
impede understanding.Purpose of change proposal is present and
complete. The submission provides the basic information
required.Purpose of change proposal is present, complete, and
incorporates additional relevant details and critical thinking to
engage the reader.PICOT5.0%PICOT is not present.PICOT is
present, but incomplete or otherwise lacking in required

detail.PICOT is present. Some minor details or elements are
missing but the omission(s) do not impede
understanding.PICOT is present and complete. The submission
provides the basic information required.PICOT is present,
complete, and incorporates additional relevant details and
critical thinking to engage the reader.Literature Search
Strategy5.0%Literature search strategy is not present.Literature
search strategy is present, but incomplete or otherwise lacking
in required detail.Literature search strategy is present. Some
minor details or elements are missing but the omission(s) do not
impede understanding.Literature search strategy is present and
required.Literature search strategy is present, complete, and
engage the reader.Literature Evaluation5.0%Literature
evaluation is not present.Literature evaluation is present, but
incomplete or otherwise lacking in required detail.Literature
evaluation is present. Some minor details or elements are
understanding.Literature evaluation is present and complete.
The submission provides the basic information
required.Literature evaluation is present, complete, and
engage the reader.Utilization of Change or Nursing Theory
(2.2)5.0%Theory utilization is not present.Theory utilization
content is present, but incomplete or otherwise lacking in
required detail.Theory utilization content is present. Some
minor details or elements are missing but the omission(s) do not
impede understanding.Theory utilization content is present and
required.Theory utilization content is present, complete, and
engage the reader.Proposed Implementation Plan with Outcome
Measures (3.2)5.0%Implementation plan is not
present.Implementation plan is present, but incomplete or
otherwise lacking in required detail.Implementation plan is

omission(s) do not impede understanding.Implementation plan
is present and complete. The submission provides the basic
information required.Implementation plan is present, complete,
to engage the reader.Identification of potential barriers to plan
implementation, and a discussion of how these could be
overcome (2.3)5.0%Identification of potential barriers to plan
implementation and /or discussion component is not
present.Identification of potential barriers to plan
implementation with a discussion component is present, but is
incomplete or otherwise lacking in required detail.Identification
of potential barriers to plan implementation with a discussion
component is present. Some minor details or elements are
understanding.Identification of potential barriers to plan
implementation with a discussion component is present and
required.Identification of potential barriers to plan
implementation with a discussion component is present,
complete, and incorporates additional relevant details and
critical thinking to engage the reader.Appendices Inclusive of
Practice Immersion Clinical Documentation
(1.2)5.0%Appendices are not present.Appendices are present,
but incomplete or otherwise lacking in required
detail.Appendices are present with minor elements missing that
do not impede understanding.Appendices are present and
required.Appendices are present, complete, and incorporates
additional relevant details and critical thinking to engage the
reader.Evidence of Revision 10.0%Final paper does not
demonstrate incorporation of feedback or evidence of revision
on research critiques.Incorporation of research critique
feedback or evidence of revision is incomplete.Incorporation of
research critique feedback and evidence of revision are
present.Evidence of incorporation of research critique feedback

and revision is clearly provided.Evidence of incorporation of
research critique feedback and revision is comprehensive and
thoroughly developed.Organization and
Effectiveness30.0%Thesis Development and
Purpose10.0%Paper lacks any discernible overall purpose or
organizing claim.Thesis is insufficiently developed or vague.
Purpose is not clear.Thesis is apparent and appropriate to
purpose.Thesis is clear and forecasts the development of the
paper. Thesis is descriptive and reflective of the arguments and
appropriate to the purpose.Thesis is comprehensive and contains
the essence of the paper. Thesis statement makes the purpose of
the paper clear.Argument Logic and
Construction10.0%Statement of purpose is not justified by the
conclusion. The conclusion does not support the claim made.
Argument is incoherent and uses noncredible sources.Sufficient
justification of claims is lacking. Argument lacks consistent
unity. There are obvious flaws in the logic. Some sources have
questionable credibility.Argument is orderly, but may have a
few inconsistencies. The argument presents minimal
justification of claims. Argument logically, but not thoroughly,
supports the purpose. Sources used are credible. Introduction
and conclusion bracket the thesis. Argument shows logical
progression. Techniques of argumentation are evident. There is
a smooth progression of claims from introduction to conclusion.
Most sources are authoritative.Clear and convincing argument
presents a persuasive claim in a distinctive and compelling
manner. All sources are authoritative.Mechanics of Writing
(includes spelling, punctuation, grammar, language
use)10.0%Surface errors are pervasive enough that they impede
communication of meaning. Inappropriate word choice or
sentence construction is used.Frequent and repetitive
mechanical errors distract the reader. Inconsistencies in
language choice (register) or word choice are present. Sentence
structure is correct but not varied.Some mechanical errors or
typos are present, but they are not overly distracting to the
reader. Correct and varied sentence structure and audience-

appropriate language are employed.Prose is largely free of
mechanical errors, although a few may be present. The writer
uses a variety of effective sentence structures and figures of
speech.Writer is clearly in command of standard, written,
academic English.Format10.0%Paper Format (use of
appropriate style for the major and assignment)5.0%Template is
not used appropriately, or documentation format is rarely
followed correctly.Appropriate template is used, but some
elements are missing or mistaken. A lack of control with
formatting is apparent.Appropriate template is used. Formatting
is correct, although some minor errors may be present.
Appropriate template is fully used. There are virtually no errors
in formatting style.All format elements are correct.
Documentation of Sources (citations, footnotes, references,
bibliography, etc., as appropriate to assignment and
style)5.0%Sources are not documented.Documentation of
sources is inconsistent or incorrect, as appropriate to
assignment and style, with numerous formatting errors.Sources
are documented, as appropriate to assignment and style,
although some formatting errors may be present.Sources are
documented, as appropriate to assignment and style, and format
is mostly correct. Sources are completely and correctly
documented, as appropriate to assignment and style, and format
is free of error.Total Weightage100%
Week 3 paper
PICOT Statement Paper
Professor’s Name
Student’s Name
Course Title
Date
Introduction
Hand Hygiene (HH) is one of the most effective ways of

reducing hospital transited infections (HTIs) in the healthcare
setting. However, most healthcare professionals fail to comply
with the international standard guidelines for hand hygiene
negatively affecting the health and safety of patients. Poor HH
of health workers has led to increased mortality rates among
patients admitted in hospitals. More awareness needs to be
created among the healthcare workers about the importance of
HH to reduce the increased mortality rate. Healthcare agencies
need to take the responsibility of ensuring their staffs are fully
aware and adhere to World health Organization (WHO)
guidelines for hand hygiene (Sadule-Rios &Aguilera, 2017).
PICOT Statement
For healthcare workers in Hospital does alcohol based solutions
compared to hand washing protocol prevent hospital acquired
infections during the period patients stay in healthcare
facilities.
Evidence based solution
Alcohol based solutions have been used widely across the
world. Studies show that this approach to HH irritates hands
less often, removes germs effectively and requires less time as
compared to hand washing. Alcohol based solutions are also
more accessible as compared to sinks. This approach to HH is
more effective when the hands are not soiled. However, in
situations where dirt can be seen on the hands, health workers
should clean their hands using water. Alcohol based solutions
have good microbial activity against various bacteria and
viruses. Multiple studies show that alcohol based solutions are
more effective in the healthcare setting as compared to hand
washing protocol (Lehotsky et al., 2017).
Nursing Intervention
Patients who have been admitted in the hospitals interact
with nurses more often than any other healthcare professional.
For this reason, nurses must take precautionary measure to
ensure patient security and overall wellbeing. Nurse
practitioners should use alcohol based solutions before and after
interacting with patients. This will reduce the spread of

infections in the healthcares setting. Nurses should also follow
the WHO guidelines which require them to wear protective gear
before interacting with patients. This will prevent them from
acquiring infections from one patient and transmitting it to
other patients within the hospital (Garus-Pakowska, Sobala &
Szatko, 2013).
Patient Care
One of the most important goals for healthcare facilities is
to provide quality services to patients. Without proper HH this
goal cannot be achieved. Hospitals should create proper HH
guidelines to be followed by all patients admitted in their
facility. Healthcare providers should also ensure that their
patients are fully aware of these guidelines and ensure they are
followed to the latter. Enough alcohol based solutions should be
provided to ensure patients adhere to the guidelines (Deochand
& Deochand, 2016). The healthcare workers should also ensure
that visitors clean their hands before visiting the patients and
after leaving wards. This ensures visitors do not bring
infections to the patients.
Health care agency
One of the main responsibilities of the healthcare agency is
to provide enough alcohol based solutions to both patients and
healthcare professionals. Without enough resources they will be
unable to follow the WHO HH guidelines. The healthcare
agency should also ensure it has enough sinks with running
water to ensure that patients and healthcare professionals can
clean their hand when they have less supply of alcohol based
solutions. They should also ensure they create awareness among
their healthcare professionals about the importance of HH.
Occasional audits should also be conducted to ensure nurses
comply with the set HH guidelines (Chatfield et al., 2016).
Nursing Practice
Most of the hospital acquired infections can be prevented
by combining the alcohol based solutions and hand washing
protocol. These techniques can complement one another
increasing patient safety and care in hospitals. Nurses should

comply with the WHO guidelines to reduce spread of infections
in the healthcare setting (McLawsa et al., 2014). The
implementation of standard HH guidelines will ensure a safe
and secure healthcare environment. This will also improve
patient outcomes and their overall well being. This can go a
long way in reducing hospital stay as a result of hospital
acquired infections. All hospital stakeholders need to take the
necessary precautions to prevent the spread of these infections.
References
Chatfield, S. L., Nolan, R., Crawford, H. and Hallam, J. S.,
(2016). Experiences of hand hygiene among acute care nurses:
An interpretative phenomenological analysis. SAGE Open
Medicine Volume 4: 1 –9
Deochand, N., & Deochand, M. E. (2016). Brief Report on
Hand-Hygiene Monitoring Systems: A Pilot Study of a
Computer-Assisted Image Analysis Technique. Journal of
environmental health, 78(10). Journal of Hospital infection 97
(2017) 26-29
Garus-Pakowska, A., Sobala, W., Szatko. F. (2013).
Observance of hand washing procedures performed by the
medical personnel before patient contact part 1.International
journal of occupational medicine and environmental health 2013
Lehotsky, A., Szilagyi, L. , Szeremy, P., Weber, G., Haidegger,
T. (2017). Towards objective hand hygiene technique
assessment: validation of the ultraviolet-dye-based hand-
rubbing quality assessment procedure.
McLawsa, M. L., Farahangizb, S., Palenikc, C. Askariand, M.,
(2014). Iranian healthcare workers’ perspective on hand
hygiene: A qualitative study. Journal of Infection and Public
Health (2015) 8, 72—79
Sadule-Rios, N., Aguilera, G. (2017). Nurses’ perception of
reasons for persistent low rates in hand hygiene compliance.
Intensive and Critical Care Nursing 42 (2017) 17-21
WEEK 6 PAPER LITERATURE REVIEW

Literature Review
Professor’s Name
Student’s Name
Course Title
Date
Introduction
Most hospital acquired infections are as a result of human
actions. Hand hygiene (HH) is a great way to prevent the spread
of germs that cause these infections. However, studies show that
nurse wash their hand less than they should contributing to the
spread of these infections. This also puts patients at the risk of
being infected during their stay in healthcare facilities. HH can
prevent the spread of these infections and reduce hospital stay
for patients. This paper aims to review various studies that are
related to this topic and determine how they support the PICOT
statement.
PICOT Statement
For healthcare workers in Hospital does alcohol based solutions
compared to hand washing protocol prevent hospital acquired
infections during the period patients stay in healthcare
facilities.
Comparison of research Questions
A study conducted in 2015 aimed to establish whether
technology can be used to do away with health acquired
infections in hospitals (Al Salman et al., 2015). Another study
conducted in 2017 aimed to establish whether HH is enough for
the prevention of cross-contamination on hospital wards (Hor et
al., 2017). A thirds study done in 2016 focused on assessing the
knowledge and attitude of nursing staff and residents towards
hand hygiene in relation to reducing hospital-acquired
infections (Maheshwari, 2014). The fourth study reviewed in
this paper was conducted in 2015 and aimed to assess the
attitude, knowledge to HH guidelines of nursing students and
final year medical students towards hand hygiene in relation to
reducing hospital-acquired infections (Ariyaratne et al., 2015).
Another study conducted in 2019 aimed to explore the

attitudes cleaning staff in hospitals as HH (Sendall, McCosker
& Halton, 2019). In 2016, another research was conducted
aiming to establish whether Hand-Hygiene Monitoring Systems
are effective at reducing hospital acquired infections (Deochand
& Deochand, 2016). Another study also conducted in the same
year aimed to capture the experiences of HH among acute care
nurses. This involved interviewing nurses to give their
perceptions about HH (Chatfield et al., 2016). Finally, a study
conducted in 2016 aimed to identify the knowledge of HH in the
fight against HAI present in teaching hospitals affiliated to
Zabol University (Sarani et al., 2016). All these research
questions aimed to determine the effectiveness of HH in
healthcare facilities.
Comparison of Sample Populations
The first study was carried out in carried out in Bahrain; a
medical system in the nation was installed and observed for
twenty-eight days. Over the twenty-eight days period,
comments, suggestions, and remarks on the system were
recorded and as a result improvements on the system were made
on the course of the system trial. The second study was done in
three hospitals in Australia. The specific areas of concern were
the general surgical wards and the intensive care units. In order
to examine if the infection prevention and control practices
were influencing cross-contamination in hospitals, ethnography
study was carried out (Hor et al., 2017). The third study was
done in Bhopal city and involved 160 respondents.
The fourth research was done at a university in Sri Lanka.
There were 289 participants, of which ninety-three were nursing
students and one hundred and ninety-six were medical students.
The fifth study involved the use of focus groups where 12
cleaning staff participated. The sixth study looked at several
implemented HH monitoring systems. In the other research,
eight nurses in the US performing various roles were
interviewed. The final study was conducted on 170 nurses of
two teaching hospitals in Zabol (Sarani et al., 2016). All these
studies had enough sample sizes that helped to bring out

reliable findings.
Comparison of limitations
The methodology used in the first study was meant that the
results could not be generalized for a wider population (Al
Salman et al., 2015). The study is also time-consuming. In the
second study, biasness on the part of the research could have
significantly affected the findings of the study. The third study
used a cross sectional approach and therefore could not be used
to determine the behavior of healthcare professionals over a
period of time. The fourth study used an approach that does not
help to determine cause and effect of a phenomenon. The
researchers experienced challenges in sampling the data that
had been obtained compromising the reliability of the study.
The fifth study used explanatory design and therefore the
interpretation of the information obtained was judgmental and
biased. The sixth study utilized observation as its method of
study. This made it difficult for researchers to determine the
behavior of interests of the participants. The next study was
limited by the fact that participants could have provided biased
information that could influence the final results. The approach
also did not help to obtain all the information required from the
respondents (Chatfield et al., 2016). The final study was limited
by the fact that the problem of the study could not be tested
statistically. Due to the observational nature of the study, the
study is not repeatable.
Conclusion
In conclusion, the studies that have been reviewed in this
paper support the PICOT Statement. A threat to the credibility
that might have been present to most of these studies was
selection bias. The monitoring technology was not put all over
the complex rather it was only installed in the coronary care
unit. It was recommended that the systems should be tested in
other sections of hospitals. HH training needs to be emphasized
in order to bring improvement in healthcare system. Infection
prevention management needs to come up with proper training
programs for HH for hospital acquired infections to be done

away with. There is a need for the study to be conducted in the
real world for a valid conclusion on the subject matter to be
done.
References
Al Salman, J. M., Hani, S., de Marcellis-Warin, N., & Isa, S. F.
(2015). Effectiveness of an electronic hand hygiene monitoring
system on healthcare workers’ compliance to guidelines. Journal
of infection and public health, 8(2), 117-126.
Hor, S. Y., Hooker, C., Iedema, R., Wyer, M., Gilbert, G. L.,
Jorm, C., & O'Sullivan, M. V. N. (2017). Beyond hand hygiene:
a qualitative study of the everyday work of preventing cross-
contamination on hospital wards. BMJ Qual Saf, 26(7), 552-
558.
Maheshwari, V. (2014). A study to assess knowledge and
attitude regarding hand hygiene amongst residents and nursing
staff in a tertiary health care setting of Bhopal City. Journal of
clinical and diagnostic research: JCDR, 8(8), DC04.
Ariyaratne, M. H. J. D., Gunasekara, T. D. C. P., Weerasekara,
M. M., Kottahachchi, J., Kudavidanage, B. P., & Fernando, S.
S. N. (2015). Knowledge, attitudes and practices of hand
hygiene among final year medical and nursing students at the
University of Sri Jayewardenepura.
Sendall, M. C., McCosker, L. K., & Halton, K. (2019). Cleaning
staff’s attitudes about hand hygiene in a metropolitan hospital
in Australia: A qualitative study. International journal of
environmental research and public health, 16(6), 1067.
Deochand, N., & Deochand, M. E. (2016). Brief report on hand-
hygiene monitoring systems: A pilot study of a computer-
assisted image analysis technique. Journal of environmental
health, 78(10), 14-21.
Chatfield, S. L., Nolan, R., Crawford, H., & Hallam, J. S.
(2016). Experiences of hand hygiene among acute care nurses:
An interpretative phenomenological analysis. SAGE open
medicine, 4, 2050312116675098.
Sarani, H., Balouchi, A., Masinaeinezhad, N., & Ebrahimitabs,

E. (2016). Knowledge, attitude and practice of nurses about
standard precautions for hospital-acquired infection in teaching
hospitals affiliated to Zabol University of Medical Sciences
(2014). Global journal of health
science, 8(3), 193
DQ . Barriers to EBP project implementation
The ultimate aim of change projects is to effect continuous
improvements in healthcare organizations for subsequent
improvements in patient care and organizational management.
One way of creating lasting change is through collaborating
with the employees to ensure that the new change is accepted
and accommodated by the professionals. This creates a space for
joint implementation of the change where the employees own
the project. Another approach is through educating the staff and
the community on the need for the change and how it is going to
benefit them. However, there exists several challenges against
the attainment of this objective including resistance to change
and the depletion of resources.
Resistance to change is a common challenge in the healthcare
sector especially when the staff are not transformative and have
no desire for change. This normally occurs where the leadership
promotes a feeling of comfortability on present dynamics
instead of advocating for continued quality improvements
(Jordan, Bowers, & Morton, 2016). To overcome this barrier, I
will educate the staff on the need for implementing this change
and the expected benefits. It is also essential to educate the
patients, their families, and communities on the importance of
engaging in constant exercises and healthy dieting to control
blood sugar among diabetes patients. The education sessions
should focus on the role of the interventions in mitigating the
cost of care, reducing the burden of diseases, and improving the
quality of life.
Another barrier likely lower the efficacy of my project in
attaining the intended objectives is the depletion of the

resources necessary to complete this change. Key resources
needed to support the implementation of this project include
finances and human resources to promote regular exercises and
healthy dieting as better strategies of promoting long-term
stability among patients. To mitigate this challenge, I will
partner with healthcare organizations, community members,
adjacent healthcare organizations, and community-based
organizations to provide financial and intellectual resources for
the project’s completion. Another strategy is utilizing the six
sigma resource management approach to avoid resource wastage
(Koeijer, Paauwe, & Huijsman, 2014).
References
Jordan, P., Bowers, C., & Morton, D. (2016). Barriers to
implementing evidence-based practice in a private intensive
care unit on the EAstern Cape. South African Journal of Critical
Care, 32(2), 50-54. doi:10.7196/SAJCC.2016.v32i2.253

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