Literature Evaluation Table
Student Name: Joyce Nwakor
PICOT Question: For patients and healthcare workers in the hospital (p) does hand washing protocol (I) compared to an alcohol-based solution (C) reduce hospital-acquired infection (O) within a period of stay in the hospital (T)
Criteria
Article 1
QUANT
Article 2
QUANT
Article 3
QUANT
Article 4
REVIEW
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Daisy, V. T., & Sreedevi, T. R.
Link:
http://eds.a.ebscohost.com.lopes.idm.oclc.org/eds/detail/detail?vid=4&sid=72619044-c224-4bc5-9982-cf6c3953f7d2%40sessionmgr4007&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=110819455&db=ccm
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., … Bader, M. K. (2015). Use of a Patient Hand Hygiene Protocol to Reduce Hospital-Acquired Infections and Improve Nurses' Hand Washing. American Journal of Critical Care, 24(3), 216-224. doi:10.4037/ajcc2015898
Knighton, S. (2017). The Use of Instructional Technology to Increase Independent Patient Hand Hygiene Practice of Hospitalized Adults in an Acute Care Setting. Open Forum Infectious Diseases, 4(suppl_1), S411-S412. doi:10.1093/ofid/ofx163.1029
João Manuel Garcia do Nascimento Graveto, Rita Isabel Figueira Rebola, Elisabete Amado Fernandes, & Paulo Jorge dos Santos Costa. Link:
https://doi-org.lopes.idm.oclc.org/10.1590/0034-7167-2017-0239
Article Title and Year Published
Effectiveness of a Multi-Component Educational Intervention on Knowledge and Compliance with Hand Hygiene among Nurses in Neonatal Intensive Care Units. 2015Use of a Patient Hand Hygiene Protocol to Reduce Hospital-Acquired Infections and Improve Nurses' Hand Washing
Published May 2015
The Use of Instructional Technology to Increase Independent Patient Hand Hygiene Practice of Hospitalized Adults in an Acute Care Setting. Open Forum Infectious Diseases.
Published in 2017
Hand hygiene: nurses’ adherence after training.
2018
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study
The study was aimed to assess the effectiveness of a multi-component educational intervention on the knowledge and compliance with handhygiene guidelines among nurses working in Neonatal Intensive Care Units.
The research investigated the reduction of infections in the hospital through observation of hand hygiene.
What handwashing procedures were performed by the medical personnel before patient contact part 1.
What is the level of effectiveness of training (I) in improving nurses’(P) adherence to hand hygiene(O)?”.
Design (Type of Quantitative, or Type of Qualitative)
A pre-experimental pre-test post-test design was adopted for the study. QUANT
Pre-experimental study design
. QUANT
A quantitative study was done using quasi observational data
Qualitative/ quantitative studies
This is a review
Setting/Sample
This study was conducted in 3 level III NICUs of selected private hospitals in Kerala
Total sample compri ...
Running head hand hygiene compliance1hand hygiene compliance8.docxwlynn1
Running head: hand hygiene compliance1
hand hygiene compliance8Hand Hygiene Education Implementation and Nurses Compliance in Reducing Nosocomial Infections
Grand Canyon University NRS-490
March 31, 2019
Background
Hygiene is a very crucial factor in prevention of infection in any health care facility. Also, compliance of handwashing ensures patients safety, aids in the treatment and recovery of hospitalized patients. Hand hygiene is important action performed by healthcare works to prevent transmission of healthcare associated infection (Smiddy, O’Connell & Creedon, 2015). Health care professionals such as doctors, nurses, physical therapist and laboratory technicians, take the responsibility of providing efficient, effective and quality care that will improve the health of their patients.
The purpose of this paper is to discuss the change proposal project components the author has been working on throughout the course. The goal of health care works rendering a quality, effective and efficient care to their patient in the health care setting will be difficult to achieve if the rate handwashing adherence is below expectation. Unclean healthcare environments harbor germs that can cause disease, thereby placing the patient at risk of developing infection instead of recovering from their present health condition. Healthcare providers inability to comply with hand hygiene is one the main reason patient develop hospital acquired infections (HAIs). Healthcare employees have the lives of patient in their hands therefore, hand hygiene should not by any means be neglected or dominated out in any healthcare facility.
Approximately 250 health care specialists in a Metro Detroit facility happened to be watched and assessed directly; prior to the start of the exercise, participants were selected based on their hand washing comprehension and compliance. Partakers expresses that they observed improvement on handwashing practices and that most nurses complied to hand washing guidelines evidenced by some significant reductions in the rate of transmission of HAIs within the healthcare facility. HAIs are the infections a patient acquire during the period of hospitalization. The result of the research showed a huge decrease in the spread of nosocomial infections due to progress of hand hygiene training and nurses’ compliance to handwashing protocols. These infections mostly manifest during or after 48 hours of admission or thirty days after discharge from the hospital or health-care facility. The author of this research study sees HAIs as a dangerous disease with many complications. Because inadequate handwashing practices by healthcare workers are the main cause of spread of hospital acquire infections, it is important to educate staff members on proper hand hygiene, implement plan to encourage hand hygiene compliance in the healthcare settings. Blood-stream, ulcers / surgical wounds, CAUTI and respiratory infections are the most common types of HA.
Hand Hygiene: Impact of Educational Training and Awareness Programmeiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Study to Assess the Knowledge and Practices of Hand Hygiene among Nursing S...ijtsrd
Topic A study to assess the Knowledge, And Practice of Hand Hygiene among Nursing Staff in different department of the Hospitals in Uttar Pradesh. Background of the study Health care associated infections persist as amajor problem in health care settings especially Intensive Care Units. Hand hygiene is the most simple and effective method for the prevention of these healthcare associated infections. So, assess the reported hand hygiene practices and observing is very much important to find out gaps, plan remedial measure to reduce HAIs. Hand hygiene practice is still burdened by inadequate compliance, whether in the professional sphere by health professionals or in the non professional sphere by lay population Aims of the study A. To assess the hand hygiene practices among nurses B. To assess the reason for non compliance. Material and method This study was conducted in different department of Fatima hospital. It was an observational, study50 different professional categories nurses were taken for observational study, 50 for assess the reported hand hygiene practices. Questionnaire and observation tool were used for data collection. Result The study revealed that there is a corelation between the knowledge and the practices of hand hygiene among the nurses. The overall observed compliance was 58 50 nurses included in observation study, 308 number of opportunities are given only 180opportunities of hand hygiene being performed . The BSc nurses shows higher compliance rate 93.4 . The GNM nurses show 64 and the ANM show low rate 60 . The reported hand hygiene compliance among Questionnaire given to50 Nurses they were may or may not be included in observation study . Conclusion There were two studies conducted by the investigator. The observational study and reported study. The observational study shows that the overall hand hygiene compliance was58 and the reported study give more than 93.4 of compliance among different categories of nurses. The investigator found that the overall observed hand hygiene compliance among nurses was 58.4 , from that BSC Nurses have performed better. They reported the reason for noncompliance was that they were too busy 64 . Sister Ancy Varghese | Dr. Priyanka Chaudhary | Mrs. Ramanpreet Kaur "A Study to Assess the Knowledge and Practices of Hand Hygiene among Nursing Staff in Different Department of the Hospitals in Uttar Pradesh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd47804.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/47804/a-study-to-assess-the-knowledge-and-practices-of-hand-hygiene-among-nursing-staff-in-different-department-of-the-hospitals-in-uttar-pradesh/sister-ancy-varghese
Johns Hopkins Nursing Evidence-Based Practice Appendix G TatianaMajor22
Johns Hopkins Nursing Evidence-Based Practice Appendix G: Individual Evidence Summary Tool
Johns Hopkins Nursing Evidence-Based Practice Appendix G: Individual Evidence Summary Tool
EBP Question: What are the barriers and importance of adherence to performing aseptic technique to decrease hospital acquired infections (HAIs) for medical-surgical nurses in an ER setting?
Article #
Author & Date
Evidence
Type
Sample, Sample
Size & Setting
Study findings that help answer the EBP
question
Limitations
Evidence Level & Quality
1
Concha-Rogazy, 2016
Systematic
review
12 scientific articles
□ N/A
-low risk of infection (<5%) when aseptic technique used for derm procedures
-iodine for broad spectrum of action against bacteria
-rise in costs when infections occur and antibiotics needed
to prevent infection
Selection bias
of articles used
Level one, B
2
Tambe, 2019
Case Report
20 nurses in a
Regional hospital in
Cameroon
□ N/A
-patient financial barriers and inadequate supply of sterile equipment/dressings are barriers to adherence
-using proper technique lowers risk of infection
- nurses are knowledgeable in proper technique but a small few still do not follow it
-Small sample size
-No competing
interests
Level five, A
3
Lin, 2019
Qualitative
72 registered
nurses in 28‐bed
general surgical
ward of a tertiary
hospital in Australia
□ N/A
The facilitators of adherence to aseptic guidelines in a clinical setting:
1) awareness of the importance and effects of surgical site infections, 2) hospital online modules on aseptic technique, and 3) hospital-wide program on handwashing adherence
The barriers of adherence to aseptic guidelines in a
clinical setting: 1) nurses were unaware of the setting to use aseptic
technique and 2) when to use clean vs. sterile gloves
Social desirability bias in a single research with a limited sample size
Level three, A
4
Towell, 2020
Qualitative
38 registered
nurses in an
emergency
department (ED) in
a tertiary hospital in
Australia
□ N/A
The influences of engagement towards standardizing aseptic technique in a clinical setting found were: 1)
motivation from self-autonomy, 2) relationships fueled by support and/or peer pressure, 3) education content & delivery, and 4) management directive which promoted
direction
Single research project with a small sample size
Level three, A
5
Mohsen, 2020
Qualitative
450 registered nurses, Shebin ElKoom University
Hospital
□ N/A
1) The hospitals need to conduct education and training programs to enhance knowledge of SSI prevention to improve the quality of nursing care in this area.
2) Improve compliance with the surgical site infection prevention guidelines through comprehensively modified
and updated nursing curriculum to include the prevention of surgical site infection.
3) Education and training program should be conducted to improve nurses’ knowledge and practice i ...
Running head hand hygiene compliance1hand hygiene compliance8.docxwlynn1
Running head: hand hygiene compliance1
hand hygiene compliance8Hand Hygiene Education Implementation and Nurses Compliance in Reducing Nosocomial Infections
Grand Canyon University NRS-490
March 31, 2019
Background
Hygiene is a very crucial factor in prevention of infection in any health care facility. Also, compliance of handwashing ensures patients safety, aids in the treatment and recovery of hospitalized patients. Hand hygiene is important action performed by healthcare works to prevent transmission of healthcare associated infection (Smiddy, O’Connell & Creedon, 2015). Health care professionals such as doctors, nurses, physical therapist and laboratory technicians, take the responsibility of providing efficient, effective and quality care that will improve the health of their patients.
The purpose of this paper is to discuss the change proposal project components the author has been working on throughout the course. The goal of health care works rendering a quality, effective and efficient care to their patient in the health care setting will be difficult to achieve if the rate handwashing adherence is below expectation. Unclean healthcare environments harbor germs that can cause disease, thereby placing the patient at risk of developing infection instead of recovering from their present health condition. Healthcare providers inability to comply with hand hygiene is one the main reason patient develop hospital acquired infections (HAIs). Healthcare employees have the lives of patient in their hands therefore, hand hygiene should not by any means be neglected or dominated out in any healthcare facility.
Approximately 250 health care specialists in a Metro Detroit facility happened to be watched and assessed directly; prior to the start of the exercise, participants were selected based on their hand washing comprehension and compliance. Partakers expresses that they observed improvement on handwashing practices and that most nurses complied to hand washing guidelines evidenced by some significant reductions in the rate of transmission of HAIs within the healthcare facility. HAIs are the infections a patient acquire during the period of hospitalization. The result of the research showed a huge decrease in the spread of nosocomial infections due to progress of hand hygiene training and nurses’ compliance to handwashing protocols. These infections mostly manifest during or after 48 hours of admission or thirty days after discharge from the hospital or health-care facility. The author of this research study sees HAIs as a dangerous disease with many complications. Because inadequate handwashing practices by healthcare workers are the main cause of spread of hospital acquire infections, it is important to educate staff members on proper hand hygiene, implement plan to encourage hand hygiene compliance in the healthcare settings. Blood-stream, ulcers / surgical wounds, CAUTI and respiratory infections are the most common types of HA.
Hand Hygiene: Impact of Educational Training and Awareness Programmeiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Study to Assess the Knowledge and Practices of Hand Hygiene among Nursing S...ijtsrd
Topic A study to assess the Knowledge, And Practice of Hand Hygiene among Nursing Staff in different department of the Hospitals in Uttar Pradesh. Background of the study Health care associated infections persist as amajor problem in health care settings especially Intensive Care Units. Hand hygiene is the most simple and effective method for the prevention of these healthcare associated infections. So, assess the reported hand hygiene practices and observing is very much important to find out gaps, plan remedial measure to reduce HAIs. Hand hygiene practice is still burdened by inadequate compliance, whether in the professional sphere by health professionals or in the non professional sphere by lay population Aims of the study A. To assess the hand hygiene practices among nurses B. To assess the reason for non compliance. Material and method This study was conducted in different department of Fatima hospital. It was an observational, study50 different professional categories nurses were taken for observational study, 50 for assess the reported hand hygiene practices. Questionnaire and observation tool were used for data collection. Result The study revealed that there is a corelation between the knowledge and the practices of hand hygiene among the nurses. The overall observed compliance was 58 50 nurses included in observation study, 308 number of opportunities are given only 180opportunities of hand hygiene being performed . The BSc nurses shows higher compliance rate 93.4 . The GNM nurses show 64 and the ANM show low rate 60 . The reported hand hygiene compliance among Questionnaire given to50 Nurses they were may or may not be included in observation study . Conclusion There were two studies conducted by the investigator. The observational study and reported study. The observational study shows that the overall hand hygiene compliance was58 and the reported study give more than 93.4 of compliance among different categories of nurses. The investigator found that the overall observed hand hygiene compliance among nurses was 58.4 , from that BSC Nurses have performed better. They reported the reason for noncompliance was that they were too busy 64 . Sister Ancy Varghese | Dr. Priyanka Chaudhary | Mrs. Ramanpreet Kaur "A Study to Assess the Knowledge and Practices of Hand Hygiene among Nursing Staff in Different Department of the Hospitals in Uttar Pradesh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd47804.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/47804/a-study-to-assess-the-knowledge-and-practices-of-hand-hygiene-among-nursing-staff-in-different-department-of-the-hospitals-in-uttar-pradesh/sister-ancy-varghese
Johns Hopkins Nursing Evidence-Based Practice Appendix G TatianaMajor22
Johns Hopkins Nursing Evidence-Based Practice Appendix G: Individual Evidence Summary Tool
Johns Hopkins Nursing Evidence-Based Practice Appendix G: Individual Evidence Summary Tool
EBP Question: What are the barriers and importance of adherence to performing aseptic technique to decrease hospital acquired infections (HAIs) for medical-surgical nurses in an ER setting?
Article #
Author & Date
Evidence
Type
Sample, Sample
Size & Setting
Study findings that help answer the EBP
question
Limitations
Evidence Level & Quality
1
Concha-Rogazy, 2016
Systematic
review
12 scientific articles
□ N/A
-low risk of infection (<5%) when aseptic technique used for derm procedures
-iodine for broad spectrum of action against bacteria
-rise in costs when infections occur and antibiotics needed
to prevent infection
Selection bias
of articles used
Level one, B
2
Tambe, 2019
Case Report
20 nurses in a
Regional hospital in
Cameroon
□ N/A
-patient financial barriers and inadequate supply of sterile equipment/dressings are barriers to adherence
-using proper technique lowers risk of infection
- nurses are knowledgeable in proper technique but a small few still do not follow it
-Small sample size
-No competing
interests
Level five, A
3
Lin, 2019
Qualitative
72 registered
nurses in 28‐bed
general surgical
ward of a tertiary
hospital in Australia
□ N/A
The facilitators of adherence to aseptic guidelines in a clinical setting:
1) awareness of the importance and effects of surgical site infections, 2) hospital online modules on aseptic technique, and 3) hospital-wide program on handwashing adherence
The barriers of adherence to aseptic guidelines in a
clinical setting: 1) nurses were unaware of the setting to use aseptic
technique and 2) when to use clean vs. sterile gloves
Social desirability bias in a single research with a limited sample size
Level three, A
4
Towell, 2020
Qualitative
38 registered
nurses in an
emergency
department (ED) in
a tertiary hospital in
Australia
□ N/A
The influences of engagement towards standardizing aseptic technique in a clinical setting found were: 1)
motivation from self-autonomy, 2) relationships fueled by support and/or peer pressure, 3) education content & delivery, and 4) management directive which promoted
direction
Single research project with a small sample size
Level three, A
5
Mohsen, 2020
Qualitative
450 registered nurses, Shebin ElKoom University
Hospital
□ N/A
1) The hospitals need to conduct education and training programs to enhance knowledge of SSI prevention to improve the quality of nursing care in this area.
2) Improve compliance with the surgical site infection prevention guidelines through comprehensively modified
and updated nursing curriculum to include the prevention of surgical site infection.
3) Education and training program should be conducted to improve nurses’ knowledge and practice i ...
Comparative efficacy of interventions to promote hand hygiene
in hospital: systematic review and network meta-analysis
Nantasit Luangasanatip,1, 2 Maliwan Hongsuwan,1 Direk Limmathurotsakul,1, 3 Yoel Lubell,1, 4
Andie S Lee,5, 6 Stephan Harbarth,5 Nicholas P J Day,1, 4 Nicholas Graves,2, 7 Ben S Cooper1, 4
Explorative study to assess the knowledge & attitude towards NABH accreditati...iosrjce
Quality in health care mainly “process-focused”, which encompasses access, care, outcomes and
evaluation. Aim of the study to assess the knowledge and attitude towards NABH accreditation among staff
nurses. Descriptive explorative approach was selected for the study and 40 staff nurses were selected trough
Purposive sampling method. Alternative structured questionnaire and attitude scale were used to collect the
data. The data revealed that 90% are belongs to age group of <25>< 3 years. All the subjects
(100%) had good knowledge about NABH accreditation. 15(37.5%) had the positive attitude, 13 (32.5%) are
had highly negative and 12(30%) had negative attitude. The mean of the knowledge score (40.75) is more than
the mean of level of attitude (34.37). There is a Partial Negative correlation between knowledge score and level
of attitude [r= 0.212, r (38) = 0.34 p>0.05]. There is a significant correlation between knowledge score and
level of attitude. Findings of the study indicate that all the subjects were having good knowledge and negative
attitude towards NABH accreditation and there is partial positive correlation between knowledge and attitude.
Evidence based projectMSN, Walden UniversityNURS-6052CDr. BetseyCalderon89
Evidence based project
MSN, Walden University
NURS-6052C
Dr. Emily Keyes
10/01/2021
introduction
Most of the health care facilities have implemented Evidence Based Practices mostly in nursing
EBP involves the use of research evidence, clinical expertise as well as patient’s preferences
There is a confusion on the pros and cons of EBP in nursing
Thus, PICOT questions are based on the use of EBP in each day’s nursing project.
Picot question
With the mechanically ventilated patients in the ICU aged 40 years or older, does the use of oral chlorhexidine in comparison to no chlorhexidine aid in reducing the incidence of VAP in 5 weeks?
population
intervention
comparison
outcome
Time
mechanically ventilated patients in the ICU aged 40 years or older
use of oral chlorhexidine
use of no oral chlorhexidine
reducing the incidence of VAP
5 weeks
Databases used for the research
PubMed:
The database aids in ensuring easy search per topic by using the search terms in order to filter results and find certain peer reviewed articles
Google Scholar
Allows me to easily navigate as well as filter the results to fit in my research
Cochrane Library
The database offers a wide range of systematic reviews as well as peer reviewed articles
CINAHL
Provides access to associated health topics as well as nursing based literature using electronic books and journals.
Peer reviewed articles
Al-Rabeei, N., Al-jaradi, A., Al-Wesaby, S., & Alrubaiee, G. (2019). Nursing Practice for Prevention of Ventilator-Associated Pneumonia in ICUs at Public Hospitals in Sana’a, City-Yemen. Al-Razi University Journal of Medical Sciences, 3(2), 69–80.
Frota, M. L., Campanharo, C. R. V., Lopes, M. C. B. T., Piacezzi, L. H. V., Okuno, M. F. P., & Batista, R. E. A. (2019). Good practices for preventing ventilator-associated pneumonia in the emergency department. Revista Da Escola de Enfermagem Da USP, 53. https://doi.org/10.1590/s1980-220x2018010803460
Jam, R., Mesquida, J., Hernández, S., Sandalinas, I., Turégano, C., Carrillo, E., Delgado-Hito, P. (2018). Nursing workload and compliance with non-pharmacological measures to prevent ventilator-associated pneumonia: a multicentre study. Nursing in Critical Care, 23(6), 291–298. https://doi.org/10.1111/nicc.12380
Kapucu, S., & ÖZden, G. (2017). Nursing Interventions to Prevent Ventilator-Associated Pneumonia in ICUs. Konuralp Tıp Dergisi. https://doi.org/10.18521/ktd.285554
Levels of evidence
The level of evidence for the article by Jam et al (2018) is level II since an observational study design was used.
The level of evidence for this article by Fronta et al., (2019) is level I since it a cross sectional study
The level of evidence for this article by Al-Rabeei, et al., (2019) is level III since it is a descriptive, cross sectional study
The level of evidence for this article by Boltey, et al., (2017) is level IV since it is a systematic review.
Strengths of systematic reviews
Systematic reviews aids ...
Running head RESEARCH PAPER1RESEARCH PAPER15.docxtodd521
Running head: RESEARCH PAPER 1
RESEARCH PAPER 15
Assessment of the knowledge, practice, and the associated factors of Healthcare Acquired Infection Prevention
Name
Institutional Affiliation
Date
Table of Contents
Table of Contents 2
Assessment of the knowledge, practice, and the associated factors of Healthcare Acquired Infection Prevention in Blessings Healthcare Facility 4
The Problem 5
Significance of the problem 6
Purpose of this study 7
Research Questions 8
Masters Essentials aligned with the topic 8
Design 10
Literature Review 10
Methodology and the design of the study 13
Sampling Methods 14
Necessary tools 14
Any logarithm or flow map developed 15
Healthcare Facility 15
Implementation 15
Stage 1: Assessment of the current practices (One Week) 16
Stage 2: Identification of the factors leading to high cases of healthcare-acquired infection (5 days) 17
Stage 3: Pre-Training (Two Weeks) 17
Stage 4: Training (5 weeks) 17
Stage 5: an ongoing process of assessing the situation 18
Materials, activities and the cost 20
Results 21
Socio-demographics features of the research population 21
Knowledge concerning the infection prevention 23
Aspects related to the knowledge of the healthcare professionals regarding the issue of preventing healthcare-acquired infections 27
Limitation of the study 28
References 30
Assessment of the knowledge, practice, and the associated factors of Healthcare Acquired Infection Prevention
Healthcare acquired infection/nosocomial infection/hospital acquired infections are becoming a major international challenge in many healthcare facilities especially in the low or middle income nations. It is anticipated that around 10 percent of patients in the healthcare facilities from developing nations are developing healthcare acquired infections and this subsequently leads to negative impacts on healthcare outcomes. It also leads to increase hospital stay, economic burden, morbidity cases, and increase in the mortality incidences. Some of the common healthcare acquired infections include Hepatitis B and C virus, HIV infections, and even Tuberculosis which are often transmitted by healthcare workers who are not observing the practice related to the infection prevention measures.
According to the United States Center for Disease Control and Prevention, there are about 1.7 million patients who have been hospitalized as a result of acquiring infection within the facilities while undergoing treatment for other healthcare concerns. Many studies reveal that simple infection control procedures like cleaning of the hands using alcohol-based hand rub is helping in the prevention of the spread of the disease. The increase in the infection rate caused by the healthcare acquired infection is due to the poor practices of infection prevention and control, lack of knowledge or failure to implement knowledge related to the process of preventing and controlling nosocomial illnesses, and other associated f.
Preventative Healthcare Associated Infections Through Hand Hygiene- Training ...Innovations2Solutions
Implementation of hand hygiene programs has traditionally been the responsibility of healthcare infection prevention staff and was focused on the clinical staff. The following discussion will describe
why comprehensive awareness and education training for infection prevention is necessary for Infection Prevention Managers, and how a multidisciplinary approach can achieve hand hygiene compliance and sustained reductions in HAIs. This type of approach involves including not just clinical staff, but also other healthcare staff members, patients and visitors, as key audiences for the hand hygiene program and campaign.
Exploring Knowledge, Attitudes and Practices of ICU Health Workers Regarding ...QUESTJOURNAL
Background: Nosocomial Infection is a localized or systemic infection acquired at any health care facility including hospitals by a patient admitted for any reason other than the pathology present during admission. Including an infection acquired in a healthcare facility that manifest 48 hours after the patient's admission or discharge. Objective: Themain aim of this study is toassess the level of knowledge, attitudes and practice of ICU health personnel with regards to the spread of nosocomial infections. Methodology: A cross-sectional and facility based study was conducted from March to November 2016 at King Khalid hospital in Najran, Saudi Arabia. By adopting convenience technique, 50 subjects had been recruited to participate in this study. Results: 62% of respondentswere female. The mean age was 29 years. Concerning educational status, 54% of the participants have Bsc. professionally most of them (48%) were nurses. 60% of the participants have less than three year working experience in ICU.86% of them highlighted that hands must be washed with soap and water or even rubbed with alcohol before contacting with patients. Additionally, the result reveals that employees who had master degree or above displayed higher mean knowledge scores as compared to the other two groups (diploma or less & bachelor) (0.7147 & 4.6656) respectively. High significant statistical differences were found between the three academic groups in relation to sharp devices, personal protective equipment (gloves, gowns &masks), care of intravenous infusion therapy, central line care and urinary catheter care (F=4.594, F=7.982, F=5.539, F=4.471, F=15.310, F=4.345) respectively at p < 0.05. Recommendation & conclusion: Health workers in ICU (King Khalid hospital) showed adequate knowledge and faire attitude regarding universal precautions
C361 TASK 2 2
C361 TASK 2 2
C361 Task 2
WGU
Evidence-Based Practice and Applied Nursing Research
C361
Eve Butler
July 28, 2019
Running head: C361 TASK 2 2
C361 Task 2
A.1 Healthcare problem
Worldwide estimates have shown that greater than 1.4 million patients have acquired nosocomial infections. Adherence to hand hygiene policies are shown to be the most effective way to help prevent these healthcare-associated infections; sadly research shows that healthcare workers have suboptimal compliance with their facilities hand hygiene policies due to lack of education and compliance monitoring. Patients in our healthcare settings are under the assumption that we are doing our best to promote their healing when in fact 7% of them will be subjected to a nosocomial infection with that rate climbing to 10% in developing countries (Finco et al., 2018).
A.2 Significance of the problem
The cost of care that is associated with nosocomial infections is estimated to be over ten billion dollars putting a burden on both patients and health organizations alike. It is estimated that 38% of all infections are caused by cross-contamination due to noncompliance with hand hygiene policies. These infections lead to approximately 99,000 deaths a year in the United States alone (Sickbert-Bennett et al., 2016).
A.3 Current healthcare practices related to the problem
Most healthcare facilities have an educational program that simply teaches how to achieve proper hand hygiene and use the WHO five moments of hand hygiene as their standard. However, this does not educate the healthcare workers on why it is important, nor does it address the far-reaching consequences for noncompliance. Along with the lack of foundational education, most facilities do not monitor for compliance.
A.4 How the problem affects the organization and patients’ cultural background
Inadequate hand hygiene leading to nosocomial infections can affect the organization's cultural background by leading to dissatisfaction in the workplace as staff becomes frustrated by their feelings of inadequacy and helplessness in dealing with patients getting sicker instead of better. The staff may also be feeling stress in the burden of caring for sicker patients. The patient's cultural background may be affected as they may be feeling despair or depression at their inability to get better, and some may feel it is punishment according to their cultural or religious beliefs.
B. Two research evidence sources and two non-research evidence sources considered
In searching for my research evidence sources, I start with the Western Governors University Library online. Once in the library, a boolean phrase was used, which allowed me to search for research articles that contain more than one topic in the same paper. Phrases I used in this search were “nosocomial infections,” “hand hygiene compliance,” and “ hand hygiene education.” With these phrases, thousands of articles were available to peruse.
One of the res.
Improving Urinary Catheterization
Reducing Catheter-Related Infections at Amsterdam Nursing Home in New York
Group Members
Introduction
Urinary catheters are vital tools that collect urinary in a drainage bag from the bladder.
They are important for patients with a compromised urinary function.
Urinary Catheters are a double-edged sword:
On the one hand, they simplify the handling of a basic bodily function.
On the other hand, they subject frail patients to the risk of infection, which may lead to death, falls, or confusion. The infection is referred to as catheter-associated urinary tract infections (CAUTI) (Parker et al., 2017).
Problem Statement
Catheter-related infections at Amsterdam Nursing Home in New York are currently quite high.
This project aims to find solutions to lower the current infection rate to manageable levels.
The high infection rates are posing diverse risks to the patients in post-acute and long-term care.
The current situation is leading to negative patient outcomes. It also results in unnecessary high healthcare costs.
Aims Statement
This project aims to decrease the infection rates from the use of urinary catheters from the current 10% infection rate to a maximum of 2% infection rate by the end to a 3 month timeframe in the elderly population at Amsterdam Nursing Home.
Establishing Measures
The following measures will prove that the object is working:
A drop in the infection rates from 10% to 2%.
A significant drop in the current expenditure used to treat complications due to infections (at least 50%).
An increase in patient satisfaction based on a survey to be filled by clients (at least 75%).
Selecting Changes
Appropriate Urinary Catheter Use.
Catheters should only be used for appropriate indications as outlined by the CDC. Also, the duration of use should be minimized in high risk patients.
Proper Techniques for Insertion and Maintenance.
High hygiene levels should be maintained. This is in reference to hand hygiene, use of sterilized products, and general cleanliness in the nursing room.
Also, catheterization should only be done by authorized personnel.
Regular maintenance of the catheters should be done. Catheters should be replaced as necessary (Gould et al., 2010).
Selecting Changes
Quality Improvement (QI) Programs.
All practitioners should be routinely educated on the proper use of catheters.
Appraisal programs should e conducted regularly to evaluate effective catheter use in the nursing home.
Administrative Infrastructure.
Provision of relevant guidelines.
Education and Training.
Sourcing of Supplies.
Surveillance.
Testing Changes
Use of Interworking Model.
Model comprised of Donabedian’s conceptual framework, Watson’s Theory of Caring, and Lewin’s Theory of Change (D'Antonio, 2018).
This model is crucial in re-educating staff to enact change, emphasize a nurse-driven initiative, and to assess quality
Testing Changes
Plan
The objective of testing changes is to see if t ...
12Plan for Evaluating the Impact of the Inte.docxmoggdede
1
2
Plan for Evaluating the Impact of the Intervention
Anne Marie WouapetName
Walden University
NURS 8310 Section 03, Epidemiology and Population HealthClass
April 29, 2018Date
Plan for Evaluating the Impact of the Intervention
Hospital-acquired infections have been determined throughout this project to be a significant problem in the United States health care system. Epidemiologic data show that there is still a considerable number of patients who die as a result of infections that they have acquired while receiving care (Umscheid et al., 2011). The older population was found to be at a higher risk of acquiring these infections because of their deteriorating immune systems (Sievert et al., 2013). Therefore, a proposed intervention to eliminate the dangers of infection was created. The intervention proposes that nurses go through hand washing education for an extended period to enhance their compliance to hand hygiene after the education program. In studying the potential impacts of this intervention, it was determined that hand washing education is usually effective in changing perceptions and behaviors with regards to hand hygiene, but the compliance to what has been learned is often not maintained. Therefore, this intervention suggests that the education is based on the practice environment and that the nurses are monitored for an extended period. The following is an evaluation plan aiming at assessing the potential outcomes of the proposed intervention.
Evaluation Plan
This evaluation plan is designed to assess the expected outcomes from the implementation of the program (Friis & Sellers, 2014). This plan will investigate the extent to which the hand washing intervention plan will help to reduce the rate of hospital-acquired in infections in the healthcare facilities in which the intervention will be implemented. The plan includes an evaluation of the short-term, medium-term, and long-term changes expected to occur after the implementation of the intervention.
Stakeholders Involved in the Intervention
For the expected outcome to be achieved, the following stakeholders will be required to participate in the intervention program. Evaluating the participation of the stakeholders is essential in determining their contribution to the outcome of the program (Centers for Disease Control, 2011). The program will require the participation of the Director of Nursing, who will be responsible for guiding the nurses included in the intervention to ensure that they participate in the program as required. The intervention will also require the participation of the Directors of the respective health care facilities where the intervention will be implemented to ensure that they provide the resources needed for the program to be implemented and approve the use of the hospital data to evaluate the outcomes of the program. The hospitals included will also need to employ super ...
THE 10 STRATEGIC POINTS FOR THE PROSPECTUS,21THE 10 STRATEGIC P.docxtodd801
THE 10 STRATEGIC POINTS FOR THE PROSPECTUS, 21
THE 10 STRATEGIC POINTS FOR THE PROSPECTUS, 28
DPI Project Milestone:10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project
Running head: THE 10 STRATEGIC POINTS FOR THE PROSPECTUS, 1
The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project
The 10 Strategic Points
Broad Topic Area
1. Broad Topic Area:
The topic taken into consideration is the Central Line-Associated Bloodstream Infections (CLABSIs) and prevention
Introduction
2. Introduction
· The paper is an analysis of the CLABSIs infection and how best the infection can be prevented or even eliminated among patients.
· The infection is characterized by a catheter gaining entry into the bloodstream, greatly affecting either the inferior or the superior vena cava or the vessels of the neck.
· The location of the catheter makes entry of pathogens into the bloodstream very occasional. Patients thus become sick easily.
· The risk factors associated with the infection can result from the healthcare provider and also the patients and include; contamination on insertion, the skin flora of the patient, non-intact dressing, poor nutrition, position of the central line, poor patient and healthcare provider hygiene.
· Symptoms include redness, swelling, discharge at the central line exit, fever, chills, respiratory distress, and altered cognitive state.
· The infection can be prevented, through monitoring of the patients for any signs and symptoms, ensuring proper hygiene practices, and keeping patients educated about management of their central line.
· The paper gives all these information in detail, why there is a need to address Central line-associated bloodstream infections (CLABSIs) and how best the infection can be handled both by the health care givers and the patients.
Literature Review
3. Literature Review:
1. Primary points basis four sections in the Literature Review:
a. Background of the problem/gap:
· Researchers have dedicated numerous efforts towards the cause and the probable symptoms related to Central line-associated bloodstream infections (CLABSIs) that one needs to be on the look-out for.
· Attention has thus been shifted from the different measures to prevent the occurrence of the infection among patients.
· There arises an urgency to intervene and develop effective measures to curtail the incidence of CLABSIs.
· The use of proper hand hygiene and skin aseptic techniques over the insertion site is necessary for preventing microbial infections
· The nurses need to have the significant knowledge associated with evidence-based practices for the Central line-associated bloodstream infections (CLABSIs), their attitude towards the guidelines and the utilization of the hygienic measures for the Central Venous Catheter (CVC) patients.
b. Theoretical foundations (models and theories to be the foundation for the project)
· The efficacy of training of nu.
This presentation provides an overview of the SIG TEL 4 Health that is located at the CELSTEC institute. We are cooperating with various medical partner organization in European projects on topics like patient safety and patient empowerment. We strongly believe that mobile solutions + semantic and analytic technologies will facilitated the empowered patient and health system of the future.
4
CHANGE PROPOSALPRESENTATIONFORFACULTY REVIEW
Capstone Project Change Proposal Presentation for Faculty Review and Feedback
Name
Name of the institution
Date
Running head: ASSIGNMENT TITLE HERE
1Running head: CHANGE PROPOSAL PRESENTATION FOR FACULTY REVIEW
Intervention
The capstone change proposal is effects of disproportionate nurse to patient staffing ratios on the quality of patient care. Patients can be exposed to several safety issues if proper care is not given to them. These problems include falls, hospital-acquired infection due to poor hand hygiene by the healthcare workers, medication administration errors, poor health education to the patients, and negligence in attending to the spiritual needs of the patients. Interventions includes presenting the safety concerns to the management team of the facility to enable them to hire more nurses to deliver adequate care to the patients. In-service training of the nurses on fall prevention, proper application of fall precautions and identification of patients who are at risk of falls are another important intervention. Proper hand hygiene is an intervention that will prevent hospital-acquired infections and nurses should form the culture of doing it (Sands, & Aunger, 2020). Medication errors can lead to complications or death of patients. Nurses should check the medications properly and identify the patients before administration of the medications.
Evidence Based Literature
The articles reviewed have different research aims and questions, but they are all centered into the idea of the effects of nurse-to-patient ratios on patient outcomes. The research questions of these articles are divided into three categories: definition of nursing staffing, effects of nursing-to-patient ratio on patient outcomes and nursing characteristics that hinders the delivery of care. The study by (Cho et al., 2020), defines the term nursing staffing in terms of the nursing care needs of the patients.
Nurses are essential in the provision of quality care in acute units, and their staffing levels have an impact on patient outcomes. (Cho et al., 2015), examine the link between nursing staffing and patient outcomes, specifically the mortality rate. Comparing to (Driscoll et al., 2018) and (Shin et al., 2018), the articles examine the effects of nursing staffing ratios on the patient outcomes in acute specialist units. Besides, (Needleman, 2016) reviews the studies that examine the effects of nursing skill mix on the patient outcomes such as patient ratings of hospitals, mortality, adverse health outcomes, and nurse burnout and dissatisfaction.
Some of the factors such as nursing skills, staffing methods, and working environment affects the nursing staffing ratio, which hinders the quality of care. The article by (Bridges et al., 2019), explores the relationship between nursing staffing skills and the quality and quantity of their interactions with patients in hospital wards. (Olley et al., 2019) ...
1
Quantitative Synopsis and Appraisal
Studentfirstname Studentlastname, Studentfirstname Studentlastname, Studentfirstname
Studentlastname, Studentfirstname Studentlastname
College of Nursing, Resurrection University
NUR4440: Research in Nursing
Professor Carina Piccinini
February 14, 2020
2
Quantitative Appraisal and Synopsis
The purpose of this paper is to summarize and appraise a research study testing the use of
disinfectant caps on intravenous (IV lines) to reduce the rate of hospital associated bloodstream
infections (BSI). The Centers for Disease Control and Prevention (CDC, 2019) reports that
central line associated bloodstream infections (CLABSI) remain a major concern in hospital
settings causing fatalities, increased length of stay, and increased costs. The CDC (2019)
recommends proper maintenance of intravenous lines to reduce the risk of infection. Current
research is still looking to define what proper maintenance should be, including whether
disinfectant caps influence rates of infection for intravenous (IV) lines.
Summary of the Study
The CDC recommends that healthcare workers disinfect all needleless connectors for
peripheral and central IVs prior to connection to reduce the risk of CLABSIs without further
recommendation on the type or length of disinfections. The authors of this study note other
studies have tested disinfecting caps and sought to confirm those results.
Merrill et al. (2014) conducted a quasi-experimental study to identify if disinfectant caps
reduce CLABSI incidence and the relationship between nursing compliance with the caps and
CLABSI rates. This study was held in a single Trauma 1 hospital with 430 beds in the United
States.
The researchers obtained their sample through nonrandom convenience sampling by
including all patients meeting inclusion criteria at the hospital starting January 2012. Participants
were included if they had a central or peripheral intravenous line, of any age, and were admitted
to 13 specific hospital floors. Subjects were excluded if they were on the following floors:
emergency department; labor, delivery or post-partum; ambulatory care, surgical services; and
3
well-baby nursery. The study did not report any demographic information about participants, the
number of participants, or attrition or loss to follow up.
The intervention involved applying a Curos brand disinfectant cap to all ports on
peripheral lines, central lines, and IV tubing when not in use on patients. The nurses on the
involved units were trained on the use of the disinfectant caps with a 1:1 follow up by the
researchers. Nurses were then responsible for placing caps. The researchers intermittently
observing nurses for compliance to the intervention and reporting compliance to nursing
departments twice a week.
CLABSIs were defined as a positive blood culture drawn within 48 hours symptom onset,
and C ...
1
Quantitative Synopsis and Appraisal
Studentfirstname Studentlastname, Studentfirstname Studentlastname, Studentfirstname
Studentlastname, Studentfirstname Studentlastname
College of Nursing, Resurrection University
NUR4440: Research in Nursing
Professor Carina Piccinini
February 14, 2020
2
Quantitative Appraisal and Synopsis
The purpose of this paper is to summarize and appraise a research study testing the use of
disinfectant caps on intravenous (IV lines) to reduce the rate of hospital associated bloodstream
infections (BSI). The Centers for Disease Control and Prevention (CDC, 2019) reports that
central line associated bloodstream infections (CLABSI) remain a major concern in hospital
settings causing fatalities, increased length of stay, and increased costs. The CDC (2019)
recommends proper maintenance of intravenous lines to reduce the risk of infection. Current
research is still looking to define what proper maintenance should be, including whether
disinfectant caps influence rates of infection for intravenous (IV) lines.
Summary of the Study
The CDC recommends that healthcare workers disinfect all needleless connectors for
peripheral and central IVs prior to connection to reduce the risk of CLABSIs without further
recommendation on the type or length of disinfections. The authors of this study note other
studies have tested disinfecting caps and sought to confirm those results.
Merrill et al. (2014) conducted a quasi-experimental study to identify if disinfectant caps
reduce CLABSI incidence and the relationship between nursing compliance with the caps and
CLABSI rates. This study was held in a single Trauma 1 hospital with 430 beds in the United
States.
The researchers obtained their sample through nonrandom convenience sampling by
including all patients meeting inclusion criteria at the hospital starting January 2012. Participants
were included if they had a central or peripheral intravenous line, of any age, and were admitted
to 13 specific hospital floors. Subjects were excluded if they were on the following floors:
emergency department; labor, delivery or post-partum; ambulatory care, surgical services; and
3
well-baby nursery. The study did not report any demographic information about participants, the
number of participants, or attrition or loss to follow up.
The intervention involved applying a Curos brand disinfectant cap to all ports on
peripheral lines, central lines, and IV tubing when not in use on patients. The nurses on the
involved units were trained on the use of the disinfectant caps with a 1:1 follow up by the
researchers. Nurses were then responsible for placing caps. The researchers intermittently
observing nurses for compliance to the intervention and reporting compliance to nursing
departments twice a week.
CLABSIs were defined as a positive blood culture drawn within 48 hours symptom onset,
and C ...
1. Discuss the organization and the family role in every one of the.docxcroysierkathey
1. Discuss the organization and the family role in every one of the heritages mentioned about and how they affect (positively or negatively) the delivery of health care.
2. Identify sociocultural variables within the Irish, Italian and Puerto Rican heritage and mention some examples.
References must be no older than 5 years. A minimum of 700 words is required.
.
1. Compare and contrast DEmilios Capitalism and Gay Identity .docxcroysierkathey
1. Compare and contrast D'Emilio's
Capitalism and Gay Identity
with the
From Mary to Modern Woman
reading. What patterns do you see that are similar to the modern American society? What can be said about global notions of gender in the modern age? Feel free to invoke Foucault.
2. How is the writer's experience important in the story being told in
Middlesex
? Describe your reaction to the reading and invoke some of the concepts discussed in the
Queer Theory
reading to try to make sense of sexuality when it does not match your own conventions. Compare both readings, but go deeper to explore your own stereotypes and socialization.
**PLEASE READ THE READINGS IN ODER TO DO THIS ASSIGNMENT.
.
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Explorative study to assess the knowledge & attitude towards NABH accreditati...iosrjce
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Evidence based projectMSN, Walden UniversityNURS-6052CDr. BetseyCalderon89
Evidence based project
MSN, Walden University
NURS-6052C
Dr. Emily Keyes
10/01/2021
introduction
Most of the health care facilities have implemented Evidence Based Practices mostly in nursing
EBP involves the use of research evidence, clinical expertise as well as patient’s preferences
There is a confusion on the pros and cons of EBP in nursing
Thus, PICOT questions are based on the use of EBP in each day’s nursing project.
Picot question
With the mechanically ventilated patients in the ICU aged 40 years or older, does the use of oral chlorhexidine in comparison to no chlorhexidine aid in reducing the incidence of VAP in 5 weeks?
population
intervention
comparison
outcome
Time
mechanically ventilated patients in the ICU aged 40 years or older
use of oral chlorhexidine
use of no oral chlorhexidine
reducing the incidence of VAP
5 weeks
Databases used for the research
PubMed:
The database aids in ensuring easy search per topic by using the search terms in order to filter results and find certain peer reviewed articles
Google Scholar
Allows me to easily navigate as well as filter the results to fit in my research
Cochrane Library
The database offers a wide range of systematic reviews as well as peer reviewed articles
CINAHL
Provides access to associated health topics as well as nursing based literature using electronic books and journals.
Peer reviewed articles
Al-Rabeei, N., Al-jaradi, A., Al-Wesaby, S., & Alrubaiee, G. (2019). Nursing Practice for Prevention of Ventilator-Associated Pneumonia in ICUs at Public Hospitals in Sana’a, City-Yemen. Al-Razi University Journal of Medical Sciences, 3(2), 69–80.
Frota, M. L., Campanharo, C. R. V., Lopes, M. C. B. T., Piacezzi, L. H. V., Okuno, M. F. P., & Batista, R. E. A. (2019). Good practices for preventing ventilator-associated pneumonia in the emergency department. Revista Da Escola de Enfermagem Da USP, 53. https://doi.org/10.1590/s1980-220x2018010803460
Jam, R., Mesquida, J., Hernández, S., Sandalinas, I., Turégano, C., Carrillo, E., Delgado-Hito, P. (2018). Nursing workload and compliance with non-pharmacological measures to prevent ventilator-associated pneumonia: a multicentre study. Nursing in Critical Care, 23(6), 291–298. https://doi.org/10.1111/nicc.12380
Kapucu, S., & ÖZden, G. (2017). Nursing Interventions to Prevent Ventilator-Associated Pneumonia in ICUs. Konuralp Tıp Dergisi. https://doi.org/10.18521/ktd.285554
Levels of evidence
The level of evidence for the article by Jam et al (2018) is level II since an observational study design was used.
The level of evidence for this article by Fronta et al., (2019) is level I since it a cross sectional study
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Strengths of systematic reviews
Systematic reviews aids ...
Running head RESEARCH PAPER1RESEARCH PAPER15.docxtodd521
Running head: RESEARCH PAPER 1
RESEARCH PAPER 15
Assessment of the knowledge, practice, and the associated factors of Healthcare Acquired Infection Prevention
Name
Institutional Affiliation
Date
Table of Contents
Table of Contents 2
Assessment of the knowledge, practice, and the associated factors of Healthcare Acquired Infection Prevention in Blessings Healthcare Facility 4
The Problem 5
Significance of the problem 6
Purpose of this study 7
Research Questions 8
Masters Essentials aligned with the topic 8
Design 10
Literature Review 10
Methodology and the design of the study 13
Sampling Methods 14
Necessary tools 14
Any logarithm or flow map developed 15
Healthcare Facility 15
Implementation 15
Stage 1: Assessment of the current practices (One Week) 16
Stage 2: Identification of the factors leading to high cases of healthcare-acquired infection (5 days) 17
Stage 3: Pre-Training (Two Weeks) 17
Stage 4: Training (5 weeks) 17
Stage 5: an ongoing process of assessing the situation 18
Materials, activities and the cost 20
Results 21
Socio-demographics features of the research population 21
Knowledge concerning the infection prevention 23
Aspects related to the knowledge of the healthcare professionals regarding the issue of preventing healthcare-acquired infections 27
Limitation of the study 28
References 30
Assessment of the knowledge, practice, and the associated factors of Healthcare Acquired Infection Prevention
Healthcare acquired infection/nosocomial infection/hospital acquired infections are becoming a major international challenge in many healthcare facilities especially in the low or middle income nations. It is anticipated that around 10 percent of patients in the healthcare facilities from developing nations are developing healthcare acquired infections and this subsequently leads to negative impacts on healthcare outcomes. It also leads to increase hospital stay, economic burden, morbidity cases, and increase in the mortality incidences. Some of the common healthcare acquired infections include Hepatitis B and C virus, HIV infections, and even Tuberculosis which are often transmitted by healthcare workers who are not observing the practice related to the infection prevention measures.
According to the United States Center for Disease Control and Prevention, there are about 1.7 million patients who have been hospitalized as a result of acquiring infection within the facilities while undergoing treatment for other healthcare concerns. Many studies reveal that simple infection control procedures like cleaning of the hands using alcohol-based hand rub is helping in the prevention of the spread of the disease. The increase in the infection rate caused by the healthcare acquired infection is due to the poor practices of infection prevention and control, lack of knowledge or failure to implement knowledge related to the process of preventing and controlling nosocomial illnesses, and other associated f.
Preventative Healthcare Associated Infections Through Hand Hygiene- Training ...Innovations2Solutions
Implementation of hand hygiene programs has traditionally been the responsibility of healthcare infection prevention staff and was focused on the clinical staff. The following discussion will describe
why comprehensive awareness and education training for infection prevention is necessary for Infection Prevention Managers, and how a multidisciplinary approach can achieve hand hygiene compliance and sustained reductions in HAIs. This type of approach involves including not just clinical staff, but also other healthcare staff members, patients and visitors, as key audiences for the hand hygiene program and campaign.
Exploring Knowledge, Attitudes and Practices of ICU Health Workers Regarding ...QUESTJOURNAL
Background: Nosocomial Infection is a localized or systemic infection acquired at any health care facility including hospitals by a patient admitted for any reason other than the pathology present during admission. Including an infection acquired in a healthcare facility that manifest 48 hours after the patient's admission or discharge. Objective: Themain aim of this study is toassess the level of knowledge, attitudes and practice of ICU health personnel with regards to the spread of nosocomial infections. Methodology: A cross-sectional and facility based study was conducted from March to November 2016 at King Khalid hospital in Najran, Saudi Arabia. By adopting convenience technique, 50 subjects had been recruited to participate in this study. Results: 62% of respondentswere female. The mean age was 29 years. Concerning educational status, 54% of the participants have Bsc. professionally most of them (48%) were nurses. 60% of the participants have less than three year working experience in ICU.86% of them highlighted that hands must be washed with soap and water or even rubbed with alcohol before contacting with patients. Additionally, the result reveals that employees who had master degree or above displayed higher mean knowledge scores as compared to the other two groups (diploma or less & bachelor) (0.7147 & 4.6656) respectively. High significant statistical differences were found between the three academic groups in relation to sharp devices, personal protective equipment (gloves, gowns &masks), care of intravenous infusion therapy, central line care and urinary catheter care (F=4.594, F=7.982, F=5.539, F=4.471, F=15.310, F=4.345) respectively at p < 0.05. Recommendation & conclusion: Health workers in ICU (King Khalid hospital) showed adequate knowledge and faire attitude regarding universal precautions
C361 TASK 2 2
C361 TASK 2 2
C361 Task 2
WGU
Evidence-Based Practice and Applied Nursing Research
C361
Eve Butler
July 28, 2019
Running head: C361 TASK 2 2
C361 Task 2
A.1 Healthcare problem
Worldwide estimates have shown that greater than 1.4 million patients have acquired nosocomial infections. Adherence to hand hygiene policies are shown to be the most effective way to help prevent these healthcare-associated infections; sadly research shows that healthcare workers have suboptimal compliance with their facilities hand hygiene policies due to lack of education and compliance monitoring. Patients in our healthcare settings are under the assumption that we are doing our best to promote their healing when in fact 7% of them will be subjected to a nosocomial infection with that rate climbing to 10% in developing countries (Finco et al., 2018).
A.2 Significance of the problem
The cost of care that is associated with nosocomial infections is estimated to be over ten billion dollars putting a burden on both patients and health organizations alike. It is estimated that 38% of all infections are caused by cross-contamination due to noncompliance with hand hygiene policies. These infections lead to approximately 99,000 deaths a year in the United States alone (Sickbert-Bennett et al., 2016).
A.3 Current healthcare practices related to the problem
Most healthcare facilities have an educational program that simply teaches how to achieve proper hand hygiene and use the WHO five moments of hand hygiene as their standard. However, this does not educate the healthcare workers on why it is important, nor does it address the far-reaching consequences for noncompliance. Along with the lack of foundational education, most facilities do not monitor for compliance.
A.4 How the problem affects the organization and patients’ cultural background
Inadequate hand hygiene leading to nosocomial infections can affect the organization's cultural background by leading to dissatisfaction in the workplace as staff becomes frustrated by their feelings of inadequacy and helplessness in dealing with patients getting sicker instead of better. The staff may also be feeling stress in the burden of caring for sicker patients. The patient's cultural background may be affected as they may be feeling despair or depression at their inability to get better, and some may feel it is punishment according to their cultural or religious beliefs.
B. Two research evidence sources and two non-research evidence sources considered
In searching for my research evidence sources, I start with the Western Governors University Library online. Once in the library, a boolean phrase was used, which allowed me to search for research articles that contain more than one topic in the same paper. Phrases I used in this search were “nosocomial infections,” “hand hygiene compliance,” and “ hand hygiene education.” With these phrases, thousands of articles were available to peruse.
One of the res.
Improving Urinary Catheterization
Reducing Catheter-Related Infections at Amsterdam Nursing Home in New York
Group Members
Introduction
Urinary catheters are vital tools that collect urinary in a drainage bag from the bladder.
They are important for patients with a compromised urinary function.
Urinary Catheters are a double-edged sword:
On the one hand, they simplify the handling of a basic bodily function.
On the other hand, they subject frail patients to the risk of infection, which may lead to death, falls, or confusion. The infection is referred to as catheter-associated urinary tract infections (CAUTI) (Parker et al., 2017).
Problem Statement
Catheter-related infections at Amsterdam Nursing Home in New York are currently quite high.
This project aims to find solutions to lower the current infection rate to manageable levels.
The high infection rates are posing diverse risks to the patients in post-acute and long-term care.
The current situation is leading to negative patient outcomes. It also results in unnecessary high healthcare costs.
Aims Statement
This project aims to decrease the infection rates from the use of urinary catheters from the current 10% infection rate to a maximum of 2% infection rate by the end to a 3 month timeframe in the elderly population at Amsterdam Nursing Home.
Establishing Measures
The following measures will prove that the object is working:
A drop in the infection rates from 10% to 2%.
A significant drop in the current expenditure used to treat complications due to infections (at least 50%).
An increase in patient satisfaction based on a survey to be filled by clients (at least 75%).
Selecting Changes
Appropriate Urinary Catheter Use.
Catheters should only be used for appropriate indications as outlined by the CDC. Also, the duration of use should be minimized in high risk patients.
Proper Techniques for Insertion and Maintenance.
High hygiene levels should be maintained. This is in reference to hand hygiene, use of sterilized products, and general cleanliness in the nursing room.
Also, catheterization should only be done by authorized personnel.
Regular maintenance of the catheters should be done. Catheters should be replaced as necessary (Gould et al., 2010).
Selecting Changes
Quality Improvement (QI) Programs.
All practitioners should be routinely educated on the proper use of catheters.
Appraisal programs should e conducted regularly to evaluate effective catheter use in the nursing home.
Administrative Infrastructure.
Provision of relevant guidelines.
Education and Training.
Sourcing of Supplies.
Surveillance.
Testing Changes
Use of Interworking Model.
Model comprised of Donabedian’s conceptual framework, Watson’s Theory of Caring, and Lewin’s Theory of Change (D'Antonio, 2018).
This model is crucial in re-educating staff to enact change, emphasize a nurse-driven initiative, and to assess quality
Testing Changes
Plan
The objective of testing changes is to see if t ...
12Plan for Evaluating the Impact of the Inte.docxmoggdede
1
2
Plan for Evaluating the Impact of the Intervention
Anne Marie WouapetName
Walden University
NURS 8310 Section 03, Epidemiology and Population HealthClass
April 29, 2018Date
Plan for Evaluating the Impact of the Intervention
Hospital-acquired infections have been determined throughout this project to be a significant problem in the United States health care system. Epidemiologic data show that there is still a considerable number of patients who die as a result of infections that they have acquired while receiving care (Umscheid et al., 2011). The older population was found to be at a higher risk of acquiring these infections because of their deteriorating immune systems (Sievert et al., 2013). Therefore, a proposed intervention to eliminate the dangers of infection was created. The intervention proposes that nurses go through hand washing education for an extended period to enhance their compliance to hand hygiene after the education program. In studying the potential impacts of this intervention, it was determined that hand washing education is usually effective in changing perceptions and behaviors with regards to hand hygiene, but the compliance to what has been learned is often not maintained. Therefore, this intervention suggests that the education is based on the practice environment and that the nurses are monitored for an extended period. The following is an evaluation plan aiming at assessing the potential outcomes of the proposed intervention.
Evaluation Plan
This evaluation plan is designed to assess the expected outcomes from the implementation of the program (Friis & Sellers, 2014). This plan will investigate the extent to which the hand washing intervention plan will help to reduce the rate of hospital-acquired in infections in the healthcare facilities in which the intervention will be implemented. The plan includes an evaluation of the short-term, medium-term, and long-term changes expected to occur after the implementation of the intervention.
Stakeholders Involved in the Intervention
For the expected outcome to be achieved, the following stakeholders will be required to participate in the intervention program. Evaluating the participation of the stakeholders is essential in determining their contribution to the outcome of the program (Centers for Disease Control, 2011). The program will require the participation of the Director of Nursing, who will be responsible for guiding the nurses included in the intervention to ensure that they participate in the program as required. The intervention will also require the participation of the Directors of the respective health care facilities where the intervention will be implemented to ensure that they provide the resources needed for the program to be implemented and approve the use of the hospital data to evaluate the outcomes of the program. The hospitals included will also need to employ super ...
THE 10 STRATEGIC POINTS FOR THE PROSPECTUS,21THE 10 STRATEGIC P.docxtodd801
THE 10 STRATEGIC POINTS FOR THE PROSPECTUS, 21
THE 10 STRATEGIC POINTS FOR THE PROSPECTUS, 28
DPI Project Milestone:10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project
Running head: THE 10 STRATEGIC POINTS FOR THE PROSPECTUS, 1
The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project
The 10 Strategic Points
Broad Topic Area
1. Broad Topic Area:
The topic taken into consideration is the Central Line-Associated Bloodstream Infections (CLABSIs) and prevention
Introduction
2. Introduction
· The paper is an analysis of the CLABSIs infection and how best the infection can be prevented or even eliminated among patients.
· The infection is characterized by a catheter gaining entry into the bloodstream, greatly affecting either the inferior or the superior vena cava or the vessels of the neck.
· The location of the catheter makes entry of pathogens into the bloodstream very occasional. Patients thus become sick easily.
· The risk factors associated with the infection can result from the healthcare provider and also the patients and include; contamination on insertion, the skin flora of the patient, non-intact dressing, poor nutrition, position of the central line, poor patient and healthcare provider hygiene.
· Symptoms include redness, swelling, discharge at the central line exit, fever, chills, respiratory distress, and altered cognitive state.
· The infection can be prevented, through monitoring of the patients for any signs and symptoms, ensuring proper hygiene practices, and keeping patients educated about management of their central line.
· The paper gives all these information in detail, why there is a need to address Central line-associated bloodstream infections (CLABSIs) and how best the infection can be handled both by the health care givers and the patients.
Literature Review
3. Literature Review:
1. Primary points basis four sections in the Literature Review:
a. Background of the problem/gap:
· Researchers have dedicated numerous efforts towards the cause and the probable symptoms related to Central line-associated bloodstream infections (CLABSIs) that one needs to be on the look-out for.
· Attention has thus been shifted from the different measures to prevent the occurrence of the infection among patients.
· There arises an urgency to intervene and develop effective measures to curtail the incidence of CLABSIs.
· The use of proper hand hygiene and skin aseptic techniques over the insertion site is necessary for preventing microbial infections
· The nurses need to have the significant knowledge associated with evidence-based practices for the Central line-associated bloodstream infections (CLABSIs), their attitude towards the guidelines and the utilization of the hygienic measures for the Central Venous Catheter (CVC) patients.
b. Theoretical foundations (models and theories to be the foundation for the project)
· The efficacy of training of nu.
This presentation provides an overview of the SIG TEL 4 Health that is located at the CELSTEC institute. We are cooperating with various medical partner organization in European projects on topics like patient safety and patient empowerment. We strongly believe that mobile solutions + semantic and analytic technologies will facilitated the empowered patient and health system of the future.
4
CHANGE PROPOSALPRESENTATIONFORFACULTY REVIEW
Capstone Project Change Proposal Presentation for Faculty Review and Feedback
Name
Name of the institution
Date
Running head: ASSIGNMENT TITLE HERE
1Running head: CHANGE PROPOSAL PRESENTATION FOR FACULTY REVIEW
Intervention
The capstone change proposal is effects of disproportionate nurse to patient staffing ratios on the quality of patient care. Patients can be exposed to several safety issues if proper care is not given to them. These problems include falls, hospital-acquired infection due to poor hand hygiene by the healthcare workers, medication administration errors, poor health education to the patients, and negligence in attending to the spiritual needs of the patients. Interventions includes presenting the safety concerns to the management team of the facility to enable them to hire more nurses to deliver adequate care to the patients. In-service training of the nurses on fall prevention, proper application of fall precautions and identification of patients who are at risk of falls are another important intervention. Proper hand hygiene is an intervention that will prevent hospital-acquired infections and nurses should form the culture of doing it (Sands, & Aunger, 2020). Medication errors can lead to complications or death of patients. Nurses should check the medications properly and identify the patients before administration of the medications.
Evidence Based Literature
The articles reviewed have different research aims and questions, but they are all centered into the idea of the effects of nurse-to-patient ratios on patient outcomes. The research questions of these articles are divided into three categories: definition of nursing staffing, effects of nursing-to-patient ratio on patient outcomes and nursing characteristics that hinders the delivery of care. The study by (Cho et al., 2020), defines the term nursing staffing in terms of the nursing care needs of the patients.
Nurses are essential in the provision of quality care in acute units, and their staffing levels have an impact on patient outcomes. (Cho et al., 2015), examine the link between nursing staffing and patient outcomes, specifically the mortality rate. Comparing to (Driscoll et al., 2018) and (Shin et al., 2018), the articles examine the effects of nursing staffing ratios on the patient outcomes in acute specialist units. Besides, (Needleman, 2016) reviews the studies that examine the effects of nursing skill mix on the patient outcomes such as patient ratings of hospitals, mortality, adverse health outcomes, and nurse burnout and dissatisfaction.
Some of the factors such as nursing skills, staffing methods, and working environment affects the nursing staffing ratio, which hinders the quality of care. The article by (Bridges et al., 2019), explores the relationship between nursing staffing skills and the quality and quantity of their interactions with patients in hospital wards. (Olley et al., 2019) ...
1
Quantitative Synopsis and Appraisal
Studentfirstname Studentlastname, Studentfirstname Studentlastname, Studentfirstname
Studentlastname, Studentfirstname Studentlastname
College of Nursing, Resurrection University
NUR4440: Research in Nursing
Professor Carina Piccinini
February 14, 2020
2
Quantitative Appraisal and Synopsis
The purpose of this paper is to summarize and appraise a research study testing the use of
disinfectant caps on intravenous (IV lines) to reduce the rate of hospital associated bloodstream
infections (BSI). The Centers for Disease Control and Prevention (CDC, 2019) reports that
central line associated bloodstream infections (CLABSI) remain a major concern in hospital
settings causing fatalities, increased length of stay, and increased costs. The CDC (2019)
recommends proper maintenance of intravenous lines to reduce the risk of infection. Current
research is still looking to define what proper maintenance should be, including whether
disinfectant caps influence rates of infection for intravenous (IV) lines.
Summary of the Study
The CDC recommends that healthcare workers disinfect all needleless connectors for
peripheral and central IVs prior to connection to reduce the risk of CLABSIs without further
recommendation on the type or length of disinfections. The authors of this study note other
studies have tested disinfecting caps and sought to confirm those results.
Merrill et al. (2014) conducted a quasi-experimental study to identify if disinfectant caps
reduce CLABSI incidence and the relationship between nursing compliance with the caps and
CLABSI rates. This study was held in a single Trauma 1 hospital with 430 beds in the United
States.
The researchers obtained their sample through nonrandom convenience sampling by
including all patients meeting inclusion criteria at the hospital starting January 2012. Participants
were included if they had a central or peripheral intravenous line, of any age, and were admitted
to 13 specific hospital floors. Subjects were excluded if they were on the following floors:
emergency department; labor, delivery or post-partum; ambulatory care, surgical services; and
3
well-baby nursery. The study did not report any demographic information about participants, the
number of participants, or attrition or loss to follow up.
The intervention involved applying a Curos brand disinfectant cap to all ports on
peripheral lines, central lines, and IV tubing when not in use on patients. The nurses on the
involved units were trained on the use of the disinfectant caps with a 1:1 follow up by the
researchers. Nurses were then responsible for placing caps. The researchers intermittently
observing nurses for compliance to the intervention and reporting compliance to nursing
departments twice a week.
CLABSIs were defined as a positive blood culture drawn within 48 hours symptom onset,
and C ...
1
Quantitative Synopsis and Appraisal
Studentfirstname Studentlastname, Studentfirstname Studentlastname, Studentfirstname
Studentlastname, Studentfirstname Studentlastname
College of Nursing, Resurrection University
NUR4440: Research in Nursing
Professor Carina Piccinini
February 14, 2020
2
Quantitative Appraisal and Synopsis
The purpose of this paper is to summarize and appraise a research study testing the use of
disinfectant caps on intravenous (IV lines) to reduce the rate of hospital associated bloodstream
infections (BSI). The Centers for Disease Control and Prevention (CDC, 2019) reports that
central line associated bloodstream infections (CLABSI) remain a major concern in hospital
settings causing fatalities, increased length of stay, and increased costs. The CDC (2019)
recommends proper maintenance of intravenous lines to reduce the risk of infection. Current
research is still looking to define what proper maintenance should be, including whether
disinfectant caps influence rates of infection for intravenous (IV) lines.
Summary of the Study
The CDC recommends that healthcare workers disinfect all needleless connectors for
peripheral and central IVs prior to connection to reduce the risk of CLABSIs without further
recommendation on the type or length of disinfections. The authors of this study note other
studies have tested disinfecting caps and sought to confirm those results.
Merrill et al. (2014) conducted a quasi-experimental study to identify if disinfectant caps
reduce CLABSI incidence and the relationship between nursing compliance with the caps and
CLABSI rates. This study was held in a single Trauma 1 hospital with 430 beds in the United
States.
The researchers obtained their sample through nonrandom convenience sampling by
including all patients meeting inclusion criteria at the hospital starting January 2012. Participants
were included if they had a central or peripheral intravenous line, of any age, and were admitted
to 13 specific hospital floors. Subjects were excluded if they were on the following floors:
emergency department; labor, delivery or post-partum; ambulatory care, surgical services; and
3
well-baby nursery. The study did not report any demographic information about participants, the
number of participants, or attrition or loss to follow up.
The intervention involved applying a Curos brand disinfectant cap to all ports on
peripheral lines, central lines, and IV tubing when not in use on patients. The nurses on the
involved units were trained on the use of the disinfectant caps with a 1:1 follow up by the
researchers. Nurses were then responsible for placing caps. The researchers intermittently
observing nurses for compliance to the intervention and reporting compliance to nursing
departments twice a week.
CLABSIs were defined as a positive blood culture drawn within 48 hours symptom onset,
and C ...
1. Discuss the organization and the family role in every one of the.docxcroysierkathey
1. Discuss the organization and the family role in every one of the heritages mentioned about and how they affect (positively or negatively) the delivery of health care.
2. Identify sociocultural variables within the Irish, Italian and Puerto Rican heritage and mention some examples.
References must be no older than 5 years. A minimum of 700 words is required.
.
1. Compare and contrast DEmilios Capitalism and Gay Identity .docxcroysierkathey
1. Compare and contrast D'Emilio's
Capitalism and Gay Identity
with the
From Mary to Modern Woman
reading. What patterns do you see that are similar to the modern American society? What can be said about global notions of gender in the modern age? Feel free to invoke Foucault.
2. How is the writer's experience important in the story being told in
Middlesex
? Describe your reaction to the reading and invoke some of the concepts discussed in the
Queer Theory
reading to try to make sense of sexuality when it does not match your own conventions. Compare both readings, but go deeper to explore your own stereotypes and socialization.
**PLEASE READ THE READINGS IN ODER TO DO THIS ASSIGNMENT.
.
1.Purpose the purpose of this essay is to spread awareness .docxcroysierkathey
1.
Purpose: the purpose of this essay is to spread awareness around stereotyping and how it can be very hurtful to some people.
2.
Audience: Anyone that uses stereotypical jokes or saying around people that are different than them even without realizing that they are making a stereotypical joke or statement.
3.
Genre: the genre that I will be trying to reach out to in this essay will be informational, reason being is that I mainly look at informational online documentaries and stories.
4.
Stance and tone: I’m just a young man who grew up around a lot of people from different places and have different cultures and never paid attention in my younger years to what was happening from stereotyping others that they are different till recently.
5.
Graphic design
: My essay will be a strict academic essay
.
1. Tell us why it is your favorite film.2. Talk about the .docxcroysierkathey
1. Tell us why it is your favorite film.
2. Talk about the interconnection between the aesthetic and the technical aspects of the film. This should include at least seven of the following: Editing, Film Structure, Cinematography, Lighting, Colors, Screenwriting, Special effects, Sound and Music.
3. After this course, will you see you favorite film in a different light? Why or why not?
.
1.What are the main issues facing Fargo and Town Manager Susan.docxcroysierkathey
1.What are the main issues facing Fargo and Town Manager Susan Harlow?
Fargo and Town Manager Harlow are on a slippery slope to corruption. I think that Harlow is handling her position the correct way by trying to remain neutral and sticking to a code of ethics so the problem really comes down to the political actors in the town. It is good that Harlow declined the invite to the dinner party, and cracked down on employees playing politics at work, that is a step in the right direction to removing the possibility of political corruption.
2.What is the basis for your answer to question #1?
At the end of the article Harlow remembers another city manager saying “you never have more authority than the day you walk into your office” What I get from that, and what I think Harlow got from that is that when you come into a position as a public manager everyone is going to want something from you. Political actors are going to want political favors, quid pro quos, you have something that everyone else wants and they are going to try and get that from you.
3.What are your recommended solutions to the problems you identified?
I think the best thing to do would be to continue to try to remain neutral. It will always be impossible to please absolutely everybody so the best thing to do is try to avoid doing everything everyone asks and stick to some sort of code of ethics.
4.What points do you agree, disagree or want further discussion from your fellow classmates and why? (tell them not me)
I think the overarching theme of this article is that people are going to want things from the government. I agree with Harlow's steps to avoid political corruption in her administration by cracking down on political favors with the snow plows and referring to the ICMA code of ethics.
.
1.Writing Practice in Reading a PhotographAttached Files.docxcroysierkathey
1.
Writing: Practice in Reading a Photograph
Attached Files:
Bachman, Ieshia Evans, Baton Rouge (2016).jpg
(277.283 KB)
For this assignment, you will practice analyzing how various rhetorical elements contribute to the overall meaning of a visual image--in this case, a photograph. To begin, click on the attached image.
By way of some context, this photo was taken in 2016 at a protest rally in Baton Rouge, Louisiana. The woman in the photo is named Ieshia Evans. The photographer is named Jonathan Bachman. Bachman's photo, which was first published by Reuters, was a finalist for a Pulitzer Prize in 2017. You can use this information to do more research on the image, if you like.
Now, review once again the Elements and Methods of Visual Rhetoric document and select from it
three
elements that you wish to discuss in relation to this photo. Please note that this is not a formal essay assignment, so do not treat it as such. For example, you do not need to create a formal introduction.
Begin by simply providing an
interpretive claim
--i.e., stating what you believe is the meaning or message of Bachman's photo. Ideally, this should be just
one
sentence (tho you can write two if necessary). After that, your document simply needs to contain
three paragraphs
, one for each rhetorical element you have selected. In each paragraph, you need to explain fully how the particular element contributes to the overall meaning or message of the image.
Note: Your assignment must be submitted as an attached .doc or .docx file. Name your file correctly, using your last name and brief description of assignment (e.g., Martinez, Photograph.docx).
2.
DB: Interpreting Political Ads
In this discussion board, you will be discussing and interpreting a recent political ad entitled "Mourning in America," which was produced by The Lincoln Project, a political action committee (PAC). If you are not familiar with the group, take a moment to research it, as that context will add to your understanding and interpretation. You can
click here
to view the ad.
As you watch "Mourning in America", think carefully about how this political advertisement compares and contrasts with Ronald Reagan's "Morning in America" ad, in terms of its rhetorical methods as well as its overall message. You will be asked to comment on
three
specific rhetorical elements, so decide which ones stand out most to you and take careful notes on those to prepare for the discussion.
When you are ready, click the link above to enter the Discussion Board, and then follow the instructions in the first thread posted in this forum for responding to this material.
Questions:-
Mourning in America
COLLAPSE
Your task here is to share with your peers your ideas on how
three
specific rhetorical elements or your choosing are used in this ad to make its appeal to an audience and to convey a message.
1. Identity the three rhetorical elements that you have selected and then
explain
how each .
1.Some say that analytics in general dehumanize managerial activitie.docxcroysierkathey
1.Some say that analytics in general dehumanize managerial activities, and others say they do not. Discuss arguments for both points of view.
2.What are some of the major privacy concerns in employing intelligent systems on mobile data?
3. Identify some cases of violations of user privacy from current literature and their impact on data science as a profession.
4.Search the Internet to find examples of how intelligent systems can facilitate activities such as empowerment, mass customization, and teamwork.
Note: Each question must be answered in 5 lines and refrences must be APA cited.
.
1.What is the psychological term for the symptoms James experiences .docxcroysierkathey
1.What is the psychological term for the symptoms James experiences after abstaining from consuming
alcohol? How do changes in the functioning of neurotransmitter systems produce these symptoms?
2.With reference to associative learning principles/models/theories, why does James consume alcohol
to alleviate these symptoms? What motivates his drinking behaviour given that he no longer enjoys this
activity (most of the time)?
3.How do these factors prevent James from quitting his drinking, and lead to a cycle of relapse when he
attempts to do so? Why are these processes important for our understanding of addiction and
substance use disorders.
1 Page
at least 3 sources
APA
.
1.Write at least 500 words discussing the benefits of using R with H.docxcroysierkathey
1.Write at least 500 words discussing the benefits of using R with Hadoop. Use APA format and Include at least 3 quotes from your sources enclosed in quotation marks.
2.Write at least 500 words discussing how insurance companies use text mining to reduce fraud. Use APA format and Include at least 3 quotes from your sources enclosed in quotation marks.
.
1.What is Starbucks’ ROA for 2012, 2011, and 2010 Why might focusin.docxcroysierkathey
1.What is Starbucks’ ROA for 2012, 2011, and 2010? Why might focusing specifically on ROA be misleading when assessing asset management (aka management efficiency)?
2.Why is ROE considered the most useful metric in measuring the overall ability of a business strategy to generate returns for shareholders?
3. How do the financial statements reveal company strategy (i.e., what story do the numbers tell and does that story align with the strategy of Starbucks?)?
.
1. Discuss the cultural development of the Japanese and the Jewis.docxcroysierkathey
1. Discuss the cultural development of the Japanese and the Jewish heritage.
2. What are the cultural beliefs of the Japanese and Jewish heritage related to health care and how they influence the delivery of evidence-based healthcare?
A minimum of 2 evidence-based references
no older than 5 years is required.
A minimum of 600 words
(excluding the first and references page) is required.
.
1. Discuss at least 2 contextual factors(family, peers, school,.docxcroysierkathey
1.
Discuss at least 2 contextual factors(family, peers, school, community, work, etc.) that might make young people more or less likely to experience adolescence as a period of storm and stress.
2. How might the dramatic physical changes that adolescents undergo—and the accompanying reactions from others—influence other aspects of development, such as social or emotional development?
3. Describe some ways in which adolescent decision making is a product of interactions among puberty, brain development, cognitive growth, and contextual influences such as parents, peers, and community.
.
1.Write at least 500 words in APA format discussing how to use senti.docxcroysierkathey
1.Write at least 500 words in APA format discussing how to use sentiment analysis how political speech affects voters. Use at least 3 references in APA format.
2.Read the below article(link below) on statistics for categorical variables. Write at least 500 words in APA format discussing how to use these statistics to help understand big data.
Link: https://uc-r.github.io/descriptives_categorical
.
1.The following clause was added to the Food and Drug Actthe S.docxcroysierkathey
1.The following clause was added to the Food and Drug Act:
“the Secretary [of the Food and Drug Administration] shall not approve for use in food any chemical additive found to induce cancer in man, or, after tests, found to induce cancer in animals.”
After this clause was adopted, no new additives could be approved for use in food if they caused cancer in people or animals.
The public loved this and industry hated it.
What do you think of this clause? Do you support it or do you oppose it?
At the top of your post, please indicate SUPPORT or OPPOSE and then give your rationale. Then after you can view your classmates' posts, make your case to your fellow students.
2.There was a law that individuals who were indigent and who wished to litigate could apply to the courts for a total waiver of the normal filing fee. In the legislative session, however, a statute was enacted which limits the courts' authority to waive filing fees in lawsuits brought by prisoners against the state government.
Under this new law, a court has to require the prisoner to pay a filing fee "equal to 20 percent ... of the average monthly deposits made to the prisoner's [prison] account ... or the average balance in that account", whichever is greater (unless this calculation yields a figure larger than the normal filing fee).
A prisoner (who was indigent) wanted to appeal his case and was to be charged this fee. He filed suit claiming it was unconstitutional to charge this fee to prisoners.
Choose the side of the prisoner or the side of the state and tell why you would rule for the side you chose.
At the top of your post, please indicate SUPPORT PRISONER or OPPOSE PRISONER and then give your rationale. After you can view your classmates' posts, make your case to your fellow students.
3.A defendant pleaded guilty to receiving and possessing child pornography and was sentenced to 108 months in prison. The sentencing judge raised the defendant’s base offense level….by two levels because "a computer was used for the transmission" of the illegal material.
The appeal filed challenged the punishment enhancement (not his guilt of the base punishment.)
The defendant argued the law did not apply to him because he did not use a computer to transmit the material. (ie He was the receiver, not the sender, of the child pornography.)
Do you believe that the sentence enhancement should be upheld? Give an economic analysis and rational for your choice.
At the top of your post, please indicate SENTENCE UPHELD or SENTENCE REVERSED and then give your economic analysis/rationale. After you can view your classmates' posts, make your case to your fellow students.
4.The ordinance was enacted that gives tenants more legal rights including:
the payment of interest on security deposits;
requires that those deposits be held in Illinois banks;
allows (with some limitations) a tenant to withhold rent in an amount reflecting the cost to him of the landlord's v.
1.What are social determinants of health Explain how social determ.docxcroysierkathey
1.What are social determinants of health? Explain how social determinants of health contribute to the development of disease. Describe the fundamental idea that the communicable disease chain model is designed to represent. Give an example of the steps a nurse can take to break the link within the communicable disease chain.
Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.
2. Select a global health issue affecting the international health community. Briefly describe the global health issue and its impact on the larger public health care systems (i.e., continents, regions, countries, states, and health departments). Discuss how health care delivery systems work collaboratively to address global health concerns and some of the stakeholders that work on these issues.
Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.
.
1.This week, we’ve been introduced to the humanities and have ta.docxcroysierkathey
1.
This week, we’ve been introduced to the humanities and have taken some time to consider the role of the humanities in establishing socio-cultural values, including how the humanities differ from the sciences in terms of offering unique lenses on the world and our reality. Since one of the greatest rewards of being a human is engaging with different forms of art, we’ve taken some time this week to learn about what it means to identify and respond to a work of art. We’ve learned about the difference between abstract ideas and concrete images and concepts like structure and artistic form. To help you deepen your understanding of these foundational ideas, your Unit 1 assignment will consist of writing an essay addressing using the following criteria:
Essay Requirements:
• 1,000 words or roughly four double-spaced pages.
• Make use of at least three scholarly sources to support and develop your ideas. Our course text may serve as one of these three sources.
• Your essay should demonstrate a thorough understanding of the READ and ATTEND sections.
• Be sure to cite your sources using proper APA format (7th edition).
Essay Prompt:
• In this essay, you will consider the meaning of art and artistic form by responding to these questions:
o To what extent does Kevin Carter’s Pulitzer Prize-winning photograph (figure 2-5) have artistic form?
o Using what you’ve learned in Chapters 1, 2 and 14 explain if you consider Carter’s photograph a work of art? Be sure to point to specific qualities of the photograph to support/develop your response.
o How do you measure the intensity of your experience in response to Carter’s photograph? What does it make you see/feel/imagine and how does your response/reaction support Carter’s image as a work of art?
.
1.What are barriers to listening2.Communicators identif.docxcroysierkathey
1.
What are barriers to listening?
2.
Communicators identified the following as major listening poor habits. Search what each poor habit means and try to set an example using your own experience.
Poor listening habit:
Pseudo-listening, Stage hogging, Filling in gaps, Selective listening, Ambushing (
Definition & Example)
.
1.Timeline description and details There are multiple way.docxcroysierkathey
1.
Timeline description and details
: There are multiple ways to construct a timeline. Find one that fits you and your information.
Include 10-15 events, each including the following descriptors:
- titles of books or writings or some sort of identifier
- your age or some time reference
- and whether it was a positive or negative experience
.
1.The PresidentArticle II of the Constitution establishe.docxcroysierkathey
1.
The President
Article II of the Constitution established the institution of the presidency. Select any TWO Presidents prior to 1933 and any TWO Presidents since 1933 and for EACH one:
a.
Discuss
any
expressed
power used by each president and the
impact
that decision had on American society at the time of its use
b.
Explain
whether you
agree/disagree
with the presidential action taken and
WHY
c.
Describe
one
legislative initiative
promoted by each president and the
impact
on America at the
time of its passage
as well as what the impact of that legislation is
TODAY
d.
Discuss
one
executive order
issued by each president and whether you
agree/disagree
with the order and
WHY
1.
Select any FOUR United States Supreme court decisions related to Civil Rights/Civil Liberties and for
each one
:
a.
Describe
the facts of the case
b.
Discuss
the arguments of each side as it pertains to the
Constitutional issue
being addressed
c.
Explain
the decision citing
Constitutional rationale
of the court including any dissenting opinion if not a unanimous verdict
d.
Explain
whether you
agree/disagree
with the court’s decision and
WHY
.
1.What other potential root causes might influence patient fal.docxcroysierkathey
1.
What other potential root causes might influence patient falls?
2.
Equipped with the data, what would you do about the hypotheses that proved to be unsupported?
3.
Based on the correctly identified hypothesis in the case scenario, what would be your course of action if you were the CEO/president of St. Xavier Memorial Hospital?
4.
What do you think of the CNO’s (Sara Mullins) position of “waiting and seeing what the data tells us” instead of immediately jumping to conclusions?
.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
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Literature Evaluation TableStudent Name Joyce NwakorPIC.docx
1. Literature Evaluation Table
Student Name: Joyce Nwakor
PICOT Question: For patients and healthcare workers in the
hospital (p) does hand washing protocol (I) compared to an
alcohol-based solution (C) reduce hospital-acquired infection
(O) within a period of stay in the hospital (T)
Criteria
Article 1
QUANT
Article 2
QUANT
Article 3
QUANT
Article 4
REVIEW
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Daisy, V. T., & Sreedevi, T. R.
Link:
http://eds.a.ebscohost.com.lopes.idm.oclc.org/eds/detail/detail?
vid=4&sid=72619044-c224-4bc5-9982-
cf6c3953f7d2%40sessionmgr4007&bdata=JnNpdGU9ZWRzLWx
pdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=110819455&db=ccm
2. Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P.,
Nelson, C., … Bader, M. K. (2015). Use of a Patient Hand
Hygiene Protocol to Reduce Hospital-Acquired Infections and
Improve Nurses' Hand Washing. American Journal of Critical
Care, 24(3), 216-224. doi:10.4037/ajcc2015898
Knighton, S. (2017). The Use of Instructional Technology to
Increase Independent Patient Hand Hygiene Practice of
Hospitalized Adults in an Acute Care Setting. Open Forum
Infectious Diseases, 4(suppl_1), S411-S412.
doi:10.1093/ofid/ofx163.1029
João Manuel Garcia do Nascimento Graveto, Rita Isabel
Figueira Rebola, Elisabete Amado Fernandes, & Paulo Jorge dos
Santos Costa. Link:
https://doi-org.lopes.idm.oclc.org/10.1590/0034-7167-2017-
0239
Article Title and Year Published
Effectiveness of a Multi-Component Educational Intervention
on Knowledge and Compliance with Hand Hygiene among
Nurses in Neonatal Intensive Care Units. 2015Use of a Patient
Hand Hygiene Protocol to Reduce Hospital-Acquired Infections
and Improve Nurses' Hand Washing
Published May 2015
The Use of Instructional Technology to Increase
Independent Patient Hand Hygiene Practice of Hospitalized
Adults in an Acute Care Setting. Open Forum Infectious
Diseases.
Published in 2017
Hand hygiene: nurses’ adherence after training.
2018
Research Questions (Qualitative)/Hypothesis (Quantitative), and
Purposes/Aim of Study
3. The study was aimed to assess the effectiveness of a multi-
component educational intervention on the knowledge and
compliance with handhygiene guidelines among nurses working
in Neonatal Intensive Care Units.
The research investigated the reduction of infections in the
hospital through observation of hand hygiene.
What handwashing procedures were performed by the medical
personnel before patient contact part 1.
What is the level of effectiveness of training (I) in improving
nurses’(P) adherence to hand hygiene(O)?”.
Design (Type of Quantitative, or Type of Qualitative)
A pre-experimental pre-test post-test design was adopted for the
study. QUANT
Pre-experimental study design
. QUANT
A quantitative study was done using quasi observational data
Qualitative/ quantitative studies
This is a review
Setting/Sample
This study was conducted in 3 level III NICUs of selected
private hospitals in Kerala
Total sample comprises of 60 nurses working in NICUs
selected through purposive sampling technique from selected
hospitals.
Two hospitals were used in the research
120 medical staff (Nurses and Physicians).
Health professionals working at the intensive care unit of a
hospital.
Methods: Intervention/Instruments
The data was collected from 60 nurses working in 3 level III
4. Neonatal Intensive Care Units of selected private hospitals in
Kerala.
Qualitative research design.
Quasi-observational study
This integrative literature review was conducted following
Cochrane’s PICOD strategy (Participants, Interventions,
Comparisons, Outcomes, and Design.
Training nurses to adhere to handwashing.
Analysis
The data collection tool consisted of a knowledge questionnaire
and an observation checklist to assess the hand hygiene
compliance, developed based on World Health Organization
hand hygiene guidelines.
The study was conducted across two health facilities
.
Technology played a key role in improving the hands' hygiene
through the development of equipment that encouraged nurses
to wash their hands.
.
Observational studies collected and analyzed.
Key Findings
Before the implementation of educational intervention,
majority, (56.66%) had only moderate knowledge on hand
hygiene and none of them had good level of knowledge. With
regard to compliance with hand hygiene guidelines, majority,
(65%) demonstrated poor compliance while none of them
showed good compliance. There was a statistically significant
improvement in the nurse's level of knowledge and compliance
with hand hygiene guidelines after the completion of the multi-
component educational intervention (P<0.001).
Observation of hand hygiene reduced the rate of new infections
within the hospitals.
.
The average compliance of medical personnel to hand hygiene
5. was as low as 5.2%.
Medical personnel washed their hand twice less frequently when
feeding patients, taking blood samples and insertion of a
vascular catheter.
Most substituted gloves for handwashing.
Nurses showed inadequate hand hygiene techniques and
adherence during their daily care routines. The reasons for this
include the lack of adequate facilities for washing and drying
hands inside the clinical areas, the lack of resources, the time
factor, the existence of solutions of continuity in hands, and
excessive workload.
Recommendations
Findings of the study recommends that hospitals should
implement handhygiene promotion programs among nurses by
using multiple approaches and persistent encouragement and
interventions in order to achieve sustained high level of
appropriate hand hygiene practices among nurses working in
various units of hospitalsettings.
The research revealed that there is a need for a collective effort
from the nurses themselves and the hospitals to constantly
remind the staff about hand washing.
Short handwashing times and noncompliance indicate the need
for increased knowledge on hand hygiene and motivation to its
adherence
.
Nursing professionals should continuously update and monitor
their knowledge and transfer it into clinical practice.
Quality can only be achieved through the implementation,
training, and development of effective and adequate hand
hygiene techniques. Some measures are perfectly feasible, such
as the implementation of standard infection control measures; a
6. greater dissemination of the importance of hand hygiene
through training actions and flyers/posters placed in strategic
locations.
Explanation of How the Article Supports EBP/Capstone Project
Hospital acquired infections are a major cause of morbidity and
mortality in neonatal intensive care units. This article supports
evidence-based practice because appropriate hand hygiene is
singled out as the most important measure in preventing these
infections.
The article explained the need for collaboration among the
nurses to ensure no new infections that arise from lack of hand
hygiene.
The article shows the results of a study done on hand hygiene
techniques performed by health providers before patient contact
Handwashing adherence guidelines are important to improve
this process, set targets for controlling HAI risks, and train
teams in the use of infection prevention measures.
Criteria
Article 5
QUANT
Article 6
QUANT
Article 7
QUANT
Article 8
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Thoa, V. T. H., Van Trang, D. T., Tien, N. P., Van, D. T.,
Wertheim, H. F., & Son, N. T.
7. Link:
http://eds.a.ebscohost.com.lopes.idm.oclc.org/eds/detail/detail?
vid=2&sid=72619044-c224-4bc5-9982-
cf6c3953f7d2%40sessionmgr4007&bdata=JnNpdGU9ZWRzLWx
pdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=S0196655315008792&
db=edselp
AJIC: American Journal of Infection Control 1 December 2015
43(12):e93-e99
Lawal, T., Monsudi, K., Zubayr, B., Michael, G., Duru, C.,
Ibrahim, Z., & Aliyu, I.
Link:
https://doi-
org.lopes.idm.oclc.org/10.4103/ijhas.IJHASpass:159_17
Niyonzima, V., Brennaman, L., & Beinempaka, F.
Link:
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.co
m/login.aspx?direct=true&db=ccm&AN=129292283&site=eds-
live&scope=site
Crawford, H., & Hallam, J. S.
https://doi.org/10.1177/2050312116675098Phan, H. T., Tran, H.
T. T., Tran, H. T. M., Dinh, A. P. P., Ngo, H. T., Theorell-
Haglow, J., & Gordon, C. J.
Link: https://doi-org.lopes.idm.oclc.org/10.1186/s12879-018-
3029-5
Article Title and Year Published
Cost-effectiveness of a handhygiene program on health care–
associated infections in intensive care patients at tertiary care
hospital in Vietnam.
2015
Hand hygiene practices among nurses in health facility in a
semi-urban setting.
2018
8. Practice and compliance
of essential handwashing
among healthcare workers at a regional referral hospital in
Uganda: A quality improvement and evidence-based practice.
2018
2016 An educational intervention to improve hand hygiene
compliance
2018
Research Questions (Qualitative)/Hypothesis (Quantitative), and
Purposes/Aim of Study
Assess the cost-effectiveness of a HH program in a large
tertiary Vietnamese hospital.
Determine the knowledge and practices of hand hygiene among
nurses in our institution.
Assess the availability and suitability of essential hand washing
facilities, assess essential hand washing practice and
compliance among healthcare workers (HCWs) on surgical and
medical ED, ICU, medical and surgical general wards
The purpose of the research was to capture the experiences of
HH among acute care nurses The aim of this study was to
determine hand hygiene compliance following an educational
program in an obstetric and gynecological hospital in Vietnam.
Design (Type of Quantitative, or Type of Qualitative)
Quantitative quasi experimental design was used. This was a
before and after study of a handhygiene program where HH
compliance, incidence of hospital-acquiredinfections (HAIs),
and costs were analyzed.
Quantitative
The study employed a cross sectional design and involved
HCWs who were providing care to patients admitted in the
selected units.
Qualitative approach-Interview Mixed method
Setting/Sample
9. The HH program was implemented in 2 intensive care and 15
critical care units.
This study involves 113 nurses of federal Medical Centre Birnin
Kebbi, Kebbi State, Nigeria and it was conducted over 12
weeks.
The study was conducted at Mbarara Regional Referral Hospital
in southwestern Uganda. The study was conducted in the five
units that specifically treat critically ill patients: medical and
surgical emergency (ED), ICU, and surgical and medical general
wards.
Eight nurses in the US performing various roles were
interviewed.Health care workers from neonatal intensive care,
delivery suite and a surgical ward from Hung Vuong Hospital,
Ho Chi Minh City, Vietnam undertook a 4-h educational
program targeting hand hygiene. Compliance was monitored
monthly for six months following the intervention. Hand
hygiene knowledge was assessed at baseline and after six
months of the study.
Methods: Intervention/Instruments
This was a before and after study of ahandhygieneprogram
where HH compliance, incidence of hospital-
acquiredinfections(HAIs), and costs were analyzed.
It was questionnaire based, which was pretested and
self‑administered. Convenience sampling was adopted.
On each observational visit, two target patients were randomly
selected using simple random numbers and all healthcare
workers’ contacts with the selected patients were observed until
the required sample size was reached.
Interview Participants completed a baseline questionnaire on
HH knowledge and repeated this at 2 months after the
intervention. The questionnaire consisted of 25 items with a
combination of yes/no, multiple choice, and true/ false
formatted question.
Analysis
10. Data collected before and after handwashing program
intervention was analyzed.
.
Quantitative variables were summarized using means and
standard deviations, qualitative variables were summarized
using frequencies and percentages..percentages.
Hard data collection tools were used especially for collecting
observation information and this could have resulted into
Hawthorne effect.
Observational data collected, cross checked and analyzed.
An interpretative phenomenological analysis methodology was
used.To analyze HH compliance over time, a multi-level mixed
model analysis was used.
All hand-entered data were double-entered and screened for
accuracy.
Key Findings
The HH compliance rate increased from 25.7% to 57.5%
(P < .001). The incidence of patients with HAI decreased from
31.7% to 20.3% (P < .001) after the intervention. The mean cost
for patients with HAI was $1,908, which was 2.5 times higher
than the costs for patients without a HAI. The mean attributable
cost of a HAI was $1,131. The total cost of the HH program was
$12,570, which equates to a per-patient cost of $6.5. The cost-
effectiveness was estimated at -$1,074 or $1,074 saved per HAI
prevented. The cost-effectiveness was estimated at -$1,074 or
$1,074 saved per HAI prevented. The intervention remained
cost savings under various scenarios with lower HAI rates.
95 (99.0%) believed that hand‑washing is an important modality
of reducing infection and cross‑ infection and only 1 (1%) did
not believe in the role of hand‑washing in reducing the risk of
infection. Although majority (76.0%) of respondents reported
11. adhering to the principles of good hand hygiene, most (54.2%)
of the respondents could not mention the steps in hand‑washing
technique; 66 (68.8%) respondents wash their hands before
attending to patients; however, almost all (99.0%) of the
respondents wash their hands after attending to patients and
after removing hand gloves.
Most of the wards had inadequate HH resources. The sink to bed
ratio ranged from 1:1 to 1:33. HH resources were not always
available. A total of 287 HH opportunities were observed from
the five wards. The overall HH compliance before and after
patient contact were 25.4% and 33.8% respectively. ANOVA
showed ICU had significantly higher rates of HH than surgical
ward before and after patient contact. HCWs in ICU and
surgical emergency were 4.86 and 3.12 times respectively more
likely to perform HH as compared to medical ward. No
significant difference in HH compliance among professional
categories before or after patient contact was detected.
There was a conflict between the perception of nurses and
hospital management as far as HH is concerned.
The main finding of this study was that HH compliance rates
improved significantly and were sustained over a six-month
period following the intervention.
Recommendations
The HH program is an effective strategy in reducing the
incidence of HAIs in intensive care units and is cost-effective in
Vietnam. HH programs need to be encouraged across Vietnam
and other countries.
Only 45.8% could correctly mention the steps in hand‑washing.
This highlights the need to reeducate them on the steps in hand
hygiene. Therefore, more proactive measures which should
involve routine physical observation of the technique by
superior officers with the aim of identifying and correcting
defaulters should be encouraged.
The low rates of HH compliance reflect the need to put more
emphasis on HH for improvement in the healthcare setting.
12. Infection prevention management needs to come up with proper
training programs for HH for HAI to be done away
with.Educational handwashing interventions should aim to
measure hand hygiene compliance for an extended observation
period to determine effectiveness. This hand hygiene model
could be used in developing countries were resources are
limited.
Explanation of How the Article Supports EBP/Capstone
The hand hygiene program is an effective strategy in reducing
the incidence of HAIs in intensive care units and is cost-
effective in healthcare settings.
This article is based on nurse’s proficiency on hand‑washing
technique; this is so because they are often exposed to the risk
of coming in contact with biohazards.
The focus of this study is to assess the availability and
suitability of essential hand washing facilities, assess essential
hand washing practice and compliance among healthcare
workers which supports evidence-based practice.
The study looked at how nurses perceived HH. The finding of
the study is correlated to the project capstone as it provides an
insight on how nurses, the primary study subject view HH in the
fight against HAIThe current study’s educational program was
developed in consultation with HH experts and used WHO
training guidelines to frame the evidence-based support of
training. Educational programs are effective at reducing HCAIs.
14. Comparison of the Limitations of the Study20.0%No
comparison of the limitations of the study is presented.A
comparison of the limitations of the study is presented, but it is
not valid.A cursory though valid comparison of the limitations
of the study is presented.A moderately thorough and valid
comparison of the limitations of the study is presented.A
reflective and insightful comparison of the limitations of the
study is presented. Conclusion and Recommendations for
Further Research10.0%No conclusion and recommendations for
further research are presented.A conclusion and
recommendations for further research are presented, but they
are not valid.A conclusion and recommendations for further
research are valid, but they are cursory. A conclusion and
recommendations for further research are valid and moderately
thorough. A conclusion and recommendations for further
research are reflective and insightful.Organization and
Effectiveness15.0%Thesis Development and Purpose5.0%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 Construction5.0%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 progressions. Techniques of
argumentation are evident. There is a smooth progression of
15. claims from introduction to conclusion. Most sources are
authoritative.Clear and convincing argument that presents a
persuasive claim in a distinctive and compelling manner. All
sources are authoritative.Mechanics of Writing (includes
spelling, punctuation, grammar, language use)5.0%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), sentence
structure, or word choice are present.Some mechanical errors or
typos are present, but they are not overly distracting to the
reader. Correct sentence structure and audience-appropriate
language are used. Prose is largely free of mechanical errors,
although a few may be present. A variety of sentence structures
and effective figures of speech are used. Writer is clearly in
command of standard, written, academic
English.Format5.0%Paper Format (use of appropriate style for
the major and assignment)2.0%Template is not used
appropriately or documentation format is rarely followed
correctly.Template is used, but some elements are missing or
mistaken; lack of control with formatting is apparent.Template
is used, and formatting is correct, although some minor errors
may be present. 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)3.0%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%
16. Running Head: PICOT STATEMENT PAPER 1
PICOT STATEMENT PAPER 5
PICOT Statement Paper
Grand Canyon University
Joyce Nwakor
12/17/19
Introduction
Hand hygiene (HH) is an essential tool in reducing the
spread of infections among patients and the healthcare
professionals in the clinical setting. Multiple studies have
however showed that healthcare professionals do not comply
with the HH guidelines provided by the World Health
Organization. This has led to increased healthcare related
infections resulting in increased mortality rates. There are
various factors that lead to non-compliance of the World Health
Organization guidelines such as work environment and
behavioral motivational factors. This shows that more needs to
do in creating awareness among healthcare professionals about
the importance of hand hygiene and patient safety (Anna, &
Sobala, 2013).
PICOT Statement
For patients and healthcare workers in the hospital (p) does
hand washing using soap and water (I) compared to an alcohol
hand-based rub (C) reduce hospital acquired infection (O)
within a period of stay in the hospital (T).
Evidence Based solution
Multiple studies show that hand washing protocol in the
healthcare setting is very effectual in reducing healthcare
related infections. The practice of cleaning hand before and
17. after attending patients can help to reduce the spread of germs
in hospitals. Healthcare professionals wash their hands more
than half times they should on average (Deochand & Deochand,
2016). This increases the chances of spreading healthcare
acquired infection (Deochand & Deochand, 2016). While hand
washing protocol is useful, alcohol-based solution is more
effective as it kills most of the germs that can be transmitted in
the healthcare setting (Deochand & Deochand, 2016). Since
alcohol-based solution is a bit expensive, patients and
healthcare workers should reduce the spread of germs by
complying with the hand washing protocol (Deochand &
Deochand, 2016).
Nursing Intervention
Nurses interact with patients more often than other
healthcare professionals and this exposes them to hospital
acquired infections. For this reason, nurses should ensure all
their practices are based on patient education, nursing research
and are evidence based. Nurses should apply universal
precautions to ensure they work in a safe environment (Sung-
Ching et al., 2013). Under the universal precaution guidelines,
nurse practitioners must wear protective gear before coming
into contact with any patient (Sung-Ching et al., 2013). Nurses
must also wash their hands before and after interacting with
patients. Alcohol based solution can be used as a substitute
(Sung-Ching et al., 2013).
Patient care
Patients are very vulnerable to hospital acquired
infections. Healthcare providers should create awareness among
patients about the importance of hand hygiene. Patients must
clean their hands regularly in the healthcare setting. They
should also ask those people visiting them to ensure that they
clean their hand before visiting and after living patient wards.
This ensures that visitors to not spread diseases to the patients
and also the patients do not infect those visiting them.
Healthcare workers must put the necessary measures to
facilitate the hand washing protocol (Chatfield et al., 2016).
18. Healthcare agency
The healthcare agency must ensure their facilities have
enough hand washing points to facilitate hand washing protocol.
Patients and healthcare professionals will not be able to clean
their hands as required if there are not enough areas designated
for hand washing. Healthcare providers should also provide
alcohol-based solutions in case there is any issue to do with the
designated hand washing points. The agency should also ensure
that all patients understand the importance of HH while in the
healthcare setting. This plays a significant role in reducing the
spreading of healthcare related infections (Dyson et al., 2013).
Healthcare agencies should also train their healthcare
professionals to increase compliance to the hand washing
protocol (Dyson et al., 2013).
Nursing practice
Combining hand washing protocol and alcohol-based
solutions can help prevent most of the hospital acquired
infections increasing patient safety and better overall patient
outcomes (Sendall, McCosker & Halton, 2019). When patient
maintain hand hygiene it will be difficult for them to spread
hospital acquired infection. The same applies to healthcare
professionals. A safe healthcare environment depends on the
ability of both the patients and healthcare professionals to
comply with the hand washing protocol. Increasing awareness
of the importance of HH in the hospitals may increase
compliance to the WHO guidelines reducing the spread of
infections (Sendall, McCosker & Halton, 2019).
References
Anna, G. P & Sobala, W. (2013). Observance of hand washing
procedures performed by the medical personnel before patient
contact part 1 Retrieved from international journal of
occupational medicine and environmental health 2013
Chatfield, S. L., Nolan, R., Crawford, H., & Hallam, J. S.
19. (2016). Experiences of hand hygiene among acute care nurses:
An interpretative phenomenological analysis. SAGE open
medicine, 4, 2050312116675098.
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).
Dyson, J., Lawton, R., Jackson, C., & Cheater, F. (2013).
Development of a theory-based instrument to identify barriers
and levers to best hand hygiene practice among healthcare
practitioners. Implementation Science, 8(1), 111.
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.
Sung-Ching, P., Tien, K. L., Hung, I., Yu-Jiun, L., Wang-Huei,
S., Wang, M. J., & Yee-Chun, C. (2013). Compliance of Health
Care Workers with Hand Hygiene Practices: Independent
Advantages of Overt and Covert Observers. PLoS One, 8(1),
e53746.
