Analyze the Outcome
Evaluating the outcome is the truth moment that allows me to see if what I was doing throughout the whole semester is worth it or not. Knowing that the semester is getting towards to the end, I do not believe that there is enough time for me to plan another session to improve staff's hand-hygiene practices. Plus I still have to evaluate the effectiveness of my presentation which will take at least two weeks of observation. My partner and I have done five hours of observation today and the result is quite shocking. We have not yet audits the data we collected today thus I do not have the total percentage to present in this praxis note. Just from observation and talking to my colleague, it seems like staff has not increases their hand-hygiene practices and the presentation and posters we posted throughout the home is ineffective. Although the data I collected today shows a minor improvement on hand-hygiene practices and for those who did washes there is because they saw me sitting in front of the nursing station collecting data. Improving hand hygiene is widely acknowledged as the most important way of reducing infections in health care facilities (Huang & Wu, 20087). Nursing home resident are at risk for nosocomial, such as urinary tract infection, wound infection and respiratory infection. The major car providers at Bloomington Cove are personal support workers who work in close contact with all residents in the home. By improving their hand hygiene practices can have a positive health outcome for the resident at home. Despite the evidence of benefit we have presented to most of the staff in the home, the adherence to hand-hygiene practices is remains poor. It is proven strategies that in-cooperate education, motivation and system changes is an effective method to propose program in a long term care setting (Huang & Wu, 20087). There are many strategies to improve hand-hygiene compliances rate in a nursing home and some of the suggested strategies include education, routine, observation and feedback, making hand-hygiene accessible, workplace reminders, administrative sanction and rewards, and provide hand lotions for staff (Huang & Wu, 20087).
Revised Your Approached
In the past, we have done many of the suggested strategies to promote hand-hygiene in Bloomington Cove. We have conducted weekly observation and collected data, placing poster throughout the home to remind staff to washes their hands, making hand-hygiene accessible by giving every staff a bottle of alcohol base hand sanitizer, and provided education through presentation. We have done many things to provide them knowledge, skills, material, and support to improve their hand-hygiene practice but I still do not understand the underlying reason why staff has not improve on their hand-hygiene practices. After doing an informal interview with one staff in the home regarding on her not washing her hands before entering a unit, she stated that she was too busy and has forgotten to washes her hands. From what she has stated, it seems like the posters that we put up as reminders enough and their motivation to washes their hands remains low. I am thinking maybe adding more reminders, such as verbal note during shift changing reports and promote a rewarding program for those with excellent hand hygiene practices as a role model for others, may help staff to adhere with their hand-hygiene practices. This will not only provide extra reminders, it also provides motivation for staff to be the next role-model for the month.
New Trail
From this experience, I have experiences that knowledge cannot be viewed as action. What people know can be very different from what people do and trying to change their behaviours can sometimes be difficult and requires a long-term strategies. I have previously read from the textbook that evaluation has to be done throughout the process to measure the progression of the project. This JCYH project has given me the first hand experiences that theory. Now that I have started to do the evaluation of the JCYH project, I have also just noted that the true project has just begun because the underlying causes of the issues have just survived. As a nurse, I will need to do what is within my power to assist them to get through their challenges and therefore reducing the infection and outbreak rate in Bloomington Cove.
Reference
Huang, T. T. & Wu, S. C. (20088). Evaluation of a training programme on knowledge and compliance of nurse assistants' hand hygiene in nursing homes. Journal of Hospital Infection. 68, 164-170.