Use of Nursing Theory to Guide DNP Projects

Conduct a literature search in one or more of the nursing databases on the potential topic or problem of interest to you for your eventual DNP Project (Health Acquired Infections is the problem of interest- SEE PROBLEM STATEMENT ATTACHED). Select one article or paper and discuss how a particular nursing theory or model (SEE THE LESSON ATTACHED ON NURSING MODELS) was used as a framework for the research study or DNP project. What insights has reading this article provided you in considering and firming up, supporting the problem statements that you have formatted in Weeks 1 and 2?
Hint: If searching the Proquest Dissertations and Theses database, use the search words: DNP (as author) and Nursing Theory (contained in abstract).
I have chosen the article below for you:
The Legacy of Florence Nightingale’s Environmental Theory: Nursing Research
Focusing on the Impact of Healthcare Environments
Zborowsky, Terri, PhD, EDAC. HERD : Health Environments Research & Design Journal; London Vol. 7, Iss. 4, (Summer 2014): 19-34.
The part of the question in bold is the only part you are working on based on the article named above.
Hand Hygiene to Control Infections
Hand Hygiene to Control Infections
In most of the healthcare facilities throughout the country be it the doctors’ offices, hospitals, home health facilities and various skilled care facilities, there has been notable lack of hand hygiene not only among the patients but also among the healthcare workers. The problem of hand hygiene is not limited only to some facilities but its known worldwide. Most infectious diseases spread through the hands since being one of the most useful parts of the body. Therefore, hand hygiene in healthcare can be one of the most effective ways to reduce the spread of infectious diseases.
Healthcare-acquired infections (HAI) are infections that are acquired in hospitals after being established by patients within two days after there are admitted or some few days once they have a surgical operation and some few days after discharge. The nurse usually transfers HAI from one patient to another as they provide to them. Low Submission to hand hygiene is due to lack of training or qualification, work overload and lack of knowledge (Fox et al.., 2015).
Healthcare-acquired infections are transmitted to the victim via healthcare provider’s contaminated hands, and therefore the healthcare organization is financially obligated for the diagnostic testing and extended long stay of the patient (Huis et al. 2013). HAI also affected the number of nurses unavailing them for their duty in the process limiting the time they should spend on the patients (Landers, Abusalem, Coty & Bingham, 2012). Additionally, HAI causes a rise in the rate of mortality and morbidity among the patients. Considering the high numbers of deaths brought about by HAI, the world health organization set up guidelines stipulating when healthcare should wash their hands that is before a procedure, once they touch a patient’s environment, after a procedure, after touching a patient and before touching a patient.
HAI infects millions of patients every year, and approximately 1.8 million patients are infected by HAI where over 110,000 of them die (Mathur, 2011). This significantly increases healthcare system financial liability as the numbers keep on increasing. HAI is opposite to what the healthcare facilities are meant to do since instead of creating a safer environment, due to this condition many people suffer in these facilities. The nurse is the largest staff in hospitals and can, therefore, assist in decreasing the number of HAI most especially by practicing hand washing (CDC Foundation, 2017).
To find a solution, the first step would be to get all the doctors, supervisors and administrators involved. Being the leaders, they will find reasons why the staff members are not complying with the set guidelines. However, some reasons may include insufficiency of the hand washing equipment, work overload or general lack of knowledge. The moment the leasers know and understand the particular reasons, they will then have the chance to correct primary issues (Fox et al.., 2015). Additionally the doctors and the entire management can approach the issue of washing hands in their facilities is by following regulations and rules themselves.
Getting the staff and the nurses involved to find a solution has in the past yielded positive results by significantly reducing HIA and improving compliance. Putting in mind that the nurses are the staff who mostly get involved with the patients, they, therefore, have ideas and chance to find ways to control the issue. Allowing the nurses to make and form visual aid may allocate a more efficient reminder since they will feel they were involved in the problem analysis and implementation (Mathur, 2011).
Getting the patients involved is also another way of ensuring that HAI is addressed through hand hygiene. One way to address this is by educating the patients on ways to promote good hand hygiene and also letting them know they have a right to ask the healthcare provider if they have washed their hands before attending to them (Huis et al. 2013).This will alert the healthcare professionals always to wash their hands. Insisting on the compliance of washing hands is important and should be a must at all times.
Etiology of low hand hygiene in hospitals
Hand hygiene compliance rates have reduced due to some reasons, and as a result of hand hygiene being strikingly very low, there has been so many readmissions and too much uncoordinated care for patients. Some of the etiological causes of hand hygiene non-compliance are: the presence of broken sinks or dispensers in the hospitals thus the nurses and doctors avoid using them. Similarly, empty dispensers discourage the nurses from bothering to use whichever dispenser they come across in the hospital. There are also inconveniently positioned hand hygiene dispensers and sinks. Bearing in mind that they should be strategically positioned for any nurse going to attend to a patient and that would reduce readmission rates. Incorrect hygiene products in the dispenser is also a factor. Sometimes the nurses and doctors are too busy or get distracted, and they forget to clean their hands. Sometimes as they pass the sinks their hands are full thus not able to clean them (Chassin, Mayer & Nether, 2015). However, ignorance of nurses is also a cause of low hand hygiene that may be due to ineffective education and some assume that putting on gloves negate the need for hand hygiene.
CDC Foundation. (2017). Hand Washing: A Simple Step To Prevent Hospital Infections.
Chassin, M. R., Mayer, C., & Nether, K. (2015). Improving hand hygiene at eight hospitals in the United States by targeting specific causes of noncompliance. The Joint Commission Journal on Quality and Patient Safety, 41(1), 4-12.
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Jones, L., Bennett, Y. P., & . .. 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.
Huis, A; et al. (2013). Impact of a team and leaders-directed strategy to improve nurses’ adherence to hand hygiene guidelines: A cluster randomised trial. International Journal of Nursing Studies . Philadelphia, Pennsylvania, 50, 4, 464-474.
Landers, T., Abusalem, S., Coty, M., & Bingham, J. (2012). Patient-centered hand hygiene: The next step in infection prevention. American Journal Of Infection Control , 40 (s1), S11-7.
Mathur, P. (2011). Hand hygiene: back to the basics of infection control. The Indian Journal Of Medical Research , 134 (5), 611-620.
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