Benchmark – Capstone Project Change Proposal
Benchmark – Capstone Project Change Proposal
In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.
Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:
- Problem statement
- Purpose of the change proposal
- Literature search strategy employed
- Evaluation of the literature
- Applicable change or nursing theory utilized
- Proposed implementation plan with outcome measures
- Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
- Appendix section, if tables, graphs, surveys, educational materials, etc. are created
Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Week 3 paper
PICOT Statement Paper
Hand Hygiene (HH) is one of the most effective ways of reducing hospital transited infections (HTIs) in the healthcare setting. However, most healthcare professionals fail to comply with the international standard guidelines for hand hygiene negatively affecting the health and safety of patients. Poor HH of health workers has led to increased mortality rates among patients admitted in hospitals. More awareness needs to be created among the healthcare workers about the importance of HH to reduce the increased mortality rate. Healthcare agencies need to take the responsibility of ensuring their staffs are fully aware and adhere to World health Organization (WHO) guidelines for hand hygiene (Sadule-Rios &Aguilera, 2017).
For healthcare workers in Hospital does alcohol based solutions compared to hand washing protocol prevent hospital acquired infections during the period patients stay in healthcare facilities.
Evidence based solution
Alcohol based solutions have been used widely across the world. Studies show that this approach to HH irritates hands less often, removes germs effectively and requires less time as compared to hand washing. Alcohol based solutions are also more accessible as compared to sinks. This approach to HH is more effective when the hands are not soiled. However, in situations where dirt can be seen on the hands, health workers should clean their hands using water. Alcohol based solutions have good microbial activity against various bacteria and viruses. Multiple studies show that alcohol based solutions are more effective in the healthcare setting as compared to hand washing protocol (Lehotsky et al., 2017).
Patients who have been admitted in the hospitals interact with nurses more often than any other healthcare professional. For this reason, nurses must take precautionary measure to ensure patient security and overall wellbeing. Nurse practitioners should use alcohol based solutions before and after interacting with patients. This will reduce the spread of infections in the healthcares setting. Nurses should also follow the WHO guidelines which require them to wear protective gear before interacting with patients. This will prevent them from acquiring infections from one patient and transmitting it to other patients within the hospital (Garus-Pakowska, Sobala & Szatko, 2013).
One of the most important goals for healthcare facilities is to provide quality services to patients. Without proper HH this goal cannot be achieved. Hospitals should create proper HH guidelines to be followed by all patients admitted in their facility. Healthcare providers should also ensure that their patients are fully aware of these guidelines and ensure they are followed to the latter. Enough alcohol based solutions should be provided to ensure patients adhere to the guidelines (Deochand & Deochand, 2016). The healthcare workers should also ensure that visitors clean their hands before visiting the patients and after leaving wards. This ensures visitors do not bring infections to the patients.
Health care agency
One of the main responsibilities of the healthcare agency is to provide enough alcohol based solutions to both patients and healthcare professionals. Without enough resources they will be unable to follow the WHO HH guidelines. The healthcare agency should also ensure it has enough sinks with running water to ensure that patients and healthcare professionals can clean their hand when they have less supply of alcohol based solutions. They should also ensure they create awareness among their healthcare professionals about the importance of HH. Occasional audits should also be conducted to ensure nurses comply with the set HH guidelines (Chatfield et al., 2016).
Most of the hospital acquired infections can be prevented by combining the alcohol based solutions and hand washing protocol. These techniques can complement one another increasing patient safety and care in hospitals. Nurses should comply with the WHO guidelines to reduce spread of infections in the healthcare setting (McLawsa et al., 2014). The implementation of standard HH guidelines will ensure a safe and secure healthcare environment. This will also improve patient outcomes and their overall well being. This can go a long way in reducing hospital stay as a result of hospital acquired infections. All hospital stakeholders need to take the necessary precautions to prevent the spread of these infections.
Chatfield, S. L., Nolan, R., Crawford, H. and Hallam, J. S., (2016). Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis. SAGE Open Medicine Volume 4: 1 –9
Deochand, N., & Deochand, M. E. (2016). Brief Report on Hand-Hygiene Monitoring Systems: A Pilot Study of a Computer-Assisted Image Analysis Technique. Journal of environmental health, 78(10). Journal of Hospital infection 97 (2017) 26-29
Garus-Pakowska, A., Sobala, W., Szatko. F. (2013). Observance of hand washing procedures performed by the medical personnel before patient contact part 1.International journal of occupational medicine and environmental health 2013
Lehotsky, A., Szilagyi, L. , Szeremy, P., Weber, G., Haidegger, T. (2017). Towards objective hand hygiene technique assessment: validation of the ultraviolet-dye-based hand-rubbing quality assessment procedure.
McLawsa, M. L., Farahangizb, S., Palenikc, C. Askariand, M., (2014). Iranian healthcare workers’ perspective on hand hygiene: A qualitative study. Journal of Infection and Public Health (2015) 8, 72—79
Sadule-Rios, N., Aguilera, G. (2017). Nurses’ perception of reasons for persistent low rates in hand hygiene compliance. Intensive and Critical Care Nursing 42 (2017) 17-21
WEEK 6 PAPER LITERATURE REVIEW
Most hospital acquired infections are as a result of human actions. Hand hygiene (HH) is a great way to prevent the spread of germs that cause these infections. However, studies show that nurse wash their hand less than they should contributing to the spread of these infections. This also puts patients at the risk of being infected during their stay in healthcare facilities. HH can prevent the spread of these infections and reduce hospital stay for patients. This paper aims to review various studies that are related to this topic and determine how they support the PICOT statement.
For healthcare workers in Hospital does alcohol based solutions compared to hand washing protocol prevent hospital acquired infections during the period patients stay in healthcare facilities.
Comparison of research Questions
A study conducted in 2015 aimed to establish whether technology can be used to do away with health acquired infections in hospitals (Al Salman et al., 2015). Another study conducted in 2017 aimed to establish whether HH is enough for the prevention of cross-contamination on hospital wards (Hor et al., 2017). A thirds study done in 2016 focused on assessing the knowledge and attitude of nursing staff and residents towards hand hygiene in relation to reducing hospital-acquired infections (Maheshwari, 2014). The fourth study reviewed in this paper was conducted in 2015 and aimed to assess the attitude, knowledge to HH guidelines of nursing students and final year medical students towards hand hygiene in relation to reducing hospital-acquired infections (Ariyaratne et al., 2015).
Another study conducted in 2019 aimed to explore the attitudes cleaning staff in hospitals as HH (Sendall, McCosker & Halton, 2019). In 2016, another research was conducted aiming to establish whether Hand-Hygiene Monitoring Systems are effective at reducing hospital acquired infections (Deochand & Deochand, 2016). Another study also conducted in the same year aimed to capture the experiences of HH among acute care nurses. This involved interviewing nurses to give their perceptions about HH (Chatfield et al., 2016). Finally, a study conducted in 2016 aimed to identify the knowledge of HH in the fight against HAI present in teaching hospitals affiliated to Zabol University (Sarani et al., 2016). All these research questions aimed to determine the effectiveness of HH in healthcare facilities.
Comparison of Sample Populations
The first study was carried out in carried out in Bahrain; a medical system in the nation was installed and observed for twenty-eight days. Over the twenty-eight days period, comments, suggestions, and remarks on the system were recorded and as a result improvements on the system were made on the course of the system trial. The second study was done in three hospitals in Australia. The specific areas of concern were the general surgical wards and the intensive care units. In order to examine if the infection prevention and control practices were influencing cross-contamination in hospitals, ethnography study was carried out (Hor et al., 2017). The third study was done in Bhopal city and involved 160 respondents.
The fourth research was done at a university in Sri Lanka. There were 289 participants, of which ninety-three were nursing students and one hundred and ninety-six were medical students. The fifth study involved the use of focus groups where 12 cleaning staff participated. The sixth study looked at several implemented HH monitoring systems. In the other research, eight nurses in the US performing various roles were interviewed. The final study was conducted on 170 nurses of two teaching hospitals in Zabol (Sarani et al., 2016). All these studies had enough sample sizes that helped to bring out reliable findings.
Comparison of limitations
The methodology used in the first study was meant that the results could not be generalized for a wider population (Al Salman et al., 2015). The study is also time-consuming. In the second study, biasness on the part of the research could have significantly affected the findings of the study. The third study used a cross sectional approach and therefore could not be used to determine the behavior of healthcare professionals over a period of time. The fourth study used an approach that does not help to determine cause and effect of a phenomenon. The researchers experienced challenges in sampling the data that had been obtained compromising the reliability of the study.
The fifth study used explanatory design and therefore the interpretation of the information obtained was judgmental and biased. The sixth study utilized observation as its method of study. This made it difficult for researchers to determine the behavior of interests of the participants. The next study was limited by the fact that participants could have provided biased information that could influence the final results. The approach also did not help to obtain all the information required from the respondents (Chatfield et al., 2016). The final study was limited by the fact that the problem of the study could not be tested statistically. Due to the observational nature of the study, the study is not repeatable.
In conclusion, the studies that have been reviewed in this paper support the PICOT Statement. A threat to the credibility that might have been present to most of these studies was selection bias. The monitoring technology was not put all over the complex rather it was only installed in the coronary care unit. It was recommended that the systems should be tested in other sections of hospitals. HH training needs to be emphasized in order to bring improvement in healthcare system. Infection prevention management needs to come up with proper training programs for HH for hospital acquired infections to be done away with. There is a need for the study to be conducted in the real world for a valid conclusion on the subject matter to be done.
Al Salman, J. M., Hani, S., de Marcellis-Warin, N., & Isa, S. F. (2015). Effectiveness of an electronic hand hygiene monitoring system on healthcare workers’ compliance to guidelines. Journal of infection and public health, 8(2), 117-126.
Hor, S. Y., Hooker, C., Iedema, R., Wyer, M., Gilbert, G. L., Jorm, C., & O’Sullivan, M. V. N. (2017). Beyond hand hygiene: a qualitative study of the everyday work of preventing cross-contamination on hospital wards. BMJ Qual Saf, 26(7), 552-558.
Maheshwari, V. (2014). A study to assess knowledge and attitude regarding hand hygiene amongst residents and nursing staff in a tertiary health care setting of Bhopal City. Journal of clinical and diagnostic research: JCDR, 8(8), DC04.
Ariyaratne, M. H. J. D., Gunasekara, T. D. C. P., Weerasekara, M. M., Kottahachchi, J., Kudavidanage, B. P., & Fernando, S. S. N. (2015). Knowledge, attitudes and practices of hand hygiene among final year medical and nursing students at the University of Sri Jayewardenepura.
Sendall, M. C., McCosker, L. K., & Halton, K. (2019). Cleaning staff’s attitudes about hand hygiene in a metropolitan hospital in Australia: A qualitative study. International journal of environmental research and public health, 16(6), 1067.
Deochand, N., & Deochand, M. E. (2016). Brief report on hand-hygiene monitoring systems: A pilot study of a computer-assisted image analysis technique. Journal of environmental health, 78(10), 14-21.
Chatfield, S. L., Nolan, R., Crawford, H., & Hallam, J. S. (2016). Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis. SAGE open medicine, 4, 2050312116675098.
Sarani, H., Balouchi, A., Masinaeinezhad, N., & Ebrahimitabs, E. (2016). Knowledge, attitude and practice of nurses about standard precautions for hospital-acquired infection in teaching hospitals affiliated to Zabol University of Medical Sciences (2014). Global journal of health
science, 8(3), 193
DQ . Barriers to EBP project implementation
The ultimate aim of change projects is to effect continuous improvements in healthcare organizations for subsequent improvements in patient care and organizational management. One way of creating lasting change is through collaborating with the employees to ensure that the new change is accepted and accommodated by the professionals. This creates a space for joint implementation of the change where the employees own the project. Another approach is through educating the staff and the community on the need for the change and how it is going to benefit them. However, there exists several challenges against the attainment of this objective including resistance to change and the depletion of resources.
Resistance to change is a common challenge in the healthcare sector especially when the staff are not transformative and have no desire for change. This normally occurs where the leadership promotes a feeling of comfortability on present dynamics instead of advocating for continued quality improvements (Jordan, Bowers, & Morton, 2016). To overcome this barrier, I will educate the staff on the need for implementing this change and the expected benefits. It is also essential to educate the patients, their families, and communities on the importance of engaging in constant exercises and healthy dieting to control blood sugar among diabetes patients. The education sessions should focus on the role of the interventions in mitigating the cost of care, reducing the burden of diseases, and improving the quality of life.
Another barrier likely lower the efficacy of my project in attaining the intended objectives is the depletion of the resources necessary to complete this change. Key resources needed to support the implementation of this project include finances and human resources to promote regular exercises and healthy dieting as better strategies of promoting long-term stability among patients. To mitigate this challenge, I will partner with healthcare organizations, community members, adjacent healthcare organizations, and community-based organizations to provide financial and intellectual resources for the project’s completion. Another strategy is utilizing the six sigma resource management approach to avoid resource wastage (Koeijer, Paauwe, & Huijsman, 2014).
Jordan, P., Bowers, C., & Morton, D. (2016). Barriers to implementing evidence-based practice in a private intensive care unit on the EAstern Cape. South African Journal of Critical Care, 32(2), 50-54. doi:10.7196/SAJCC.2016.v32i2.253
|Course Code||Class Code||Assignment Title||Total Points|
|NRS-490||NRS-490-O500||Benchmark – Capstone Project Change Proposal||300.0|
|Criteria||Percentage||Unsatisfactory 0-71% (0.00%)||Less Than Satisfactory 72-75% (75.00%)||Satisfactory 76-79% (79.00%)||Good 80-89% (89.00%)||Excellent 90-100% (100.00%)||Comments||Points Earned|
|Background||5.0%||Background section is not present.||Background section is present, but incomplete or otherwise lacking in required detail.||Background section is present. Some minor details or elements are missing but the omission(s) do not impede understanding.||Background section is present and complete. The submission provides the basic information required.||Background section is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|Problem Statement||5.0%||Problem statement is not present.||Problem statement is present, but incomplete or otherwise lacking in required detail.||Problem statement is present. Some minor details or elements are missing but the omission(s) do not impede understanding.||Problem statement is present and complete. The submission provides the basic information required.||Problem statement is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|Change Proposal Purpose||5.0%||Purpose of change proposal is not present.||Purpose of change proposal is present, but incomplete or otherwise lacking in required detail.||Purpose of change proposal is present. Some minor details or elements are missing but the omission(s) do not impede understanding.||Purpose of change proposal is present and complete. The submission provides the basic information required.||Purpose of change proposal is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|PICOT||5.0%||PICOT is not present.||PICOT is present, but incomplete or otherwise lacking in required detail.||PICOT is present. Some minor details or elements are missing but the omission(s) do not impede understanding.||PICOT is present and complete. The submission provides the basic information required.||PICOT is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|Literature Search Strategy||5.0%||Literature search strategy is not present.||Literature search strategy is present, but incomplete or otherwise lacking in required detail.||Literature search strategy is present. Some minor details or elements are missing but the omission(s) do not impede understanding.||Literature search strategy is present and complete. The submission provides the basic information required.||Literature search strategy is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|Literature Evaluation||5.0%||Literature evaluation is not present.||Literature evaluation is present, but incomplete or otherwise lacking in required detail.||Literature evaluation is present. Some minor details or elements are missing but the omission(s) do not impede understanding.||Literature evaluation is present and complete. The submission provides the basic information required.||Literature evaluation is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|Utilization of Change or Nursing Theory (2.2)||5.0%||Theory utilization is not present.||Theory utilization content is present, but incomplete or otherwise lacking in required detail.||Theory utilization content is present. Some minor details or elements are missing but the omission(s) do not impede understanding.||Theory utilization content is present and complete. The submission provides the basic information required.||Theory utilization content is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|Proposed Implementation Plan with Outcome Measures (3.2)||5.0%||Implementation plan is not present.||Implementation plan is present, but incomplete or otherwise lacking in required detail.||Implementation plan is present. Some minor details or elements are missing but the omission(s) do not impede understanding.||Implementation plan is present and complete. The submission provides the basic information required.||Implementation plan is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|Identification of potential barriers to plan implementation, and a discussion of how these could be overcome (2.3)||5.0%||Identification of potential barriers to plan implementation and /or discussion component is not present.||Identification of potential barriers to plan implementation with a discussion component is present, but is incomplete or otherwise lacking in required detail.||Identification of potential barriers to plan implementation with a discussion component is present. Some minor details or elements are missing but the omission(s) do not impede understanding.||Identification of potential barriers to plan implementation with a discussion component is present and complete. The submission provides the basic information required.||Identification of potential barriers to plan implementation with a discussion component is present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|Appendices Inclusive of Practice Immersion Clinical Documentation (1.2)||5.0%||Appendices are not present.||Appendices are present, but incomplete or otherwise lacking in required detail.||Appendices are present with minor elements missing that do not impede understanding.||Appendices are present and complete. The submission provides the basic information required.||Appendices are present, complete, and incorporates additional relevant details and critical thinking to engage the reader.|
|Evidence of Revision||10.0%||Final paper does not demonstrate incorporation of feedback or evidence of revision on research critiques.||Incorporation of research critique feedback or evidence of revision is incomplete.||Incorporation of research critique feedback and evidence of revision are present.||Evidence of incorporation of research critique feedback and revision is clearly provided.||Evidence of incorporation of research critique feedback and revision is comprehensive and thoroughly developed.|
|Organization and Effectiveness||30.0%|
|Thesis Development and Purpose||10.0%||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 Construction||10.0%||Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.||Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.||Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.||Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.||Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.|
|Mechanics of Writing (includes spelling, punctuation, grammar, language use)||10.0%||Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.||Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.||Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.||Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.||Writer is clearly in command of standard, written, academic English.|
|Paper Format (use of appropriate style for the major and assignment)||5.0%||Template is not used appropriately, or documentation format is rarely followed correctly.||Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.||Appropriate template is used. Formatting is correct, although some minor errors may be present.||Appropriate template is fully used. There are virtually no errors in formatting style.||All format elements are correct.|
|Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)||5.0%||Sources are not documented.||Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.||Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.||Sources are documented, as appropriate to assignment and style, and format is mostly correct.||Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.|