Practice Immersion Clinical Evaluation Tool – Agency/Site
Agency/Site Criteria Student Evaluation Faculty Evaluation Comments
Does Not Meet Meets Excels* Does Not Meet Meets Excels*
1. Agency/site was able to provide the opportunities for the student to meet practice immersion clinical objectives. ☐
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2. Agency/site was able to establish a comfortable, yet stimulating, practice environment. ☐
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Does Not Meet: Elements are missing.
Meets: Agency/site meets this criterion.
Excels: Agency/site meets this criterion and further a teaching point opportunity or expanded information, guidance, or other element to further enhance student learning.
Agency/site – strengths:
Student Evaluation Faculty Evaluation
Agency/site – areas of improvement needed:
Student Evaluation Faculty Evaluation
Agency/site – Suggestions to incorporate more responsiveness to student learning needs:
Student Evaluation Faculty Evaluation
Practice Immersion Clinical Evaluation Tool – Mentor
Clinical Criteria Student Feedback of Mentor Experience Comments
Does Not Meet Meets Excels*
3. Exemplify professionalism in diverse health care settings. ☐
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4. Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents. ☐
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5. Implement patient care decisions based on evidence-based practice. ☐
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6. Utilize patient care technology and information management systems. ☐
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7. Communicate therapeutically with patients. ☐
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8. Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care. ☐
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9. Understand the human experience across the health-illness continuum. ☐
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10. Provide culturally sensitive care. ☐
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11. Preserve the integrity and human dignity in the care of all patients. ☐
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Criteria:
Does Not Meet: Elements are missing; mentor did not achieve.
Meets: Mentor meets this criterion.
Excels: Mentor meets this criterion and further incorporates a teaching point scenario or expanded information, guidance, or other element to further enhance student learning.
Practice Immersion Clinical Evaluation Tool – Student
Clinical Criteria Mentor
Sign Off Faculty Sign Off Comments
Does Not Meet Meets Excels*
12. Exemplify professionalism in diverse health care settings. ☐
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13. Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death as opportunity presents. ☐
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14. Implement patient care decisions based on evidence-based practice. ☐
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15. Utilize patient care technology and information management systems. ☐
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16. Communicate therapeutically with patients. ☐
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17. Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care. ☐
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18. Understand the human experience across the health-illness continuum. ☐
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19. Provide culturally sensitive care. ☐
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20. Preserve the integrity and human dignity in the care of all patients. ☐
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Criteria:
Does Not Meet: Elements are missing; student is required to remediate this element to pass the course
Meets: Student meets this criterion.
Excels: Student meets this criterion and further incorporates a teaching point scenario.
Benchmark – Capstone Project Change Proposal
Background
Millions of patients across the world experience hospital-acquired infections (HAIs), which reduces the likelihood of having better health outcomes. According to Oyapero and Oyapero (2018), 1.4 million patients in the world experience these infections at any point in time, leading to an increased risk of patient morbidity and mortality. In developing economies, the rate of preventable HAIs as a result of medical care is at least 40% because of the risk factors such as low levels of awareness, multiple trauma, and the lack of effective preventive mechanisms (Asadollahi et al., 2015). Primarily, direct contact between healthcare workers with transient contamination of their hands with nosocomial pathogens and patients is the main route of infection transmission leading to patients getting infected (Luangasanatip et al., 2015). Fortunately, hand hygiene is considered one of the most critical interventions to reduce the menace of HAIs in admitted patients. However, it is necessary to understand whether or not washings hands with soap and water is more effective than the use of alcohol-based wash solution in reducing HAIs.
Problem Statement
Microbial pathogens mainly contaminate healthcare workers’ hands, yet these providers do not frequently wash their hands with water and soap or alcohol-based solution. Awoke et al. (2018) explain that the hands of these workers are the vehicle of healthcare-associated pathogen transmission because they continuously touch body fluids, patients’ skin and mucous membranes, surfaces, and their own bodies while performing a myriad of healthcare activities. Awoke et al. (2018) defines hand hygiene as the transient removal of microbial organisms by killing or removing them from dirty hands through the use of handwashing agents and different techniques. Unfortunately, hand hygiene is less practiced by these workers (Sharif et al., 2016). It is worse than healthcare workers do not practice handwashing with the use of soap after touching potentially contaminated surfaces.
Purpose of the Change Proposal
This change proposal purpose of fostering the execution of hand hygiene measures through hand hygiene as the most effective intervention to prevent or reduce the occurrence of HAIs in intensive care units (ICUs). Therattil et al. (2015) explain that there is no difference between the counts of hand bacteria when using ethyl alcohol-based sanitizer or soap-and-water hand washing. Planned behavior to inspire hand hygiene by educating and motivating healthcare workers to abide by the hand hygiene protocols and evidence-based guidelines are fundamental to improve the practice of this therapeutic intervention (White et al., 2015). According to Zhao et al. (2018), nurses prefer adopting or implementing interventions in which they participate during the planning and formulation phases. Besides, these interventions should be simple and easy to execute, which makes hand hygiene to be an appropriate solution for adoption in the ICU. Therefore, purposing to engage the healthcare workers and inspiring them to implement appropriate hand hygiene practices as well as soliciting and providing the necessary hand hygiene resources, such as water, soap, or alcohol-based sanitizer, is crucial.
PICOT Statement
This change proposal is based on the knowledge or evidence obtained to answer the PICOT question: in nurses working within the ICU (P), does the use of alcohol-based hand wash solution (I) compared with soap-and-water handwashing (C) reduce HAIs (O) in patients within three months (T)? Already, Therattil et al. (2015) reveal that both the intervention and the comparison are effective in mitigating HAIs after establishing that alcohol-based and soap-and-water hand washing does not depict any significant variations in hand pathogen count. However, nurses can effectively participate in the formulation of clinical solutions to existing problems for the interventions to be executed and sustained (Zhao et al., 2018). Therefore, healthcare workers should use scientific evidence to answer the PICOT question and formulate an evidence-based solution to the problems of HAIs in ICUs.
Literature Search Strategy
The search for evidence from scholarly, peer-reviewed sources relied on the use of different databases. Some of the most critical databases used to access these sources comprised Google Scholar and PubMed. Important search terms from the PICOT statement, as well as those related to the problem of HAIs in hospitalized patients, were used to help in accessing the sources through the databases. The search terms included “nurses,” “healthcare workers,” “hand hygiene,” “handwashing,” “alcohol-based hand hygiene,” “healthcare-associated infections,” “alcohol sanitizer,” and so forth. After completing the search, many sources were identified. However, it was the duty of the research to select only those that met the inclusion criteria. Only peer-reviewed journal articles published in English from 2015 to date were selected. Besides, these articles were to have relevant information concerning the PICOT statement with much focus on HAIs and hand hygiene. Eight articles were selected after meeting the inclusion criteria.
Evaluation of the Literature
Fundamentally, the literature from the eight sources was evaluated for reliability, validity, and credibility of the evidence. It was established that these evidence-based, peer-reviewed sources contained the necessary information to answer the PICOT question and address different aspects of the change proposal. For example, Asadollahi et al. (2015) discussed the levels of knowledge of nurses concerning the concept of hand hygiene and the need for training while Awoke et al. (2018) addressed the issue of hand hygiene compliance, which was found to be poor leading to the need for adopting measures aimed at improving the adherence levels. Conversely, Luangasanatip et al. (2015) examined the efficacy of different interventions to promote hand hygiene, while Oyapero and Oyapero (2018) assessed hand hygiene perceptions among nurses, which is similar to Sharif et al.’s (2016), which explored hand hygiene perceptions and attitudes in nurses. Therattil et al. (2015) had credible evidence on different hand hygiene methods as White et al. (2015) sought to assess the determinants of hand hygiene decisions in nurses, while Zhao et al. (2018) provided evidence on how to improve the attractiveness of hand hygiene interventions. Therefore, this credible evidence revolves around promoting hand hygiene to mitigate HAIs.
Application of the Change Theory
Kurt Lewin’s theory of planned change is appropriate for this change proposal. Its details are indicated in Appendices A and B. Batras et al. (2016) explain that this change theory aims at destabilizing the status quo by creating room for change where stakeholders such as clinicians are engaged to overcome the tendency to implement routine practices by adopting evidence-based interventions. During unfreezing, which is the first phase of this theory, stakeholders are mobilized through awareness to inspire change by acknowledging the need to adopt new interventions to solve existing problems (Wojciechowski et al., 2016). After planning, the moving phase follows where is implementation is actualized. In this case, planning to improve hand hygiene compliance and the implementation of measures to actualize the plan is an outcome of following this theoretical framework. Finally, refreezing is evident when the healthcare organization and providers formulate and execute policies to sustain the evidence-based solution.
Implementation Plan with Outcome Measures
The plan will commence with the collection of credible evidence from peer-reviewed sources about the problem of HAIs and the need for complying with hand hygiene protocols and guidelines as the most appropriate solution. This step will be followed by the organized engagement of nurses and other stakeholders through meetings, discussions, and dissemination of written evidence to inspire change. Consequently, collective planning through a team-based approach will help in designing protocols and measures to improve hand hygiene compliance. This plan will then be actualized during the implementation phase before evaluations of the effectiveness to achieve high adherence levels, reduce the occurrence of HAIs in the ICU, the duration of ICU stay, and improve the associated health outcomes, among others.
Potential Barriers
The lack of knowledge, nurses’ resistance to change, and the insufficiency of hand hygiene resources are the potential barriers to the successful implementation of this proposed plan. Zhao et al. (2018) explain that hand hygiene attractiveness can be achieved and sustained through increased training of providers and inclusion of the same clinicians into planning change interventions. Through the inclusion and training of nurses, the challenges of provider resistance and knowledge deficit will be mitigated. Further, these providers require sufficient hand hygiene resources to comply with hand hygiene protocols and guidelines effectively. As such, the administration should seek and obtain funds to purchase the resources, such as soap, water, and alcohol-based solutions, as well as facilitate the training of healthcare workers.
Conclusion
Overall, HAIs are a menace to the health and lives of hospitalized patients in ICUs; however, the solution to this problem is hand hygiene, which is a simple practice but difficult for healthcare workers to comply with when delivering services. The best solution is to promote soap-and-water or alcohol-based hand washing, which are two effective methods to clean and remove microbial pathogens from contaminated hands. However, adequate resources should be available in addition to reducing potential resistance through teamwork and inclusivity and improving provider knowledge levels of the need and technical knowledge about hand hygiene practices.
References
Asadollahi, M., Arshadi Bostanabad, M., Jebraili, M., Mahallei, M., Seyyed Rasooli, A., & Abdolalipour, M. (2015). Nurses’ knowledge regarding hand hygiene and its individual and organizational predictors. Journal of Caring Sciences, 4(1), 45–53. doi:10.5681/jcs.2015.005
Awoke, N., Geda, B., Arba, A., Tekalign, T., & Paulos, K. (2018). Nurses practice of hand hygiene in Hiwot Fana Specialized University Hospital, Harari Regional State, Eastern Ethiopia: Observational study. Nursing Research and Practice, 2018, 2654947. doi:10.1155/2018/2654947
Luangasanatip, N., Hongsuwan, M., Limmathurotsakul, D., Lubell, Y., Lee, A. S., Harbarth, S., … Cooper, B. S. (2015). Comparative efficacy of interventions to promote hand hygiene in hospital: Systematic review and network meta-analysis. BMJ, 351, h3728. doi:10.1136/bmj.h3728
Oyapero, A., & Oyapero, O. (2018). An assessment of hand hygiene perception and practices among undergraduate nursing students in Lagos State: A pilot study. Journal of Education and Health Promotion, 7, 150. doi:10.4103/jehp.jehp_56_17
Sharif, A., Arbabisarjou, A., Balouchi, A., Ahmadidarrehsima, S., & Kashani, H. H. (2016). Knowledge, attitude, and performance of nurses toward hand hygiene in hospitals. Global Journal of Health Science, 8(8), 53081. doi:10.5539/gjhs.v8n8p57
Therattil, P. J., Yueh, J. H., Kordahi, A. M., Cherla, D. V., Lee, E. S., & Granick, M. S. (2015). Randomized controlled trial of antiseptic hand hygiene methods in an outpatient surgery clinic. Wounds: A Compendium of Clinical Research and Practice, 27(12), 347-353.
White, K. M., Starfelt, L. C., Jimmieson, N. L., Campbell, M., Graves, N., Barnett, A. G., … Brain, D. (2015). Understanding the determinants of Australian hospital nurses’ hand hygiene decisions following the implementation of a national hand hygiene initiative. Health Education Research, 30(6), 959-970.
Zhao, Q., Yang, M. M., Huang, Y. Y., & Chen, W. (2018). How to make hand hygiene interventions more attractive to nurses: A discrete choice experiment. PloS One, 13(8), e0202014. doi:10.1371/journal.pone.0202014
Wojciechowski, E., Murphy, P., Pearsall, T., & French, E. (2016). A case review: Integrating Lewin’s theory with lean’s system approach for change. The Online Journal of Issues in Nursing, 21(2), 4. doi: 10.3912/OJIN.Vol21No02Man04.
Batras, D., Duff, C., & Smith, B. J. (2016). Organizational change theory: Implications for health promotion practice. Health Promotion International, 31(1), 231-241. https://doi.org/10.1093/heapro/dau098.
Appendices
Appendix A: The Three Steps of the Theory of Lewin’s Planned Change
Source: Wojciechowski et al. (2016)
Appendix B: Lewin’s Explanatory Factors and the Change Strategy
Source: Batras et al. (2016).
NRS-490 Individual Success Plan
REQUIRED PRACTICE HOURS: 100
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ISP Instructions
Use this form to develop your Individual Success Plan (ISP) for NRS-490, the Professional Capstone and Practicum course. An individual success plan maps out what you, the RN-to-BSN student, needs to accomplish in order to be successful as you work through this course and complete your overall program of study. You will also share this with your mentor at the beginning and end of this course so that he or she will know what you need to accomplish.
Application-based learning assignments are listed in the course syllabus with a Practice Portfolio Statement requirement element noted within the assignment itself. In order for you to successfully complete and graduate from the RN-to-BSN Program you must meet the following programmatic requirements: (1) completion of 100 practice immersion hours, and (2) completion of work associated with all program competencies.
In this ISP, you will identify all of the objectives, tasks, and/or assignments relating to the 100 practice immersion hours you need to complete by the end of this course. Specify the dates by which you will complete each tasks and/or assignments. Your plan should include a self-assessment of how you met all applicable GCU RN-to-BSN Domains & Competencies (see Appendix A).
ALL course assignments listing a “Practice Hours Portfolio” statement must be included in the ISP and are worth and recorded here as approximately 10 hours each. Actual clock hours must be recorded on this time log.
General Requirements
Use the following information to ensure successful completion of each assignment as it pertains to deliverables due in this course:
• Use the Individual Success Plan to develop a personal plan for completing your practice immersion hours and self-assess how you will meet the GCU RN-to-BSN University Mission Critical Competencies and the Programmatic Domains & Competencies (Appendix A) related to that course.
Show all of the major deliverables in the course, the topic/course objectives that apply to each deliverable, and lastly, align each deliverable to the applicable University Mission Critical Competencies and the course-specific Domains and Competencies (Appendix A).
Completing your ISP does not earn practice hours, nor does telephone conference time, or time spent with your mentor.
• Within the Individual Success Plan, ensure you identify all course assignments which may include the following: Memorandums of Understanding (MOU)(if Affiliation Agreement is not required); comprehensive log of practice immersion hours applied to baccalaureate level learning outcomes; evaluations from faculty and mentors; your evaluations of your mentor; scholarly activity report; competency self-assessment (part of your ISP); reflective journal (Submitted in Week 10 but covering all weeks in the course); course goals and plan for how competencies and practice immersion hours will be met; and both faculty and mentor approvals of course goals and documented practice immersion hours.
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Application-based Learning Course Assignments List of Current Course Objectives Number of Clock Hours Associated with Each Assignment
Assignment
Date Due Self-Assessment:
GCU RN-to-BSN
University Mission Critical Competencies and
Programmatic Domains & Competencies
(see Appendix A) Date
Assignment
Completed
WEEK 1
Professional Capstone and Practicum Documentation
Individual Success Plan
Professional Capstone and Practicum Reflective Journal and Scholarly Activities 1. Identify problems, issues, and opportunities to improve patient care, patient outcomes, and organizational procedures within a clinical practice setting.
2. Examine a health care clinical problem or an organizational issue and its implications to nursing practice.
3. Determine evidence-based solutions that address patient care or clinical practice quality problems or issues.
4. Analyze health care clinical problems and organizational issues utilizing the PICO(T) process
5. Demonstrate values consistent with the role of a nursing professional through fundamental knowledge and advanced skills. 12 hours 12/08/2019 MC1; MC2; 2.3; 1.1; 5.1 12/07/2019
WEEK 2
Capstone Project Topic Selection and Approval
1. Identify problems, issues, and opportunities to improve patient care, patient outcomes, and organizational procedures within a clinical practice setting.
2. Examine a health care clinical problem or an organizational issue and its implications to nursing practice.
3. Determine evidence-based solutions that address patient care or clinical practice quality problems or issues.
4. Analyze health care clinical problems and organizational issues utilizing the PICO(T) process
5. Demonstrate values consistent with the role of a nursing professional through fundamental knowledge and advanced skills. 7 hours 12/15/2019 MC1; MC2; MC3; MC4; 1.1; 1.2; 1.3; 1.4; 1.5; 2.1; 2.2; 2.3; 3.2; 5.1
WEEK 3
PICOT Statement Paper
1. Evaluate evidence-based research and other appropriate resources to inform the development of a change plan.
2. Identify strategies for logistical implementation of proposed solutions.
3. Demonstrate the ability to evaluate levels of evidence into a concise format.
4. Integrate evidence, clinical judgment, inter-professional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. 6 hours 12/22/2019 MC1; MC2; MC3; MC4; 1.1; 1.2; 1.4; 2.1; 2.2; 2.3; 3.2; 3.3, 5.1; 5.3; 5.4
WEEK 4
Literature Evaluation Table
1. Evaluate evidence-based research and other appropriate resources to inform the development of a change plan.
2. Identify strategies for logistical implementation of proposed solutions.
3. Demonstrate the ability to evaluate levels of evidence into a concise format.
4. Integrate evidence, clinical judgment, inter-professional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. 12 hours 01/12/2020 MC1; MC2; MC4; 1.1; 1.3; 1.4; 2.1; 2.2; 2.3; 5.1
WEEK 5
Topic 5 Practice Hours Completion Statement NRS-490 1. Identify objectives, strategy, and measurable outcomes of the evidence-based practice proposal.
2. List steps needed to implement each strategy in a change proposal.
3. Outline the resources needed to develop and implement a change proposal.
4. Describe methods for obtaining the necessary support from key stakeholders.
5. Develop a plan to evaluate the effectiveness of the change proposal project.
6. Evaluate the role of information sources and technologies impacting the delivery of care within an adequate environment of care.
7. Develop appropriate change plans that promote health and prevent disease. 8 hours 12/19/2020 MC1; MC4; 1.1; 2.1; 2.2; 2.3; 3.1; 3.2; 4.1; 4.3
WEEK 6
Literature Review
1. Identify objectives, strategy, and measurable outcomes of the evidence-based practice proposal.
2. List steps needed to implement each strategy in a change proposal.
3. Outline the resources needed to develop and implement a change proposal.
4. Describe methods for obtaining the necessary support from key stakeholders.
5. Develop a plan to evaluate the effectiveness of the change proposal project.
6. Evaluate the role of information sources and technologies impacting the delivery of care within an adequate environment of care.
7. Develop appropriate change plans that promote health and prevent disease. 15 hours 01/26.2020 MC1; MC2; MC3; MC4; 1.1; 1.2; 1.3; 1.4; 1.5; 2.1; 2.2; 2.3; 3.2; 5.1
WEEK 7
Topic 7 Practice Hours Completion Statement NRS-490
1. Identify methods to evaluate a proposed solution.
2. Describe variables and outcomes to be assessed pre and post project implementation.
3. Utilize appropriate tools such as basic statistics to evaluate project outcomes.
4. Summarize plans for disseminating evidence.
5. Use communication and collaboration skills to deliver high-quality, evidence-based, patient-centered care. 10 hours 02/02/2020 MC1; MC2; MC3; 1.1; 2.1; 2.2; 2.3; 4.3
WEEK 8
Topic 8 Practice Hours Completion Statement NRS-490 1. Identify methods to evaluate a proposed solution.
2. Describe variables and outcomes to be assessed pre and post-project implementation.
3. Utilize appropriate tools such as basic statistics to evaluate project outcomes.
4. Summarize plans for disseminating evidence.
5. Use communication and collaboration skills to deliver high-quality, evidence-based, patient-centered care. 10 hours 02/09/2020 MC1; MC2; MC3; 1.1; 2.1; 2.2; 2.3; 4.3
WEEK 9
Benchmark – Capstone Project Change Proposal
1. Produce a comprehensive and professional change initiative presentation.
2. Integrate acquired knowledge and skills into professional practice.
3. Examine the implementation of evidence-based research in nursing practice.
4. Analyze research findings for the enhancement of evidence-based practice in the clinical setting.
5. Apply leadership concepts, skills, and decision making in the provision of high-quality nursing care in a collaborative inter-professional setting.
6. Analyze the impact of organizational and environmental factors on health care delivery and practice.
7. Demonstrate leadership and communication skills to effectively implement change initiatives for nursing practice. 8 hours 02/16/2020 MC1; MC2; MC5; 1.1; 1.2; 1.3; 1.4; 1.5; 2.1; 2.2; 2.3; 3.2; 4.2; 4.3, 5.1; 5.3; 5.4
WEEK 10
Benchmark – Professional Capstone and Practicum Reflective Journal
Scholarly Activities
Practice Hours Documentation
Practice Immersion Clinical Evaluation Tools Submission
1. Produce a comprehensive and professional change initiative presentation.
2. Integrate acquired knowledge and skills into professional practice.
3. Examine the implementation of evidence-based research in nursing practice.
4. Analyze research findings for the enhancement of evidence-based practice in the clinical setting.
5. Apply leadership concepts, skills, and decision making in the provision of high-quality nursing care in a collaborative inter-professional setting.
6. Analyze the impact of organizational and environmental factors on health care delivery and practice.
7. Demonstrate leadership and communication skills to implement change initiatives for nursing practice effectively. 12 hours 02/23/2020
MC1; MC2; MC3; MC4; MC5; 1.1; 1.2; 1.3; 1.4; 1.5; 2.1; 2.2; 2.3; 3.2; 5.1, 5.2; 5.4
By typing in his/her signature below, the student agrees to have read, understood, and be accountable for the instructions, assignments, and hours shown above and that all questions have been satisfactorily answered by the faculty and/or program director.
Mentors will sign upon initial receipt and at the end of the course to confirm that assignments have been complete with your guidance.
Student Signature
Name:
Date:
Mentor Signature [Upon Initiation of Course]
Name:
Date:
Mentor Signature [Upon Completion of Course]
Name:
Date:
APPENDIX A:
GCU RN-to-BSN Domains & Competencies
A. University’s Mission Critical Competencies
How does this Individual Success Plan support the GCU Mission?
MC1: Effective Communication: Therapeutic communication is central to baccalaureate nursing practice. Students gain an understanding of their ethical responsibility and how verbal and written communication affects others intellectually and emotionally. Students begin to use nursing terminology and taxonomies within the practice of professional and therapeutic communication. Courses require students to write scholarly papers, prepare presentations, develop persuasive arguments, and engage in discussion that is clear, assertive, and respectful.
MC2: Critical Thinking: Courses require students to use critical thinking skills by analyzing, synthesizing, and evaluating scientific evidence needed to improve patient outcomes and professional practice.
MC3: Christian Worldview: Students will apply a Christian worldview within a global society and examine ethical issues from the framework of a clearly articulated system of professional values. Students will engage in discussion of values-based decisions made from a Christian perspective.
MC4: Global Awareness, Perspectives, and Ethics: The concept of global citizenship is introduced to baccalaureate students in the foundational curriculum. Some courses will focus on the human experience across the world health continuum. The World Health Organization (WHO) definitions of health, health disparities, and determinants of health are foundational to nursing practice.
MC5: Leadership: Students will apply a Christian worldview within a global society and examine ethical issues from the framework of a clearly articulated system of professional values. Students will engage in discussion of values-based decisions made from a Christian perspective.
B. Domains and Competencies
How does this Individual Success Plan support the Program Domains and Competencies?
Domain 1: Professional Role
Graduates of Grand Canyon University’s RN-BSN program will be able to incorporate professional values to advance the nursing profession through leadership skills, political involvement, and life-long learning.
Competencies:
1.1: Exemplify professionalism in diverse health care settings.
1.2: Manage patient care within the changing environment of the health care system.
1.3: Exercise professional nursing leadership and management roles in the promotion of patient safety and quality care.
1.4: Participate in health care policy development to influence nursing practice and health care.
1.5: Advocate for autonomy and social justice for individuals and diverse populations.
Domain 2: Theoretical Foundations of Nursing Practice
Graduates of Grand Canyon University’s RN-BSN program will have acquired a body of nursing knowledge built on a theoretical foundation of liberal arts, science, and nursing concepts that will guide professional practice.
Competencies:
2.1: Incorporate liberal arts and science studies into nursing knowledge.
2.2: Comprehend nursing concepts and health theories.
2.3: Understand and value the processes of critical thinking, ethical reasoning, and decision making.
Domain 3: Nursing Practice
Graduates of Grand Canyon University’s RN-BSN program will be able to utilize the nursing process to provide safe quality care based on nursing best practices.
Competencies:
3.1: Utilize the nursing process to provide safe and effective care for patients across the health-illness continuum: promoting, maintaining, and restoring health; preventing disease; and facilitating a peaceful death.
3.2: Implement patient care decisions based on evidence-based practice.
3.3: Provide individualized education to diverse patient populations in a variety of health care settings.
3.4: Demonstrate professional standards of practice.
Domain 4: Communication/Informatics
Graduates of Grand Canyon University’s RN-BSN program will be able to manage information and technology to provide safe quality care in a variety of settings. In addition, graduates will be able to communicate therapeutically and professionally to produce positive working relationships with patients and health care team members.
Competencies:
4.1: Utilize patient care technology and information management systems.
4.2: Communicate therapeutically with patients.
4.3: Professionally communicate and collaborate with the interdisciplinary health care teams to provide safe and effective care.
Domain 5: Holistic Patient Care
Graduates of Grand Canyon University’s RN-BSN program will be able to provide holistic individualized care that is sensitive to cultural and spiritual aspects of the human experience.
Competencies:
5.1: Understand the human experience across the health-illness continuum.
5.2: Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.
5.3: Provide culturally sensitive care.
5.4: Preserve the integrity and human dignity in the care of all patients.
PICOT Question
Hygiene is crucial in any medical environment. In clinical practice, people are educated on the value of maintaining personal hygiene as a mean of avoiding contamination and risking their health. Nurses’ hygiene is paramount in protecting the wellness of patients through minimizing the spread of infection or causing infection among uninfected patients and staff members. In this study will focus on nurses working in the Intensive Care Unit (P) using alcohol-based hand wash solution (I) compared to soap and water hand wash (C) to help reduce hospital-acquired infection (HAIs) among patients in the ICU within a period of 3 months (T)
Evidence-based Solution
The PICO focuses on the significance of maintaining hand hygiene through hand wash using an alcohol-based hand wash solution. According to a study by Maher (2007) indicated that compliance with hand hygiene ensures a majority of the people get to wash their hands for the safety of the patients. The author concentrates on the value of clinical hygiene especially in the ICU to maintain patient safety through avoiding the spread of infectious disease through handwashing with compliance to the patient’s care. Hand washing using an alcohol-based hand wash solution is beneficial in killing microorganisms compared to basic water and soap handwash. The article by Srigley, Furness, Baker and Gardam (2014) conducted a study that uses an electrical system to monitor whether nurses who use alcohol-based hand wash solution to wash their hands before and after handling patients eliminated any possibility of infecting others. The study observed that soap and water are not very effective in eliminating germs especially microscopic germs. In ICU there is a high risk of patient infection especially due to contact with contaminated suffers such as nurses’ hands. As such, the study by Bolton, Rivas, Prachar, and Jones (2015) recommend thorough hand cleaning before and after visiting the ICU as a strategic measure of reducing hospital-acquired infections. It is confirmed that the participation by healthcare workers was suboptimal and hence could increase the chances of transmitting hospital-acquired infection (Srigley, Furness, Baker, & Gardam, 2014). The main aim of the research entailed ensuring that a proper strategy is determined to meet the concerns of health care workers.
Nursing Intervention
The process of advocating for hand wash hygiene is considered as part of nursing intervention. The PICOT statement fulfills the process of nursing intervention through educating nurses on the value of handling patients with the clean hand using appropriate hand wash solution that effectively removes germs and reduces the chances of infection within the hospital. Nurses are urged to regularly clean their hands before they are in contact with a patient and after handling any patient to reduce the chances of putting other people within the health facility at risk. Hand wash intervention is important in promoting patient wellness and safety. It guides nurses on the appropriate mechanism to help reduce hospital infection especially when handling patients who are sick with communicable diseases. These nursing interventions proved that then Hawthorne effect that patients tend to have their hands watched if they have the feeling that they are being watched. Hence, the act of having an observer means that more hands will be washed, leading to minimized cases of hospital infections.
Patient Care
The PICOT statement writing help is patient cantered through ensuring nurses protect and provide safety of the patient by protecting them from hospital-acquired infections. Hand washes hygiene involves patient care by establishing a clean environment for the patient to thrive without In the study by Srigley et al. (2014), It was determined that anytime an individual went to the dispenser, he or she washed the hands. The action of handwashing is confirmed through the use of RTLS placed on the faucets that audit any time a person visits the dispenser. Proper code of nurses should be instilled that will ensure that adequate hygiene techniques have been maintained as well as ensure that minimal infections are to be made through the hospital-acquired infections.
Health Care Agencies
According to the PICOT statement, health care agencies involved in the process of reducing hospital-acquired infections are agencies such as insurance companies that protect the welfare of patients. Agencies such as the CDC have conducted research on the dangers of poor hygiene in hospitals especially in the ICU department where nurses get in conduct with patients with critical conditions. Washing hands with an alcohol-based hand wash solution help reduce such risk that can affect the health of other people within the hospital and even causes an outbreak of a disease or virus.
Nursing Practice
Patients have been helped to have a recovery from the illness, which could have resulted in harming through the transmission of pathogens that could have been from the nurses or even failure of the patients to clean hands. There is a need to ensure that hands are washed, and proper education should be made to both nurses and patients on the need for washing hands to prevent HAIs. Hand washing has a significant impact on an individual if not adequately done, and it can lead to adverse outcomes, especially on patients. Health Care Agencies are advocating for a campaign on handwashing by both nurses and patients with the belief that if hands are properly washed, the results expected will be improved health on patients. Hence, there is a need for policy changes to ensure that the outbreaks from HAIs are reduced.
Conclusion
The use of alcohol-based hand wash solution over soap and water is effective in reducing HAIs and protecting patients and other members of the hospitals. As such, proper education should be created for all individuals concerning hand hygiene, especially to nurses. Quality care is achieved through proper clinical hygiene and nurses must demonstrate proper hygiene when it comes to appropriate hand wash intervention using alcohol-based hand wash solution rather than simple soap and water solution.
References
Bolton, P. M., Rivas, K., Prachar, V., & Jones, M. P. (2015). The observer effect: Can being watched enhance compliance with hand hygiene behavior? A randomized trial. Asia Pacific Journal of Health Management, 10(3), GS14-GS16.
Maher, Helen K, (2007). Handwashing: Back to the basics. AAOHN Journal, 55(3), 132
Srigley, J. A., Furness, C. D., Baker, G. R., &Gardam, M. (2014). Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study. BMJ Quality & Safety, 23(12), 974-980.
