Proper Hand Washing – a Quality Improvement Proposal

Proper Hand Washing – a Quality Improvement Proposal

Purpose This proposal aims to implement better hand washing practices in the nursing home setting. The idea is making handwashing education a continuous process rather than a single event throughout the year. The project focuses on encouraging the nursing home to hold hand washing training sessions every two months. The implementation includes choosing a team leader who will be carrying out follow-up modules. The education will encourage health care practitioners, patients, and their relatives to wash hands more frequently. It will convince nurses to embrace the practice of washing hands after feeding patients, preparing beds, in between drug administration, and after assessing patients. This plan will not only be cost-effective in the long run but will also make handwashing a norm amongst the nursing home fraternity. Such an initiative will reduce the prevalence of germs within the nursing home environment. The plan capitalizes on the evidence that proper handwashing minimizes the rate of infection of multi-drug resistant pathogens. Since hand washing reflects peoples’ beliefs and attitudes, the effective way to increase its acceptability is by educating the target population continuously. The acceptability of effective hand washing practices remains low in many healthcare institutions, such that barely 40 percent of these institutions implement the recommended methods (Mathur, 2011). This project aims to improve the acceptability level..

Target Audience -This project targets clients, staff members, and clients’ relatives. The interaction of these different groups is somewhat unavoidable yet impactful in the spread of healthcare-related infections. Contact takes place in various circumstances, including during feeding, administering medicine, and dressing wounds. In such cases, bacteria and other pathogens move from one person to another. At the same time, microorganisms spread among the patient environment, including bed furniture, gowns, linen, and other components. The skin sheds about a million epithelial cells daily, and with these cells spread viable pathogens (Mathur, 2011). Therefore, the health care setting is a highly risky environment that endangers health care workers, patients, and anyone else who comes into contact with equipment and utilities of this environment. Education should, therefore, target all the affected groups.

Benefits Research evidence suggests that hand washing minimizes acquisition and healthcare-associated infections. Some pathogens are highly resistant and difficult to eradicate by sanitization. The use of antiseptics cannot eliminate S. aureus (methicillin-resistant), Candida spp., and Clostridium difficle, among other resistant pathogens (Mathur, 2011). These microorganisms require handwashing with soap to increase the chances of shedding them from the skin. One advantage of handwashing is that it is relatively inexpensive. Also, it will help to achieve the zero preventable deaths initiative, which argues that medical errors are possible to avoid (Patient Safety Movement, n.d.). One of the ways to achieve that goal is through hand washing. This project fortifies a global initiative of transformational change that allows organizations to improve patient safety. The project joins a worldwide initiative that will allow the exchange of knowledge for continuous improvement that will help achieve the globally envisioned goal, “Clean Care is Safer Care” (WHO, n.d.).

Inter-Professional Collaboration Health care is not a separate discipline in that it requires a partnership among different specialties and professionals. Similarly, the handwashing project involves the collaboration of different professionals within the nursing home setting. They include the administrative staff members (typically headed by the Director of Operations), direct care personnel (certified and licensed nurses), Human Resource Managers and staff (typically Nursing Managers), and the support staff (usually cleaners, meal preparers, and maintenance staff under supervisors (Rosado, n.d.)). Association is vital for these different players to ensure that the project gains adequate funding, proper management of the finances, and smooth implementation and support.

The Cost/Budget Justification According to (Luangasanatip et al., 2018), it would cost around 1,743 US dollars to increase the hand hygiene compliance of an adult Intensive Care Unit from ten to forty percent “for every 10,000 bed-days with 3.7 quality-adjusted life-years.” The authors argue further that hand hygiene intervention projects are always cost-effective whenever the initial compliance does not exceed 20 percent. Cost-effectiveness, coupled with other benefits, justifies the implementation of a handwashing project. Numerous advantages exist which support the application. Lee, Hong & Kim (2015) argue, for example, that hand washing (with soap) reduces waterborne and foodborne diseases by percentages as high as 50 to 70. There exist numerous disorders for which the practice has proved to be effective in reducing. They include SARS, contagious eye disease, and cholera (Lee, Hong & Kim, 2015). Given these advantages, and bearing the economic nature of its implementation, it is reasonable to campaign for hand washing practices in the nursing home for the welfare of clients and the entire nursing home fraternity.

 The Basis for Evaluation One of the ways of assessing the effectiveness of a quality improvement initiative is to choose a performance metric (or more) through which the sponsor can measure a variety of issues. For instance, such measures may determine the level of acceptance, the perceived patient experience changes, and the effect on care delivery (AHRQ, 2020). In the context of the handwashing project, a pragmatic measure that is consistent with prior research is the level of acceptance among clients and health care workers. Measurement may take numerous forms, such as recording the number of clients that utilize handwashing facilities per day and the frequency of use.

References

AHRQ. (2020). Section 4: Ways To Approach the Quality Improvement Process (Page 1 of 2). Retrieved 14 March 2020, from https://www.ahrq.gov/cahps/quality-improvement/improvement-guide/4-approach-qi-process/index.html

Lee, M. S., Hong, S. J., & Kim, Y. T. (2015). Handwashing with soap and national handwashing projects in Korea: focus on the National Handwashing Survey, 2006-2014. Epidemiology and health, 37.

Luangasanatip, N., Hongsuwan, M., Lubell, Y., Limmathurotsakul, D., Srisamang, P., Day, N. P. J., … & Cooper, B. S. (2018). Cost-effectiveness of interventions to improve hand hygiene in healthcare workers in middle-income hospital settings: a model-based analysis. Journal of Hospital Infection, 100(2), 165-175.

Mathur, P. (2011). Hand hygiene: back to the basics of infection control. The Indian journal of medical research, 134(5), 611.

Patient Safety Movement. Retrieved 13 March 2020, from https://patientsafetymovement.org/

Rosado, James. (n.d.). What Are the Business Organizational Structures of a Nursing Home? Small Business – Chron.com. Retrieved from http://smallbusiness.chron.com/business-organizational-structures-nursing-home-75958.html

WHO. Benefits of Hand Hygiene Campaigns. Retrieved 13 March 2020, from https://www.who.int/gpsc/national_campaigns/hand_hygiene/en/