EBP Hand Hygiene

EBP Hand Hygiene Due to the increased rates of infections that are acquired in hospitals, there have been attempts to fight to them in the United States hospitals. These infections are responsible for more than 90, 000 deaths that occur annually. One of the methods that have been tried to fight the infections is the use of Patient Hand Hygiene Protocol (PHHP) to reduce hospital-acquired infections (HCIs) and improve nurses’ hand washing compliance. This presentation covers the facts about the use of PHHP to reduce HCIs as well as improving hand-washing compliance by nurses in hospitals. It also covers the recommendations to hospitals and nurses on hand hygiene protocol. Facts Obtained from the Article Proper implementation of PHHP in hospitals can reduce infection rates and improve nurses’ hand washing compliance. It can be used to prevent the deaths that are brought about by the infections. For proper usage, PHHP should be applied three times in a day between equal intervals. The nurses should be trained and educated thoroughly so that the protocol yields maximum effectiveness. A lot of precautions should be taken when using chlorhexidine gluconate (CHG) as a PHHP method to avoid harming the patients. Patients’ hands should be inspected severally to ensure they are free from wounds, blisters, or cracks. Nurses should also identify the patients who are allergic to CHG and exclude them from the protocol. They should also educate the patients the effects of the CHG on the mucous membrane such the eyes; it causes redness and irritation (Fox, et. Al, 2015). Nurses have a responsibility for encouraging the patients as well as their families to ask questions. They should provide answers to all the questions politely and to the best of their knowledge. In case the patients’ need writing materials to write down questions, nurses should be willing to provide for them. Nurses are also obliged to communicate the next steps of treatment, for example, surgery, to the patients and families (AHRQ, 2017). Isolation is also used to control hospital infections. In diseases such as Neutropenia, diarrhea, and skin rashes, isolation is the best measure that can be used to prevent the diseases from spreading among patients (Abhinav, et al., 2017). Nurses should wear protective gloves to avoid infecting patients with germs in their hands. They should also avoid wearing long sleeves or ties while handling patients. Adequate eye protection or face masks should be worn in procedures that are likely to generate body fluid splashes to prevent the mucous membrane from contamination. Antimicrobial soap and water can be used to wash patients who are allergic to CHG. Alcohol-based hand rubs can also be used as a substitute. Nurses are also advised not to wear hand jewelry such as watch and bracelets during surgery (Abhinav, et al., 2017). Recommendation for Practice Hospitals should adopt the use of hand hygiene protocols to reduce the spread of infections in hospitals and the deaths that are associated with them. The hospital management should ensure that the nurses use the protocol on the patients three times a day. Nurses should be trained and educated on the importance of using the PHHP in reducing HCIs in hospitals. Nurses should observe universal precaution when attending patients. They should wear protective equipment when coming into contact with some body fluids such as blood and amniotic fluid. They should wear protective gown to prevent them from getting soiled during procedures that are likely to cause blood or body splashes. The soiled gown should be removed immediately and with a lot of care to avoid contamination. They should also be made aware of the proper application of hand hygiene protocol to ensure it is effective. The risks associated with the protocol, for example, using CHG on an open wound, should also be brought to their attention. The patients should also be sensitized on precautions to observe when under the protocol medication, for example, they should not touch their eyes when their hands are wet of CHG to avoid irritation. The patients whose hands have wounds should also be advised not get in touch with CHG protocol. Catheter dressing should be replaced immediately when they get damp or loosen. Patients should not be afraid to ask nurses to wash their hands before attending to them. They should obey the instructions they are given by nurses and ask questions for clarification (Preventing Infections in the Hospital, 2017). The family members and friends who visit the patients should observe hand hygiene to avoid spreading of HCIs. Conclusion The study on the use of hand hygiene has paved the way for preventing the deaths that occur annually as a result of infections that are acquired in hospitals. The government should ensure that hospitals employ the use of PHHP in fighting the spread of infections in hospitals. Nurses should adopt safety-minded attitude to control the rate of spreading of infections in hospitals. Nurses should use they knowledge, skills, and judgments to prevent HCIs in hospitals.

Summary Of The Night Before The Wedding - 1349 Words

Words and Reference Page 240, middle, Piteously Page 241, last 6’th line, Portmanteau Page 247, first paragraph, Intonation Page 248-249, Bigamy. Outmanoeuvered page 250, Acrid, desolate Page 251, Conjugal Page 261, last line, Noxious Page 279, Middle bottom, Parsonage Page 299, Middle half, Ministerial, hosry Page 305, last line, Granage Summary The night before the wedding Jane can not sleep, and as she walks through the garden she sees the tree that was split, and Jane tells Rochester of what she saw and all the strange things that have happened while he was gone. Jane then receives her wedding dress with a expensive veil (which was Rochester’s gift to Jane) Jane had a dream of a child falling from her knee which scared her and woke her up, but when she woke up saw someone in the closet, and it was a stranger that looked like a poor women who tore Jane’s Veil into two. Rochester says he will explain everything to Jane after a year and a day. Sophie helps Jane get ready for the wedding, and Jane and Rochester walk to the church to be wed, There is a stranger who objected to Jane and John’s marriage, and the stranger says that Rochester is already married to another woman whom he married 15 years ago. The stranger then says his name is Mr. Briggs and shows a letter that said he was married to Mason’s sister Bertha. The other stranger is Mr. Mason Rochester admits that he has a wife already (Bertha) and Jane would become his second wife. Rochester shows everyone where heShow MoreRelatedResearch Proposal : Evolution Of Wedding Ceremony729 Words   |  3 PagesResearch Proposal: Evolution of wedding ceremony in Dhaka Date: October 11, 2017 To: Ms. Nasrin Pervin From: M. Alif Ur Rahman, ID#141 012 0042, ENG 105, Sec: 25 Subject: Proposal to conduct a research project on the evolution of wedding ceremonies in Dhaka INTRODUCTION A Bengali wedding is a mixture of unique tradition, culture and rituals. 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Evidence Based Practice in Nursing Clinical Expertise

Question: Discuss about theEvidence Based Practice in Nursingfor Clinical Expertise. Answer: Introduction Evidence-based practice is a dynamic process that entails deliberate integration of a nurses cumulative clinical expertise, the best and current available scientific evidence and patients preferences and values in providing the highest possible quality care (Felice 2014). To ensure the success of this practice, the nurses mandated in its execution should acquire the requisite competency and skills. This is in line with the Nursing and Midwifery Board of Australia (NMBA) that has propounded stringent professional and competency for registering nurses (Australia, 2015). In contemporary health care practice, nurses have the mandate of using evidence based practice (EBP) however, it is expected that they are not in the frontline during its implementation because of many substantiated reasons. In this regard, nurses have a right to defend themselves as far as underutilization of EBP is concerned (Seers, Crichton, Martin, Coulson, Carroll, 2008). This paper explores this position, that nu rses are not able to fully implement EBP even though it is the most effective approach in care of patients. Furthermore, it will discuss some ways in which EBP improves patient outcome, how it is applied and some barriers towards its uptake. The widespread utilization of evidence-based practice in nursing care has had a positive impact on the outcome of the patients and their families according to a randomized controlled trial done in Southern Melbourne by Dr. Melnynk and group (Melnynk Fineout, 2015). One of the core aspect championed by this practice is a collaborative approach to care. In this approach, a forum whereby different professionals with different expertise work in close collaboration to ensure optimal care of the patient is created. Each professional in this team comes on board with a different approach to tackling a given menace. The net result of this collaboration is the better patient outcome. Also, this partnership ensures that there is no duplication of services. Apart from seeing that the institutions meager resources are properly utilized, it also relieves the patient and family from unnecessary additional costs (Melnynk Fineout, 2015). Evidence based practice has been proved to be underutilized by the profession of nursing (Glasziou, 2015) as Paul Glasziou puts it after conducting a randomized controlled trial in 2015 on 200 nurses in a period of three years. Their use of EBP in patient care was substandard throughout the study (Glasziou, 2015). The evidence-based practice embraces the integration of the best and presents available scientific evidence in the planning and during the discharge of care. This aspect of the practice attempts to ensure that the entire healthcare is standardized and that all discharged care has a scientific backup.This will hinder nurses from executing illogical nursing interventions with unknown and unpredictable results. When this aspect is critically upheld in the clinical area, patient s safety will be protected thus an improvement in the outcomes of care (Watt Snowdon, 2013). Another promising aspect of this practice is that, during the entire process of planning and giving care, patients preferences, values, attitudes, and beliefs are taken into consideration. It is a patient and family-centered process. The nurse and the patient work collaboratively during the coming up of the plan of care to ensure that it is relevant to the patient and his/her family. This aspect also ensures that the care is discharged in the culturally safe environment. Consequently, this will go a long way in creating a trusting and understanding environment where patients will express themselves freely. All these will culminate in proper nursing assessment thus improving patients outcome (Stevens, 2014) The evidence-based practice comes into practicability when the nurse encounters a patient. The critical thinking skill is paramount in the utilization of this practice. This engagement generates questions about the entire or some parts of the treatment and culminates in the nurse coming up with the clinical problem, for instance, a nurse who has just met a patient with a wound, may identify the clinical problem to be the management of a wound. After identifying the case or clinical problem, the nurse then develops a well-structured clinical question out of the case e.g. how to manage a chronic wound (Kim Mallory,2014) Afterward, the nurse critically selects the proper resources and tools and thoroughly conducts research to tackle the pre-determined clinical question(s).This is a time-consuming stage whereby the nurse is required to be accustomed to a wide range of current published literature. For this to materialize, the institutions should endeavor to see that relevant resources are at the disposal of the staff to engineer learning and for easy search (Sansee, Johnson Welch, 2014). In addition, proper working environments should be created for nurses. This includes adequate staffing to ensure that there is manageable workload. This will offer nurses sufficient time to conduct research for their clinical questions thus furthering their professional development (Fink, Thompson Bones, 2013). Before putting the gathered evidence into clinical practice, the nurse keenly, scrutinizes the evidence to determine its proximity to the truth and whether it can have a positive impact if applied in the clinical practice. This entails cultivating interprofessional and consultative avenues. In addition, this also involves being flexible and ready to accept, and value inputs from other professionals who, in one way or another are involved in the management of the patient. The appraisal of the evidence is paramount as it promotes quality of care and ensures that patient safety is enhanced (Pravikoff Pierce, 2016). After appraising the evidence and determining its usefulness in the clinical practice, the nurse returns to his/her patient for implementation. Here the nurse exercises flexibility by listening and taking into account the patient s preferences. The nurse and the patient work collaboratively in the development of the plan of care. Afterward, the nurse integrates his /her acquired expertise in practice, patient values and beliefs and the scientifically proven evidence in managing the patients condition. In addition to this aspect, all interventions and evidences should be clearly documented for accountability (Emerson, 2015). The last phase of this process is the evaluation of the effectiveness of care discharged or if the clinical question was answered. It is the nurses responsibility to see that the pre-determined goals are achieved. If the goals are not achieved and since this is a continuous process, the process starts over again but with a different approach. This phase of the practice also entails sharing the finding with others through writing. (Steven, 2014) Although nurses in Australia have demonstrated a positive attitude towards the implementation of evidence-based practice, still numerous roadblocks are curtailing its smooth implementation. These hindrances are partly related to institutional structure and individual nurse factors. A systematic review on the impediments of nursing implementation of EBP done by PubMed Central (PMC) found that the nurses involved did not practice EBP for at least five days in a week. It concluded that many of them do not have preliminary knowledge and skills. A blame was put on the system of education (Dizon, 2009). Despite the endeavors of NMBA to ensure that all health institutions have enough nurses, still some have not met the required threshold (Australia, 2015). Daily, numerous literatures are discharged from different sources. Consequently, nurses need a lot of time daily to keep updated with present evidence. Unfortunately, due to this inadequacy of workforce, the nurses stay engrossed in their work for long hours, and this denies them a chance to stay abreast with the current evidence. Moreover, some health facilities in the country, especially in remote areas,are not endowed with the requisite facilities that are crucial for the implementation of this practice. Such incentives include a well-equipped library and internet connectivity. Furthermore, some institutions policies do not mandate nurses to alter the patients care procedure (Felice, 2014). As aforementioned, sound education background, skills, professional and competency standards are crucial in the implementation and success of this core practice. Lack of these key aspects can pose as a barrier to its growth according to Vivian Coates finding on EBP utilization on diabetic patients (Schultz, Harmsen, Spronk, 2010). Nurses did not understand the evidence behind administration of glucose when a diabetic has hypoglycemia. Failure of some nurses to comprehend and interpret statistical terms and the language used in research has been the core impediment in fishing out the valuable evidence glued in many kinds of literature. Moreover, wanting IT skills and searching expertise among nurses has deeply curtailed the sourcing of appropriate information to enhance better patient care. Furthermore, most nurses lack proper communication skills and this has hindered the mushrooming of the evidenced based practice. Coates concluded that more than 50% of the nurses did not document patient information in the standard way thus covering less details about diabetes. This is due to the inability of some nurses to clearly deliver the acquired evidence to patients (Emersion, 2015). Consequently, for the sake of making this practice a success, Bergstrom strongly advocates that only thoroughly trained and people who have sound knowledge of the EBP principles to be involved in its championing and implementation (Bergstrom, 2008). This is based on a randomized controlled trial carried out in California which found that nursing trainers have less research knowledge (Bergstrom, 2008). Unfamiliarity with the principles of the evidence-based practice may result in its impartial utilization. Also, this practice requires that the nurse sorts and critiques the literature to acquire the best evidence that will result in high-quality service. Lack of training may lead to using inappropriate evidence in clinical practice that will jeopardize the patients safety and health (Emersion, 2015). In conclusion, evidence-based practice is a life changing practice if properly executed. The Australian Health Practitioner Regulating Agency, The NMBA, and government should collaborate to see that all barriers to its success area averted. This includes proper training of nurses while incorporating its principles early in their career. Various randomized controlled trials and systematic reviews have presented evidence about the challenges that nurses have in EBP implementation. References Australia. (2015). Nursing in Australia. Canberra: A.G.P. Bergstrom, N. (2008). The gap between discovery and practice implementation in evidence-based practice. International Journal Of Evidence-Based Healthcare, 6(2), 135-136. https://pt.wkhealth.com/pt/re/lwwgateway/landingpage.htm;jsessionid=YHnGvTPrRvbBTNY9Y5pFSLJNXQyt2xngSFM6ThYHTGjW9QJWnMgv!-1552860756!181195628!8091!-1?sid=WKPTLP:landingpagean=01258363-200806000-00001 Dizon, J. (2009). A systematic review of the effectiveness of evidence based practice (EBP) educational programs in enhancing knowledge, skills, attitudes and behaviour of allied health practitioners. International Journal Of Evidence-Based Healthcare, 7(3), 207. https://pt.wkhealth.com/pt/re/lwwgateway/landingpage.htm;jsessionid=YHnpwhLWJ2F2hRk1xr6hmzqs2ymTt5nqy4bGL8y25PbxDkRpCl3Y!-1552860756!181195628!8091!-1?sid=WKPTLP:landingpagean=01258363-200909000-00019 Emerson, T. S. (2014). Barriers to Evidence practice. Albany, state university of New York Felice,W.(2014). Evidence Based Practice.Elsevier,Sydney Fink, R., Thompson, C. J., Bonnes, D. (2005). Overcoming barriers and promoting the use of Research in evidence-based practice. Journal of Nursing Administration, 35 (3), 121129. Glasziou, P. (2015). The paths from research to improved health outcomes. Evidence-Based Nursing, 8(2), 36-38. https://ebn.bmj.com/content/8/2/36 Kim, M. J., Mallory, C. (2014). Statistics for evidence-based practice in nursing. Burlington, MA: Jones Bartlett Learning Melnyk, B. M., Fineout, E. (2015). Evidence-based practice in nursing healthcare.SouthMelbourne, OxfordUniversityPress. Pooler, A. (2014). An Introduction to Evidence-based Practice in Nursing Healthcare: New York, Pantheon. Pravikoff .T Pierce, S.T. (2016). Readiness of Australia nurses for evidence-based Practice. Australian Journal of Nursing, 105 (9), 4051. Sansnee, J, Johnson, M., Welch, A. (2014). Research methods in nursing and midwifery: Pathways to evidence-based practice:Phildephia,Elsevier Schultz, M., Harmsen, R., Spronk, P. (2010). Clinical review: Strict or loose glycemic control in critically ill patients - implementing best available evidence from randomized controlled trials. Critical Care, 14(3), 223. https://ccforum.biomedcentral.com/articles/10.1186/cc8966 Seers, K., Crichton, N., Martin, J., Coulson, K., Carroll, D. (2008). A randomised controlled trial to assess the effectiveness of a single session of nurse administered massage for short term relief of chronic non-malignant pain. BMC Nurs, 7(1). https://bmcnurs.biomedcentral.com/articles/10.1186/1472-6955-7-10 Steven,K. Low,V .(2015).An instrument to means in means Evidence Based Practise readiness in student clinical population,Auckland,Woolong press Stevens K.R.(2014).Delivering on the Promises of Evidence Basesd Practise:Nursing Management,Philadephia:Lippincott,WilliamsWilkins Watts, Snowdon, T. (2013). General and I practice nursing in Australia. Royal Australian College of General Practitioners and Royal College of Nursing, Australia: Canberra, Australia