NURS FPX 8030 Assessment 4 Methods and Measurement
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Despite significant efforts and interventions, hospital-acquired infections (HAIs) are still one of the most serious issues today, with 150-300 million patients affected annually, according to (Puro et al., 2022). The Director of Clinical Operations and Nursing Excellence would use the proper and well-tested procedures to guarantee that many patients are away from health system-acquired infections. The alternative here is to ensure the program is implemented and monitored, which is the right way for hand hygiene. In this context, it is necessary to measure the success of such interventions to address this HAI problem. The choice of proper tools to measure it out is, however, critical for the success of this undertaking. The four stages of the PDSA model, namely Plan, Do, Study, and Act can support such changes in hospitals and nursing practice (Harkness & Pullen, 2019). The feature this application provides allows the team to do the pilot tests and further extend the initial practice after the expiry of the trial period (NHS England, 2021).
Instruments for Evaluation of Implementations Plan
Many methods exist for light measurement, especially for the intervention plan. Two appropriate instruments can be used to determine the effectiveness of hand hygiene improvement programs in reducing the risk of HAIs: Two proper instruments can be used to evaluate the effectiveness of hand hygiene improvement programs in reducing the risk of HAIs:
WHO Framework Tool
WHO (World Health Organization) has designed a WHO (World Health Organization) has a set of operational procedures for evaluating compliance with hand hygiene. It is an instrument to measure the exact sensitivity of hand hygiene in an area. So, it gives a rate of hand hygiene compliance before and after the intervention, therefore comparing it with how effective the program is. This analytical tool will offer us quantitative details of how frequently people have done the right-hand hygiene practices. We can then use data to identify issues and their solutions. (WHO, 2023).
Standardized Infection Ratio (SIR)
SIR is a parameter of the Centers for Disease Control and Prevention (CDC) used when assessing and comparing the state of HAIs in various hospitals. One can get an infection risk ratio for a healthcare setting by comparing the HAIs seen there with the number of HAIs that would typically occur there. If the ratio is more significant than 1, HAI is more prevalent than anticipated within the facility. The SIR statistic is a valuable instrument for determining the extent of HAIs encountered in hospitals as it provides a basis for comparing facilities over time.
HAI incidence rate = Total observed infections / Total number of predicted infections
(CDC, 2022)
It is appropriate to use both of the tools in question that might be indicative of the effectiveness of the program for hand hygiene improvement linked to the reduction of HAI. The hand hygiene adherence monitoring device developed by WHO permits compiling the number of times that healthcare workers wash their hands in adherence to a hand hygiene regimen. This makes it possible to evaluate the impact of the program on the hand hygiene practice as a whole. The advantage of SIR is the ability to calculate the speed of hospital-acquired infections in hospitals with meaningful comparisons of infection rates among the different healthcare facilities, providing continuous information vital for infection prevention and control effectiveness. Using both tools will yield a deeper insight into assessing hand hygiene improvement program implementation.
Construct Analysis
WHO Hand Hygiene Self-Assessment Framework is a hand hygiene direct application control device designed by WHO. Professionals to see how often healthcare workers comply with hand hygiene protocol (de Kraker et al., 2022). It comprises the 5 designated components in the WHO’s (Tartari et al., 2019) multimodal hand hygiene plan. The device is based on a checklist; it monitors healthcare workers while passing their care to patients. The checklist includes hand hygiene at different times before and after the patient’s contact and taking steps like sterilization and gloves for the procedure and after body fluid exposure. Compliance is defined as the number of hand hygiene incidents carried out of the number of hand hygiene opportunities for each person. It was validated, and reliability was assessed in a multi-center trial where participants rated the tool quite similarly to each other and showed good internal consistency.
The standard infection ratio (SIR) is an essential parameter utilized by healthcare facilities to trace the healthcare-associated infection (HAI) rates and make comparisons between them. The tool was recently unveiled by the CDC, which protects the public health and safety of the U. S. population (Armbrister et al., 2021). The dimension that SIR (es) (e) (w) AIDS (measures) is the rate of (n)HAIs (e) (n)healthcare (facility), which is an essential indicator of (p)HIAs’ (n)quality of care (s) and (o) patient safety. SIR would simply be a rate or percentage calculated by multiplying the number of HAIs over the population size and having a value greater than 1. 0 indicates an elevated rate. The equal is represented by a value of 1 and tells us that the rate is identical to the expectations level. SIR’s efficacy has been demonstrated through prior research and the research conducted on it. The CDC collects data on HAI ratios in healthcare facilities through its accepted definition of HAIs and the nationally recognized surveillance system (Gozel et al., 2021).
Supporting Literature for the Validity of Tools
Nurses can sort out credible account databases and search keywords to obtain the studies and research in which the Hand Hygiene Compliance Monitoring Tool and HAI Incidence Rate tools were used.
Recently, it has been reported (Roshanali, 2022) that an LMIC had come up with an HH program (which was modeled after the World Health Organization (WHO)). The program’s objective was to educate healthcare workers about HH practices and reduce the incidence of HAI by using the WHO Guidelines on Hand Hygiene. The funds, advertisements, and operations were regularly monitored to ensure the problem was resolved.
The report outlined that every hospital in the LMICs should follow the WHO administration manual as an indicator and lower the possibility of infection in the ward. This study specifies that this tool is a vehicle for thought-provoking sources of solutions and assisting in tackling future problems (Roshanali, 2022). Overall, this article brings to light the level of HH in HAI prevention and the possibility of the role of WHO in the coincidence of HH practices in LMIC cities.
A study was conducted to assess the rates of two HAIs: Catheter-Associated Urinary Tract Infection (CAUTI), and Central Line-Associated Bloodstream Infections (CLABSI) are some of the hospital infections that are experienced in some hospitals in Turkish (Can et al. 2020). The main goal was to determine the standardized infection ratio (SIR) and the cumulative attributable difference (CAD) related to catheter-related bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs). The researchers, however, used the definitions from the NHSN for CLABSI and CAUTI and calculated the SIR and CAD using the NHSN’s methodology.
A significant reduction of CLABSI and CAUTI incidence in ICUs was observed in the study findings. 87 and 0. 64, respectively. The study lesson is about reinforcing, preventing, and controlling infections in Turkish hospitals. One such example is SIRs, EDUCATION, and HA clinical surveillance, which enables continuous rating of interventions’ impact (Can et al., 2020).
Similarities and Differences in Studies
Nurse analyses should be done to confirm the research studies’ relevancy to the PICOT issues for which scales or tools are created. To support improving patient care and satisfaction (Tschannen et al.,2020), nurses have to participate in quality improvement healthcare projects.
As both studies indicated, the presentation program is similar in its emphasis on preventing HAIs by evidence-based measures. With this in mind, the WHO recommended a hand hygiene self-assessment framework tool in the Roshanali (2022) satisfactory intervention program for the implementation of lower-middle income countries. In addition, it adopted the same PDSA cycle on which this project is based. Similarly, the comparison made by another group of experts (Can et al., 2020) was centered on evaluating two kinds of infections in hospitals in Turkey. They used the adjusted standardized infection ratio (SIR) as an assessment tool for the intervention outcomes, which is also one of the strategies used in this project. This research recruited the (in intensive care unit or ICU) participants from the hospitals considered acute care facilities. The study was similar to the intervention evaluated in the current project, which focused on a hand hygiene program.
The studies vary since they focus on population size and the monitoring method. During her project, Roshanali (2022) sought to enhance the hand hygiene practices of health workers, unlike this study, which relies on numerous tools as the medium to address HAIs. The research paper by Can et al. (2020) was dedicated to the rates of two HAIs (CLABSI and CAUTI), while this project covers the process of implementing the evidence-based protocol for the reduction of HAIs in a general course. Contrarily, various groups may take part in a study and research. However, the survey by Can et al. (2020) involving healthcare (HCW) workers and administrators in Turkish hospitals contrasts this project, which intended to lower the HAI risks in a single healthcare setting.
Conclusion
Implementing the best evidence of practice to reduce hospital-acquired infection (HAI) has become a necessity in healthcare services. Tools such as the WHO Hand Hygiene Self-Assessment Framework could work together with the Standard Infection Ratio to assist in assessing progress and measuring the efficiency of the interventions focused on reducing HAI rates. Healthcare professionals need to put measures in place and, at the same time, monitor the tools that they use to make sure that the interventions achieve the desired goals.
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References
Armbrister, A. J., Finke, A. M., Long, A. M., Korvink, M., & Gunn, L. H. (2021). Turning up the volume to address biases in predicted healthcare-associated infections and enhance U.S. hospital rankings: A data-driven approach. American Journal of Infection Control, 50(2).
https://doi.org/10.1016/j.ajic.2021.08.014
Can, H., Hekimoğlu, Hüseyin Hekimoğlu, C., & Meşe, A. (2020). The adjusted standardized infection ratio and cumulative attributable difference for central line-associated bloodstream infections and catheter-associated urinary tract infections in Turkey. Journal of Immunology and Clinical Microbiology, 5(1), 41–49.
https://dergipark.org.tr/en/download/article-file/1077347
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CDC. (2022). The NHSN STANDARDIZED INFECTION RATIO (SIR) A Guide to the SIR.
https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf
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de Kraker, M. E. A., Tartari, E., Tomczyk, S., Twyman, A., Francioli, L. C., Cassini, A., Allegranzi, B., & Pittet, D. (2022). Implementation of hand hygiene in health-care facilities: Results from the WHO Hand Hygiene Self-Assessment Framework global survey 2019. The Lancet Infectious Diseases, 22(6).
https://doi.org/10.1016/S1473-3099(21)00618-6
Gozel, M. G., Hekimoglu, C. H., Gozel, E. Y., Batir, E., McLaws, M.-L., & Mese, E. A. (2021). National infection control program in Turkey: The healthcare-associated infection rate experienced over 10 years. American Journal of Infection Control, 49(7), 885–892.
https://doi.org/10.1016/j.ajic.2020.12.013
Harkness, T. L., & Pullen, R. L. (2019). Quality improvement tools for nursing practice. Nursing Made Incredibly Easy!, 17(3), 47–51.
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NHS England. (2021). Plan, Do, Study, Act (PDSA) cycles and the model for improvement (pp. 1–8).
https://www.england.nhs.uk/wp-content/uploads/2022/01/qsir-pdsa-cycles-model-for-improvement.pdf
Retrieved: March 18, 2023.
Puro, V., Coppola, N., Frasca, A., Gentile, I., Luzzaro, F., Peghetti, A., & Sganga, G. (2022). Pillars for preventing and controlling healthcare-associated infections: An Italian expert opinion statement. Antimicrobial Resistance & Infection Control, 11(1).
https://doi.org/10.1186/s13756-022-01125-8
Roshanali, R. (2022). A WHO-guided hand hygiene (HH) journey from basic to advanced level in lower-middle-income countries (LMIC). American Journal of Infection Control, 50(7), S30–S31.
https://doi.org/10.1016/j.ajic.2022.03.046
Tartari, E., Muthukumaran, P., Peters, A., Allegranzi, B., & Pittet, D. (2019). Monitoring your institution: Is the WHO hand hygiene self-assessment framework worth it? Clinical Microbiology and Infection, 25(8), 925–928.
https://doi.org/10.1016/j.cmi.2019.04.009
Tschannen, D., Alexander, C., Tovar, E. G., Ghosh, B., Zellefrow, C., & Milner, K. A. (2020). Development of the nursing quality improvement in practice tool. Journal of Nursing Care Quality, Publish Ahead of Print.
https://doi.org/10.1097/ncq.0000000000000457
WHO. (2023). Hand hygiene tools and resources. Www.who.int.
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