Developingan Implementation Plan
Methodof obtaining Necessary Approval
The hospital management is supposed to prioritize the health of thepatient, and they will reject any plan that does not consider that.Hence, the project will have to be assessed by the Institution ReviewBoard (IRB) to ensure that it is focused on the patient’s safety.Besides that, the IRB also meets and interacts with projectparticipants to make sure that they are in their right mind status.In this case, the approval of the IRB will most certainly influencethe support of the organization. The IRB’s approval will confirmthat the project participants have the ability to establish that eachelement meets the standards required. In fact, it will also highlightthe mental, emotional as well as the physical risks that theparticipants will be exposed to. With its approval, the project willbe safe for everyone since no one will be afraid of any consequencesthat might arise later. More importantly, the “Code of FederationRegulations, 45 CFR 46.102d” section also analyzes if a particularresearch involving humans meet all the requirements needed. Themanagement will accept the proposal if it is accompanied by the IRB’sreview and approval. More specifically, the project requires a highfinancial budget, and that also needs the approval and the support ofthe organization’s management. The employees also are aninstrumental part of the implementation since they are the ones thatwill participate directly in the process of making it a success.Hence, the employees will be notified that they will be helping inprotecting the patients from the nosocomial infections to win theirtrust and support too. They will access all the materials needed sothat they will understand the role that they will be playing in theentire scenario.
Descriptionof Current Problem that Requires a Change
The high rate of the nosocomial infections in the hospital settingshowed the need for improvement. For instance, the hospitaldetermined the increased morbidity rate was a result of theunhygienic conditions in the oncology unit. Hence, the managementdecided that the right approach was urging the nurses to adopt a handwashing approach to improve the hygiene in the units. The mostconvenient approach at that time was the nurses using soap and waterin washing their hands to destroy the germs. In most cases, thenurses were urged to use the antimicrobial soaps that are used inkilling some of the pathogens that are more likely to result in thehigh rate of the nosocomial infections. In particular, thehandshaking, holding medicinal and surgical equipment and othergadgets in the hospital are some of the activities that result in thecontaminated hands (Barrera et al., 2011). Hence, the hand washingprocedure was effective in minimizing the spread of the pathogensthat might result in the nosocomial infections. In this case, theoncology unit has cancer patients that are in their advanced stages,and they are often undergoing chemotherapy and other treatmentapproaches. Chemotherapy often weakens the immunity of the patients,and that leaves them vulnerable to the nosocomial infections. In theprocess, the cancer patients are more likely to contract theinfections but, the hand washing approach was introduced to help inreducing the spread of the diseases too.
DetailedExplanation of Proposed Solution
The use of the soap and water in hand washing was ineffective inreducing the nosocomial infections, and that led to the alcohol-basedhand rubs. In this case, the alcohol-based hand rubs provided abetter way of minimizing the morbidity rate in the hospital. Nursingis supposed to prioritize the safety of the patients, and if oneapproach does not work, then it is advisable if the managementimplements another approach that is much more effective in thelong-run. However, the use of the hand rubs will reduce theinfections sufficiently, if the management insists on the strictcompliance with the guidelines. In some cases, the nurses might usethe hand rubs once in a day, and that will make the implementation ofthe process much more difficult. Instead, there is the need to ensurethat the nurses comply with the standards as defined by the WHO toconfirm that the organization is free from the pathogens thatincrease the rate of infections. More importantly, the availabilityof the pocket bottles that have the alcohol substance used in washingthe hands is also more appropriate. For instance, the nurses will beable to use their hands any time that they are in contact with thepatient and they have to initiate care or treatment as well. Besidesthat, the specific point of care should have a significant number ofthe alcohol hand rubs that will be used in removing any signs of thepathogens. By reducing the hand transmission, the oncology unit willbe a safer place for the cancer patients that are exposed to theinfections. At times, the scent of the alcohol hand rubs might beannoying, and that will ensure that the hospital provides enoughsupply of the lotions, creams as well as the disposable towels thatwill be effective in ensuring that the hand washing process is moreefficient in the long run.
Rationalefor Selecting Proposed Solution
The high morbidity rate of the nosocomial infections in the oncologywas the reason for the project. In this case, the present approachused in reducing the infections was somehow inefficient since it wasunable to have a positive impact on the scenario. For instance, theuse of the soap and water in the hand washing activities did not workout as expected. The nursing department needs to ensure that thepatients are safe and free from nosocomial infections that evenundermines the recovery process (Huskins et al., 2011). The cancerpatients in the oncology unit tend to be vulnerable to the pathogenssince the chemotherapy treatment weakens their immunity. Hence, therewas the need to protect the patients from the severe spread of theinfections that even undermine their safety. The high morbidity andthe mortality rate arising from the infections were creating a badname for the hospital management. In the process, the implementationof the alcohol hand-rub was an efficient way of managing theincreased rate of contamination. The project was also a process ofimproving the quality of care in the hospital and ensuring that thepatients are satisfied by the services (Huskins et al., 2011). Theproblem made the hospital seem like an unsafe place where thepatients are exposed to the hospital acquired infections. Hence, theimplementation of the project will also reassure the patients intobelieving that the hospital is a safe place where they can access therequired medical attention. All in all, the project will help thehospital in reassuring the patients of how credible the quality ofcare is.
Evidencefrom Review of Literature in Topic 2
According to Barrera et al., (2011) the alcohol hand rubs areeffective when they are used efficiently since they reduced the rateof central line-associated bloodstream infection morbidity by (-12.7%per year P < .001). The statistics prove that the properimplementation of the project will be helpful in making sure that thepatients are safe from the nosocomial infections as well. Chen et al.(2011) insist that the increase of the conformity rate from 43.3% in2004 to 95.6% in 2007 helped in reducing the nosocomial infections’morbidity cases by 8.9% in one year. More importantly, the statisticsillustrate how the compliance with the WHO guidelines on the handhygiene is quite appropriate in ensuring that the hospital managementreduces the likelihood of the infections spreading among thepatients. Yeung et al. (2011), on the other hand, shows that theappropriate use of the alcohol-based hand gels helped in reducing thepneumonia infection from 0.91 to 0.28 cases. Besides that, the samehand hygiene approach was responsible for minimizing the mortalitycases from 0.37 to 0.10 in every 1000 resident days. In this case,the various scholars have shown that the project will be moreeffective in reducing the rate of infections in the oncology unit. Italso shows that the proper compliance with the guidelines willprovide the expected results. The failure to comply with the measureswill most certainly lead to the higher rate of the nosocomialinfections.
Descriptionof Implementation Logistics
The implementation process will be categorized into six phases thatwill cover all the detailed aspects needed to make it successful. Inthis case, the first phase will be justifying the credibility of theproject before the IRB and the management to get their approval. Theapproval being an important aspect, the other parties will haveconfidence in its viability in the long-run. After the approval, thesecond phase will commence immediately to make sure that all theparts required are in place. For instance, the phase will need theplanning and the design in which the project will be implementedsuccessfully. Besides that, there is the need to create somesustainable sources of the funds that will provide enough cash topurchase the resources needed. After getting the funds, budgetingwill be more important to make sure that the available cash is usedsufficiently and ensuring that it will assemble all the requiredresources. Besides that, the third phase will focus on evaluating theviability of the project by considering its strengths and theweaknesses that might occur along the way. The analysis will alsoevaluate any possible solutions that might be used in handling theweaknesses that the project might illustrate. The phase will considerthe availability and the sustainability of the resources as well. Thefourth phase will focus on the education of the health officers andother employees in the organization. In fact, seminars will beeffective in sensitizing the employees on what they will be expectedto do. The fifth phase should be implemented within a ten monthperiod after the IRB had approved the project. The phase will alsoinitiate the official launch of the project and make sure that theorganization and the employees are well-prepared for the execution ofthe detailed steps.
ResourcesRequired for Implementation
The project will also need a huge amount of resources to help in theimplementation and the planning stages. In this case, the educationalmaterials are some of the important aspects that are required. Moreimportantly, the project needs the full participation of the nursesand the other employees in the organization. For instance, the nursesare the ones that will be expected to implement some of the goals tomake sure that the project succeeds. Hence, the education materialssuch as the pamphlets, PowerPoint presentations, posters as well ashandouts that will have the critical concepts needed. The awarenesswill be effective in ensuring that the employees acquire informationthat will sensitize them on the appropriate steps that they shouldadopt in enacting the project. Besides that, the project will alsoneed funds that will be used in purchasing all the required equipmentthat will be used in the hand washing procedures. Apart from that,the funds will be used to pay the salaries of the lawyers, planners,and designers as well as the accountants that will be instrumental inthe implementation process. The lawyer deals with any issues to dowith the legal advice, the legality of the project, any damages thatmight arise if the participant or a nurse is injured in the course ofexecuting the process. The accountant is in charge of the funds aswell as the budgeting process that will determine the right directionthat the project will need. All in all, the entire process will needresources that will make sure the project is enacted successfully.
Barrera, L., Zingg, W., Mendez, F., & Pittet, D. (2011).Effectiveness of a hand hygiene promotion strategy usingalcohol-based handrub in 6 intensive care units in Colombia. Americanjournal of infection control, 39(8), 633-639.
Chen, Y. C., Sheng, W. H., Wang, J. T., Chang, S. C., Lin, H. C.,Tien, K. L., … & Tsai, K. S. (2011). Effectiveness andlimitations of hand hygiene promotion on decreasinghealthcare–associated infections. PLoS One, 6(11),e27163.
Huskins, W. C., Huckabee, C. M., O`Grady, N. P., Murray, P.,Kopetskie, H., Zimmer, L., … & Wallace, D. (2011). Interventionto reduce transmission of resistant bacteria in intensive care. NewEngland Journal of Medicine, 364(15), 1407-1418.
Yeung, W. K., Tam, W. S. W., & Wong, T. W. (2011). Clusteredrandomized controlled trial of a hand hygiene intervention involvingpocket-sized containers of alcohol-based hand rub for the control ofinfections in long-term care facilities. Infection Control &Hospital Epidemiology, 32(01), 67-76.