Recommending An Evidence-Based Change: Develop A Proposal ✓ Solved

Recommending an Evidence-Based Change: Develop a proposal fo

Recommending an Evidence-Based Change: Develop a proposal fo

rr an evidence-based change in a geriatric hospital focused on improving hand hygiene through Alcohol-Based Hand Sanitizers (ABHS). Context: The organization values ethical culture and high-quality patient care, emphasizes efficiency and effectiveness of care processes, strong communication and technology use, ongoing training, and evidence-based models. Need for Change: Rise in hospital-acquired infections (HAI), low hand hygiene observance and competencies, COVID-19 context. Risks: resistance, confusion and fatigue, leadership challenges, disruption of other activities, forced change. Proposed change: adoption of ABHS, placement in strategic locations, portability, training, guidelines in print/digital forms. Plan for knowledge transfer: training, role-modeling, access to guidelines, periodic meetings, stakeholder research. Organizational adoption and implementation: leadership support, location of ABHS, posters, rewards. Measurable outcomes: increased ABHS use, reduced HAI, improved quality of care, reduced spread of disease, improved hand hygiene. Lessons learned: ABHS superiority, importance of organizational culture, addressing knowledge gaps. What I Learned: evidence levels, ABHS effectiveness, role of culture in hand hygiene efforts. References: include credible sources.

Paper For Above Instructions

Introduction and context. Hand hygiene is a foundational infection prevention practice in all healthcare settings, and it is particularly critical in geriatric hospitals where residents are highly vulnerable to infections and complications from even minor pathogens (World Health Organization, 2009; Centers for Disease Control and Prevention, 2023). The organization described here embeds an ethical culture that prioritizes quality of care, efficient care processes, robust team communication, and ongoing staff development. This environment provides a fertile ground for implementing an evidence-based change to improve hand hygiene, specifically through the adoption of alcohol-based hand sanitizers (ABHS). The shift aligns with both a moral obligation to minimize patient risk and a practical strategy to enhance care quality with minimal disruption to workflows (Pittet & Boyce, 2001; Allegranzi & Pittet, 2009).

Need for change and evidence base. The rising incidence of hospital-acquired infections (HAI) and observed gaps in hand hygiene compliance create a compelling imperative for change. In geriatric populations, infections can lead to severe morbidity and prolonged hospitalization, underscoring the need for reliable, accessible hand hygiene solutions (World Health Organization, 2009; Lagaya-Aranas, 2016). ABHS have demonstrated superior convenience and equal or superior efficacy in reducing microbial load on hands compared with traditional handwashing in many clinical settings, which can translate into lower HAI rates when properly implemented (Akuoko, 2019; Munoz-Figueroa & Ojo, 2018). The current COVID-19 era further amplifies the importance of hand hygiene as a frontline prevention strategy (Assefa et al., 2020). The literature supports prioritizing ABHS in healthcare facilities when there are appropriate guidelines and training to ensure correct use (Lagaya-Aranas, 2016; World Health Organization, 2009).

Risks and mitigation considerations. Implementing any organizational change carries risks, including staff resistance, confusion, fatigue, and potential leadership gaps that could undermine adoption (Vokes, Bearman, & Bazzoli, 2018). An evidence-based approach anticipates these risks by coupling ABHS deployment with targeted education, role modeling by leaders, and ongoing feedback mechanisms. To mitigate disruption, the plan emphasizes alignment with existing workflows, availability of ABHS at strategic points, and inclusive engagement of all stakeholders (Vokes et al., 2018; World Health Organization, 2009).

Proposed change: ABHS adoption and deployment. The proposed intervention centers on widespread ABHS use, supported by strategic placement in wards, waiting areas, and other high-traffic zones, coupled with portable bottles that staff can carry. ABHS offers rapid, effective hand disinfection between patient contacts and reduces reliance on soap and water when sinks are not readily accessible. The evidence base indicates ABHS can significantly reduce microbial transmission and is often more practical in busy clinical settings (Akuoko, 2019; Assefa et al., 2020). The proposal also includes ensuring ABHS availability does not replace handwashing where it is indicated, but rather complements it to improve overall hand hygiene compliance (Lagaya-Aranas, 2016).

Plan for knowledge transfer and training. A comprehensive knowledge-transfer strategy is essential for sustainable change. Training should cover the correct use of ABHS (including frequency and duration), indications for when soap and water are preferred, and the limitations of ABHS (e.g., visible soiling or certain pathogens). Role-modeling by clinical leaders and supervisors, alongside accessible print and digital guidelines, will reinforce best practices. Regular, brief refreshers and periodic meetings will sustain awareness and address barriers as they arise (Assefa et al., 2020; Munoz-Figueroa & Ojo, 2018). Encouraging stakeholder-led research on ABHS use can foster ownership and continuous improvement (Lagaya-Aranas, 2016).

Organizational adoption and implementation. Adoption requires leadership commitment, resource allocation, and a structured rollout plan. Practical steps include placement of ABHS in strategic locations, demonstrations of pocket ABHS use, visible posters and guidelines on notice boards, and recognition or incentives for departments achieving high compliance. Leadership support should accompany monitoring and feedback to sustain momentum. The organizational context described—prioritizing quality, efficiency, and evidence-based practice—supports these actions and helps ensure integration with existing quality improvement initiatives (Vokes et al., 2018; World Health Organization, 2009).

Measurable outcomes and evaluation. Evaluation should track process and outcome measures to determine effectiveness. Primary process outcomes include high-frequency ABHS use across all stakeholders (physicians, nurses, allied health staff, and ancillary personnel). Primary outcome measures should include reductions in hospital-acquired infections and improvements in patient safety indicators and overall care quality. Additional indicators might include reductions in disease spread within the hospital and improved hand hygiene compliance rates. A robust evaluation plan should include baseline data collection, ongoing monitoring, and a plan for adjusting the intervention based on feedback and outcomes (World Health Organization, 2009; Lagaya-Aranas, 2016).

Lessons learned and knowledge gained. Existing evidence consistently shows ABHS can outperform handwashing in many clinical contexts, particularly when used correctly and when organizational support enables sustained compliance. A strong organizational culture that supports hand hygiene practices, coupled with clear guidelines and leadership role-modeling, emerges as a critical determinant of success (Lagaya-Aranas, 2016; Vokes et al., 2018). Addressing knowledge gaps through training and accessible resources is essential to maximize the impact of ABHS interventions and to prevent superficial compliance that fails to reduce HAIs (Assefa et al., 2020).

What I learned from critical appraisal. The critical appraisal of relevant studies reinforces that high-evidence syntheses (including meta-analyses and well-conducted RCTs) consistently support ABHS as an effective intervention for reducing pathogen transmission in healthcare settings. Organizational culture and leadership support are repeatedly identified as crucial enablers of sustained hand hygiene improvement, while knowledge gaps among staff can undermine implementation if not addressed (Lagaya-Aranas, 2016; Vokes et al., 2018). The integration of ABHS with comprehensive training and ongoing governance yields durable improvements in hand hygiene practices and patient outcomes (World Health Organization, 2009; Munoz-Figueroa & Ojo, 2018).

Conclusion. Implementing ABHS as part of an evidence-based hand hygiene program aligns with the organization’s ethical culture, emphasis on quality, and commitment to evidence-based practice. The proposed change—supported by training, leadership engagement, strategic ABHS placement, and ongoing measurement—offers a scalable approach to reduce HAIs and improve geriatric patient care. By leveraging established guidelines and robust research, the hospital can realize meaningful gains in patient safety while fostering a culture of continuous improvement in infection prevention.

References

  • Centers for Disease Control and Prevention. (2023). Hand Hygiene in Healthcare Settings. Retrieved from https://www.cdc.gov/handhygiene
  • World Health Organization. (2009). WHO Guidelines on Hand Hygiene in Health Care. Geneva: World Health Organization.
  • Allegranzi, B., & Pittet, D. (2009). Role of hand hygiene in preventing infection in healthcare settings. Lancet Infectious Diseases, 9(6), 356-360.
  • Pittet, D., & Boyce, J. (2001). Hand hygiene and infection prevention in healthcare. Lancet, 357(9263), 155-159.
  • Lagaya-Aranas, L. M. O. (2016). Randomized controlled trial comparing the efficacy of 70% isopropyl alcohol hand rub versus standard hand washing for hand hygiene in healthcare workers. Journal of Hospital Infection, 92(2), 123-130.
  • Akuoko, C. P. (2019). Bacterial Reduction of Hand Contamination: Hand Rubbing with Alcohol-Based Solution or Hand Washing with Soap and Water. Journal of Health, Medicine and Nursing, 67(3), 67-69.
  • Assefa, D., Melaku, T., Bayisa, B., & Alemu, S. (2020). COVID-19 Pandemic and its Implication on Hand Hygiene Status by Alcohol-based Hand Sanitizers Among Healthcare Workers in Jimma University Medical Center, Ethiopia. Journal of Infection Prevention, 21(4), 120-126.
  • Munoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising in infection control. British Journal of Nursing, 27(7), 456-463.
  • Vokes, R. A., Bearman, G., & Bazzoli, G. J. (2018). Hospital-acquired infections under pay-for-performance systems: An administrative perspective on management and change. Current Infectious Disease Reports, 20(9), 35.
  • World Health Organization. (2020). Hand hygiene knowledge and practices in the time of COVID-19. Retrieved from https://www.who.int

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