Name
Capella University
NURS-FPX8030
Prof. Name
September, 2024
Methods and Measurement
Assessment of the proposed practice change in health care requires the appropriate methods and measurement tools to be selected to assess the impact of the proposed change on patient safety effectively. This process entails an identification of instruments used for the evaluation of the goals of the intervention as well as certain specific characteristics of the target population. One of the bases for using these tools is based on the principles of Quality Improvement (QI) and evidence-based practices that inform their choice, probably including validated surveys or biometric assessment. Therefore, if appropriate instruments that measure relevant factors such as patient care outcomes, safety indicators, or the level of patient satisfaction are used, then the healthcare practitioner will receive meaningful information for informed decisions and continuous improvement processes (Belita et al., 2020). Then, a proper appraisal would enable stakeholders to be able to gauge the success of the initiated changes, which would accordingly improve the quality of care, further strengthening best practices at the medical facility.
Instruments Appropriate for the Effectiveness of the Intervention
1. National Healthcare Safety Network (NHSN) Surveillance System
The NHSN Surveillance System is an important tool created to enhance patient safety through the monitoring and tracking of various HAIs and other pertinent safety events in healthcare facilities (Takaya et al., 2020). Centered around the CDC, the system helps healthcare organizations collect standardized data on infection rates, thus supporting their identification of trends and areas for improvement. Joining the NHSN would enable facilities to benchmark their performance against national data, facilitate an evaluation of the effectiveness of infection prevention efforts, and implement evidence-based practices. In this manner, systematic surveillance serves not only to minimize HAIs but also cultivates a culture of safety and accountability among healthcare organizations, thereby ultimately leading to better patient outcomes and care quality.
2. Hand Hygiene Observation Tool (HHOT)
The HHOT is one of how hand hygiene compliance is evaluated among healthcare professionals in the healthcare environment (Al Sawafi, 2021). It is aligned closely with patient safety interventions. Through systematic observation of healthcare professional practices during interactions with patients, the HHOT provides quantifiable data that could help distinguish compliance to hand hygiene practices important for preventing HAIs. The HHOT is also helpful in identifying where adherence is inadequate or will be inadequate. In addition, it may also be used to assess the effectiveness of education in the prevention of inappropriate hand hygiene. The Hospitals apply the HHOT during an intervention for practice change and use it to track their progress and make appropriate improvements for resultant improved outcomes in patient safety. Thus, the HHOT emphasizes hand hygiene to help build a safety and accountability culture toward healthcare quality improvement success.
Nature of Instruments
The National Healthcare Safety Network (NHSN) Surveillance System CDC was designed as a comprehensive report tool for healthcare-associated infections (HAIs) and other safety-related events within healthcare settings. HAI incidence and prevalence are key measures that the NHSN centers on; incidence and prevalence are essential information in infection prevention efforts (Masoudifar et al., 2021). Standardized metrics, such as infections per 1,000 patient days or procedures, help the system to make consistent comparisons across facilities. The rigor of collecting data and well-defined concepts of HAIs strengthen the validity of the NHSN while reliability has been proven through repeated assessments and benchmarking against national data. With this, the systematic methodology used by the NHSN brings into sight healthcare organizations an opportunity to recognize trends and thereby apply evidence-based interventions in boosting patient safety outcomes.
The Hand Hygiene Observation Tool (HHOT) is developed by the World Health Organization. It is useful for observing hand hygiene practices among healthcare workers. The construct is adherence to hand hygiene protocols: The measurement scale is binary by classifying compliance as “compliant” or “non-compliant” with patient care activities. The HHOT, by being based on the WHO hand hygiene guidelines, ensures that the tool represents best practice at the time of measurement, addressing its validity (Suchomel et al., 2020). Reliability has also been done in terms of inter-rater agreement where multiple observers reported observer aggregated compliance rates in similar settings. Applying the HHOT will allow healthcare facilities a chance to collect actionable data that could help to enhance hand hygiene practice and, therefore, reduce the risk of HAIs and increase patient safety.
Best Literature for The Utilization of Instruments
The NHSN Surveillance System has become one of the most commonly utilized surveillance systems in several studies assessing the levels of HAIs in diverse settings. For instance, one of the largest studies was carried out in several hospitals that assessed the effectiveness of infection control practices by reviewing the data collected under NHSN over the years (Dhar et al., 2021). Based on the results, targeted interventions based on NHSN metrics have a significant effect on CLABSIs and CAUTI rates. The outcome of this study indicates the importance of NHSN data in guiding infection prevention strategy and holds healthcare providers accountable for the end product, leading to better patient safety outcomes.
Similarly, HHOT was used in many studies to measure hand hygiene compliance in healthcare settings. A very notable example of such a study was the effectiveness of an education strategy to influence hand hygiene compliance among the nursing staff in a hospital setting. Compliance before and after an education intervention was documented by using HHOT (Gabiola & Labitigan, 2022). Results of this work demonstrated compliance progression, with a baseline of 60% increased by 25% to 85% post-intervention, clearly demonstrating the efficacy of the HHOT in measuring compliance and detailing the impact of targeted training. This work illustrated that this tool not only produces useful data for hand hygiene practice appraisal but, through doing so, also acts as a facilitator for fostering a culture of safety and accountability within health organizations.
Difference and Similarity in Studies
Many studies using the National Healthcare Safety Network (NHSN) Surveillance System have similar goals of research in eliminating healthcare-associated infections with improved monitoring and intervention. One example is a research study about whether the implementation of an evidence-based program for infection control affected SSI rates by taking data available from NHSN (Morikane et al., 2021). Unlike the objectives of the present study, this study aimed at identifying several interventions that may lead to significant reductions in infection rates. However, whereas the current project may cover a broad scope of infections including CLABSIs and CAUTIs, the above research was limited to only SSIs. Both studies highlighted the need to make standardized metrics when assessing interventions and have demonstrated the role of the NHSN as a very critical tool in quality improvement for patient safety.
Regarding the Hand Hygiene Observation Tool, varied studies also used this tool to assess hand hygiene compliance with comparable research objectives concerning infection prevention. For instance, an investigation that studied the association between hand hygiene practices and the occurrence of HAIs within an intensive care unit used HHOT to evaluate compliance rates before the beginning of a hand hygiene campaign (Mouajou et al., 2021). It nearly replicates what the current project sets out to do: improving hand hygiene to increase patient safety. Though the continuation of such a project might include observation of more than one department, the study quoted above was based on the compliance of only a particular unit. Both these studies have proven that the HHOT is a useful tool in measuring adherence and in the achievement of intended changes in patient care workers’ hand hygiene practices, and hence its application can be further validated as a possible device for monitoring intervention programs aiming at patient safety improvement.
Summary
Evaluating proposed changes in practice in healthcare is relevant to ensure that interventions have the desired outcomes of making patient safety and the quality of care better. This paper will focus on two of the key instruments, the National Healthcare Safety Network (NHSN) Surveillance System and the Hand Hygiene Observation Tool (HHOT), among others that are necessary to assess the impact of some interventions on reducing infections associated with healthcare (Peters et al., 2022). This discussion will spotlight these tools in monitoring compliance and outcomes while considering the origins, constructs, and measurement capability of these tools. Only successful implementation of such interventions will support employing reliable and validated instruments in practice by contributing to a better environment for patient health and safety.
NURS FPX 8030 Assessment 4 References
Al Sawafi, K. M. (2021). Examining the importance of hand hygiene policy and patient safety culture on improving healthcare workers’ adherence to hand hygiene practice in critical care settings in the sultanate of Oman: a scoping review. Cureus, 13(11).https://www.cureus.com/articles/77446-examining-the-importance-of-hand-hygiene-policy-and-patient-safety-culture-on-improving-healthcare-workers-adherence-to-hand-hygiene-practice-in-critical-care-settings-in-the-sultanate-of-oman-a-scoping-review#!/
Belita, E., Squires, J. E., Yost, J., Ganann, R., Burnett, T., & Dobbins, M. (2020). Measures of evidence-informed decision-making competence attributes: a psychometric systematic review. BMC Nursing, 19(1).https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-020-00436-8
Dhar, S., Sandhu, A. L., Valyko, A., Kaye, K. S., & Washer, L. (2021). Strategies for effective infection prevention programs. Infectious Disease Clinics of North America, 35(3), 531–551.https://www.sciencedirect.com/science/article/abs/pii/S0891552021000350?via%3Dihub
Gabiola, K., & Labitigan, J. (2022). Challenges in nursing students’ compliance with hand hygiene practices – effective teaching methods: a descriptive literature review. Www.theseus.fi.https://www.theseus.fi/handle/10024/784948
Masoudifar, M., Mehdí, G., Pezeshki, Z., Eshrati, B., Afhami, S., Rahnamaye, F., & Seifi, A. (2021). Healthcare-associated infections, including device-associated infections, and antimicrobial resistance in Iran: The national update for 2018. PubMed, 62(4), E943–E949.https://www.jpmh.org/index.php/jpmh/article/view/1801
Morikane, K., Russo, P. L., Lee, K. Y., Chakravarthy, M., Ling, M. L., Saguil, E., Spencer, M., Danker, W., Seno, A., & Charles, E. E. (2021). Expert commentary on the challenges and opportunities for surgical site infection prevention through the implementation of evidence-based guidelines in the Asia–Pacific region. Antimicrobial Resistance & Infection Control, 10(1).https://aricjournal.biomedcentral.com/articles/10.1186/s13756-021-00916-9
Mouajou, V., Adams, K., DeLisle, G., & Quach, C. (2021). Hand hygiene compliance in the prevention of hospital-acquired infections: a systematic review. Journal of Hospital Infection, 119(3), 33–48.https://www.journalofhospitalinfection.com/article/S0195-6701(21)00341-8/abstract
Peters, A., Schmid, M. N., Parneix, P., Lebowitz, D., de Kraker, M., Sauser, J., Zingg, W., & Pittet, D. (2022). Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review. Antimicrobial Resistance & Infection Control, 11(1).https://aricjournal.biomedcentral.com/articles/10.1186/s13756-022-01075-1
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