Solution Description Evidence Based Practice Proposal

Evidence-Based Practice Proposal

Section D: Solution Description

Proposed Solution

In seeking to prevent/reduce the risk of nosocomial infections in acute care oncology, it has been proposed that the practice of hand rubbing with a waterless, alcohol-based solution be implemented at XXXXX. It is important to note that various studies conducted in the past support this particular course of action in as far as the minimization of hospital-acquired infections is concerned. In one such study, Girou, Loyeau, Legrand, Oppein, and Brun-Buissson (2002) found out that in comparison to hand washing using a standard antiseptic soap, hand rubbing with a waterless, alcohol-based solution was indeed more effective. In the words of the authors, “during routine patient care, hand rubbing with an alcohol based solution is significantly more efficient in reducing hand contamination than hand washing with antiseptic soap” (Girou, Loyeau, Legrand, Oppein, and Brun-Buissson, 2002, p. 362). This is a finding collaborated by Widmer (2000) who makes a finding to the effect that there is a significant risk of recontamination when water and a standard antiseptic soap is used. According to the author, hand washing with soap is a systemic process that in most cases has to be completed by turning off the faucet. Therein lies the risk of reinfection. Picheansathian (2004) observes that the relevance of hand hygiene cannot be overstated in as far as the reduction of nosocomial infections in health settings is concerned. According to the author, whereas there are various strategies that are used to advance hand hygiene, one of the most effective approach involves hand rubbing with products that are alcohol-based. In a systematic review seeking to assess how effective alcohol-based solutions are in the advancement of hand hygiene, Picheansathian (2004) came to the conclusion that “alcohol-based hand rub removes microorganisms from hands of personnel more effectively, requires less time, and irritates hands less often than traditional hand washing with non-medicated soap or other antiseptic agents and water” (25).

It should also be noted that to a large extent, compliance happens to be one of the main concerns in any attempt to bring about change. For this reason, there is need to explore various strategies meant to enhance compliance in as far as the solution proposed herein is concerned. Girou, Loyeau, Legrand, Oppein, and Brun-Buissson (2002) point out that “to improve compliance with hand hygiene during patient care, hand rubbing with an alcohol based solution has been proposed as a substitute for hand washing because of its rapid action and accessibility” (363). Keller, Wolfensberger, Clack, Kuster, Dunic, Eis, Flammer, Keller, and Sax (2018) also posit that hand rubbing with a waterless, alcohol-based solutions is one of the strategies with known effectiveness in as far as hand hygiene compliance is concerned.

Organization Culture

In addition to being people-oriented, my organization tends to have an entrenched culture of continuous improvement. To a large extent, the proposed intervention would result in a reduced rate of nosocomial infections in acute care oncology. This would be a significant improvement in as far as patient outcomes are concerned. Thus, the proposed solution is in line with the organizational culture.

Expected Outcomes

The expected outcomes on this front would be reduced risk of nosocomial infections in acute care oncology. In as far as the prevention of microorganisms’ cross-transmission in healthcare settings is concerned, the observance of hand hygiene has been shown to be effective. A review of literature clearly indicates that the most effective hand hygiene approach in this regard is hand rubbing with a waterless, alcohol-based solution.

Method to Achieve Outcomes

In this case, a step-wise approach will be adopted in seeking to achieve the outcome highlighted above. In that regard, a total of 4 steps will be undertaken in a systematic format. These have been highlighted below:

1. Assessing Current Situation: The assessment of the current situation helps in the formulation of the specific goals and objectives to be achieved in as far as infection control is concerned. Further, progress can only be measured if the current situation is compared with the desired future state.

2. Action Readiness: In this case, the resources required for the successful implementation of the proposed solution will be mobilized and key stakeholders identified. Further, those who will be actively involved in seeing the entire undertaking to fruition will be identified.

3. Implementation: This phase concerns itself with the actual implementation of the proposed hand hygiene standard. More specifically, implementation in this case will largely focus in ensuring that alcohol-based handrub is availed in acute care oncology and that staff are sensitized on the ‘why and how’ of the new standard.

4. Evaluation: Evaluation is of great relevance in tracking the effectiveness of the standard so as to identify deviations from intended outcomes.

Outcome Impact

Quality Care Improvement: The key objective of improved hand hygiene is decreased rate of healthcare acquired infections. According to the Centers for Disease Control and Prevention – CDC (2020), people’s hands are responsible for the spread of some of the most serious infections in healthcare settings. Towards this end, CDC (2020) concludes that “preventing the spread of germs is especially important in hospitals and other facilities such as dialysis centers and nursing homes.” With this in mind, the present undertaking could be considered a step in the right direction in as far as quality care improvement is concerned. This is more so the case given that it would contribute towards improved outcomes for patients.