1. Professional presentation Presentation: Infection Control
The issue of controlling and preventing hospital-acquired infections is a major problem in the healthcare system. Most patients admitted to hospitals are at risk of contracting a hospital-acquired infection (Paterson, 2012).
The problem that has been identified as needing a solution is the issue of controlling and preventing hospital-acquired infections through education and working with healthcare providers to come up with techniques to prevent these infections. The proposed solution is to create an evidence-based education program for nurses to teach them how to recognize and prevent the spread of infections. The rate of hospital-acquired infections is increasing every year regardless of different policies and regulations set by hospitals (Paterson, 2012). Thus, nurses need to be educated about key evidence-based clinical elements they can apply early on to help prevent infections in hospitals.
Professional presentation Presentation: Infection Control
By Nanncie Constantin
NUR/590B
Dr. Hulsey

2. Objectives Provide and overview of practicum
Describe the development of the project.
Describe the implementation of practicum learning agreements
Personal reflection on practicum.
Provide rationale for topic selection
Highlights professional relationship developed.
Research supports that innovation in evidence-based education can impact hospital-acquired infections by improving staff knowledge of them, thereby improving compliance with hand hygiene; the proposed evidence-based practice (EBP) innovation involves reducing hospital-acquired infections by educating staff about the importance of hand hygiene through the implementation of an educational program. This proposed evidence-based practice (EBP) will enable nurses and other health-care providers to obtain the information needed to identify signs of infection early and to seek proper intervention in order to help eliminate hospital-acquired infections. There is a wealth of supporting evidence on hand hygiene practices and their impact on hospital-acquired infections. Current research on the proposed innovation focuses on studies conducted near the end of the 20th century (Picheansathisan, 2004). Research studies concluded that educating staff on compliance with hand hygiene appears to be the best way to help reduce the transmission of hospital-acquired infections (Mathai, George, & Abraham, 2011).

3. Introduction/overview of practicum
Different types of hospital acquire infections.
-surgical site infection
-central line-associated bloodstream infection
-Ventilator-associated pneumonia
-catheter-associated urinary tract infections.
Methicillin-Resistant Staphlococcus Aureus (MRSA) are most common HAI
 The issue of controlling and preventing hospital-acquired infections is a major problem in the healthcare system. Most patients admitted to hospitals are at risk of contracting a hospital-acquired infection (Paterson, 2012). Some patients are more vulnerable than others; these include the elderly, patients with defective immune systems, and premature babies. Hospital-acquired infections remain a major concern, and they can occur in any care setting, including acute care within hospitals, outpatient surgery centers, clinics, and long-term care facilities (such as nursing homes or rehab centers). Four categories account for 75% of all acquired infections in the acute care hospital setting. These are surgical site infections, central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections (Paterson, 2012). Urinary tract infections comprise the highest percentage (Paterson, 2012). These infections are usually spread by contaminated hands of healthcare providers or by the patient’s family members. They are also caused by contaminated surfaces or hospital equipment that has not been properly cleaned or disinfected (Paterson, 2012).

4. Participant Greenville Hospital System Cardiac Units (4B, 4C & 4D)
Diverse patient population
Staff receiving the training-
Nurses (Registered Nurses )
Certified Nursing Assistants
The staff including nurses and certified nursing assistants or PCT received evidence base training about how to prevent hospital acquire infections using evidence-based practice to educate healthcare providers about infection prevention in the hospital, help them to be more compliant . The educational research proposal project will include supportive data from reliable research studies, an action plan on how to implement different strategies to help healthcare providers develop ways to eliminate hospital-acquired infections; and a post-test to help determine the staff’s knowledge and attitudes upon completion of the educational program.

5. Development focus of practicum
Infection Control
Compliance of hand hygiene
Hand Hygiene in the Health care Organizations
Hand hygiene Education of health professionals and the clients
According to Devadason ( August 2010), Hand disinfection purpose is to remove bacteria with its rapid and persistent effect. Many health organizations are focusing on hand hygiene as one of the crucial elements to prevent infection. Therefore, health education about hand hygiene is important in health care today. However, various methods of compliance monitoring are in stages of research. Data regarding compliance levels in health care settings are minimal. He posted that the health care organization requires technologies that address issues about compliance monitoring, effective hand sanitization, and making hand hygiene more user friendly. Clearly, devices and products that response to these needs will increase the compliance level of hand hygiene. Consequently, infection will be controlled in the health care settings, and the infection level will decrease in the hospital.

6. Development of practicum
Hand Hygiene Compliance
Danger of poor Hand Hygiene
Frequency of Hand Hygiene
Education of Hand Hygiene Need
The practice of hand hygiene compliance monitoring remains the most struggling task in most health care setting in America (Devadason August 2010). Many health professionals are not performing hand hygiene, or are not performing it properly. The reason may be because they are not aware of the danger that it may cause to themselves or others. Health Compliance of hand hygiene is the responsibility of all health care professionals. Knowing the importance of hand hygiene will encourage them to perform hand hygiene before entering each patient’s room, and performing any procedures, and after each procedure, and when exiting the patient’s room. Therefore, implementing hand hygiene education and its associated risks to the health professionals, patients, and others are necessary.

7. Development of practicum
At the moment, there are many hand hygiene devices available to use in the health care institutions other than water and soap. Some of the developing trends in hand hygiene management are foam dispensers, persistent hand sanitizers, UVC, and compliance monitoring. Most health institutions use alcohol-based gels. Alcohol-based gels are antiseptic agents that do not require the use of water and soap; they require less application time. They are recommended for use when the hand is not visibly soiled or contaminated. Alcohol-based gels have improved hand hygiene compliance among healthcare workers. However, those devices do not replace soap and water because when the hands are visibly soiled, the health professionals should wash their hands with soap and water for at least 15 seconds.

8. Employer Needs Health care organizations (HCOs) must:
Ensure staff competency and compliance by
Supporting educational departments
Create environment of accountability and responsibility
Decrease patient safety risks of infection secondary to poor hand hygiene
Improving patient outcomes will increase patient & staff satisfaction
Instructional methods used to educate staff members to help improve knowledge, skill, and compliance with hand hygiene practice and hospital policy includes educational materials from the “My five moment for Hand hygiene” , power point presentation on information from different research on infection preventions, and a post-test. By integrating both traditional and service learning through instructional methods the staff members will have opportunity to participate and engage actively in the process. Learners in general prefer to learn in a variety of methods so flexibility, creativity, and repetition are important. (Billings & Halstead, 2009, pp. 134). Gardner identified the differences in which individuals process information and in doing so he validates diversity. An imperative factor is to ensure nurse educators are flexible and willing to accept various learning needs of nurses, patients, and other customers (DeYoung, 2009).
Pittet, Hugonnet, Harbarth, and Mourouga (2000) state that more than 65% of U.S. hospitals miss opportunities to improve hand hygiene (p. 3, para 5). Identifying priority learning needs is key to preventing Health care associated infections (HCAIs) and improving compliance with organizational and national hand hygiene policies. Educating staff on the importance of hand hygiene, assessing comprehension of proper hand washing techniques, and educating patients and their families on the importance of hand hygiene are essential to reduce HCAIs.

9. Educational Tool
This diagram created by World Health Organization was used during the presentation as a guide to help nurses and PCTs remember the” My Five moments for hand hygiene”. The World Health Organization’s “My five moments for hand hygiene” concept has created awareness about preventing the spread of infections and is full of information and beneficial tips that educate healthcare workers on infection prevention. The goal of this concept was to provide information on hand hygiene and to determine the specific time at which hand hygiene is required during patient care in order to effectively prevent the spread of infection (Mathai, George, & Abraham, 2011). This study is relevant to clinical practice because it educates staff on when hand hygiene is most effective and also helps educators understand the importance of educating staff on proper hand hygiene when caring for patients in order to prevent the transmission of infection.
Before patient contact
Before an aseptic task
After body fluid exposure even if wearing gloves!
After patient contact
After contact with patient surroundings

10. Outcome Measurement Tools
Three main Methods for measuring outcomes
Directly Observing
Measuring product use
Conducting surveys
The standard method of measurement the outcome of this project was by direct observation of employees behavior. Observation allows the observer to identify frequently used hand hygiene products and staff compliance with hand hygiene requirements, cleaning hospital equipments. Further, direct observation allows the observer to provide prompt feedback in situations when improvement is necessary.
A second method is to analyze the use and amount of product the employees use. Tracking the use of products including liquid soap, alcohol-based hand sanitizers, and paper towels, is an indirect method to estimate staff adherence to organizational guidelines. Product measurement also allows the observer to track workplace trends.
Last, observers can conduct a survey of health care workers, to obtain information about perceptions, attitudes, and behaviors related to infection prevention in the hospital. A survey can reveal health care workers’ perceptions of their own behavior, which can be compared with the perceptions of patients and family members (Measuring Hand Hygiene Adherence, 2009).

11. Rationale For Selection
Prevent Infections
Improve patient outcomes
Decrease Infection Rates.
Lack of proper hand hygiene training is a main problem within the health care industry. Perceived barriers include a lack of active participation in hand hygiene promotion, few available role models and advocates, and institutional failure to place priority on the importance of hand hygiene. Clear understanding of proper hand hygiene requires health care workers to comprehend rationales for this concept.
Situations requiring hand hygiene such as before and after patient contact, before the start of a procedure, after contact with blood products, body fluids or excretions, or after removing gloves. When health care workers grasp the importance of hand hygiene, an improvement of patient health, employee health, and reduction of nosocomial infection rates will occur as well.

12. Implementation of the practicum
Educational classes
My five Moments
Forming an infection control committee
The first step in implementing the proposed innovation involves forming a committee comprising the nurse educators from both the cardiac units and the infection control department so they can help manage and become familiar with the project description and solution. Once they approve the project, the implementation of this evidence-based practice (EBP) innovation can begin. The nurse educators will appoint two charge nurses from each cardiac unit (B, C, D) who demonstrate interest and have enough expert knowledge on the topic; Once the charge nurses have been selected, the second step will be for them to be trained in accordance with the methods proposed by the World Health Organization (WHO), which recently developed a concept called “My five moments for hand hygiene.” The third step in the implementation process was to educate the participants by use of handouts focusing on infection prevention and workstations to promote proper hand washing techniques incorporating role play through patient care scenarios. The final step to implement the educational program will be to monitor staff competency through the computer training program (CBT) offered by the hospital on hand hygiene quarterly.

13. Reflection of practicum
Time spent during research on the topic
Meeting with the mentor for feedback
The importance of the journal and timeline.
During any practicum experience, a person is able to develop a number of important skills and competencies that would help further his or her career as he or she continues in the nursing profession. Any type of educational research project allows a person to have the chance to help improve his or her research skills and also gives a person a much greater understanding about what sort of data and information is available on different topics in healthcare
Taking part in a research project such as this helps a person to build skills with regard to working independently; having good time-management and self-discipline are a must in order to stay motivated and meet specific deadlines for such a big practicum project. It is very challenging for a person to be in school, working in a full-time job, and creating enough time to meet all of the demands of such a practicum project. One must learn how to manage one’s time wisely in order to accomplish all of the tasks that are required in this practicum. Having a timeline and a journal was a good way for one to stay on task during this practicum; also having a specific time to meet with one’s mentor to discuss different sections of the practicum helped with time management during this project.

14. Professional relationship developed during practicum
With Mentor
Nurse educator from the cardiac units
Infection prevention nurses
Nurses from different units
The personal relationship a person develops during this practicum experience with mentors and other nurses can be a great asset for future projects. During a practicum such as this, most mentors invest time, ideas and inputs to help implement and complete the practicum. The mentor’s expert knowledge about research and being a nurse educator for the ICU was of great use for this practicum project. Mentors provide their mentees with reliable insights that would otherwise have been gained only through trial and error, which was true for this particular project. My mentor’s questions and ideas encouraged a person to reflect on different situations and alternatives that could be used to help better implement the research project. She was very committed to the project, and always made time to meet me, answer any questions and provide feedback that was beneficial for the completion of the practicum project. Overall, the practicum experience was useful and appropriate for my academic and professional career.

15. Conclusion Hand hygiene decreases risk for infections
Infection control is everyone’s responsibility
Ongoing education to patients, health care professionals, will assist with the goal of preventing hospital acquire infection.
The problem of hospital-acquired infection is a major issue with regard to patients’ lives and the financial burdens on both the patients and the healthcare facility. Effective monitoring of infection rates can alert a healthcare provider of the different causes of infection in hospital and aid the provider in resolving the problem in a timely manner. Following basic infection control measures, such as good hand hygiene and using standard precautions for all patients at GHS or in any type of healthcare setting, can reduce rates of nosocomial infection. The success of any infection prevention program depends on healthcare knowledge levels and on the willingness of participants to learn how to prevent the spread of infection. It is very important for staff members to be compliant with hospital protocol, maintain ongoing education, and take active roles in preventing hospital-acquired infections. Therefore, implementing an EBP innovation program will have positive results for patient outcomes and for Greenville Hospital System.   

16. References
Billings, D. M., & Halstead, J. A. (2009). Teaching in nursing: A guide for faculty. Retrieved from The University of Phoenix eBook Collection database. Devadason B(August 2010). Hand Hygiene technology trends, Frost and Sullivan, Retrieve from DeYoung, S. (2009). Teaching strategies for nurse educators. . Retrieved from The University of Phoenix eBook Collection database. Mathai, A. S., George, S. E., & Abraham, J., (2011). Efficacy of a multimodal intervention strategy in improving hand hygiene compliance in a tertiary level intensive care unit. Indian Journal of Critical Care Medicine, 15 (1), 6-15 Measuring Hand Hygiene Adherence (2009) The Joint commission. Retrieved from Patterson, J. (2011). Auditing urinary catheter care. Nursing Standard 26, 20, 35

17. Picheansathian, W. (2004). A systematic review on the effectiveness of alcohol-based solutions for hand hygiene. International Journal of Nursing Practice, 10, 3-9.
  Pittet, D., Hugonnet, S., Harbarth, S., & Mourouga, P. (2000). Effectiveness of a hospital-wide program to improve compliance with hand hygiene. The Lancet, 356(9238), Retrieved from