Introduction
Evaluation of HH education and intervention plays a vital role in measures taken for the improvement of HH compliance among HCWs aimed at reducing HAIs (Kelcikova, et al., 2012). Continuous assessment and evaluation are essential for constant improvement in infection control practices to assess adherence and compliance of HCWs to HH practices (CDC, 2002). Even though several HH interventions occur, many of them show short term success and very few have shown long term effectiveness in reducing HAIs though appropriate compliance to HH practices (Kelcikova, et al., 2012).
Long term interventions are the corner stone for invoking changes in attitudes towards HH standards and are vital to the improvement of HH practices which in turn reduce HAIs in medical settings (Kelcikova, et al., 2012). However, evaluation of data indicates a serious lack of compliance to HH requirements (CDC, 2002). Program interventions and implementations should be supported by effective evaluations to determine the level of emphasis on HH practices and compliance by HCWs.
Evaluation is thus an important part of the process of implementation involving the value or success rate of a program through appropriate appraisal and study. In order to effectively measure the rate of HH compliance among HCWs, it is important to evaluate and monitor their HH behaviour. As such, development of an evaluation plan is crucial to the success of the promotion and implementation of a program aimed at reducing HAIs through effective HH among HCWs.
Evaluating the Effectiveness of the Solution
An observation study will be conducted to evaluate the effectiveness of the solution. The observation study will be conducted before and after the implementation of the program to test HH compliance using ABHs for the baseline and post-intervention stages with two phases. The difference will be used to calculate the rate of difference between HH compliance before and after the intervention. The purpose of the observation study is to evaluate the effectiveness of the HH program and gauge the level of compliance of HCWs to HH behaviour.
Overall adherence to HH guidelines will be monitored in the NICU of the hospital through observational surveys (CDC, 2002). These observational surveys will be conducted before and after the implementation of the program to evaluate HH behaviour using the ABH provided to the HCWs. Individual bottles of ABH will be provided to the staff and the supply of AB hand-wash solutions will be made available throughout the NICU.
Additionally, HCWs will be encouraged to carry their individual bottles in their pockets to ensure and facilitate easy access to HH solutions (CDC, 2002). The HCWs of the NICU will have access to wall posters and ample supply of ABH and AB based solutions throughout the unit. A senior experienced nurse with acute knowledge of HH practices will observe the staff and document the compliance of HH using a form (Appendix A). Both results, preliminary and post implementation will be compared to evaluate results.
Regular performance feedback will be given to HCWs during and after the promotion and evaluation. Since the strategy is multimodal, monitoring and evaluation of data will be accomplished by direct observation of compliance with HH practices and indirect observation by monitoring the use of the ABH and AB hand-wash solutions provided and made available to the HCWs. Additionally, HCWs will be asked to evaluate the overall effectiveness of the program and to describe their experiences and reactions to program (CDC, 2002). This feedback from the HCWs is an essential part of evaluation and provides meaningfulness to the evaluation.
Assessments of Variables
The variable to be measured in the study is the effectiveness of alcohol based hand-rubs in reducing HAIS in acute care settings such as neonatal ICUs. The outcome of the study is likely to be affected by non compliance to HH practices and infrequent use of the ABHs provided.
Tools Necessary to Educate Project Participants
HCWs will be trained and educated about the importance of compliance to HH using ABHs. Education will be imparted using posters, meetings and focus group sessions. HCWs will be mailed links to important data and researches related to HH for prevention of HAIs. HCWs will be provided with education materials, posters and display charts to emphasize the importance of HH compliance. Informational tips will be provided to the participants through e-mails consisting of reports and latest research based data from CDC about HH practices.
Increased supply of ABHs will be provided to HCWs (Picheansathian et al., 2008). Hand washing with an alcohol based solution or ABHs as compared to plain soap and water reduces the transmission of health care associated pathogens among personnel, thereby decreasing the rate of HAIs (CDC, 2002). Previous research studies confirm that mortality and morbidity rates due to HAIs decrease when alcohol based solution rather than traditional soap and water is used for HH (Eveillard et al., 2011). The most radical change in the new CDC guidelines is the recommendation to use ABH in place of traditional soap and water for effective HH (Lam et al., 2004).
Advantages of using ABHs are saving time, improved hand health and effective decontamination of hands (Lam et al., 2004). HCWs from all units will be educated using a power point presentation (Appendix P). The PowerPoint presentation will assist in explaining all HCWs about the need and importance and correct procedures used for appropriate adherence to HH using ABHs. Other necessary tools and resources required are approval from leaders, permission to educate HCWs, PowerPoint presentation, technical reference manual, HH posters, how to wash, and how to hand rub posters and observation chart to monitor HH practices by HCWs (CDC, 2002).
Assessment Tool for Evaluation of Project Results
Survey results and tool used to assess the compliance and practice of HH using the ABH sanitizers among HCWs will help in the evaluation of the project results.
References
Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee (CDC/HICPAC) (2002). Guideline for Hand Hygiene in Health-Care Settings. Web.
Eveillard, M., Raymond, F., Guilloteau, V., Pradelle, M., Kempf, M., Zilli-Dewaele, M., & Brunel, P. (2011). Impact of a multi-faceted training intervention on the improvement of hand hygiene and gloving practices in four healthcare settings including nursing homes, acute-care geriatric wards and physical rehabilitation units. Journal Of Clinical Nursing, 20(19/20), 2744-2751.
Kelcíkova, S., Skodova, Z., & Straka, S. (2012). Effectiveness of Hand Hygiene Education in a Basic Nursing School Curricula. Public Health Nursing, 29(2), 152-159.
Lam, B., Lee, J., & Lau, Y. (2004). Hand hygiene practices in a neonatal intensive care unit: a multimodal intervention and impact on nosocomial infection. Pediatrics, 114(5), 565-71.
Picheansathian, W., Pearson, A., & Suchaxaya, P. (2008). The effectiveness of a promotion programme on hand hygiene compliance and nosocomial infections in a neonatal intensive care unit. International Journal Of Nursing Practice, 14 (4), 315-321.