Nurs6050Healthcare Policy 2021 PDF

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Healthcare Program Policy...

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Healthcare Program/Policy Evaluation Analysis Template

Healthcare Program/Policy Evaluation Analysis Template Use this document to complete the Module 5 Assessment Assessing a Healthcare Program/Policy Evaluation

Healthcare Program/Policy Evaluation

Hand Washing Policy – MSVH 210-20 The outcomes of this policy showed that consistent and through hand washing is effective in preventing spread of contagious virus and bacteria. Outcome also showed that hand washing should also be done after touching surfaces in residents’ rooms such as bed remote, light switch, and overbed tables. The success was measured monthly with a decrease in number of clustered infections. Throughout the period of the policy being revised or strictly enforced we reached on average 150 Veterans. The impact of this policy is life a death in those that are elderly with weakened immune systems. The impact of this policy also showed that frequently touched surfaces in residents’ rooms, should be frequently wiped down with disinfectant. Once we did the monitoring, we realized how important hand washing is when caring for multiple residents living in close quarters. This evaluation was conducted May 2020 after our first round with COVID as we noticed and increase in urinary tract infections with ESBL, as well as COVID in the same residents, on the same unit and hall.

Description Hand washing policy states that it is imperative that all employees practice good hand hygiene and prevent the spread of infection by washing their hands. Hands should be washed when coming on duty, whenever visibly soiled, before and after

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performing procedures. Before and after preparing and handling medications. Before and after handling clean or soiled dressings, gauze, or pads. After contact with blood, body fluids, excretions, secretions, mucous membranes, or non-intact skin. After personal body functions. After removing gloves. Before and after eating Whenever in doubt and upon completion of duty. How was the success of the program or policy measured?

How many people were reached by the program or policy selected? How much of an impact was realized with the program or policy selected?

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The success of this program was measured by the decrease in urinary tract infection and COVID positive residents on the affected unit and overall in the facility. We would first see a resolution in the urinary tract infection, then we saw a decrease in the number of residents on that unit with urinary tract infection. With COVID we measured the success by a decrease in the number of residents that tested positive each week. After about strict adherence and monitoring, education we saw a decrease with both infections, and we observed better hand washing practicing by staff.

Average number of residents reached by this policy during the period of monitoring was 150. Average number of staff reached was 180. The impact of this was realized when we were able to compare the numbers from the month of the spike to the month of the strict monitoring. Once we were able to get staff to realize how important it was to wash hands in what we consider small moments, it had a significant impact on overall infection control. Staff was observed not only washing hands more but using sanitizer stations, and wiping surfaces such as computers, telephones, and siderails more. So, I would say that is a significant impact in an ongoing battle. I have even observed staff assisting and encouraging residents to wash their hands more.

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What data was used to conduct the program or policy evaluation?

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Data used to conduct evaluation. 1. Number of residents affected with same infections. 2. Location of residents affected. 3. Staff that provided care to these residents in all departments. 4. We evaluated if staff was new or experienced. 5. We evaluated if there any new residents to that unit. 6. We evaluated the history of residents infected to see if this was the first infection of that type. 7. We evaluated location of sanitizer stations. 8. We evaluated what would cause staff to not wash hands as frequently, as in was wearing the PPE associated with COVID an issue. 9. We wanted to know if any residents had been out on appointments or to ER. 10. We checked employee files for updated hand washing procedure awareness. 11. Researching recommendations or policies listed by the Centers for Disease Control and Prevention.

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What specific information on unintended consequences were identified? What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.

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One issues that was identified is that when staff is dressing out in full PPE and having to change in between residents they were lacking in following this protocol fully. There was cross contamination due to this which caused a cluster of residents to become infected with the same bacterial infection. Following hand washing procedure first is the single most effective tool to preventing infection.

Stakeholders identified in this is the residents, nurses, certified nursing assistants, physicians, dietary, and housekeeping. The residents will benefit the most because they are whom we are there to provide care for. Reporting the outcomes of this evaluation would prevent or decrease outbreaks in long term facilities. Example is a resident on contact precautions under the care of one CNA, when he or she is providing care for that resident and touches the remote to turn the TV on, he or she would then need to wash hands before providing care for the next resident to prevent cross contamination. If other facilities have access to the reporting from this evaluation, they would be able to educate their staff on the importance of wiping surfaces and washing hands between contact with all surfaces, no matter how simple the take may seem. Most of the time when we educate on hand washing, we do not give enough specific information as in wash hands after passing out trays between residents. Staff would benefit too as it would prevent them from picking up infections and taking home to their family more particularly respiratory infection like COVID.

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Did the program or policy meet the original intent and objectives? Why or why not?

Yes, the program policy did meet the original intent to educate or notify on circumstances in which one should was their hands, however due to vagueness in the policy it leads room for error. When writing policies like this it should be more specific to the situation to register the information. Yes, when observing and reminding about the policy we did have an overall drop in the number of infections both urinary tract and respiratory. So, the policy did serve it purpose it just needs some general updating or details added. Hand washing is one of the oldest policies, which has undergone very little changes over the years and mainly because many consider this to be common sense. However, with evolving viruses and bacterial infection, this policy could use some touching up to include sanitizing of hands, when to sanitize and when to wash hands.

Would you recommend implementing this program or policy in your place of work? Why or why not?

Yes, I would recommend revising and reeducation of this policy routinely. This policy is universal, so it is being implemented, it just needs to be simplified and relatable to each specific situation. I would recommend this due to the various job descriptions being unaware of what they are encountering. For example, staff in house keeping may pick up oxygen mask off floor with hands to place on table not knowing that it has been in possible contact with mucous membranes, then may touch another surface without washing hands causing cross contamination. Being active and creative with this policy alone will decrease infections and prevent infections significantly in any facility. By doing this facilities can improve patient outcomes when they are being treated for other issues, this can be cost effective, and this could prevent staffing shortages related to outbreaks.

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Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after one year of implementation.

General Notes/Comments

First way as nurse advocate to become involved is making sure staff is educated, updated regularly on changes or new findings. Reminding staff to sanitize or wash hands between simple task as in tray set up or assisting resident with making phones calls with personal devices. Second, I could become involved by reporting my observations, what could have been done differently, what was done, or who was affected by this choice. Monitoring for clusters or similarities in residents with certain infections. Monitoring the tracking and trending reports regularly is another way to become more involved in evaluation of policies and programs. Joining facility quality assurance committee, and attending meeting is another way to become involved. Evaluating the policy after implementation would also mean being current with new recommendations from guiding agencies like CDC, WHO, and CMS which targets health care.

References Centers for Disease Control and Prevention. (n.d.) When and How to Wash Your Hands. Retrieved May 7,2021 from https://www.cdc.gov/handwashing/when-how-handwashing.html

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MSVH 210-020 Handwashing policy 2012. Retrieved May 3,2021 from MSVH Policy and Procedure manual. The Centers for Medicare and Medicaid Services.(n.d.) Retrieved May 7, 2021 from https://www.cms.gov/files/document/hand-hygiene-initiative-overview World Health Organization. (2009). WHO guidelines on hand hygiene in health care. Retrieved May 7, 2021 from https://www.who.int/infection-prevention/publications/hand-hygiene-2009/en/

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