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    The document summarizes a proposed hand washing campaign in a neonatal intensive care unit (NICU) to reduce hospital-acquired infections. It discusses that infections are a leading cause of neonatal death. A literature review found that hand hygiene compliance and infection rates improved with educational interventions. The proposed evidence-based project would provide nurses education and direct observation to increase hand washing compliance and reduce neonatal sepsis rates over six months.

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    Jfine - Ebp Presentation

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    148 views11 pages
    The document summarizes a proposed hand washing campaign in a neonatal intensive care unit (NICU) to reduce hospital-acquired infections. It discusses that infections are a leading cause of neonatal death. A literature review found that hand hygiene compliance and infection rates improved with educational interventions. The proposed evidence-based project would provide nurses education and direct observation to increase hand washing compliance and reduce neonatal sepsis rates over six months.

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    The document summarizes a proposed hand washing campaign in a neonatal intensive care unit (NICU) to reduce hospital-acquired infections. It discusses that infections are a leading cause of neonatal death. A literature review found that hand hygiene compliance and infection rates improved with educational interventions. The proposed evidence-based project would provide nurses education and direct observation to increase hand washing compliance and reduce neonatal sepsis rates over six months.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    148 views11 pages

    Jfine - Ebp Presentation

    Uploaded by

    api-383995637
    The document summarizes a proposed hand washing campaign in a neonatal intensive care unit (NICU) to reduce hospital-acquired infections. It discusses that infections are a leading cause of neonatal death. A literature review found that hand hygiene compliance and infection rates improved with educational interventions. The proposed evidence-based project would provide nurses education and direct observation to increase hand washing compliance and reduce neonatal sepsis rates over six months.

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    Hand Washing

    Campaign in the
    NICU
    Jennifer Fine
    Background
    Infection is one of the leading causes of death for
    neonates and accounts for 36% of deaths (WHO, 2011)

    Hospital-acquired infections and sepsis can cause an


    increase in hospital charges up to as high as $10,055 per
    patient (Johnson, Patel, Jegier, Engstrom, & Meier, 2013)

    Many hospitals have started campaigns to improve hand


    hygiene, but have continued to struggle with compliance
    of these campaigns among workers
    PICOT
    Among nurses working in the NICU, does a standardized hand
    hygiene campaign to improve hand hygiene compliance
    compared to no campaign result in decreased incidence of
    nosocomial sepsis among neonates over a 6-month period?
    P Neonates admitted to NICU
    I Compliance to hand washing campaign
    C No compliance to hand washing campaign
    O Decreased hospital-acquired sepsis rate
    T Over a 6 month period
    Literature Review
    Five studies incorporated some type of education in their
    campaign to increase compliance
    Chhapola and Brar (2015) used 30-minute education sessions along
    with reminders, audits, and feedback
    Saw an increase in compliance by 23% with education and infection rate
    dropped 25%

    Fuller et al. (2012) used a feedback intervention using behavioral


    theories
    13% increase in hand hygiene compliance

    Three studies utilized direct observation as a way to increase


    compliance
    Not as effective alone without education
    Some studies used overt observation rather than covert, which may
    cause bias
    Hierarchy of Evidence

    One level I Systematic


    review of RCTs

    Two Level II RCTs

    Four Level III


    Observational and cohort
    studies

    One Level V Cross-sectional


    Clinical Implications
    EBP modeled after the My Five Moments for Hand Hygiene
    campaign (Sax et al., 2007)
    Response to WHOs infection control initiative in 2005

    Nurses come 10 minutes before shift to thoroughly scrub hands


    WHO guideline: 40-60 sec scrubbing fingernails, all parts of fingers,
    palms, and lower wrists

    Weeklong workshop with 30 min educational materials (videos,


    posters, discussions)
    Interactive and engaging

    Direct and covert observation by hired team to ensure compliance


    Nurse will know someone is watching, but wont know who or when
    Barriers to Implementation
    Nurses may not want to come in 10 minutes before shift
    Nurses may also not want to come to educational meetings
    Incentive
    Get paid for extra time
    Food will be provided during educational meetings

    Older hospitals may not be designed conveniently to make it


    easy for healthcare workers to use proper hand hygiene
    techniques
    Make sure sinks in hallways are automatic
    Soap, towels, and gel are stocked appropriately
    Ethical Considerations
    Ethical values touched on:
    Beneficence
    Non-maleficence

    By not performing adequate hand hygiene, nurses are


    putting neonates at risk, exposing them to harmful
    bacteria
    Outcomes
    Hand hygiene compliance will increase
    Nurses and other healthcare workers will be educated on
    proper techniques as well as why it is so important
    Measured through observation

    Neonatal sepsis from hospital-acquired infections will be


    prevented and rates will drop
    Golden Standard for diagnosing sepsis
    Three consecutive blood cultures positive for bacteria
    Conclusion
    In conclusion, hospital-acquired infections should be avoided at
    all costs
    They cost the hospital thousands of dollars extra
    Put patient at risk and cause suffering

    This literature review showed that infection rates and neonatal


    sepsis can be decreased with improved hand hygiene techniques

    Compliance to these hand hygiene techniques can increase with


    education, direct observation, and feedback
    References
    Beauchamp, T. & Childress, J. (2009). Principles of Biomedical Ethics (7th ed.). New York, NY: Oxford
    University Press

    Chhapola, V. & Brar, R. (2015). Impact of an educational intervention on hand hygiene compliance and
    infection rate in a developing country neonatal intensive care unit. International Journal of Nursing Practice, 21,
    486-492. doi: 10.1111/ijn.12283

    Fuller, C., Michie, S., Savage, J., McAteer, J., Besser, S., Charlett, A., , & Stone, S. (2012). The feedback
    intervention trial (FIT) Improving hand hygiene compliance in UK healthcare workers: A stepped wedge
    cluster randomized controlled trial. PLoS ONE, 7(10), 1-11. doi: 10.1371/journal.pone.0041617

    Johnson, T., Patel, A., Jegier, B., Engstrom, J., & Meier, P. (2013). The cost of morbidities in very low birth
    weight infants. Journal of Pediatrics, 162(2), 243-249. doi: 10.1016/j.jpeds.2012.07.013

    Sax, H., Allegranzi, B., Uckay, I., Larson, E., Boyce, J., & Pittet, D. (2007). My five moments of hand
    hygiene: A user-centered design approach to understand, train, monitor, and report hand hygiene. Journal of
    Hospital Infection, 67(1), 9-21. doi: 10.1016/j.jhin.2007.06.004

    World Health Organization (2005). Clean Care is Safer Care. Retrieved from http://www.who.int/gpsc/
    5may/background/5moments/en/

    World Health Organization (2011). Newborn Death and Illness. Retrieved from http://www.who.int/pmnch/
    media/press_materials/fs/fs_newborndealth_illness/en/

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