National Purity, LLC. (2012). - Weebly



Running head: WELLNESS PROJECTWellness Project: Saving Lives, One Clean Hand at a TimeSUNY Polytechnic InstitutePublic Health IISpring 2015Kristine MillsAssessmentFindingsProper hand hygiene is an important method of illness prevention. We see reminders to wash our hands in restaurants, stores, healthcare facilities, and schools. As healthcare workers, proper hand hygiene is a large part of our daily routine, and also a component we use to educate others. Much of the data and research regarding proper hand hygiene methods consists of either, the community scene, such as restaurants, but also health care facilities as well. A world-wide hygiene company, known as Svenska Cellulosa Aktiebolaget (SCA), conducted a study in 2012 of 1,000 online interviews, which revealed, shocking data in relation to hand hygiene practices among Americans. Every 30 minutes, we are exposed to approximately 840,000 germs while being in connection to approximately 300 surfaces (National Purity, 2012). Using soap while practicing good hand hygiene helps to eliminate germs from hands. Hand washing helps to prevent infection through various ways. Individuals commonly touch three areas of the body, which include the eyes, nose, and mouth. These areas being common locations of germ transportation. Germs from our hands if unwashed can be passed to other objects, including our food and drink (Centers for Disease Control and Prevention, 2014). The SCA research study showed, 71 percent of individuals reported washing their hands on an everyday basis. These individuals reported having good hand hygiene practices. However, it was found that a certain percent of these individuals barred witness to others not practicing good hand hygiene. Fifty eight percent of those stating they practice proper hand hygiene, have seen others not wash their hands after utilizing a public bathroom. According to the SCA, 33 percent of these individuals have seen friends, 35 percent have seen co-workers, and 25 percent have witnessed restaurant workers not wash their hands after using the bathroom. Thirty nine percent were not considered to have good hygiene practices, which included, not using appropriate hand hygiene methods after blowing their nose, or after coughing, or sneezing. Lastly, more than half of the individuals in the study were found to not use hand hygiene after touching money, using public provided transportation, or using exercise equipment that was utilized by multiple individuals.The Centers for Disease Control and Prevention (CDC), found that hand washing education within the community can help individuals and their communities stay well. This education reduces cold illnesses, including the respiratory kind, by 21 percent. A reduction of 31 percent of diarrhea illness was seen. Lastly, in individuals with a compromised immune system, there is a 58 percent reduction in overall diarrheal illness (Centers for Disease Control and Prevention, 2014).Proper hand hygiene is not only important for the community but for the hospital setting as well. Approximately 722,000 infections occur every year in those hospitalized within the United States. Converted, this data means for approximately every 25 patients, one will develop a hospital acquired infection. “Healthcare providers should practice hand hygiene at key points in time to disrupt the transmission of microorganisms to patients including: before patient contact; after contact with blood, body fluids, or contaminated surfaces (even if gloves are worn); before invasive procedures; and after removing gloves (wearing gloves is not enough to prevent the transmission of pathogens in healthcare settings)” (CDC, 2014). Hospital acquired infections often are more difficult to treat and can be very dangerous. Hand hygiene is one of the most essential steps in the prevention of the transmission of germs (CDC, 2014).Community DiagnosisRisk of infectious illness, among those individuals within a health care setting, related to a lack of proper hand hygiene.Target populationReasoning. For my teaching purposes, the population I will be focusing on consists of patients and members of the faculty at Bassett Healthcare Herkimer’s out-patient Prime Care. “Healthcare workers’ hands are the most common vehicle for the transmission of healthcare-associated pathogens from patient to patient and within the healthcare environment” (Allegranzi & Pittet, 2009, p. 305). After my clinical time spent, working within the community as a Community Health Nurse (CHN), and reviewing information pertaining to hand hygiene, I felt hand hygiene education was necessary for the community. A leader within the Bassett Healthcare organization suggested that they are always in need of hand hygiene education, and asked if I would present at their location. This location is ideal because it not only addresses the patient population, it also speaks to faculty members. “Hand hygiene is the leading measure for preventing the spread of antimicrobial resistance and reducing healthcare-associated infections (HCAIs), but healthcare worker compliance with optimal practices remains low in most settings” (Allegranzi & Pittet, 2009, p. 305). The learning needs of health care employees and patients a-like consist of hand hygiene basics including when to wash your hands, how to wash your hands, and how to use alcohol-based sanitizer. Educational material is to be comprised on a poster for easy, short-formatted viewing, as well as pictorial handouts of proper hand hygiene instruction. Hand hygiene facts and data will also be used to enforce the importance of proper hand hygiene to participating patients and staff.Learning Barriers. Potential learning barriers for the patient visiting the facility include, state of wellness the day of presentation and level of education. Information used for educational purposes will be worded for basic comprehension to help ensure understanding of material occurs across most levels of education. Actual learning barriers for both the patient visiting the facility and the employees, is the busy, fast paced, environment. This form of environment makes it challenging for an individual to focus. Hand-outs will be provided to reinforce any education missed.Learner Strengths. The patient visiting the facility and the employees of the facility may have the desire to learn new facts and information about hand washing. Nursing staff and physicians of the facility already have a medical background and will be more apt to pick up the information more quickly.Environment Assessment. Different environmental factors can affect learning capabilities. The presentation will take place late morning. Some individuals may be hungry as lunchtime approaches. If the individual is focusing on their hunger or what they are going to eat for lunch, it will be difficult for them to focus on the education being presented. Bassett Healthcare Herkimer Prime Care is a busy, out-patient facility that sees many patients throughout the day. This may make learning for the staff more difficult as they are busy rooming patients and the providers are busy with patient appointments. This busy environment may also make it difficult for the patient to focus on the teaching. At any time, there may be a number of individuals in the waiting room/lobby where the teaching will take place. The noise level may impact both the patients and the staff while listening to the education, they may have difficulty hearing what is being said. While the presentation is going on, there can be many distractions including patients being called into the rooms, patients registering, the television sounding, patients checking out, patients getting water from the cooler, patients talking, etc.PlanGoalsTwo learner goals and two teaching goals were established for this Wellness Project. “A goal is a statement that describes the general direction of logical response to a demonstrated need” (Stanhope & Lancaster, 2012, p. 558). With each goal that was created, there is a set of objectives. “Objectives are concise statements describing in measurable and time-bound terms precisely what specific outcome is to be accomplished” (Stanhope & Lancaster, 2012, p. 558). According to Stanhope & Lancaster (2012), objectives need to be clear and specific in order for it to be possible to measure the goals. Learner goals are goals that are set forth for the learner to achieve. The following goals and objectives were created for the learner.Bassett Healthcare Herkimer Prime Care participants will have an understanding of the basics of hand washing by the end of the teaching/learning session.ObjectivesThe participant will be able to answer the question(s) pertaining to the basics of hand washing correctly on the questionnaire. The participant will be able to state one fact about hand washing.The participant will be able to demonstrate one proper hand washing technique.Bassett Healthcare Herkimer Prime Care participants will have an understanding of the benefits of hand washing by the end of the teaching/learning session.ObjectivesThe participant will be able to answer the question(s) pertaining to the benefits of hand washing correctly on the questionnaire.The participant will be able to state one benefit of hand washing.The participant will be able to state in what way hand washing benefits their life.Teacher goals are created for the teacher to achieve. The following teacher goals and objectives were created for myself to achieve for this project.Present self as a professional for participants as related to professionalism. ObjectivesClean, well-maintained appearance, and dressed in either office attire or nursing attire.Well organized display for the educational presentation.Demonstrate expertise in hand hygiene as related to educational expertise.ObjectivesProvide sufficient information to participants with adequate and appropriate references.Be able to demonstrate the appropriate hand washing technique.ContentThe CDC, describes proper hand hygiene as one of the most valuable ways to prevent the transmission of germs and infectious processes. The CDC recommends the use of soap and water when practicing proper hand hygiene first. If unavailable, alcohol-based sanitizer can be used. The sanitizer should contain at least 60 percent alcohol. The following topics will be discussed in the content of the presentation, as well as the hand hygiene data listed within the Findings portion at the beginning of this paper. Two pictorial handouts will also be given, one containing the proper steps to hand hygiene, and the other provides how to properly utilizing alcohol-based hand sanitizer.When to Wash Your Hands. The CDC provides a bulleted list of when an individual should wash their hands, using proper hand hygiene methods. The list provided below was retrieved directly from the CDC (2014) webpage:Before, during, and after preparing foodBefore eating foodBefore and after caring for someone who is sickBefore and after treating a cut or woundAfter using the toiletAfter changing diapers or cleaning up a child who has used the toiletAfter blowing your nose, coughing, or sneezingAfter touching an animal, animal feed, or animal wasteAfter handling pet food or pet treatsAfter touching garbageHow to Wash Your Hands. The CDC has recommendations as to how an individual should wash their hands for proper hand hygiene. These recommendations were derived from scientific research which is listed in a link directly below their description of proper hand washing on their website as referenced on the Reference page. The CDC has proper hand hygiene broken down into five steps. Step one, is to wet your hands. The CDC recommends using running water that is clean, temperature of the water is not of importance. Once wet, stop the water and start soap application. Step two, rub your hands together with soap until foamy. While rubbing, be sure to also touch the following surfaces such as below your nails, in between all of your fingers, and the backs of the hands. Step three, from here, rub your hands together in a scrubbing motion for a minimum of 20 seconds. The CDC uses the “Happy Birthday” song, sung twice, as an example of a timer one could use. Step four, once again, utilizing running water that is clean, rinse your hands. Finally, step five, utilizing a dry towel that is clean, dry your hands. Hands may also be left to air dry (CDC, 2014).How to Use Alcohol-Based Sanitizer. The CDC still recommends soap and clean water as the most effective way to remove germs from the hands. However, if either or both are unavailable, alcohol-based sanitizer can be used. The CDC recommends the sanitizer contain at least 60 percent alcohol. Also note that if your hands are dirty to the eye or have a greasy surface, the sanitizer will not be as capable to remove germs from your hands. The CDC has listed three steps to describe how one should apply a hand sanitation liquid. Step one involves the application of the sanitizer to one hand, on the palm. Next, step two, is combining the hands and rubbing them together. Lastly, step three, make sure to spread and rub the sanitizer all over your hands and fingers. Keep doing this until the hands are dry (CDC, 2014).Hand Hygiene Facts. The CDC provides facts about hand hygiene on their website with references listed below. First, approximately half of diarrheal related deaths could be decreased by using hand hygiene methods. Second, according to research performed in London, approximately 1,000,000 deaths a year could be stopped by routine hand hygiene. The third, discusses how foodborne illness are for a large portion caused and spread by hands that are contaminated. Practicing proper hand hygiene could reduce the chance of contracting a foodborne sickness. The fourth deals with respiratory illnesses stating that proper hand hygiene could decrease the risk of these illnesses by 16 percent. Lastly, in a study including 16 elementary schools and 6,000 students, school absences related to illness were reduced by 19.8 percent by classrooms that utilized an alcohol hand sanitizer (CDC, 2014)Teaching Methods/MaterialsA poster board display will be created from a Power Point format to be presented in the lobby of Bassett Healthcare Herkimer Prime Care. Power Point handouts will be available as well as picture handouts related to hand hygiene to reinforce teaching education. These handouts are to help overcome the environmental barriers previously listed where the participant may have difficulty focusing. Also I chose to use multiple teaching methods such as verbal (presentation), visual (poster), and written (handouts), to hopefully accommodate all of the individuals’ learning needs of the participants. The evaluation of the project will take place through a 5 question hand hygiene questionnaire that I will create based from the content presented. The questionnaire is to be completed by the participants and submitted for my review to determine the effectiveness of the educational presentation.ImplementationI presented my Wellness Project: Saving Lives, One Hand at a Time to Herkimer’s Bassett Healthcare’s Prime Care Clinic on April 15th at 11 am. I started off by introducing myself including my name, school, and what I would be presenting. Before I reviewed my material with the participants, I passed out handouts including the power point that comprised of the poster, a How to Handwash and How to Handrub handout developed by the World Health Organization (the WHO), as well as a five question questionnaire to assess the participants educational response to the information presented. I informed the participants that the all of the handouts except for the questionnaire were for them to keep. I suggested hanging the How to Handwash and How to Handrub poster handouts on their bathroom wall or on their kitchen refrigerator. I came across approximately 30 people during my time at Bassett. Sixteen of those thirty, were willing to participate including completing the questionnaire. These participants included patients and employees of the facility. After presenting my information, I went around to the participants to assist with any questions. After two hours I closed my presentation time. Participation by the following participants occurred throughout the two hour block. I presented my information multiple times to accommodate those who wished to participate. Later, I reviewed the results of my five question questionnaire. The only question that gave the participants difficulty was in regards to how long one should scrub their hands together while washing. The correct answer according to the CDC is a minimum of 20 seconds. I had six participants choose 25 seconds out of the 16 participants. I believe this to be a result of the posters I passed out developed by the WHO with a recommending hand washing time of 40-60 seconds. Twenty-five seconds was the longest time frame on the survey, I feel this is why individuals chose this answer. EvaluationOverall I view this project as a success. Both learner goals were met by the end of this project presentation. The Bassett Healthcare Herkimer Prime Care participants obtained a better understanding of the basics of hand washing by the end of the teaching/learning session as demonstrated through not only discussion, but by multiple correct answers provided by the participants on the questionnaire. Many participants were disturbed by the statistics I presented to them regarding the number of people who do no not actually participate in proper hand hygiene, even if they believe they do. After reviewing the material presented, the participants demonstrated a verbal understanding of the benefits of hand washing as well as answering the appropriate question correctly on the questionnaire. The teaching goals of the educational presentation were met. For my presentation I displayed a clean look while wearing a blue scrub outfit, representative of SUNY, as well as my SUNY ID to accomplish a professional look. My display and information was well organized. I placed the Power Point at the center back of the table. The table, I had placed in the center of the lobby with the chairs surrounding, so that everyone could see the presentation. Next, I had the handouts laid out in front individually for those who only wished to receive the poster handouts and for one reason or another, could not stay for the presentation. I also had some handouts clipped together as packets, these including the Power Point version of the presentation for those who did not wish to or were unable to only stand near the poster board. This way any participant could sit during the entire presentation even if seated further from viewing distance of the poster board while still being able to following along. A wide abundance of information was provided to the participants. I also demonstrated proper hand hygiene expertise during my presentation.Changes I would make to this project if performed in the future, include a time change and a revision of the questionnaire utilized. I performed my presentation at 11 a.m., due to the fact that this was nearing lunch time hours, there were not as many patients as there would normally be at a different time. In the future I would choose to either present an hour earlier or after 1 p.m. Lastly, in the future I would revise the question on the questionnaire regarding how long you should scrub your hands together while washing. I would chose to make this question more specific to the organization making the recommendation. I would do this by stating either “the Centers for Disease Control and Prevention (CDC) recommends”, or replacing the CDC with the World Health Organization (WHO) and their specific recommended time frame.ReferencesAllegranzi, B., & Pittet, D. (2009). Role of hand hygiene in healthcare-associated infection prevention. Journal of Hospital Infection, 73(4), 305-315.Centers for Disease Control and Prevention (CDC). (2014). Show me the science – Why wash your hands? Retrieved from Purity, LLC. (2012). New Hand Washing Survey Reveals Some Gross Statistics. Retrieved from , M., & Lancaster, J. (2012). Public Health Nursing: Population-Centered Health Care in the Community (8th ed.). Maryland Heights, MO: Mosby. ................
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