The second phase is persuasion which is when the

or idea and acquires an understanding. The second phase is persuasion, which is when the
individual must form a personal view toward the idea or innovation based off of further
information. The third phase, the decision, is based off of the individual’s values and choosing to
adopt the innovation or reject it. After adoption of the innovation, the fourth phase is
implementation, which is when the interventions are carried out. The fifth and final phase is
confirmation. This is when evaluation of the interventions take place, and further decisions are
made to either continue the interventions, or adjust them if needed (Mohammadi, Poursaberi, &
Salahshoor, 2018).
For this evidence-based change proposal Roger’s Change Theory was most appropriate
and most relatable, in terms of nursing. Roger’s Change Theory mirrors the nursing process;
knowledge is the assessment, persuasion is the diagnosis, decision is planning, implementation is
intervention, and confirmation being evaluation. With the nursing process engraved within us,
theories that mimic it make the most sense. Each step goes further into detail and can take
different lengths of time to complete, but having an outlined process or theory is beneficial.

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PREVENTING HEALTHCARE-ASSOCIATED INFECTIONS IN HEMODIALYSIS
Implementation
Hand hygiene is one of the most basic skills taught to nurses and is also the number one
way to prevent the spread of infection. Patient safety is always a priority and protecting them
from or preventing infection is at the top of that list.
Education
Nurses need to stay up to date on evidence-based practice, especially when it comes to
infection control, but sometimes they need to be re-educated on important topics. Regular staff
meetings will be held every two weeks to go over new changes related to up to date EBP, with a
focus on hand hygiene do’s and don’ts. Patients and family members or caregivers need to be
more educated, as well, especially in the simple form of hand hygiene and infection control.
Patients will be educated monthly, chairside, and receive handouts to take home that cover tips,
statistics, and additional sources for information. The families or caregivers will be educated
every three months at the patients care plan meeting so everyone, staff, family, and the patient,
can be on the same page.
Accountability
Staff that do not adhere to changes and updates in infection control must be held
accountable. Too often nurses say, “That isn’t how I learned it”, or, “If it ain’t broke, don’t fix
it”. These are just reasons not to change habit and routine, and it must be stopped. The patient is
the reason this profession exists, and we have a duty to take care of them to our best ability, and
accountability plays a large role in that. After speaking with my Nurse Manager and mentor, we
have decided to start enforcing old policies and to stop turning a blind eye to the staff that
continue to break policy and procedure. It will start with a verbal warning, followed by a written

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PREVENTING HEALTHCARE-ASSOCIATED INFECTIONS IN HEMODIALYSIS