Expected Outcomes It is the expectation of this project that staff at BEMC will improve hand hygiene using multi-modal interventions compared to current practice, thereby reducing the risk of HAIs. The expectation is the new data collection process will provide a better representation of hand hygiene compliance at BEMC. Lastly, BEMC will see a decrease the rate of HAIs during the three-month course of this study. Strategies to Achieve Outcomes Powell et al. (2015) provide 73 evidence-based implementation strategies that can be used individually or in combination during the implementation process. For this project, seven of these strategies were utilized: 1. Assess for Readiness and Identify Barriers and Facilitators. The organizational assessment of BEMC was completed in January 2019 and showed they were indeed ready for implementation of a multi-modal hand hygiene intervention (See Appendix C & D). 2. Stakeholder Engagement. Administrative support and stakeholder buy-in are critical for the success of an improvement project. 3. Audit and Feedback. Collecting data provides a means of monitoring through direct observation, evaluation, and opportunities to modify behavior related to hand hygiene practices at BEMC. The goal for the number of hand hygiene observation audits per month
17 Running Head: EVIDENCE-BASED PRACTICE PROPOSAL was 20. Compliance data was displayed in the staff break rooms each month (See Appendix H). 5. Workflow Modifications. To meet this objective an evaluation of ABHR placement was performed at BEMC and concluded that more were needed for compliance to improve. 6. Dynamic Training. Education was provided prior to and during the project period from February to April 2019. An educational booth on hand hygiene was provided at BEMC’s annual Skills Fair on February 22 nd and 25 th 2019. Included were handouts and a station for staff utilizing the GlitterBuddyTM hand washing kit to demonstrate areas commonly missed during hand washing. 7. Reminder Systems. This provides visual reminders to prompt staff on hand hygiene. This includes wash in/wash out signs by patient rooms and posters placed throughout the facility. Limitations Time is a major limitation as there are only three months to implement strategies. This narrow window did not allow time to determine trends, impacts or sustainability of the project. It is also a relatively small project and tailored for the specific needs of BEMC. As a result, it may prove difficult to apply the results to a larger organization with similar goals. Barriers A few barriers to overcome are lack of knowledge about the EBP process from staff, resistance to change and lack of leadership support. A way to overcome these barriers is engagement from staff and leadership. This helps to build trust and allows staff to play a key role in identifying and implementing improvements. Leadership support is a key factor for success for their expertise and influence in building an organizational culture supportive of EBP.
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