Hospital acquired infection is a major issue and it can affect the quality of life for any one (Marije, Marlies, Martin, Michel, and Richard, 2007). It is very important that health care staff continue to properly use good hand washing techniques (Maskerine and Loeb, 2006). In order to assist with this issue program developers made use on theories. The theory models used in the literature were Social Cognitive Theory, Health Belief Model and Trans-theoretical Model. Constructs were used to design the programs and were effective in helping the population because it did reduce the high incidence of hospital acquired infections. Although these theories have been used to help solve the issue they have not been quite successful in maintaining a low rate of incidence (Creedon, 2008). Health Belief Model may further improve the program in addition to decreasing or eliminating acquired infections with the help of these constructs; perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy.
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Health belief model helps explain the reason why people perform certain behaviors. The constructs emphasizes that health behavior is determined by one’s beliefs about a disease and the approach to decrease the occurrence (Hayden, 2014). Hayden (2014, pg31) states, ” that personal perception is influenced by the whole range of intrapersonal factors affecting health behavior including but not limited to: knowledge, attitudes, beliefs, experiences, skills, culture, and religion”. If the health belief model is further used it may help to get a better understanding for the noncompliance of hand hygiene. Changing the behavior will enable a successful outcome and decrease the risk for all patients in the hospital setting. In this case, Health Belief Model provides a way to understanding and predicting how healthcare staff will behave in relation to their health as well as the patient and how they will comply with health care policies.
Promoting hand hygiene in the hospital field will help to eliminate high rates of hospital acquired infections (Maskerine and Loeb, 2006). This theory based program will hopefully engage the HCW to change their perceptions and eventually use what is learned to effectively practice good hand hygiene. This health care program is designed using the constructs of the health belief model. This program proposed is developed to help reduce healthcare acquired infections by improving hand washing techniques among hospital staff, mainly in registered nurses, respiratory therapists, nursing techs and physicians. This program will help engage the health care staff by using media( video) and mock scenarios to educate and answer survey questionnaires based on the constructs; perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy. It will consist of 50 HCW from 4 different hospitals, two with low HAI rates and two with high infection rates. Consent from the employees as well as the hospital will be needed for the process. During the program the staff will be split into groups and will work with those individuals that are part of the group. Before advancing into teaching, the healthcare workers will be placed into a mock hospital setting and each will be given a title and job description to perform. This process is to determine how many times and during what times hand washing or alcohol based sanitizer is used. Secondly a survey questionnaire will be given. Third, a video will be presented to educate about the consequences of poor hand washing compliance and how it also affects them as well as the patient. The staff will be able to engage in discussion and state what was done wrong in the video, why it was done wrong and things that should be changed. One of the videos will consist of a recording of the mock scenario performed by the healthcare workers. Lastly, the mock will be repeated to acknowledge if the staff did anything different from the first scenario. After reviewing the results of the program, an evaluation will take place to determine whether the program was effective and whether there were significant changes.
There are many programs in the world to help improve conditions within communities. Although there are so many, people need to know whether they are effective and beneficial. Milstein and Wetterhall (2013 pg. 3) states, “The systematic use of evaluation has solved many problems and helped countless community-based organizations do what they do better.
Community Health and development programs are evaluated to help clarify program plans, improving communication among partners and Gather the feedback needed to improve and be accountable for program effectiveness (Milstein and Wetterhall, 2013). When an evaluation is done, people are able to see their mistakes. It provides insight on whether to use a different strategy to improve what the program intended. Thus this will help improve the efficacy of the program. Evaluation can also determine whether the participants of the program were at all affected, empowered, and if participants retained knowledgeable facts. “Evaluation is a powerful strategy for distinguishing programs and interventions that make a difference from those that don’t. It is a driving force for developing and adapting sound strategies, improving existing programs, and demonstrating the results of investments in time and other resources. It also helps to determine whether the process taking place is worth the cost” (Milstein and Wetterhall, 2013, p25). The framework serves for further improvement with the use of best practice which supports steps and standards that can be used in most settings. Because the framework is purposefully general, it provides a stable guide to design and conduct a wide range of evaluation efforts in a variety of specific program areas (Milstein and Wetterhall, 2013).
To evaluate the program’s effectiveness, direct observation can be done as well as tracking the infection rates of the hospital from where the healthcare workers are employed. Permission by the Hospital committee would be needed to obtain data. During the process of the program direct observation can be used during both mock scenarios to determine if the healthcare staff retained what they learned and if it was used. Throughout the program direct observation will take place and a recording will be kept of the times the healthcare staff used hand washing techniques. This will be formed into a data graph to be evaluated at the end. The survey taken by the healthcare staff will also be reviewed to define if perceptions, attitudes and knowledge are still the same. This program will be compared with other programs to determine what worked and how many people effectively used hand hygiene. Comparing with other programs allow visual of their process to determine whether the same results were produced. The best way to determine whether a difference was made is to review the infection rates of the hospital before and after the program was initiated. This will produce whether there was improvement and if the program made an impact to significantly decrease the infection rates. It will allow determination of beneficial factors to the healthcare workers as well as the patients. By evaluating the program and the effect on the hospital it will determine whether goals and objectives were met. This will allow for changes to be made to the program and new work plans to take effect based on data reviews, experiences and surveys.
Creedon, S.A. (2008) Hand hygiene compliance: exploring variations in practice between hospitals.
Nursing Times; 104: 49, 32-35.
Hayden, J. (2014). Introduction to Health Behavior Theory. Sudberry, M: Jones and Bartlett Publishers
Improvement in Patient Care: The Use of Theoretical Perspectives. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690312/
Journal of Continuing Education in the Health Professions. Vol. 26 Issue 3, p244-251. 8p, 0894-1912 DOI: 10.1002/chp.77
Milstein, B. and Wetterhall, S. CDC Evaluation Working Group. (2013). Recommended framework for
program evaluation in public health practice. Atlanta, GA. Retrieved from http://ctb.ku.edu/en/table-of-contents/evaluate/evaluation/framework-for-evaluation/main
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