The healthcare sector is very delicate and needs to be treated with a lot of care. This is because it is directly linked to the life of human beings, and like it is always said, there is no second chance in life. Once life is lost, it goes forever. Due to this and many other reasons, Evidence-Based practice (EBP) is widely acknowledged as significant to improve patient outcomes and health quality ( Aiken, et al., 2018 ). EBP involves gathering, processing, and executing research in a healthcare setting. As indicated by the American Nurses Association (ANA), healthcare interventions should be practical and decisions based on EBP studies. The application of the EBP approach helps in promoting cost-efficient care. To meet their objectives and goals, nurses should be proficient in assessing different types of EBP since they are effective and proved to be rational during nursing actions ( Mahmoud at., 2019 ). However, several obstacles are linked to the implementation of evidence-based practice.
Organization limitations are one of the most significant barriers during EBP implementation. In most health care settings, nurses have inadequate facilities due to limited human and economic resources. Restriction of fiscal resources results in the intricacy of executing EBP research findings that require extra supplies and equipment ( Revelas, 2012 ). Additionally, the lack of enough organizational infrastructures is also a challenge for the endorsement of evidence-based practice (sole et al., 2018). Most healthcare settings lack full –text articles or updated and advanced textbooks.
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Interdisciplinary challenges also affect the implementation of EBP. There is a lack of communication between clinical and academic practice environments. In the last decades, there has been a lack of teamwork and a negative image concerning the nursing profession ( Khazaei et al., 2018 ). Another barrier to implementing EBP is inadequate staffing, like lacking time at the workplace to research and read reports and articles (Shayan et al., 2019). As a result of workload, nurses also do not find time to implement new ideas due to individual-related barriers due to lack of ability to operate using advanced technological devices and insufficient English-language proficiency.
Readiness Assessment
When undertaking this research, every person participating should be responsible for protecting human subjects. The significance of showing respect for research participants is reflected by principles that define ethical regulations, guidance, and policies ( Revelas, 2012 ). Research that involves human subjects sometimes may result in a dilemma for investigators. Protecting human subjects is essential since living in an ethical society is guided by regulations to ensure minimum ethical standards ( Mahmoud at., 2019 ). The paper discusses some of the methods that can be used to protect vulnerable communities' rights.
Researchers can protect vulnerable people's rights by creating responsive research that addresses the needs and priorities of vulnerable communities. The additional measure should also be involved in the study to ensure the involvement happens in ethical ways. Researchers will need to understand that susceptible groups usually have the right to participate in research trials by first accessing their benefits ( Solis-Hernandez, et al 2016) . The personal rights of vulnerable groups will be protected by providing sufficient time and an appropriate environment to ensure information is thoroughly understood and explained. Readiness will also mean that the investigators take a stepwise approach that protects the welfare of vulnerable people.
It is equally important to learn that patient values in deciding on treatments method are very significant in health care settings. Decisions about treatments to provide to patients should be value-laden. The researchers will balance the available time for an individual patient with the time left to rest patients (Kennerly et al., 2015). Care providers also should set flexible guidelines that promote patient involvement during clinical decision making. It is also vital to note that patient personal traits and preferences should be considered for guideline use. Hospital management should ensure that clinical judgments are integrated from the knowledge and understanding of patient care experiences.
Proposal/Problem Statement And Literature Review
Implementing strategies that help reduce hospital infections to elderly patients requires a detailed and robust system that integrates all treatment elements and care elements. Health care facilities must have both resources and policies to ensure that patients do not get infected while at the health care facility ( Revelas, 2012 ). The policies should cut across all care levels in the facility and should be implemented among all patients. To obtain data on how well the health facility in question implements hygiene policies and the amenities to reduce hospital infections, data is collected from nurses and health care practitioners working in the section of the facility that serves elderly patients.
As a way of respecting subject privacy and assuring them of the same while informing them of the project's purpose, consent will be sought through an introduction letter from the faculty (sole et al., 2018). The letter serves as an assurance that the data collected will be used solely for the research and gives the participants information on the project's goal. Additionally, the implementation of EBP is faced with several barriers ( Aiken, et al., 2018 ). These barriers include organization limitations, where nurses experience inadequate facilities due to limited human and economic resources. There is a lack of communication between clinical and academic practice environments. All these are what the project seeks to find solutions to.
Literature Review
Hospital Acquired Infections are a menace to medicine all over the world. In a study by Solis-Hernandez et al. (2015), older patients are at a higher risk of getting HAIs than other patients. This can allude to the fact that their weakened immune systems result in frequent visits to the hospital and prolonged hospital stays when monitoring their conditions. The current coronavirus pandemic makes the situation worse as hospitals are overcrowded, resulting in fluctuations in the level of care and attention by health care personnel in preventing HAIs, especially when dealing with elderly patients (Kennerly et al., 2015). This paper suggests a solution to minimize the prevalence of hospital-acquired infections in older adults.
There are several interventions to protect elderly individuals from acquiring new infections when seeking treatment in hospitals. This solution can be broken down into two key aspects; infection control and patient education. While there are many techniques to actualize the two aspects, efficient considerations of both should be done simultaneously and possibly by the same staff to minimize resource expenditure and maximize results ( Aiken, et al., 2018 ). To actualize this, a nursing staff unit should be assigned to solely attend to elderly patients in the hospital. The number of this nursing team can be increased or decreased accordingly to the number of geriatric patients (Lee et al., 2017). Exposing ICU patients to multiple medical team members (for example, different nurses from different departments) places the patient at a higher risk for infection.
Hospital-acquired infections (HAIs) are serious concerns, especially during unprecedented circumstances. For instance, with the current coronavirus pandemic, healthcare departments across the U.S. tend to be overcrowded. As a result, there is a high likelihood of negligence, resulting in high rates of HAIs ( Khazaei et al., 2018 ). Far from that, the population that is quite at risk comprises older adults who are likely to seek various healthcare services due to a weakened immune system due to their advanced age. In modern times, there is quite an emphasis on better healthcare outcomes for older adults, who are from the baby-boomer generation. The aging population has increased, and there is a proportional need for healthcare services. If HAIs are still prevalent in most healthcare settings within the U.S., then the objective of ensuring quality healthcare outcomes for older adults may remain a pipe dream (sole et al., 2018). Older adults who acquire HAIs may spend significant finances treating these conditions, and may overburden the healthcare system as well as family members and close dependents ( Revelas, 2012 ). Therefore, HAIs may negatively affect the health outcomes of older adults and healthcare institutions’ health goals if stringent measures are not taken to ensure quality standards.
Solution Description
It is suggested that properly educating patients on preventive measures such as hand washing and limiting exposure to other patients reduces the risk for HAIs. The staff allocated to an elderly patient will not interact with other patients and be responsible for patient education and infection control (Kennerly et al., 2015). This system, coupled with adhering to the medical safety protocols, will reduce the prevalence of HAIs in the elderly.
The proposed solution can easily be integrated into a typical healthcare organization system. Nursing schedules are already planned into department and shift changes. This proposed method will require creating a team that will focus solely on elderly patients with limited to none interaction with patients or staff from other units ( Solis-Hernandez, et al 2016) . This will require an increase in the number of nursing staff, especially if the number of geriatric patients is high. The extra investment will surely pay off as a study by Aiken et al. (2018) shows that increased attention given to patients reduces the odds of HAIs and, subsequently, overall costs and resources channeled to treatment.
This proposed solution's main expected outcome is to reduce the risk of elderly patients being exposed to infection carriers. HAIs in the elderly can also be attributed to operative procedures. Still, there are a prevalence of pneumonia and urinary tract infections, spread upon exposure to the causative organisms (Li et al., 2019). To protect the elderly, the number of health staff and other patients they are exposed to should be reduced to prevent microorganism transmission. The major barrier to formulating this solution will be the financial resources needed to properly allocate the necessary nursing staff (sole et al., 2018). However, this is a cheaper alternative than building a whole unit specifically for the elderly (which will still hire more staff) or subsequently treat the complications from HAIs.
A reduction in the prevalence of HAIs will positively impact the elderly patient’s health and the healthcare system as a whole. Reduction in nosocomial infections leads to a decreased hospital stay by the elderly; this subsequently results in the availability of medical resources for other patients (sole et al., 2018). Allocating nursing staff to a certain group of patients ensures that the necessary precautions are taken when dealing with them, for example, frequent disinfection of fomites and care when performing catheterization procedures. While this approach may seem a tad costly in the short term, in the long run, improved patient care and attention will prove efficient in managing hospital-acquired infections of the elderly.
How Data Will Be Collected
Both primary and secondary data will be used in the research. Primary data will be collected from the facility through detailed questionnaires issued to a sample of staff working in elderly units ( Khazaei et al., 2018 ). Secondary data will be obtained from secondary material such as books, journals, and publications related to hospital-acquired infections among the elderly.
Change Model
The change model is going to be very important in helping to solve the problem at hand. Kurt Lewin coined the change model known as the change theory of nursing. He is regarded as the father of social psychology. In this model, there are three stages of change, and all these are going to be used in the research to try reaching a solution. These three major phases of the change model are; driving forces, restraining forces, and equilibrium ( Aiken, et al., 2018 ). In this case, the change will mean the various processes that will be put in place to replace or alter existing attitudes, knowledge, skills, policies, procedures, and systems.
The three phases in the change model are based on the premise that human behavior is a dynamic balance of forces working in opposition. These forces will facilitate change in the hospital by pushing the nurses and doctors toward the desired direction (Kennerly et al., 2015). The steps will follow as shown below;
Phase 1: this is the process that will be used to alter behavior to agitate or ‘unfreeze’ the status quo (equilibrium state) ( Solis-Hernandez, et al 2016) . This is a very important stage, especially if resistance is to be overcome.
Phase 2: the stage is known as ‘change.’ It will involve the movement of healthcare workers to a new level of equilibrium (sole et al., 2018) . It will help both the patients and the service providers view change from a new perspective and work together to attain the desired goal to reduce infection at the hospital.
Phase 3: This is step is referred to as ‘freezing.’ It is where the equilibrium will be attained with the new desired preventive behaviors ( Khazaei et al., 2018 ). This will only occur after implementing change so that the desired outcomes and new behaviors will be integrated into the hospital.
Implementing Plan
Intervention, in this case, will take two approaches; patient education and infection control. Both roles will be implemented by the staff working in these units with the collaboration of the management ( Solis-Hernandez, et al 2016) . Patient education will be carried on a patient to patient basis as opposed to group work. This is in line with the hospital's patient-centered model, which stipulates that patients are different and require special attention. As such, practitioners dealing with these patients must educate them personally on the risk of infections and prevent themselves from getting infected (Haque et al., 2018). With the current Covid-19 pandemic, practitioners must have a personal touch in educating patients on the importance of social distancing and washing hands. At the same time, the practitioners must also be trained to ensure that they can train the patients.
Infection control is a more complex activity that encompasses all the hospital activities, including the procedures to be followed by practitioners to treat patients. For example, Hygiene begins with the facility's general cleanliness, sterilizing equipment, clean garments for the patients, and food hygiene (Li et al., 2019). Infection control should be implemented as a culture of the institution, a step that will enable the firm to attain targeted patient outcomes (Revelas, 2012). When dealing with the elderly, it is also important to note that they are more vulnerable to infections and increase measures.
Evaluation Process And Recommendation
The nurses have a moral obligation to promote healthy behaviors that prevent diseases among diverse populations. The nurses have a moral duty to inform people about any health hazards, ways to have better lifestyles, and some diseases that can affect their health ( Revelas, 2012 ). The nurses should abide by the biblical teachings that dictate an individual to treat their neighbor as they would like to be treated. This means that they should advocate for their health considerations and help them lead better lives. Such strategies are crucial for advanced practice nurses, and the moral duty should be carried out at any time ( Solis-Hernandez, et al 2016) . The nurses should forge ahead and always be ready to remind people about preventive measures. This is one of the best strategies that can be used to prevent infection among older adults in hospitals ( Khazaei et al., 2018 ). Reduction in the infection rate will be one way or an evaluation that will assist in getting to know that the strategies suggested are working.
References
Aiken, L. H., Cerón, C., Simonetti, M., Lake, E. T., Galiano, A., Garbarini, A., ... & Smith, H. L. (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes, 29(3), 322-327. Assessment Tool (NCAT) in Long-Term Care: An Update on Psychometrics and Scoring
Haque, M., Sartelli, M., McKimm, J., & Abu Bakar, M. (2018). Health care-associated infections: Infection in Geriatric Patients. Canadian Journal of Infectious Diseases and Medical
Kennerly, S., Heggestad, E. D., Myers, H., & Yap, T. L. (2015). Using the Nursing Culture
Khazaei, S., Khazaei, S., & Ayubi, E. (2018). Importance of prevention and control of nosocomial infections in Iran. Iranian journal of public health, 47(2), 307-308.
Lee, A., Cheung, Y. S. L., Joynt, G. M., Leung, C. C. H., Wong, W. T., & Gomersall, C. D. (2017). Are high nurse workload/staffing ratios associated with decreased survival in critically ill patients? A cohort study. Annals of intensive care, 7(1), 46.
Li, Y., Ren, L., & Zou, J. (2019). Risk Factors and Prevention Strategies of Nosocomial
Mahmoud, Manal Hamed, and Zizi Fikry Mohamed Abdelrasol. "Obstacles in employing evidence-based practice by nurses in their clinical settings: a descriptive study." Frontiers of Nursing 6.2 (2019): 123-133.
medical journal : journal of the Nigeria Medical Association, 53(2), 59–64. https://doi.org/10.4103/0300-1652.103543
Microbiology, 2019. Research Data 24 Hours a Day: Challenges, Lessons, and Recommendations. American journal of critical care : an official publication, American Association of Critical-Care Nurses, 27(4), 305–311. https://doi.org/10.4037/ajcc2018448
Revelas A. (2012). Healthcare - associated infections: A public health problem. Nigerian
Shayan, Shah Jahan, Frank Kiwanuka, and Zainah Nakaye. "Barriers associated with evidence‐based practice among nurses in low‐and middle‐income countries: A systematic review." Worldviews on Evidence‐Based Nursing 16.1 (2019): 12-20.
Sole, M. L., Talbert, S., Bennett, M., Middleton, A., Deaton, L., & Penoyer, D. (2018). Collecting Nursing
Solis-Hernandez, P. S., Vidales-Reyes, M., Garza-Gonzalez, E., Guajardo-Alvarez, G., Chavez Moreno, S., & Camacho-Ortiz, A. (2016). Hospital-acquired infections in elderly versus younger patients in an acute care hospital. Int J Infect, 3(1), e32620. Standardization. Healthcare (Basel, Switzerland), 3(3), 637–647.
