Practicum Summary Report
Name: Bethany McClymont
Team Members:
Project Title: Improving patient hand hygiene
University/Organization Name: University of stirling
Health System Sponsor Name: Sutor ward (S/N Helen Goodwin/Charge nurse Julie Ransome)
Aim of project (1-2 sentences)
The aim of this project is to improve patient cooperation with local hand washing policies on ward X by 100% by June 2014. This practicum will focus specifically on increasing patient hand hygiene adherence at or around mealtimes to 100% by March 2014.
Planned changes tested (2-3 sentences)
It was agreed that housekeeping staff would circulate the ward prior to mealtimes with hand gel/wipes and encourage patients to wash hands. Patients would receive a leaflet on hand hygiene and HAIs whilst on ward. An audit would be completed at the start of each week to see patient progress. An audit of staff timing would also be taken to see if these changes had a negative impact.
Predictions (2-3 sentences)
It was predicated that both patient and staff education would impact significantly on the percentage of patients who regularly maintain hand hygiene at mealtimes. However staff time may be cut into.
Results
Present your results with a graph(s).
Summary of results (3-4 sentences):
Initially there was a vast improvement in patient compliance, and the project on a whole appears to be continually improving staff compliance.
Learning (4-5 sentences)
Comparison of questions, predictions, and analysis of data:
The implementation of PDSA cycles has showed that there has to be some sort of cooperation between staff and patients to maintain hand hygiene. These PDSA cycles show that one can be used to good effect but several small positive changes can be used together to good effect. So far the practicum has showed positive results and with further work it could reach even better results. However there are many issues that could cause the project to flounder. Staff could lose momentum and the simple act of providing the patients with hand gel could fall to the wayside.
Impact on systems (3-4 sentences)
Discuss the project’s significance on the local system and any findings that may be generalizable to other systems:
It cannot be accurately calculated how significant this project will be in relation to HAIs but it can be suggested that there would be a decrease as HAI are greatly hindered if the chain of infection is broken. This could in theory be generalized on other wards, but it is already common practice in the nearby general hospital to provide alcohol hand wipes with each meal tray.
Conclusions (3-5 sentences)
Summarize the outcome of the project. Is this project sustainable? What are the requirements for sustainability?
The outcome of this practicum is not yet known. It was shown in the 5th audit that it is very easy to forget something if it is not already practice, and will require some work to make it so. If strategies were used, such as visual reminders, or a note posted in the admission checklist, or it becoming common place for information leaflet to be in the admission pack to remind admitting nurses.
Reflections/Discussions (5-7 sentences)
Discuss the factors that promoted the success of the project and that were barriers to success. What did you learn from doing this project? What are your reflections on the role of the team?
There were several barriers that impacted my project plan within the ward. Including staff compliance I was straight out refused any sort of cooperation within the ward by some staff so my 2nd PDSA cycle may have been impacted by this. I also had difficulty ensuring that the correct hand hygiene tools were available to all patients especially the immobile ones, as the hand gel was fixed to the walls and the ward would not supply hand hygiene wipes
I have learnt much from this project, including how to use common QI tools, however I could have put more effort in learning about them before going on placement as much of the time there was wasted getting familiar with the tools and QI measures. This project was very difficult and time consuming, but is still a long way from finishing.
Following the ‘blip’ in the 5th audit it became apparent that if the process was not maintained it could easily fall by the wayside and become yet another failed project.
By signing this document (electronic signature is acceptable), I attest that the information provided by the learners in this project is accurate.
LEARNER(S):
Signature: B.McClymont
Printed Name: Bethany McClymont
Area of Study: Student nurse
Signature: C.Mackenzie
Printed Name: Catherine Mackenzie
Area of Study: Housekeeper
FACULTY SPONSOR:
Signature: J.Ransome
Printed Name: Julie Ransome
Institution: Charge nurse (Sutor ward)
HEALTH SYSTEM SPONSOR (if different from faculty sponsor):
Signature: H.Goodwin
Printed Name: Helen Goodwin
Institution: Staff nurse (Sutor ward)
AUTHORIZATION
Do the learners, faculty sponsor, and health system sponsor authorize this project for publication at www.ihi.org?
[X] Yes ☐ No