Applying the Theory of Planned Behaviors to Nosocomial Infections
Identify a public health theory you will use to support the implementation of your prevention and health promotion activities. Provide evidence that supports the use of this theory within the program you designed

According to the tenets of the theory of planned behavior, individuals first think about a behavior (e.g., the intent to act) and only then proceed to act (Chambers & Benibo, 2011). The dependent variables of intent to act in the theory of planned behavior include individual attitudes, perceived behavioral control, self-efficacy, and behavioral norms which are in turn dependent variables to the actual behavior demonstrated (Chambers & Benibo, 2011). The theory of planned behavior has been applied in a number of different settings, including in the context of nosocomial infections (Hughes, 2008).

In this context, the planned behavior theory conceptualizes individuals' intent to engage in handwashing as involving three main factors:…...

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References

Bijari, R. & Abassi, A. (2014, January 1). Nosocomial infections and related factors in southern Khorasan hospitals. Iranian Journal of Public Health, 43(2), 197.

Chambers, V. & Benibo, B. R. (2011, October 1). Reactions to the 2008 economic crisis and the theory of planned behavior. Academy of Accounting and Financial Studies Journal, 15(4), 17-20.

Davis, R. & Anderson, O. (2012, April). Predictors of hospitalized patients' intentions to prevent healthcare harm: A cross sectional survey. International Journal of Nursing Studies, 49(4), 407-415.

HAIs at a glance. (2017). U.S. Centers for Disease Control. Retrieved from  

hygiene techniques with traditional soaps may or may not be more effective than using alcohol-based solutions concerning reduction in nosocomial infection rates in acute hospitals. With recent usage of alcohol-based solutions, use of traditional antibacterial soaps may be outdated and take longer. Nosocomial infections present as a major issue for acute care hospitals and require research in identifying the most effective way to sterilize hands to avoid increasing infection rates. While traditional handwashing with antibacterial soaps have been done for years, water availability and time taken to perform handwashing may not promote efficiency among hospital staff. Alcohol-based solutions require no water and additional washing or scrubbing. This research paper will focus on recent articles and studies that highlight which method works best.
Integration and Synthesis of the Evidence

Many articles and studies the past and in recent years attest to the effectiveness and efficiency of alcohol-based solutions. One 2012 studied noted…...

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References

Appelgrein, C., Hosgood, G., Dunn, A., & Schaaf, O. (2016). Ozonated water is inferior to propanol-based hand rubs for disinfecting hands. Journal Of Hospital Infection, 92(4), 340-343.  http://dx.doi.org/10.1016/j.jhin.2015.08.029 

Chen, S., Chou, C., Huang, J., Tang, Y., Kuo, Y., & Chien, L. (2013). Antibacterial effects on dry-fast and traditional water-based surgical scrubbing methods: A two-time points experimental study. Nursing & Health Sciences, 16(2), 179-185.  http://dx.doi.org/10.1111/nhs.12082 

Howard, J., Jowett, C., Faoagali, J., & Mckenzie, B. (2014). New method for assessing hand disinfection shows that pre-operative alcohol/chlorhexidine rub is as effective as a traditional surgical scrub. Journal Of Hospital Infection, 88(2), 78-83.  http://dx.doi.org/10.1016/j.jhin.2014.06.013 

Salmon, S., Truong, A., Nguyen, V., Pittet, D., & Mclaws, M. (2014). Health care workers' hand contamination levels and antibacterial efficacy of different hand hygiene methods used in a Vietnamese hospital. American Journal Of Infection Control, 42(2), 178-181.  http://dx.doi.org/10.1016/j.ajic.2013.07.013

NICU Nosocomial Infections
Preventing NICU Nosocomial Infections

hine (2006) writes an editorial to appeal to clinicians staffing neonatal intensive care units (NICUs) to increase their awareness of patient safety measures because a large number of studies have shown that educating and training clinicians on how to prevent nosocomial infections (NI) can have a significant positive impact on patient outcomes. The author was motivated to write this editorial because of the findings from a NICU study completed at the University of Alabama in Birmingham (UAB). The main findings of this study were clinician education, especially concerning hand hygiene, together with NICU culture, can significantly reduce NIs in the NICU over the long-term.

The UAB NICU intervention capturing the attention of hine (2006) involved a number of steps, but it was unclear which ones were individually the most effective. The author admits this, while at the same time suggesting that a systematic intervention which changes…...

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References

Rhine, W.D. (2006). Eliminating nosocomial infections in the NICU: Everyone's duty. Journal of Perinatology, 26(3), 114-143.

Long-Term Nursing Facility Management Risks
FACILITY-ACQUIRED INFECTIONS

Long-Term Nursing Family Management Risks

The major risk management issue of our hospital is the spread of nosocomial infections, more popularly known in the medical circle as hospital-acquired infections. This infection is something that a patient can contract or develop besides the condition for which he is admitted (Duel et al. eds, 2004). The include infections, which surface after discharge and occupational types among the workforce of the facility. These are widespread globally and assert strong impact among patients and facility workforce. The most common sites, according to a recent survey, are the urinary tract, the catether site, respiratory tract, bacteremia, skin and soft tissue, lower respiratory, surgical and the eyes (Duel et al., eds).

In our 150-bed facility in Chicago, pneumonia is a critical respiratory nosocomial infection concern. Our facility is a component of one of the biggest network of medical care facilities in Illinois. The…...

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BIBLIOGRAPHY

Anderson, BM. And Roschm N, (2000). Hospital-acquired infections in Norwegian long-

term care institution. Vol. 46 Issue 4, Journal of Hospital Infections: The Hospital

Infection Society. Retrieved on March 18, 2015 from http://www.lofhospitalinfection.com/article/S0195-6701(00)90840-5/abstract?showall=true=

Conly J. And Johnston, L. (2001). The impact of health care structures on nosocomial infections and transmission of antimicrobial and resistant organisms. Vol. 12 # 5,

Nurse burnout is a common occurrence. This can exacerbate an ongoing problem that is seen in hospitals, nosocomial infections. Nosocomial infections remain prevalent for patients with extended hospital stays like those in intensive care units. An infection that starts roughly 48 hours after admission, those in intensive care units (ICUs) experience a continued rate of infection leading to increase length of stay, mortality, and morbidity. The number of patients that develop a nosocomial infection are from 7 to 10% internationally (Dasgupta, Das, Hazra, & Chawan, 2015). As such, hospitals have decided to classify nosocomial infection sites based on clinical and biological criteria.
esearch has led to the discovery of several bacterial strains that involve the formation of nosocomial or hospital acquired infections. "The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members, namely,…...

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References

CDC. (n.d.). HAI Data and Statistics. Retrieved from  https://www.cdc.gov/hai/surveillance/ 

Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200-1216. doi:10.1108/pr-05-2015-0118

Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care -- associated infection. American Journal of Infection Control, 40(6), 486-490. doi:10.1016/j.ajic.2012.02.029

Dasgupta, S., Das, S., Hazra, A., & Chawan, N. (2015). Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India. Indian Journal of Critical Care Medicine, 19(1), 14. doi:10.4103/0972-5229.148633

Problem From the onset, it is important to note that nosocomial or healthcare-acquired infections (HAIs) happen to be rather common in our healthcare settings. In basic terms, nosocomial infections could be defined as the all those infections that are acquired or contracted within the healthcare environment. To be more specific, the World Health Organization – WHO (2020) defines the said infections as all those infections that “affect patients in a hospital or other health-care facility, and are not present or incubating at the time of admission.” Further, according to WHO (2020), this category of infections could also be inclusive of infections acquired by hospital staff in the course of executing their functions within a healthcare facility. This is the definition that will be adopted in this policy brief. As the Centers for Disease Control and Prevention – CDC (2018) observes, at least 1 out of a total of 31 hospitals across…...

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References

Andersen, B.M. (2019). Prevention and Control of Infections in Hospitals: Practice and Theory. New York, NY: Springer.

Centers for Disease Control and Prevention – CDC (2018). HAI Data. Retrieved from  

Centers for Disease Control and Prevention – CDC (2020). States with HAI Reporting Mandates. Retrieved from  https://www.cdc.gov/hai/state-based/required-to-report-hai-nhsn.html 

Despotovic, A., Milosevic, B., Milosevic, I., Mitrovic, N., Cirkovic, A., Jovanovic, S. & Stevanovic, G. (2020). Hospital-acquired infections in the adult intensive care unit—Epidemiology, antimicrobial resistance patterns, and risk factors for acquisition and mortality. American Journal of Infection Control, 48(10), 1211-1215.

McIntosh, D.G. (2018). Healthcare-associated infections: potential for prevention through vaccination. The Adv Vaccines Immunother., 6(1), 19-27.

Stone, P.W., Pogorzelska-Maziarz, M., Reagan, J., Merrill, J.A., Sperber, B., Cairns, C. …Skillen, E. (2015). Impact of laws aimed at healthcare-associated infection reduction: a qualitative study. BMJ Qual Saf., 24(10), 637-644.

World Health Organization – WHO (2020). Health care-associated infections FACT SHEET. Retrieved from  https://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf?ua=1 

https://www.cdc.gov/hai/data/index.html 

In the U.S healthcare environment, the clinical practice guidelines are the effective healthcare protocol to enhance patient’s safety as well as achieving evidence-based practice. The clinical guidelines provide recommendations to the best available practice to assist clinicians and other healthcare professionals to deliver best and quality care. More importantly, the clinical practice guidelines are designed to optimize patients’ care using the systematic assessment and evidence based review to assess pros and cons of the alternative care options. The guidelines serve as the strongest resources to assist the healthcare professionals to make clinical decisions as well as incorporating evidence gained through practice and scientific investigations into patient practice.  Healthcare organizations develop the guidelines in form and policies, which are endorsed across the organization to create a platform that employees will follow and holding employees accountable to achieve a standard of care.  
Clabsi Hospital is one of the best healthcare organizations the…...

One possible explanation for the differences observed in the studies could be that the strengths of the chlorhexidine solution were different. It could also be that over time more effective techniques have been developed in the application of the solution, as the results do appear to improve over time.
There are limitations to the methodology of the study which are centered on the use of secondary data for analysis. The use of secondary data allows a wider range of data to be gathered from across the U.S. than would be practical from primary data collection which is the reason for the choice in this study. However this puts the control of several variables beyond the researcher. The results of the techniques may have been affected by the application of different individuals, departments and hospitals, all of whom may vary techniques and other factors influencing the success of these techniques. The…...

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References

Adams, D., Quavum, M., Worthington, T., Lambert, P., & Elliott, T. (2005). Evaluation of a 2% chlorhexidine gluconate in 70% isopropyl alcohol skin disinfectant. Journal of Hospital Infections, 61 (4), 287-290.

Brungs, S., & Render, M. (2006). Using Evidence-Based Practice to Reduce Central line Infections. Clinical Journal of Oncology Nursing, 10 (6), 723-725.

CDC. (2002). Guidelines for Prevention of Intravascular Catheter-Related Infections. Morbidity and Mortality Weekly Report; Recommendations and Reports, 51 (RR-10), 1-34.

CDC Mission. (n.d.). Retrieved February 6, 2006, from CDC Web site:  http://www.cdc.gov/about/mission.htm

Evidence-Based Solution to educing Incidence
The goal of this assignment is to increase my ability to appraise and synthesize evidence to provide experience a logical argument in support of a proposal for practice change, and to provide experience in designing a detailed implementation and evaluation plan for my project. I need to discuss my project plan with you.

An evidence-based solution to reducing incidence of hospital acquired infections through indwelling medical devices

Hospital-acquired or nosocomial infections are the fourth leading cause of disease in developed countries. The increased insertion and implanting of prosthetic or indwelling medical devices is a leading cause of these infections since the introduction of a foreign body significantly reduces the body's immunity and decreases the number of bacteria needed to produce an infection. Prosthetic or indwelling medical devices such as urethral catheters, suprapublic catheter, nasogastric tubes, hemodialysis catheters, central venous catheters, and tracheostomy tubes are associated with higher…...

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References

Chambless, J.D., Hunt, S.M., & Stewart, P.S. (2006). A three-dimensional computer model of four hypothetical mechanisms protecting biofilms from antimicrobials. Appl Environ Microbiol, 72(3), 2005-2013. doi: 10.1128/aem.72.3.2005-2013.2006

Chu, V.H., Crosslin, D.R., Friedman, J.Y., Reed, S.D., Cabell, C.H., Griffiths, R.I., . . . Fowler, V.G., Jr. (2005). Staphylococcus aureus bacteremia in patients with prosthetic devices: costs and outcomes. Am J. Med, 118(12), 1416. doi: 10.1016/j.amjmed.2005.06.011

Cookson, S.T., Ihrig, M., O'Mara, E.M., Denny, M., Volk, H., Banerjee, S.N., . . . Jarvis, W.R. (1998). Increased bloodstream infection rates in surgical patients associated with variation from recommended use and care following implementation of a needleless device. Infect Control Hosp Epidemiol, 19(1), 23-27.

Digiovine, B., Chenoweth, C., Watts, C., & Higgins, M. (1999). The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J. Respir Crit Care Med, 160(3), 976-981. doi: 10.1164/ajrccm.160.3.9808145

Caglar S; Yildiz S; Savaser S. (2010). Observation results of hand-washing by health-care workers in a neonatal intensive care unit. International Journal of Nursing Practice, 16(2), 132-137.
In this article the authors wanted to determine whether healthcare professionals were washing their hands and if they were doing so effectively. The researchers observed 344 incidents in which hand washing was warranted and found that nurses were 63% compliant and physicians were 53% compliant. However, when it came to making sure that the job was done thoroughly, physicians were able to do a better job than nurses at a 24% to 13% rate of success. Since hand washing has been proven to be the most effective and simplest method for preventing infection, it is imperative that healthcare professionals perform it as often as needed and thoroughly.

amos M.M., Schrader, ., Trujillo, ., Blea, M., & Greenberg, C. (2011). School nurse inspections improve hand-washing…...

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Researchers are trying different techniques to increase the incidence of compliance with hand washing guidelines and in this study they used social pressure. Initially, compliance with hand washing regulations was deemed to be significantly below expected standard within the nursing staff. To hopefully combat this, researchers told the staff that they were going to weigh the soap dispenser bags to see if people were actually using them or not. The object of the study was to determine if this type of pressure would induce the staff into better compliance with hand washing regulations. The researchers found that this type of behavioral technique is very effective.

15. Parish, C. (2008). Patient campaigner calls for TV cameras to check hand-washing. Nursing Standard, 22(38), 6.

The author of the article looked at the compliance records of staff and whether patients and visitors used infection controls. The campaigner, Roger Goss, said that because MRSA and other similar healthcare-acquired infections were becoming more dangerous that staff and visitors needed to be monitored more closely to prevent spread. The man advocated that close-circuit televisions be used to determine compliance with regulations, and he encouraged staff to be fired and visitors not welcomed if they did not comply. The warning here to nurses is that people are watching whether they wash their hands properly, and they are ready to have them terminated if they do not.

Urinary tract infections (UTIs) are typically the most prevailing healthcare-associated infection (HAI) in acute care facilities in the U.S. The Centers for Disease Control and Prevention (CDC) has estimated that up to 150,000 hospital-onset, symptomatic catheter-associated UTIs (CAUTIs) occurred in 2013, resulting in as much as $161 million in excess direct medical costs (Kuntz, 2010, p. 319). Current research examines the reason for such a high occurrence of infection. oughly 75% of healthcare-associated UTIs are connected to improper use of indwelling urinary catheters, to which up to a quarter of hospitalized patients are exposed. Adult ICUs have the highest exposure rate for catheter use and reveal over 95% of UTIs related to catheter use.
In the last twenty years, various strategies have been implemented to aid in reducing the risk of CAUTI in healthcare settings. One of which includes identifying proper times to use catheters and proper care and insertion…...

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References

Deron, D.C., Edwards, J.R., Srinivasan, A., Fridkin, S.K., & Gould, C.V. (2011). Trends in Catheter-Associated Urinary Tract Infections in Adult Intensive Care Units -- United States, 1990 -- 2007. Infection Control and Hospital Epidemiology, 32(8), 748-756.

Flynn, M.B., Martins, S.A., Burns, S., Philbricks, D., & Rauen, C. (2013). Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence. Critical Care Nurse, 23(2), 37. Retrieved from  http://www.aacn.org/wd/Cetests/media/C1322.pdf 

Goeschel, C.A., Cosgrove, S.E., Romig, M., & Berenholtz, S.M. (2011). Prevention of Central Line -- Associated Bloodstream Infections: A Journey Toward Eliminating Preventable Harm. Current Infectious Disease Reports, 13(4), 343-349.

Kuntz, G. (2010). Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009. Infection Control and Hospital Epidemiology, 31(4), 319-326.

Psuedomonas Aeruginosa
Pseudomonas aeruginosa

Epidemiology

The Gram-negative, motile, rod-shaped bacterium Pseudomonas aeruginosa is an opportunistic killer that takes advantage of people suffering from medical problems (Van Delden and Iglewski, 1998).For this reason, P. aeruginosa is one of the most common nosocomial infection that occurs in hospitals. P. aeruginosa is responsible for causing 16% of pneumonia cases, 12% of urinary tract infections, 10% of bloodstream infections, and 8% of surgical infections due to hospital care. Patients who are immune-compromised are also susceptible to P. aeruginosa infections, such as patients undergoing chemotherapy, suffering from HIV / AIDS, recovering in burn units, and suffering from cystic fibrosis. With death rates ranging from 30 to 60% for these patients, P. aeruginosa is considered to be a significant threat to patient health.

Ecology

P. aeruginosa can switch between a free-swimming planktonic form and colonies enclosed within slime-protected biofilms attached to surfaces (Baltch and Smith, 1994, p. 1). The planktonic form…...

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References

Baltch, A.L. And Smith, R.P. (Eds.). (1994). Pseudomonoas aeruginosa Infections and Treatment. New York, NY: Marcel Dekker, Inc.

Botzenhart, Konrad and Doring, Gerd. (1993). Ecology and Epidemiology of Pseudomonas aeruginosa. In M. Campa, M. Bendinelli, H. Friedman (Eds.), Pseudomonas aeruginosa as an Opportunistic Pathogen (pp. 1-18). New York, NY: Plenum Press.

Hawkey, Peter M. And Kerr, Kevin G. (2004). Laboratory investigation of health care-associated infection. In P. Hawkey and D. Lewis (Eds.), Medical Bacteriology: A Practical Approach (pp. 331-354). Oxford, UK: Oxford University Press.

Hurley, Matthew N., Camara, Miguel, and Smyth, Alan R. (2012). Novel approaches to the treatment of Pseudomonas aeruginosa infections in cystic fibrosis. European Respiratory Journal, published online ahead of print, 1-19. Retrieved 23 July 2012 from  http://erj.ersjournals.com/content/early/2012/06/27/09031936.00042012.long .

Management of Immunocompromised Patients
In beginning I writer specific nursing assignment. The Question: 2000 Words While clinical placement asked prepare a single room an admission. The patient requiring admission isolation room immunocompromised.

Immunocompromised patients usually require isolation in order to prevent them from becoming infected with infections from other patients which is known as protective isolation. For the immunocompromised patients, their immune system is unable to fight the infectious diseases. There are many diseases or conditions that lead to immunodeficiency in patients.

One is AIDS (acquired immunodeficiency syndrome). The pathophysiology of AIDS starts when the person's CD4+ T cell count begins to decrease as the disease kills these cells. This is HIV-induced cell lysis where the virus enters the CD4+ cells where it inserts its genetic information to the cell nucleus thus taking over the cell and replicating itself. The virus then mutates extremely rapidly thus making it more and more difficult for…...

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References

Agusti, C., & Torres, A. (2009). Pulmonary Infection in the Immunocompromised Patient: Strategies for Management. New York: John Wiley & Sons.

Bodey, G.P. (2010). Managing Infections in the Immunocompromised Patient. Clinical Infectious Diseases, 40(Supplement 4), S239. doi: 10.1086/427328

Glauser, M.P., & Pizzo, P.A. (2009). Management of Infections in Immunocompromised Patients New York: Elsevier Health Sciences.

Hayden, R.T. (2008). Diagnostic Microbiology of the Immunocompromised Host. Washington, DC: ASM Press.

This clearly shows that alcohol-based hand-washing, when used regularly and vigorously (e.g. prior to any healthcare procedure by any level of personnel), infection will be reduced.
The Saudi study was a bit more detailed, with protocols varying depending on severity of procedure (surgery, etc.) and the administering of prophylactic antibiotics as part of the regular treatment procedure. Statistical analysis of the samples showed no significant differences between the Betadine Group and the Alcohol-Based Gel Group. However, the total number of infections within both groups were quite small, 20 out of 600 subjects in the trial. This suggests that the conditions at the Saudi hospital were already more sterile, with less than 5% (3.33%) even developing infections; compared to 13.1% in Vietnam. In both cases, demographic differences between patients were not statistically significant in the protocol.

Combining the data from the two studies, however, results in two conclusions: 1) There is a…...

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REFERENCES

Al-Naami, M.Y., et al., (2009). EWMA Journal. 9 (3): 5-10.

Nguyen, K., et al., (2008). Tropical Medicine and International Health. 13 (10): 1297-1302.

Informatics and Nursing Quality Sensitive IndicatorsIntroduction: Nursing-Sensitive Quality IndicatorThe National Database of Nursing-Sensitive Quality Indicators (NDNQI) is a tool designed to help nurses track and improve the quality of care they provide. The NDNQI consists of a set of indicators that measure various aspects of nursing care, including patient satisfaction, nurse turnover, and falls rates. By tracking these indicators, nurses can identify areas where care could be improved and work to implement changes that will improve the quality of care they provide. In addition, the NDNQI provides data that can be used to compare the performance of different hospitals and nursing homes. As a result, the NDNQI is an important tool for ensuring that nurses are providing high-quality care (NM, 2022).What They AreNursing-sensitive quality indicators (NSQIs) are measures of the quality of care provided by nurses. They are used to assessment the impact of nursing care on patient outcomes, and…...

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ReferencesGray, D., Nussle, R., Cruz, A., Kane, G., Toomey, M., Bay, C., & Ostovar, G. A. (2016). Effects of a catheter-associated urinary tract infection prevention campaign on infection rate, catheter utilization, and health care workers\\\\\\\\\\\\\\\' perspective at a community safety net hospital. American journal of infection control, 44(1), 115-116.Maryniak, K., & Garrett, R. (2022). Best Practices to Prevent Nursing Errors. In Preventing Errors and Pitfalls in Nursing with Infectious Patients (pp. 59-88). Springer, Cham.NM. (2022). Retrieved from  https://www.nm.org/about-us/quality/quality-measures/sites-of-care/northwestern-memorial-hospital/national-comparisons/ndnqi-national-database-of-nursing-quality-indicators#:~:text=%E2%80%9CThe%20National%20Database%20of%20Nursing%20Quality%20Indicators%C2%AE%20%28NDNQI%C2%AE%29,States.%E2%80%9D%20Source%3A%20National%20Database%20of%20Nursing%20Quality%20Indicators

Here are some strategies that healthcare providers can use to effectively manage pneumonia in older patients with underlying health conditions:

1. Early detection and diagnosis: Healthcare providers should be vigilant in monitoring older patients with underlying health conditions for symptoms of pneumonia. Early detection and prompt diagnosis are crucial in initiating appropriate treatment.

2. Tailored treatment plan: Healthcare providers should develop a tailored treatment plan for each older patient with pneumonia, taking into account their underlying health conditions, age, and overall health status. This may include antibiotic therapy, oxygen therapy, and other supportive measures.

3. Close monitoring: Healthcare providers should closely monitor older....