Educational interventions may increase adherence (Huang et al., 2002), especially when provided by a clinical role model (Whitby et al., 2006; Ellingson et al., 2014). Likewise, LTCF nurses who received HH training using return demonstration were more likely to educate patients, family members, or visitors (Hill et al., 2014).
Internal HSBs: Bacterial Load
Bacterial load refers to the measureable quantity of pathogenic bacteria present on cultures. Bacterial load will quantify the number of strains present as well as the amount of each strain present. The distinction between colonization and infection is important. Colonization is the presence of the bacteria, without illness or infection (WHO, 2006). Infection refers to clinical signs
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Administrative support and leadership is associated with improved adherence rates. Understaffing and workload correlates to HH nonadherence (Liu et al., 2014; Ellingson et al., 2014), while shared accountability and financial incentives may lead to sustained HH adherence (Talbot et al., 2013). Feedback should be timely and include HH adherence and HAI rates. Feedback may be provided privately or publicly. For example, just-in-time coaches may provide one-on-one point of care counseling on proper HH (Chassin, Nether, Mayer, & Dickerson, 2015). Corporate aggregate data may be posted in hallways to promote transparency.
Because no behavioral theory consistently predicted behavior, Kretzer and Larson (1998) proposed a multimodal approach to connect institutional and individual factors. Inclusion of the individual enhances the individual’s commitment to achieving the goal, reducing the difficulty of getting individuals to buy into HAI prevention (Harrod et al., 2014). In other words, an individual with a high sense of self-efficacy who understands and believes in the institution's HH goals will strive to attain those goals (Kretzer & Larson,
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Self-protection is a strong motivator. The HHP will promote patients’ sense of self-efficacy as the HH skill remains with patient regardless of setting or staffing. The HHP allows the patient to serve as a role model to others regarding HH. The HHP is an example of patients and nurses working as partners in health to enhance comfort, resulting in realistic and desirable
Still, the previous advantages discussed should influence the nurse to improve in identifying patient vulnerability. This is evident by this patient where I utilized my interpersonal skills to communicate to this patient so that he/she is aware that he/she is not alone in this journey. Nurses need to utilize models and theories to guide nursing practice. For instance, McCormack’s framework focuses on patient-centered care which influences nurses to understand the patient as a whole and their values (Abley, 2012, p. 42). Being able to identify values will give nurses and myself a better comprehension about the patients resulting in worthiness and belonging expressed. As a result, informing nurses about patient’s subjective vulnerability because a trust and understanding relationship is established. This is supported in a clinical experience where a patient “felt understood and opened up for further interactions based on trust” through an honest, supportive relationship with a nurse (Gjengedal, 2013, p. 134). Nurses should provide patient-focused provision of service, and assist this patient in overcoming his/her obstacle as a way of encouragement. Furthermore, Sellman (2005) explains how encouragement may compromise human flourish (p. 7), it is dependent on the situation and it cannot be assumed all encouragement will lead to harm. This informs nurses to be aware of the consequences that prevent the
...s, K.D., London, F. (2005). Patient education in health and illness (5th ed.). New York: Lippincott.
... have shown that by increasing education or explaining rationale to clinicians, they are more likely to follow protocol.
As our health care system continues to evolve and become more focused on a preventive and coordinated approach to patient care, we too must progress and create programs that follow such principles. The Patient-Centered Medical Home (PCMH) model follows similar ideologies and recently has gained increasing support. The patient’s primary care physician, who will provide preventive and continuing care for the patient, directs this medical model. The PCMH model of care is comprised of a health care team working together to serve their patient and provide quality care.1 The model works to empower the patient by promoting communication with not only the physician but with the nursing staff, specialists, and other health care providers. Every patient
Glanz, K., Rimer, B.K., Lewis, F.M. (2002). Health behavior and health education. San Francisco: Jossey-Bass
DiClemente, R. J., Salazar, L. F., & Crosby, R. A. (2013). Health Behavior Theory for Public Health: Principles, Foundations, and Applications. Burlington, MA: Jones & Bartlett Learning
The health care system of today will be invaluable without the help of well-trained registered professional nurses. According to Wilkinson, Treas, Barnett, Smith (2016) registered nurses in today’s health care have the training required to develop a care plan with other health care workers that is specific for each patient in their care, instead of the same general approach for every patient. This is known as patient centered care because each patient is different from the other and the registered nurse role includes developing a good plan for every patient they care for. In performing such duties, registered nurses tend to create a strong bond with their patients by caring for their patients by all means possible. By caring for their patients, they tend to gain their patients and their families trust. According to Wilkinson et al. (2016) There are many support systems for patients in our communities that have good intentions of assisting sick people and those in need. Most of them are not known by the patient or their families. The registered nurse is the one who is in the position to inform the patient or family about such resources that may be very helpful for them if they are interested. By doing so, the patient knows that the nurse really cares about him/her and that feels very comforting and may help the patient get well
Communication is an essential tool of a HCP and defines the first impression a patient receives.
During my career as a registered nurse I have had the privilege of caring for my patients at the bedside and meeting their needs holistically. Additionally, the safety of my patients is one of the most important aspects of my current role. The experience of advocating for my patients during my nursing career has taught me to place my patient’s health and wellbeing first. The second most important aspect of nursing that I have learned during my career is how to meet my patient’s needs as a whole, not just physically but also emotionally and psychologically applying the holistic approach to each patient. I believe that the patient’s needs
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
Therefore, I strive every day to be that professional, that health care provider that has a positive and long lasting impact on patient’s health and wellbeing. I always strive to be that professional that my patients and colleagues trust, respect and admire. As a registered nurse, I have accomplished that. I know it because I am asked to precept new nurses and students, because my colleagues come to me frequently to ask me questions when they are in doubt, because when there is a difficult or complicated patient, my supervisor trust me with his care, because at the end of a long busy shift with seven to eight patients under my care, my patients praise me and thank me for the great and unique care I provided them.
Any learning that occurs should focus on treatments, tests, and minimizing pain and discomfort as they improve they can shift their focus of learning (Kitchie, 2014, p.127). I will continue to provide a meeting location that is both comfortable and private. In the emotional aspect of M.M. and her family I will try to identify moments when members feel emotionally supported as it sets the stage for a teachable moment (Miller & Nigolian, 2011, p.56). I will also discuss with each member their previous coping strategies that used that have been successful and to encourage them to find a way to build on and strengthen these qualities. Using teaching methods that are interactive and allow patients equal contributions and participation can help promote health compliance (Habel, 2005,
Before when our HCAHPS scores where in the eighty percent level overall the survey reports were read only on Mondays. We have gained new employees which has helped in productivity, but has caused a decrease in patient satisfaction. The director reads the scores everyday now which one could consider it as nagging or a negative reinforcement. (Hirsch, n.d.). If the director or other staff probe the employee why he or she received the bad rapport, the laborer usually goes into defensive mode and will give excuses. People that have worked there for years are experiencing a drastic
UPenn, e. (n.d.). Health Behavior and Health Education. Perelman School of Medicine at the University of Pennsylvania. Retrieved April 21, 2014, from http://www.med.upenn.edu/hbhe4/part4-ch15-organizational-development-theory.shtml
Moody, J. (2011). Strengthening prevention program theories strengthening prevention program theories. Society for Prevention Research, 349-360.