Introduction
MRSA is a major source of healthcare associated diseases, increased hospital mortality, and leading surgical site infection (Jennings, Bennett, Fisher, & Cook, 2014, p. 83). With the implementation of active surveillance screening and contact isolations program, an overall decrease in hospital associated MRSA infections has been observed (Jennings, Bennett, Fisher, & Cook, 2014, p. 83). The author of this paper will identify a theory that can be used to support the proposed intervention i.e., reduce the transmission of MRSA by active screening in patients at high-risk for MRSA on admission. This paper will then describe the selected theory, and rational for the selection, and how this theory will support the proposed solution and how to incorporate this theory in this project.
Theoretical framework: Kurt Lewin’s Change Theory
A theoretical framework provides guidance as a project evolves. The end results will determine whether the knowledge learned from implementing a project should create a change in practice (Sinclair, 2007). In this project is relied on the Kurt Lewin’s Change Theory. Burnes (2004) states that despite the fact that Lewin built up this three-step model more than 60 years prior, it keeps on being a commonly referred framework to support effective change projects. The three steps are unfreezing, moving and refreezing. Lewin decided in Step 1, unfreezing, that human conduct is held in balance by driving and limiting powers. He trusted this equilibrium should be disrupted with the end goal for change to happen (Burnes, 2004). Step 2 or moving, includes learning. Learning incorporates knowledge of what the conceivable alternatives are and proceeding onward from past practices to new practices which will...
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... be incorporated for this project. For implementing this proposal, Step 1, unfreezing is needed. The current admission procedures for all high-risk patients need to be evaluated and if needed a new policy for enforcing admission screening for MRSA should be introduced. Secondly using Step 2 or moving, includes learning, will be incorporated by providing adequate training and learning sessions on the proposed intervention. Finally the Step 3 or refreezing, will help to maintain the new policy in the health care setting, once all health care workers learned and adapted to the implemented changes.
Conclusion
With the intent to select a nursing theory to support the implementation of admission screening for MRSA, the author has selected Kurt Lewin’s Change Theory, since this theory can be effectively incorporated in implementing a new evidence-based nursing intervention.
Rouda, R. H., & Kusy, M. E., Jr. (1996, May 4). MANAGING CHANGE WITH LARGE-SCALE, REAL-TIME INTERVENTIONS. Tappi Journal. Retrieved from http://alumnus.caltech.edu/~rouda/T5_LSRTOD.html
According to the Centers for Disease Control and Prevention (2013), MRSA is easily transmitted from person to person or from touching materials or surfaces that had previous contact with the infection. Using the implementation of infection control along with patient education will help in the decrease of the spread and help in the prevention in MRSA as well as get patients involved in their own care. The purpose of this paper is to present the problem of MRSA as well as include the rationale and history, review the proposed solution, integrate an implementation plan, summarize the literature review, establish an implementation plan, use a nursing theory to support the implementation plan, use a change theory to support the implementation plan, discuss how the project will be evaluated, and create a dissemination
Kurt Lewin, a social psychologist developed this theory in the early 20th century. He was the first to recognize that change should be planned and not allowed to happen by chance or haphazardly. There are three stages of change according to Lewin’s theory.
Because of this issue the CDC has instituted a campaign entitles, "Campaign to Prevent Antimicrobial Resistance." The campaign focuses on four integrated strategies: preventing infection, diagnosing and treating infection effectively, using antimicrobials wisely, and preventing transmission.() This campaign consists of 12 steps that teach nurses as well as other healthcare providers about antimicrobial resistance and presents plans to advance nursing practice, as well as antimicrobial use.
One factor prevalent in our nation’s hospitals which, although under-represented by the media, is significantly detrimental to the advancement of the United States healthcare system is Hospital/Healthcare Associated Infections, or HAIs. These infections were first identified as a serious threat to patient safety during the 1930s. In the 1940s, The British Medical Council appointed infection officers in various hospitals to attempt to regulate and control causes of infection, although such officers only became common in the 1950s during a severe outbreak of Staphyloccosus. After a brief investigation had been conducted, it was found that nearly 100% of patients and staff in various British hospitals had contracted elements of the virus through lack of hygienic precaution during open wound surgeries. Fortunately, the ready availability of penicillin prevented a severe outbreak, but the continued overuse of the drug resulted in drug resistant bacteria and virus and the discovery of the Staphyloccosus Aureus - a virulent skin pathogen immune to initial penicillin serums and recognized as the first antibiotic resistant bacterium - in the late 1960s. By the early 1970s, the drive to control hospital infections was well established in the United States, however, the movement was unorganized and there was no success in eliminating infections associated with medical practices at the time. It was not until 1976 that the control of infectious diseases in hospitals was transformed from a movement to a mandate when The Joint Commission on Accreditation of Hospitals demanded that accredited hospitals have infection control programs. Currently the majority of research of HAIs is conducted by the CDC through The Prevention Epicenter Program, w...
Patient education is of paramount importance if MRSA is to be reduced to its lowest minimum. According to Noble 2009, patient’s education stands a critical component of managing MRSA therefore; nurses are expected to be prompt in educating patients on specific measures in limiting and reducing the spread of MRSA by person to person contact. (Noble, 2009) The specific measures includes definition of MRSA, mode of transmission, the damage it can do to the body, specific treatments available and the process of treatment. This is to help the patient take part in the care. Noble 2009 explains that during care giving nurses and all other healthcare provider involve in giving care to a patient should communicate to patient all the precaution that will prevent the transmission of MRSA, and also giving the scientific rationale for the use of any precaution that is been used in the cause of care giving. (Noble, 2009.)
The 7 Levels of Change provides a different way of thinking to enhance behaviors and processes. The author demonstrates throughout the book a seven process of change that builds upon the next. He believes that by thinking differently, being creative and stepping out of the norm is the catalyst to solutions and results beyond one’s expectations. Although the author uses the analogy of a new work environment to expound on the level of changes, the fundamentals can be used in both your personal and professional life.
The internal validity is, that because nurse know they are being observed they will be more cautious on how they perform all types of procedures and not just hand washing. If the nurses are more cautious than this can have an effect on the results. Because nurses are being more cautious that might be another factor on why the numbers of hospital acquired infections are reducing. The external validity in this study is the population’s age group. This study will focus on patients ages 40-60. Because a specific age group is being studied it is not known whether this method will have the same effect on the other different age groups.
...f infections acquired during the hospital. Many of these studies have indicated that these infection control interventions will decrease the number of sick or dying patients related to hospital acquired infections and lower the medical cost by decreasing the stay of each patient in the hospital.
Graetz, F., & Smith, A. C. T. (June 2010). Managing organizational change: A philosophies of change approach. Journal of Change Management 10(2), 135–154.
The infection control plays an important role for the prevention from bacteria and other microorganism that may affect the condition of the patient.
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
(2014) shed light on two key components for infection control, which includes protecting patients from acquiring infections and protecting health care workers from becoming infected (Curchoe et al., 2014). The techniques that are used to protect patients also provide protection for nurses and other health care workers alike. In order to prevent the spread of infections, it is important for health care workers to be meticulous and attentive when providing care to already vulnerable patients (Curchoe et al., 2014). If a health care worker is aware they may contaminate the surroundings of a patient, they must properly clean, disinfect, and sterilize any contaminated objects in order to reduce or eliminate microorganisms (Curchoe et al., 2014). It is also ideal to change gloves after contact with contaminated secretions and before leaving a patient’s room (Curchoe, 2014). Research suggests that due to standard precaution, gloves must be worn as a single-use item for each invasive procedure, contact with sterile sites, and non-intact skin or mucous membranes (Curchoe et al., 2014). Hence, it is critical that health care workers change gloves during any activity that has been assessed as carrying a risk of exposure to body substances, secretions, excretions, and blood (Curchoe et al.,
The responsibility of preventing hospital acquired infections does not solely rest upon the feet of the nursing staff. The effort must be a team effort that includes all of the personnel at a facility.
The change process within any organization can prove to be difficult and very stressful, not only for the employees but also for the management team. Hayes (2014), highlights seven core activities that must take place in order for change to be effective: recognizing the need for change, diagnosing the change and formulating a future state, planning the desired change, implementing the strategies, sustaining the implemented change, managing all those involved and learning from the change. Individually, these steps are comprised of key actions and decisions that must be properly addressed in order to move on to the next step. This paper is going to examine how change managers manage the implementation of change and strategies used