During this program, you will complete an evidence-based practice project addressing a problem, issue, or concern in your specialty area of professional practice. Consider an area in your specialty that you believe needs improvement. Which nursing theories could you apply to this problem? Why is this the best theory?
Education of the correct technique of aseptic hand washing needs improving in the perioperative setting. The CDC recommends the use of alcohol-based hand sanitizer as the primary method for hand hygiene in most healthcare situations. The alcohol-based hand sanitizers used for surgical hand washing is the most popular choice with the surgical team due to its easy application and its fast-drying time. In the perioperative setting, the recommended use is a total of 3 applications or 3 pumps out of the applicator to be used on bilateral upper extremities prior to donning on gown and gloves. Because of its ease of use, it is most often misused by staff. The perioperative staff is seen often applying 1 application or 1 pump to bilateral upper extremities. 1 application of alcohol-based sanitizer should be applied to one extremity at a time and the 3 applications should be applied to bilateral hands up to the bilateral wrists simultaneously.
The main objective of aseptic hand washing is to reduce as much as possible of the germ load (especially bacteria) that may be found on the skin of the hands and arms of the surgical team. It is widely known that saprophytic microorganisms live on the skin, but in the case of health personnel, pathogenic bacteria, and fungi (capable of producing infections) can also be found that, although they do not directly affect them, can be transmitted to the sick. (Gavin, 2003). The CDC states that hand washing is the first line of defense in the fight against postoperative infections. If aseptic hand washing is not applied correctly by the perioperative staff, it could put intraoperative patients at risk for surgical site infections. This statement also applies to all patients in all areas of the healthcare settings.
Nightingale’s environmental theory states that the environment is partly responsible for the patient’s health. This theory can be applied to the perioperative setting. An environmental factor affecting health with a positive patient outcome is cleanliness. Cleanliness is a greater part of nursing consisting in preserving health. This theory is supportive for research and evidence-based practice. Daily audits by observations would have to be obtained to monitor the effects of teaching and the retention by the staff. Feedback from infection control the department would be also helpful in monitoring the effectiveness of hand washing.
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Gavin, M., (2003, April 1). Perioperative Hand Hygiene: The Challenge of Integrating Rinseless Products in the OR. Infection Control Today. https://www.infectioncontroltoday.com
Hand Hygiene in Healthcare Settings Page last reviewed: July 28, 2022. Centers for Disease Control and Prevention. https://www.cdc.gov
I agree with your post! Florence Nightengale’s Environmental Theory was developed to address the problem in the nursing environment. When a patient is admitted to an institution of healthcare, the patient needs a certain environment to heal and and even to be discharged, according to this theory. Ventilation and warming in institutions are some of the primary factors defined by this theory. Patients must be kept warm and the units must be properly ventilated to avoid infections and re-infections. Hospitals or institutions cleanliness of the area, proper lighting, and controlled noise are also identified as important factors in the process of a patient getting well enough to go home. Other critical factors that nurses must take into consideration includes a nurses own personal cleanliness, a clean bed and linens, proper nutrition, close observation, and taking care of a patient’s mental health by offering them hope and advice as may be necessary. This theory reminds nurses that nursing is a calling and they must be ready to serve the population of the sick and dying. It prepared the nurse psychologically, which will make it easy to deliver patient care without complaints. This theory was developed by the founder of modern nursing, and it has stood the test of time.
