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EB Outcomes in nursing

Introduction
This EBP project will utilize the Stetler model of evidence based planning and the practice implementation. The model uses the experiences of daily practice to inform the planning and the implementation of the change program (Stetler, 2010). In the current case, the change program will use the evidence collected from research studies, towards identifying areas of change and implementing the proposed changes in the area of nursing care. During the planning and the implementation of the change, the practitioners covered by the program will use the findings of previous research studies and other evidence-bases towards improving nursing practice (Stetler, 2010).  This paper will discuss the implementation of a change program covering poor hand washing among healthcare service providers at Veema center, which has been found to cause adverse outcomes, during service delivery (Titler, 2008).
Planning for Change
This stage will cover the phases of preparation (Phase I), Validation (Phase II), and Decision making/ Comparative Evaluation (Phase III)
From the evidence given studies, including Garrette (2013) and Canham (2011) hand hygiene is acknowledged by control experts and infection prevention personnel, as the single and most effective measure that helps in reducing the spread of infections in the community and at health care settings (Garrette, 2013). This is the case, because the hands are transmission areas between individuals and the objects, as well as the surfaces within the healthcare environment. Some of the objects that can transfer infections in the healthcare setting include blood pressure cuffs. The means of hand hygiene include that of using soap and water, and using alcohol-based products, in the cases where water and soap cannot be used. The World Health Organization (WHO) and the CDC (Center for Disease Control and Prevention) maintain that hand hygiene can aid healthcare providers to uphold quality practice, and patient safety (Pittet, Allegranzi & Boyce, 2009). The practice of extensive hand washing will lessen the risk of infection between patients, lessen the infection of healthcare personnel, and lessen the cases of morbidity, mortality and the costs incurred during the treatment of infection-based conditions (Garrette, 2013).
In preparation for the change, a survey was administered to the personnel at the health care center, aiming at realizing the factors limiting hand hygiene. Some of the factors explained as causes of poor hand hygiene at the health center and from studies like Garrette (2013) and Pittet, Allegranzi and Boyce (2009) include that hand washing agents leads to dryness and the irritation of the skin; sinks are not available in convenient areas and there is also a lack of soap, water, and disposable towels for drying hands. Others include understaffing, giving priority to patient care needs, disagreement with hand hygiene directives and the low risk of getting infected by patients (Cambell, 2010).
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