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Improving Health Outcomes:
Principles of Infection Control and Prevention
Shannon E. Curry
Western Governors University
College of Health Professions
Introduction of the project
- Capstone field experience took place in the University of Missouri: Kansas City (UMKC) nursing school simulation laboratory
- Introduce Dr. Christine Zimmerman RN, PhD, CHSE
- Improving Health Outcomes: Principles of Infection Control and Prevention
The Course
Improving Health Outcomes: Principles of Infection Prevention and Control
- Creation and implementation was completed alongside Dr. Zimmerman for approximately 6 weeks.
- Created to mimic a free-standing training program, the project is 6-8 hours in length, primarily occurring over 1 day in the simulation lab.
- There is pre-work.
- Students will be graded on simulation scenario performance.
Gap in Education
Gap In Education
- "Healthcare-acquired infections are among the most commonly reported adverse events in healthcare (Whitcomb, 2014, p. 269)."
- There is a discrepancy in didactic content covered and clinical experience.
- The content is provided clearly, without distraction of other complex topics. At UMKC this content is woven throughout various courses when applicable.
Current Evidence & Literature
Current literature and practice...
- "Hours of infection prevention education recieved among student nurses was significantly associated with student nurses' self-reported ability to comply with infection prevention practices (Carter et al., 2017, p. 24)."
- "Cross-infection of patient's by HCWs [healthcare workers] with contaminated hands remains a significant driver of HAIs (Cox et al., 2015, p. 56)"
- Research shows students readily see errors in infection prevention measures (Whitcomb, 2014).
- More time spent with undergraduate nurses on infection prevention and control, research shows they will have a better understanding and more confidence when using infection prevention measures (El Bushra et al., 2017; Whitcomb, 2014). '
- Infection prevention aligns with nursing ethical principles.
- Simulation experiences and problem-based learning allows educators to assist in the development of essential nursing behaviors.
Implementation Steps
Implementation Plan
- Identified preceptor, Dr. Christine Zimmerman.
- Literature review revealed education gap in infection control and prevention. Topic was compared to nursing benchmarks like QSEN, education standards like Scope & Standards of RNs, and infection control and prevention standards outlined by CDC and WHO. Research compared and defined the gap in education to field and clinical experiences.
- Compared literature review information to current practice at UMKC.
- Created an interprofessional team composed of faculty at UMKC to determine implementation plan specifics.
- Course will utilize problem-based learning (PBL) with aspects of a flipped classroom model and the use of simulation manikins.
Lesson Topic
Lesson Topic
This learning experience allows universities to offer students an engaging and creative learning experience providing infection prevention and control the deserved attention. The educational program is built to take place in one day and is anywhere from 6-8 hours in length, but includes online material, and pre- and post-quizzes. Students will also partake in a simulation experience that will place them in everyday bedside scenarios. Students will collaborate with staff and peers to learn current, evidence-based principles of infection control and prevention.
Learning Objectives
Learning Objectives
- At the end of the course, the student will be able to assess risk factors for infection of a simulated patient.
- At the end of the course, the student will be able to categorize patient diagnosis or procedure protocol with appropriate CDC guidelines and standards.
- At the end of the course, the student will be able to perform a demonstration of hand hygiene and sterile field set-up/technique.
- At the end of the course, the student will be able to apply required material themes within the confines of a simulated scenario.
Teaching Strategies
Teaching Strategies
The course mimics a free-standing training program, in that students engage with faculty in 6-8 hours of online and in-person simulation lab time. The program will utilize the following teaching strategies:
- PBL
- A flipped classroom model
- Simulation manikin learning scenarios
Required Materials
Required Materials
- Fundamentals of Nursing compiled by Patricia A. Potter, Anne Griffin Perry, Patricia A. Stockert, and Amy M. Hall. A 9th edition was published in 2017.
- Centers for Disease Control and Prevention (CDC) website containing infection control basics https://www.cdc.gov/infectioncontrol/basics/index.html.
- "5 Moments for Hand Hygiene," campaign poster found at https://www.who.int/infection-prevention/campaigns/clean-hands/5moments/en/.
Student Learning Outcomes
Student Learning Outcomes
- Assess infection risk
- Confidently choose PPE based on patient diagnosis
- Critically evaluate positive and negative impacts related to infection control and prevention
- Collaborate with faculty and peers to practice isolation precaution categories
- Engage in active simulation scenarios related to infection control and prevention
- Successfully complete hand hygiene and sterile technique.
Lesson
Plan
Details
Lesson Plan Details
Ten Key Concepts
Ten Key Concepts
- Explain the parts of the infection chain. (L.O. #1,3)
- Identify patients most at risk for infection. (L.O. #1,4)
- Describe the signs and symptoms of a localized infection versus a systemic infection. (L.O.#1)
- Perform proper hand hygiene. (L.O. #3, 4)
- Perform sterile technique. (L.O. #3, 4)
- Identify proper precautions for common hospital procedures. (L.O. #2)
- Differentiate the terms disinfection, asepsis, and medical sepsis. (L.O. #3)
- Names types of PPE. (L.O. #2, 4)
- Define and compare the terms standard precautions, airborne precautions, and droplet precautions. (L.O. #2)
- Match isolation precautions to various diagnoses. (L.O. #2, 4)
Required Readings/Materials
Required Readings
- The Fundamentals of Nursing text, will only require understanding of chapter 29.
- "5 Moments For Hand Hygiene," campaign poster created by The WHO.
- Students should understand how to utilize government funded websites like The CDC and The WHO.
Non-gradable Experiential Activity
Non-gradable Activity
The process of hand hygiene will make up this activity.
Student reading: pages 471-472 in The Fundamentals of Nursing.
Activity can be supported by the "Hand Washing Experiment," found on the CDC website.
Correlates with learning objectives 3 &4.
Authentic Assessment/Assignment
Authentic Assessment/Assignment
Each student will complete an infection risk assessment within a simulated scenario.
Student reading: pages 448-451 in The Fundamentals of Nursing text, box 29-5 provides "Nursing Assessment Questions."
Correlates with student learning objectives 2 & 4.
Critical Thinking Activity
Critical Thinking Activity
Student will participate in a 30-minute simulated scenario where they will be expected to successfully complete a catheterization using sterile technique, hand hygiene, cleaning of supplies like a stethoscope, and an infection risk assessment.
Student reading: The Fundamentals of Nursing text, specifically chapter 29.
Correlates with learning objectives 1, 2, 3, & 4.
Evaluation Plan
Evaluation Plan
How to Determine Success?
How to determine success?
- Post-course quiz
- Authentic assessment/assignment
- Critical thinking activity
Decision-making process to determine efficacy
- Frequent evaluations
- Interprofessional team
- Future planning
Decision-Making Process
Future Outcomes
- Interprofessional Collaboration
- Positive impacts on faculty communication
- Opportunity for formative and summative evaluation
- Course expansion to impact more experienced students
- Narrow the gap between education provided and clinical experience received
Challenges
Challenges
- Timing of capstone project
- Utilizing more diverse teaching techniques
- IT challenges
- Staff/faculty assistance
Short- and long-term maintenance
Maintenance
Plan
Long-term Maintenance
- Future, affected faculty (i.e. Critical Care)
- Leadership collaboration
- Formative evaluation
Short-term Maintenance
- Preparing learning materials
- Simulation scenario creation
- IT specialist collaboration
- Lecture faculty input
Resources
- Dr. Zimmerman, also leadership and faculty members
- IT specialist, Matt Gardner
- Simulation laboratory staff
- Printing cost
- Technological resources
Resources
MSN program outcomes
- Provide oversight and guidance in the integration of technology to manage care and identify performance measures and standards that improve quality and safety outcomes.
- Design innovative nursing practices to impact quality outcomes for individuals, populations, and systems congruent with ethical, professional, and legal standards.
MSN program outcomes
References
References
References
References
Carter, E., Mancino, D., Hessels, A., Kelly, A., & Larson, E. (2017). Reported hours of infection education received positively associated with student nurses' ability to comply with infection prevention practices: Results from a nationwide survey. Nurse Education Today, 53, 19-25. doi:10.1016/j.nedt.2017.02.021
Cox, J., Simpson, M., Letts, W., & Cavanagh, H. (2015). Re-thinking microbiology/infection control education to enhance the practice-readiness of health professional students: More than just a curriculum issue. Journal Of Learning Design, 8(1), 55-67. Retrieved from https://eric.ed.gov/?q=EJ1060124&id=EJ1060124.
El Bushra, H., Al Arbash, H., Mohammed, M., Abdalla, O., Abdallah, M., Al-Mayahi, Z., & BinSaeed, A. (2017). Outcome of strict implementation of infection prevention control measures during an outbreak of Middle East respiratory syndrome. American Journal Of Infection Control, 45(5), 502-7. doi:10.1016/j.ajic.2016.12.020
Potter, P., Perry, A., Stockert, P., Hall, A. (2017). Fundamentals of nursing (9th ed.). St. Louis, MO: El Sevier Inc.
Whitcomb, K. (2014). Using a multidimensional approach to improve quality related to students' hand hygiene practice. Nurse Educator, 39(6), 269-273. doi: 10.1097/NNE.0000000000000070