Hand hygiene plays an important role upon the health of human being. Numerous bacteria and germs may present even in the clean hand which cannot be visible. These bacteria and germs cause adverse effects on health and leads to serious life threatening diseases also. MRSA is one of them in which there is a huge contribution of unhygienic and bacteria full hand. In order to reduce the effects of the disease, it is important to improve the hygiene of the hands (Marimuthu, Pittet & Harbarth, 2014). Washing hands with plain water is not sufficient to maintain the hygiene of it. Bacteria will not be visible but will be present and be equally effective in causing several health hazards among the people (White et al., 2015). Many people do not know the exact way of maintaining the hand hygiene and people are also not aware of the time when to perform hand hygiene especially while treating the patients in healthcare (Kelly, Blackhurst, Boeker & Steed, 2016). In various literatures it has been reviewed that compliance of hand-hygiene cause reduces the MRSA colonization and it was proven in the survey conducted in the University of Geneva Hospital (Tyner et al., 2017). In order to enhance the knowledge of the staff nurses I had been associated with a teaching program held among the nurses in SNB. While teaching the nurses I had experienced a lot of happenings which helped me to regain another series of knowledge.
After collating the evidences from various literatures I found that hand hygiene is regarded as one of the important and effective way to improve the health and reducing the infectious diseases that includes MRSA. I felt that this important factor must be informed to the health professionals so that they can also incorporate several strategies to improve the hand hygiene while dealing with patients. I also feel that providing the best healthcare to the patients there is a great contribution of cleanliness which includes a good hygiene of hands. In order to conduct the teaching program, 10 staffs were chosen and among them staff nurses, enrolled nurses and patient care assistants were also included. The registered nurses, who had communication barrier due to language problem and lack of English proficiency, were also included in the teaching program. It was my desire to share my knowledge on hand hygiene with all the staffs of SNB who are directly involved in the patient care. At the primary stage I had set the goal and planned appropriate strategies to achieve that. I also highlighted the learning outcomes after the completion of the teaching program. First of all, at the beginning of the session I put a closer look on the environment. If the learners get a comfortable environment, then their efficiency also increases which helps them in developing the attention and acquiring the knowledge (Harrigan & Commons, 2015). While teaching the staffs I found that all of the nurses were aware of the importance of hand hygiene and they had the knowledge of basic hand hygiene as well as the 5 moments of hand hygiene. I entered the hall in my ward where the whole set up was organised with my laptop and projector to show video and pamphlet as well as power point presentation as a part of teaching process. In order to save the time of the presentation and the teaching program, I had distributed the pamphlets among all the learners, so that they can get a primary idea and the time can also be saved. I used various strategies and theories in order to improve the learning process and the environment for learning. I also acquired several strategies to increase the compliance for hand hygiene. To get an idea about the learning outcome, I performed a small assessment through some activities after the delivery of speech and knowledge among learners. At the end of the session, to encourage all the participants I prepare 10 MCQ questions with different scenarios so that they can assess own knowledge about the discussed topic. During the whole teaching process, I noticed that nurses were courageous to know the facts associated with the program but somehow, language gap stood as the main barrier between them. However, to address the issue I incorporated some strategies in my program, so that all of them can understand the main facts that are being discussed.
At the time of the teaching program I thought it was necessary to be attentive about the needs of the participant so that they can sit comfortably and also can ask question when required. In this purpose, I used Maslow Hierarchy Theory to address the comfort issue and needs of the participants (Harrigan & Commons, 2015). This hierarchy model addresses the safety as well as self actualization needs (Shmeleva, Kislyakov, Luneva & Maltseva, 2015). It also addresses the physiological needs such as food, water etc. I wanted to make all the participants comfortable and supported them with sufficient food and water during the teaching program. I felt that including evidence based practice in the teaching program can be helpful as well as interesting for the participants to understand the whole program. I was also aware of the language barrier and to overcome the issue I applied Vygotsky theory for the cognitive development of the participants (Ali & Watson, 2018). In order to accomplish this I engaged the participants in some activity-based learning processes. I also incorporated Kolb’s learning style model in my teaching strategy so that the strength of understanding can be increased among the participants (McKenna, Copnell, Butler & Lau, 2018). I used video and power point presentation in the teaching program and it helped the participants in thinking and cultivating the learned theories in their mind. Participants were asked to express their feelings also.
The main positive side of the whole teaching program was that nurses had basic knowledge about the importance of hand hygiene and 5 moments of hand hygiene too (Moghnieh et al., 2017). Also, the participants were enthusiastic enough and they were a good listener. They actively participated during the whole teaching program. But, the main negative side was when I went to elaborate the 5 moments of hand hygiene they could not clearly understand my words due to language gap as I used English as communication language and many of the participants had not proficiency in English. According to my opinion, this language barrier created various problems in the whole teaching program.
As there were language gap, I used some demonstrative strategies. I showed them video and a demonstration of 7 steps of hand-washing (Clark et al., 2018). All the participants were excited and they enthusiastically performed the tasks. While teaching them I realized all of the participants were active and they already knew the basic methods of washing hands. I felt, sometimes patient care is hampered due to this language barrier issue as many of the nurses cannot communicate properly with the patients due to this barrier. I also realized that Kolb’s learning style was so much helpful in this regard as it incorporated visual demonstration which was easily understandable by the nurses with language gap.
Conclusion
Looking back at the whole teaching program I can see that it was successful and all of the nurses and other participants were highly interested during the whole program. Throughout the teaching process they were extremely attentive as well as active. They were patient enough to attentively listen the whole program and they also participated in the activities associated with the teaching program courageously. Applying the theories and the strategies were so much helpful to address all the issues and barriers. Even, the participants were comfortable with the environment also. This teaching program helped me have more respect for them as all of them kept their patience instead of presence of language barrier during the program.
In future, I will aim to develop some more strategies to address the communication gap. I will arrange some more demonstrative and activity-based program where the participants can actively participate instead of just listening to the lecture during the program. If I could show some more data on MRSA then it would be better for them to understand the issues associated with it. I will make this goal as my learning and will try to find other strategies which will help such program to gain more success.
In order to share more knowledge about the effectiveness of hand hygiene in reducing the MRSA and other diseases I had organised a teaching program for the staffs of SNB where 10 participants were chosen, and the teaching program incorporated many strategies to enhance the learning process. This program helped me to gain more knowledge and respect about the staffs and I also realized how language stood as a main barrier for them in the patient care. This barrier also created several issues during the teaching program.
I felt that, in order to address the issue of language barrier, if an interpreter would present then many of the staffs would be benefited. In the video, if subtitles of preferred language can be used then it would be easier to understand for the participants. If some bilingual and drama-based program can be organized then such program will be more interesting to the participants. However, this teaching program was helpful enough to find the exact issues which will be helpful in future to address the issues before organizing any teaching program.
References
Ali, P. A., & Watson, R. (2018). Language barriers and their impact on provision of care to patients with limited English proficiency: Nurses’ perspectives. Journal of clinical nursing, 27(5-6), e1152-e1160. Doi: https://doi.org/10.1111/jocn.14204
Clark, J., Jimenez, M., Raso, E., Antwi, L., Ofosu-Appiah, L., Opare, D., & Torondel, B. (2018). Evaluation of Key Antimicrobial Properties of Moringa oleifera in Relation to Its Use as a Hand-Washing Product. Water, 10(9), 1154. Retrieved from: https://www.mdpi.com/2073-4441/10/9/1154
Harrigan, W. J., & Commons, M. L. (2015). Replacing Maslow’s needs hierarchy with an account based on stage and value. Behavioral Development Bulletin, 20(1), 24. Retrieved from: https://psycnet.apa.org/fulltext/2015-22913-003.html
Kelly, J. W., Blackhurst, D., Boeker, S., & Steed, C. (2016, October). Hand Hygiene Compliance: Is Measurement of “In & Out” Comparable to the WHO 5-Moments and Does It Truly Reflect the Risk to Our Patients. In Open Forum Infectious Diseases (Vol. 3, No. suppl_1, p. 1372). Oxford University Press. Retrieved from: https://academic.oup.com/ofid/article/3/suppl_1/1372/2635705
Marimuthu, K., Pittet, D., & Harbarth, S. (2014). The effect of improved hand hygiene on nosocomial MRSA control. Antimicrobial resistance and infection control, 3(1), 34. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4417535/
McKenna, L., Copnell, B., Butler, A. E., & Lau, R. (2018). Learning style preferences of Australian accelerated postgraduate pre-registration nursing students: A cross-sectional survey. Nurse education in practice, 28, 280-284. Doi: https://doi.org/10.1016/j.nepr.2017.10.011
Moghnieh, R., Soboh, R., Abdallah, D., El-Helou, M., Al Hassan, S., Ajjour, L., … & Mugharbil, A. (2017). Health care workers’ compliance to the My 5 Moments for Hand Hygiene: Comparison of 2 interventional methods. American journal of infection control, 45(1), 89-91. Doi: https://doi.org/10.1016/j.ajic.2016.08.012
Shmeleva, E. A., Kislyakov, P. A., Luneva, L. F., & Maltseva, L. D. (2015). Psychological factors of the readiness of teachers to ensure social security in the educational environment. Psychology in Russia, 8(1), 74. Doi: 10.11621/pir.2015.0107
Tyner, K., Nailon, R., Beach, S., Drake, M., Fitzgerald, T., Lyden, E., … & Ashraf, M. S. (2017, October). Frequently Identified Infection Control Gaps Related to Hand Hygiene in Long-Term Care Facilities. In Open Forum Infectious Diseases (Vol. 4, No. suppl_1, pp. S407-S407). US: Oxford University Press. Doi: 10.1093/ofid/ofx163.1018
White, K. M., Jimmieson, N. L., Graves, N., Barnett, A., Cockshaw, W., Gee, P., … & Paterson, D. (2015). Key beliefs of hospital nurses’ hand?hygiene behaviour: protecting your peers and needing effective reminders. Health Promotion Journal of Australia, 26(1), 74-78. Doi: https://doi.org/10.1071/HE14059
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