HNN320 Deakin Wk 2 Strategies To Reduce Risk Of Hospital-acquired Infections

HNN320 Deakin Wk 2 Strategies To Reduce Risk Of Hospital-acquired Infections

Page |0 This is one of submitted assignment Page |1 A worldwide systematic review found that the incidence of healthcare-associated infections ranged from 1.7 to 23.6 per 100 patients (Pfoh, 2013). On average, at least seven patients per hundred admissions acquire health care acquired infection (HAI) in developed countries while around ten patients per hundred admissions acquire HAI in developing country. This figure is high at about thirty patients per hundred admissions among critically ill patients in intensive care units. (WHO, 2013) While many methods exist to prevent health care-associated infection, most experts believe that improving hand hygiene (HH) is the simplest and effective way. Many of the pathogens responsible for nosocomial infection are transmitted by the hands of health care workers (HCWs); therefore, the primary measure to prevent infections in hospitals is proper HH (as sited in Larson et al. 2009). The goal of HH is to reduce the microbial count on the skin of HCWs to prevent cross transmission of pathogens among patients (cited in WHO guidelines on HH in health care, 2009). However, previous studies have shown that HH compliance is poor among the nurses’ due to various other factors. Despite the adherence to hand hygienic compliance, the

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rate remains low within patient care settings. WHO and Centres for Disease Control and Prevention (CDC) has identified that lack of knowledge on proper hand hygienic practices among HCWs less than optimal level. (WHO, 2012). Other than this, some other factors influencing to low compliance includes health care setting system design, positive attitude on practices, availability of appropriate products, ignorance of guidelines, time deficient, forgetfulness, intensification of hand hygienic demand, work load and understaffing. Moreover, frequent barriers have been reported by nurses that they are facing on HH that include developing allergic reaction by antimicrobials, lack of systematic information, difficulties in accessible to facilities such as provisions are lead to nonadherence. These factors can be overwhelmed by adopting suitable strategies in the clinical settings. Two strategies are discussed in this essay Page |2 that significantly enhance the compliance of nurse’s HH practices by supporting recent literatures. Implementing programs of hand hygiene promotions and institutional changes in infrastructure facilities and clinical governance are selected as key strategies. Strategy No.01- Hand hygiene promotions HH promotion is a main challenge for infection control. It is impossible to overcome by single intervention to improve the compliance of HH among nurses. Therefore, executing promotional programs may improve the knowledge of HH and it motivate to make behavioural changes among nurses. Educational programs promote knowledge improvement and create positive attitude in HH (Lee et al. (2014). HCWs used to perform HH in a routine manner rather than following proper WHO guidelines. The reason behind this poor compliance is lack of knowledge and poor attitude on HH. A study conducted in 2015, 67% among the participants has agreed that they should be upgraded their knowledge on HH (Asadollahi et al. 2015). Moreover, WHO stressed to provide knowledge regarding basic principles, five moments, standards of practicing HH and appropriate procedure of hand washing with the use of suitable agents (WHO, 2009). Therefore, carry out promotional sessions with the scope of education and changing behaviours are important to enhance HH compliance within healthcare facilities. There are several studies conducted to elicit the strategy of conducting promotional programs based on knowledge improvement that increases the compliance of HH. A study done in Saudi Arabia by conducting successful HH promotional program across a 350-bed community hospital has found significant results with increased HH compliance. This promotion included; educational sessions, practical trainings and evaluation on performance within HCWs. The result of HH compliance percentage got increased from a baseline of 38% to 65% in 2006, 65% in 2010 and then to 85% in 2011 (Setoet al. 2013). Another study done Page |3 to enhance HH compliance by promoting education sessions. Which conducted with short repeated educational sessions and found significant improvements in HH compliance along with a reduction of nosocomial infections. After the session HH compliance rate increased by 23.6% (68.9%-86.9%) before touching a patient and 22.5% increased (68.9%-84%) after touching a patient. Also, nosocomial infections rate decreased by 18.9% (Heldera, Brugb, Loomanc, Goudoevera, & Kornelissea, 2010). Although, conducting educational programs are inefficient when the lectures delivered alone. Alternatively, promotional sessions of educating nurses could be delivered by conducting small group seminars, frequent written and verbal information, discussions on practical issues, reminder systems by posters and creative awareness sessions might be more efficient and effective. However, acquiring only the theoretical knowledge insufficient to improve adherence to HH, unless it failed to make behavioural changes among HCWs. Intention of educational promotions strategy is to develop positive behavioural changes within nurses to improve HH compliance. The educational promotions enabling to gain evidence based knowledge, recent updates of statically analysed data of patient outcomes and importance of adhering guidelines among HCWs. Similarly, practicing with proper procedural knowledge may motivate and encourage them to change their behavioural perception to practicing on professional way to ensure the quality of care. An evidence can be given, a systematic study done in South Korea shown the HH promotions can change the perception of HH; that leads to HH compliance. Further it illustrates that effective education programs can change nurses’ perception about HH which causes to improve their positive attitude and proper practice regarding HH. Research revealed about observational findings of nurses went throughout the study are; changes in positive intention of HH adherence, awareness of knowledge about indications, perception of knowledge relate to HH process, perception on preventing HAIs, behavioural norms of HH, responsibilities to holding a Page |4 leadership role for colleagues and the improved motivation to do HH (Susan et al. 2013). Lee et al. (2014) says as per their research findings those positive changes in attitude, knowledge and perception lead to improve HH compliance among nurses. The third standard of in bench mark point of national safety and quality health service standards is saying about ‘preventing and controlling and health care associated infections’ (NSQHS, 2012). The purpose of this standard is to protect the institutionalised patients from healthcare associated infections by implementing standard precautious infection control systems such as HH and aseptic techniques. HAIs which is preventable and effective management of HAI using evidence based strategies. Achieving this standard nursing leaders and other responsible managers make awareness about standard procedures to institutional staff by promoting educational programs by experts. It is the major responsible of nursing leaders educating and following above mentioned HH promotional strategy to improve HH compliance of HCWs to eliminate or minimise the prevalence of hospital acquired infections (HAI). Strategy No.02- Institutional changes in infrastructure facilities and clinical governance Making opportunistic changes in institutional and management regards to improve HH could be carried the result of ensured safety and quality care with reduced HIA via crosstransactional. In this strategy will be discuss about the changes should be made to provide optimum institutional support to improve HH compliance to HCWs. Particularly the changes in infrastructure of hospital facilities with adequate supplies and governance on real-time monitoring by utilizing available resources are the criterions should be achieved to improve HH adherence. Page |5 Infrastructural changes should be made in convenient way to perform HH in the healthcare facilities to manage crucial circumstances with concerning on appropriate units. For example, increasing availability of sinks according to necessity and accessibility may encourage to perform HH even in-patient zone, ICU settings and emergency rooms. Furthermore, ensuring availability of clean running water, disposable towels, suitable soap, and alcohol-based hand rub at the point of patient care will increase the HH compliance. A study done by Mathur (2011) says, majority of the male participants complained on their poor compliance on HH due to lack of sinks availability, inadequate washing supplies at the point and sinks inconvenient sink locations. Another study stressed the inconvenient sink location heavily effect the HH practice. Rate of HH habit reduced to 16.3% from 25.6% when the sink located at inappropriate apart from patient zone (Deyneko et al. 2016). It is apparent that HCWs required the changes in infrastructure of institution systematically to maintain HH compliance up to a higher standard. According to the NSQHS (2012) standards under ‘roles for safety and quality in healthcare’ stressing, healthcare leaders should be ensuring the maintenance of materials and proper system requirements to meet the HCW’s demands to deliver effective, safe and reliable patient care. Other important component of system changing strategy is to improve proper clinical governance on real time monitoring on HH compliance by institutional leaders such as registered nurses, nursing managers to evaluate and encourage fellow workers or junior staff. Dynamic nature of hospital environment keeps nurses involving with multiple tasks. Within these crucial schedules they are more likely to un-attend or poorly perform the hand hygienic practices due to less priority comparing with other tasks and procedures, ignorance and forgetfulness. In this regard, real time governing system can overcome this issue to improve HH compliance and it has proven as an effective strategic element. A recent study says, it is seen that HH compliance drops in nurses whether their perception that they are not being Page |6 monitored. There is no any system to find whether they are performing HH or not in appropriate method (Quan, Taylor, & Zborowsky, 2015). Therefore, following continuous real-time monitoring or supervising is found to be effective to limit nonadherence to HH. Nevertheless, frequent monitoring system implemented by many countries as an effective component of quality assurance and it considering as major contributing factor to eliminate HAIs by increasing HH compliance (Goulda et al. 2017). Hence, real time monitoring system can be taken as an effective component to support to institutional system changes strategy to improve HH compliance. NSQH standard one states ‘Governance for Safety and Quality in Health Service Organizations’ is intended to create a combined governance system that sets procedures and policies to maintain and improve the reliability and ensuring quality of client to obtain better patient outcomes (NSQHS Standards, 2012). Our system changes towards monitoring to improve HH practice meets the NSQH criteria. Moreover, institutional system changes strategy should be implemented by nursing leaders. NSQH governing systems criterion 1.3 also requiring assigning responsible and accountabilities through workforce leaders. Above discussed strategy also need to execute through nursing leaders to maintain HH compliance to meet NSQH standard to prevent HAIs. Barriers/facilitators influencing when implementing the strategies identified in clinical settings. The strategies of HH promotion and institutional system changes are an effective approach to increase adherence of HH compliance, however carryout these strategies in to real time professional nursing practice need to overcome towards barriers. To succeed these strategies should be executed through leadership qualities within hospital settings. Nursing leaders were chosen to apply these strategies, because they are playing a vital role dealing Page |7 with patients. Therefore, nurses should develop behavioural and social compliance to demonstrate as a role model in the healthcare facility (White et al. 2014). In order to being a nursing care giver, act as changing agent to deliver multimodal tasks to other group of people is important role in nursing leadership. This could be possible by improving knowledge and changing behaviours through multimodal promotional programs. Nurses as educators has conducting educational sessions covering with both theoretical and practical content, communication campaigns and leadership commitment to all nursing staff once a month is beneficial to update knowledge (Pfoh, 2013). One of the main barrier for educational promotion is lack of active participation to the sessions. This habit is due to negative perception towards the sessions that carries knowledge perceiving that they already have enough. To encouragement of active participation of other nurses, nursing leaders and managerial positioned individuals also to be participated in to the sessions to inspire other co-workers. Interactive interventions could be implemented as a nursing leader with utilising leadership qualities of critical thinking and creativity. preparing educational materials to increase involvement of participants; multimedia presentations, leaflets, poster presentations, concise pocket notes and explanatory videos are ideal to increase interaction of audience. Research find of King et al. (2015) shows 33% HH practice improved by displaying awareness posters at the entrance of client’s room. Absent rate increase by the availability of nurses on duty due to roster circulation; and they miss the opportunity to participate to the session. It can be adopted by knowledge sharing among the peer groups (Pittet, 2001). Hierarchical barrier impact on non-compliance of HH within the hospitals. The physicians and surgeons perform poor adherence on HH due to crucial work schedule and negligence. In this situation developed positive behavioural changes guided to overcome this Page |8 problem by demonstrating proactive ability and applying technical knowledge to encourage them without hurting to adhere HH is to ensure the patient safety. Experimental researches done to check viability of real time practices in to clinical practices. A complain executed to the ward nurses with the theme of ‘Helping doctors with HH compliance during ward rounds’ in November 2012 by infectious disease control of Australia; nurses initiating HH in front of doctors and then requesting them to do politely. Awareness posters also displayed in this pilot with the theme of ‘Help your doctor for excellence in HH’. Physician’s compliance rate of HH dramatically increased to 65.1% from 36.9% (Seto et al. 2013). In this practice exhibit the applying higher leader ship quality of being inspirational modal can increase the HH compliance. Organisational factors effecting HH compliance among HCWs which availability of product using to HH, accessibility to HH stations. A study finding says, inconvenient sink location, HH supplies could not meet to requirement or unavailability at washing stations, unsuitable supplies, lack of motivational factors are providing poor HH outcomes. HCWs mostly engage in busy situation and that tasks prioritise than HH, more time consuming due to readily unviability of hand washing products at the site and insufficient motivational factors including reminder posters and guidelines are reducing HH (Chagpar, Banez, Lopez & Cafazzo, 2010). However, it is the responsibility of nursing leaders to arrange adequate facility from organisational resources to establish patient and HCWs safety. The direct monitoring enabling to provide real time feedback about HH compliance of individual and to the nursing leaders. Therefore, the individual nurses are motivated and imposed to perform proper HH practice on the supervision of expert senior nursing leaders. Indirect observation implemented by electronic monitoring systems such as continuous video recording, computing of HH product consumption, usage of HH devices and automated Page |9 reporting (Koss et al. 2009). Practicing with this latest system limited within high grade hospitals due to lack of funding. However, direct observation can be implemented in all the institutional levels with minimal cost. Moreover, providing real time feedback make facilitators to improve more responsibilities other nurses getting opportunities correct their faults on time (Goulda et al. 2017). There is a barrier for implementing this strategy is, it demands extra job role with trained nurse for supervision. Yet, it could be overcome by splitting this responsibility over nursing leaders by rotationally; which make more competence nurses over the period. In conclusion, although it is apparent that HH adherence is a vital less cost-effective practice for patient and HCWs by reducing HCAIs, compliance with this practice is keeping low. The reason behind this are barriers to implement multi modal approach to increase HH compliance; some were discussed above. Two main strategies discussed that would be more significant to execute; which can achieve by providing strong and multi-dimensional leadership support towards nursing leaders (WHO, 2009). Finally, strategies need further researches to implement up to the standard expected by NSQH. P a g e | 10 Reference Asadollahi, M., Bostanabad, M. A., Jebraili, M., Mahallei, M., Rasooli, A. S., & Abdolalipour, M. (2015). Nurses’ Knowledge Regarding Hand Hygiene and Its Individual and Organizational Predictors. Journal of Caring Science, 45-53. Chagpar, A., Benaz, C., Lopez, R., & Cafazzo, J.A., (2010). Challenges of Hand Hygiene in Healthcare: The Development of a Tool Kit to create Supportive Processes an Environments. Healthcare Quarterly, 13, 59-66. doi:10.12927/hcq.2010.21968 Deyneko, A., Cordeiro, F., Berlin, L., Ben-David, D., Perna, S., & Longtin, Y. (2016). Impact of sink location on hand hygiene compliance after care of patients with Clostridium difficile infection: a cross-sectional study. BMC Infectious Diseases, 16, 1-7. doi:10.1186/s12879-016-1535-x Goulda, D., Creedonb, S., Jeanesc, A., Dreyd, N., Chudleighe, J., & Moralejof, D. (2017). Impact of observing hand hygiene in practice and research: a methodological reconsideration. Journal of Hospital Infection, 169-174. Hand Hygiene Australia. (2017). National Data. Canberra. Heldera, O. K., Brugb, J., Loomanc, C. W., Goudoevera, J. B., & Kornelissea, R. F. (2010). The impact of an education program on hand hygiene compliance and nosocomial infection incidence in an urban Neonatal Intensive Care Unit: An intervention study with before and after comparison. International Journal of Nursing Studies, 12451252. King, D., Vlaev, I., Everett-Thomas, R., Fitzpatrick, M., Darzi, A., & Birnbach, D. J. (2016). ‘Priming’ hand hygiene compliance in clinical environments. Health Psychology, 35(1), 96-101. http://dx.doi.org/10.1037/hea0000239 Koss, R., Williams, S., Galvez, E., Kupka, N., Mearday, T., Savides, K., & Donofrio., K. (2009). Measuring Hand Hygiene Adherence: Overcoming the challenges. New York: Joint Commission International. Larson, E., Goldmann, D., Pearson, M., Boyc, J. M., Rehm, S. J., Fauerbach, L. L.,Shapiro, E. (2009). Measuring Hand Hygiene Adherence: Overcoming the Challenges. New York: Joint Comission Mission. Lee, S. S., Park, S. J., Chung, M. J., Lee, J. H., Kang, H. J., Lee, J.-a., & Kim, Y. K. (2014). Improved Hand Hygiene Compliance is Associated with the Change of Perception toward Hand Hygiene among Medical Personnel. Infection and Chemotherapy, 165171. Mathur, P. (2011). Hand hygiene: back to the basics of infection control. The Indian Journal Of Medical Research, 134(5), 611-620. doi:10.4103/0971-5916.90985 Pfoh, E., & Engineer, C. (2013). Interventions To Improve Hand Hygiene Compliance: Brief Update Review. In E. Pfoh, & C. Engineer, Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices. Agency for Healthcare Research and Quality (US). P a g e | 11 Pittet, D. (2001). Improving Adherence to HH Practice: A Multidisciplinary Approach. Emerging Infectious Diseases, 7(2), 234-240. https://doi.org/10.1086/501777 – Published 2015 Quan, X., Taylor, E., & Zborowsky, T. (2015). Clean Hands Save Lives: A Systems Approach to Improving Hand Hygiene. Retrieved from health design. https://www.healthdesign.org/insights-solutions/clean-hands-save-livessystemsapproach-improving-hand-hygiene Seto, W. H., Yuen, S. S., Cheung, C. Y., Ching, P. Y., Cowling, B. J., & Pittet, D. (2013). HH promotion and the participation of infection control link nurses: an effective innovation to overcome campaign fatigue. American Journal Of Infection Control, 41(12), 1281-1283. doi:10.1016/j.ajic.2013.04.011 Susan, R., Beth, H., Nasia, S., Sue, S.-R., Teri, S., & Michelle, S. (2013). Success of a Multimodal Program to Improve Hand Hygiene Compliance. Journal of Nursing Care Quality, 312-318. World Health Organization. (2009). A Guide to the Implementation of the WHO: Multimodal Hand Hygiene Improvement strategy. Geneva. 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:10.1071/HE14059 World Health Organization (WHO). World Alliance for Patient Safety. Global Patient Safety Challenge 2005-2006. Clean care is safer care. Geneva: WHO,2005. Retrieved from http://www.who.int/patientsafety/events/05/GPSC_Launch_ENGLISH_FINAL.pdf. 2012. World Health Organization. WHO Guidelines on HH in Health Care: First Global Patient Safety Challenge. 2009. www. who.int/gpsc/country_work/en/ HNN320 Leadership and Clinical Governance Assessment Task 2 2500 words: Weighting 60% of your mark Purpose of assessment task 2 Clinical risk management (CRM) improves the quality and safe delivery of healthcare by introducing systems that identify and prevent circumstances that put patients at risk of harm. The nurse’s knowledge of and role in clinical risk management is crucial to help identify potential risks. The purpose of this assessment task is to provide you with the opportunity to demonstrate your understanding of the nurse’s leadership role in relation to clinical risk management. Assignment question: The Nurse Unit Manager (NUM) has identified that the number of hospital acquired infections on your ward has increased over the past three months. As a Registered Nurse working on the ward, the NUM has asked you to develop two (2) strategies that could be implemented to reduce the risk for these infections occurring. For this assessment task, you are required to: • Identify two (2) key strategies from the literature for reducing the risk of hospital acquired infections for patients. Your discussion must include how each strategy will reduce hospital acquired infections; and • To show understanding of the role of the Registered Nurse, critically discuss the implications for professional nursing practice in implementing each of the identified strategies. Unit learning outcomes and Deakin Graduate Learning Outcomes This assessment task provides you with the opportunity to demonstrate the following Unit Learning outcomes and Deakin Graduate Learning Outcomes: Unit Learning Outcomes ULO2 Differentiate between the concepts of management and leadership ULO3 Critically examine the role of the nurse leader in quality improvement and change management practices ULO4 Critique the principles and processes of clinical risk management and their application in health care domains ULO5 Discuss critically the accountability of the Registered Nurse in relation to clinical governance Deakin Graduate Learning Outcomes GLO1 Discipline-specific knowledge and capabilities: appropriate to the level of study related to a discipline or profession GLO2 Communication: using oral, written and interpersonal communication to inform, motivate and effect change GLO3 Digital literacy: using technologies to find, use and disseminate information 1 GLO4 Critical thinking: evaluating information using critical and analytical thinking and judgment GLO5 Problem solving: creating solutions to authentic (real world and ill-defined) problems GLO6 Self-management: working and learning independently, and taking responsibility for personal actions 2 Submission information: This assignment task is to be submitted into the designated assessment dropbox for this unit. Due date: Monday 20th May 2019 – assignment to be submitted no later than 11.59pm. To ensure appropriate support is available should any technical issues arise, you are strongly advised to submit your assignment into the designated dropbox before 5pm on the due date. You are responsible for ensuring that the correct version of your assessment task is properly uploaded into the correct assessment dropbox. Student instructions for assessment task To be successful with this assessment task you are strongly advised to: • Draw upon relevant cloud concepts, content and readings provided in this unit; • It is expected this essay will be written in third person, • Utilise current and relevant literature to identify and discuss two (2) strategies that you could implement to reduce the incidence of hospital acquired infections in the clinical setting; • Provide a critical discussion, using the literature, on how these strategies will lead to a possible decrease in hospital infections; • Critically discuss the implications of implementing the two (2) strategies identified o How will it be implemented on your ward? o What are barrier/s and facilitators to implementing this strategy? o What clinical governance structures may need to be considered? • Self-assess your assignment against the marking rubric before submission. This will enable you to make sure that all the required elements have been covered Presentation requirements Front page: to include student name and number, Assignment title and word count. Adhere to word limit requirements (within 10%). The word count does not include headings, references page, reference citations and direct quotes. A reference list should be provided on a separate page headed ‘References’ at the end of the assignment. Do not include a table of contents unless instructed to do so (delete if table of contents required) Headings are not necessary for this assignment task Font: 12-point type size. Times or Times New Roman. Spacing: Double-line spacing (Do not insert extra lines between paragraphs or the references list entries.) 3 Page numbers Page numbers to be provided on all pages except front page. Place page number in the top right hand corner Margins 2.54 cm at the top, bottom, left-hand, and right-hand sides of the page. Paragraph indents Indent the first line of each paragraph (using the tab key or paragraph tool). Exceptions: abstract, block quotations, titles and headings, table titles and notes (consult with APA 6 style manual for specific detail). Justification of text All text needs to be aligned to the left, not justified Your assignment is to be converted to a PDF document before submission. Please check the document before submitting to the dropbox to ensure the formatting has not changed. Software for converting word documents to PDF is available to download from the Deakin software catalogue at no cost. Structure: Your assignment must contain a purposeful introduction outlining some general background to the topic, an aim and purpose and themes for discussion (approximately 10% of the word limit). The body of the assignment will constitute about 80% of the word limit and provide key arguments supported by literature. The body of the assignment is normally organised in paragraphs of approximately 150 words with each paragraph focused on explanation of one idea. There should be a logical progression of ideas as demonstrated by logically linked arguments/discussion made in each paragraph. Each paragraph should commence with a topic sentence and end with a link to the next paragraph. The conclusion paragraph should provide a summation of ideas, draw together the discussion, present no new material (references are not expected in the conclusion paragraph) and offer your position drawn from the discussion (approximately 10% of the word limit). Academic writing style The conventions of written English are expected to be followed to ensure clarity of discussion. This includes correct use of grammar, punctuation and spelling as well as the use of appropriate sentence and paragraph structure. It is also expected that word choice will be formal and professional language will be used. Paraphrasing and direct quotations Unless really necessary, most assignments do not require the use of direct quotes. Instead, re-expression of author arguments (paraphrasing) into your own words is required. Paraphrasing of author arguments/statements must be supported by a reference. If a direct quotation is used, you must explain how it adds to the discussion and provide a reference as per APA Style guide 6 4 Turnitin (Feedback Studio) The Turnitin/Feedback Studio is a program that allows you to check whether there is any copied material in your assignment. Checking prior to submission in the dropbox gives you the opportunity to correct any errors. See the following link to Turnitin. https://d2l.deakin.edu.au/d2l/le/content/394791/viewContent/2505293/View?_ga=2.1364 91952.1459866433.1517178021-1392669345.1509937587 Resources for essay writing The following links provide guidance for essay writing http://www.deakin.edu.au/students/studying/study-support/academic-skills http://www.deakin.edu.au/students/studying/study-support/academic-skills/academic-style http://www.deakin.edu.au/students/studying/study-support/academic-skills/essay-writing http://www.apastyle.org/ Referencing style Acknowledge sources and adhere to referencing conventions as per APA Style www.deakin.edu.au/referencing 5 HNN 320 Leadership & Clinical Governance: Assessment Task Two 60% Total marks 100 Performance Standards High Distinction Demonstrates understanding of the principles and processes of clinical risk management by identifying two (2) strategies to decrease hospital acquired infections. Discussion provides an explanation of how each strategy will reduce hospital acquired infections in the clinical setting. (40 marks) Demonstrates understanding of the role and accountability of the nurse in quality and change management practices. A critical analysis and discussion related to practice implications of each identified strategy. (30 marks) Relevant literature selected and used to support discussion AND Referencing style is accurate and consistent with APA style (20 marks) Assignment is presented and structured according to instructions. AND Writing is in accordance with standard language conventions (10 marks) Distinction Credit Pass Unsatisfactory All elements of this criterion met with occasional minor errors/gaps All elements of this criterion met with several minor knowledge errors /gap Most elements of this criterion met but has many minor knowledge errors /gaps or one significant gap or error Meets most elements of the criterion but has more than one significant knowledge error/gaps Does not demonstrate understanding of the principles and processes of clinical risk management identify two (2) strategies and/or did not identify suitable strategies and/or did not explain how the strategies will decrease infections. (32-40 marks) (28-31 marks) (24-27 marks) (20-23 marks) (
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