Paper topic: nursing community assessment education project
This community nursing assessment paper was part of the community assesssment project for the community nursing class in the RN to BSN program. An outline was the first step in the project and was submitted to the instructor. The outline is available here. This paper is a draft of the final paper submitted for the project and may be used for ideas and references.
Final Community Education Project
The community of XX child care center and the surrounding area of Cypress, Katy and Houston, Texas was assessed using the community assessment guidelines as outlined in Anderson and McFarlane (2008). After completion of the assessment a plan was proposed to educate the community of the child care workers in this facility on hand washing and the spread of germs. The presentation included a short video along with a poster board presentation and discussion. Additional tools were provided for future reference and education. The topic of hand hygiene was deemed an important educational topic for this group based on the assessment.
The topic of hand washing and germ spread was discussed with the director of XX (personal communication, February 27, 2009) based on the community assessment. The director felt that education in relation to hand washing was always important and should be ongoing. She also commented on a feeling of a high turnover in staff which would in turn require more frequent education. Although a variety of topics could have been chosen the director specifically requested that a presentation on hand washing be offered. She also requested information of alcohol based hand sanitizers and on preventing skin breakdown with repeated hand washing. The fact that hand washing is listed as the most important and effective way to prevent the spread of germs (Centers for Disease Control and Prevention, 2008) the decision was made to pursue this topic.
Further research in relation to this topic supported the importance of this educational presentation. A study by the American Society of Microbiology concluded that many individuals will claim that they wash their hands but the numbers are actually substantially lower. 97% of females claim to wash their hands while the statistics show that only 75% actually do. For men the numbers are even lower with 92% claiming to wash while only 58% actually do (Minnesota Department of Health, 2007). Children tend to spread germs from one to another as well as to the adults who care for them. Children’s habits such as putting toys and other items in their mouths, touching each other during play times and not washing after using the restroom make controlling the spread of germs among this group more difficult (Lee & Greig, 2008). The presence of children in diapers also poses increased risks in the spread of germs. The care givers may spread germs from the diapered children on their hands and clothes, and germs can be spread from leakage of diapers or from using a change table without adequate sanitation between children (Lee & Greig). Hand washing is one of the most important ways to decrease this spread of germs. Hand washing helps to rid the hands of germs that are picked up from person to person or from the surfaces or animals that an individual touches (Centers for Disease Control and Prevention, 2008).
The hands are the listed as being one of main sources of transmission of infection by the International Scientific Forum on Hand Hygiene. One reason for this is because they come into contact with many portals of entry for infection such as the nose, mouth and eyes (Purell, 2009). This is another reminder that hand washing is the most effective way to prevent the spread of germs. The Purell website also stated that the Centers for Disease Control and Prevention agrees that when soap and water is unavailable or hands are not visibly dirty that the use of alcohol based hand sanitizers can be used with children (Purell). In addition to proper hand hygiene providing education on proper skin care was also deemed important as intact skin can assist with preventing the spread of germs by providing a barrier. The sloughing of skin cells also helps rid the hands of microorganisms (Ulrich & Canale, 2005). Overall, a review of the literature and specifically information from the Centers of Disease Control and Prevention has supported the need for this type of education. It is important to note that this type of education should be ongoing and with this in mind the presentation included reference material for future needs and reminders for placement in the classrooms.
Based on the assessment and interview with the director, as well as the supporting references a plan was formulated and an educational project was designed. The attached power point presentation was used to prepare a tri-fold poster board presentation. The presentation was begun with a brief introduction followed by a brief video from Web MD. This particular video was used as a resource as it contained a brief overview of my presentation points. The video can be found at http://www.webmd.com/video/dirty-truth-handwashing. The power point presentation was reviewed as a discussion and time was allowed for questions. During the discussion, a brief demonstration of simulated hand washing was given. The discussion also included some child friendly information and resources. A discussion with the director previously included information on some of the available resources regarding hand washing that had been located. She had stated (personal communication April 21, 2009) that she planned to continue the education by having the teachers pass it on to the children and she would continue to use the resources as a teaching guide. Based on this discussion these resources were provided. The website for Henry the Hand (Sawyer, 2009) was provided as free resources including songs and videos are available. During preparation for the presentation an attempt was made to use glo-germ as a demonstration to the teachers on how effective their hand washing was. The product was not very effective when a trial demonstration was performed so it was not utilized during the presentation.
During the planning phase of the presentation, a plan was proposed and a discussion with the director (personal communication, February 27, 2009) which included her requests and recommendations, and finalized the plans. During the preparation phase, the project changed directions for the presentation. The initial plan was to present during nap time at the center to the entire group of teachers. She felt the teachers would be available at that time and would still be able to watch the children. During a follow up conversation April 21, 2009, she stated it would need to be separated out to at least two groups, or to smaller groups of one or two. This was because of the realization that a location allowing for visualization of all rooms was not available. This plan was agreed to and the director stated she would present the information to anyone who missed the initial presentation.
During the semester the center director was given opportunity to review.
The director (personal communication April 25, 2009) requested some
adjustments. A one page reference guide to include when and how to wash
your hands was agreed upon. An additional request was received to
separate the listings into when teachers should wash their hands and
when children should wash their hands. This one page reference guide was
to be laminated and posted in all classrooms. With this known intent,
recommendations were considered and followed to promote use of the tool
at the center. In relation to this preparation phase, having the final
presentation ready for the director’s consideration earlier would have
allowed for better planning of the education session. More time was
required by presenting in small groups and time was precious at this
point in the semester.
The audience was receptive to the educational presentation. Some of the teachers asked appropriate questions. Upon a review of the assessment phase of this community project it was noted that many workers documented washing their hands only 10 times per day. During the presentation many commented that if they were washing when they should, they would be washing their hands a lot more than 10 times. A few comments were made surrounding the video and the Henry the Hand website. A few teachers thought Henry’s hand washing song would be a big hit with the children. Overall, the presentation was a success. The evaluation tool as referenced in the Appendix was given to all participates. The evaluations showed that the teachers were in agreement to the success.
An evaluation of the presentation and the materials that were used was performed. The information did included references. It was difficult to offer some of the requested information. The director had requested skin care information. At the time of the request this seemed reasonable. Upon researching this area there are references that skin care is important and decreases the spread of germs but offering certain products was felt to be controversial, therefore no product names were offered. It may have been more valid to have had time to investigate multiple products and provide information as recommending one may show a bias. The information on alcohol based hand sanitizers did provide information that they are not as hard on the skin as many include moisturizers. A few other things that could have been improved on were the tools. The director had requested a copy of the hand washing song from Henry the Hand. Although the site offers many free resources and the song can be played online, it was not available to download to a compact disc. With proper planning the disc can be purchased and this would have been helpful. The main tool planned was to use the demonstration of glowing germs to show proper hand washing. Again, with planning earlier in the process this may have been more effective. The product did not work well, and an effective ultraviolet light source was not available to improve the effectiveness. This demonstration would have been an excellent learning tool to show how hard one needs to scrub to really get all of germs off their hands. In the end it was not utilized as the intended purpose would not have been met.
Overall this community education project was successful, but it definitely could have been more effective from a presentation stand point. The presentation itself was worked in quickly at the end of the semester and felt somewhat awkward and rushed. A true community education project should have been followed through by evaluating the effectiveness and adjusting the project as needed based on that evaluation. It is anticipated that if adjustments are needed the director would do so. To prevent multiple changes in the laminated reference cards input and evaluation was done prior to the final draft. The references placed throughout the center and the poster board which was left for future use was welcomed by the director and staff. The presentation and poster board were effective and the fact that the director plans to utilize this in the future shows the success of these tools. The laminated references pages on when and how to wash were a great success and the director plans to utilize them throughout both of her centers. The intent to have the educational project continue on past this semester shows success.
Note: the link to the previously mentioned powerpoint is available on the community nursing class page.
Anderson, E. T., & McFarlane, J. (2008). Community as partner: Theory in practice and Nursing (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.Centers for Disease Control and Prevention (2008). An ounce of prevention keeps the germs away: Seven keys to a safer healthier home. Retrieved May 2, 2009, from http://www.cdc.gov/ounceofprevention/docs/oop_brochure_eng.pdfCenters for Disease Control and Prevention (2008). Clean Hands Save Lives. Retrieved May 2, 2009, from http://www.cdc.gov/cleanhands/Centers for Disease Control and Prevention (2008). Taking care of yourself: What to do if you get sick with the flu. Retrieved February 8, 2009, from http://www.cdc.gov/flu/takingcare.htmLee, M. B., & Greig, J. D. (2008). A review of enteric outbreaks in child care centers: effective infection control recommendations. Journal of Environmental Health, 71(3), 24-32. Retrieved February 27, 2009, from http://web.ebscohost.com.databases.wtamu.edu:2048/ehost/pdf?vid=11&hid=102&sid=4bd164d8-e080-4449-9ba3-35622691f4d5%40sessionmgr108Minnesota Department of Health (2007). Hand washing statistics: People don’t wash hands. Retrieved May 2, 2009, from http://www.health.state.mn.us/handhygiene/stats/statistics.htmlPurell (2009). What everyone should know about hand hygiene products. Retrieved May 2, 2009, from http://www.purell.com/page.jhtml?id=/purell/include/facts.incSawyer, W. (2009). Henry the hand home page. Retrieved April 19, 2009, from http://www.henrythehand.com/pages/content/index.htmlUlrich, S. P., & Canale, S. W. (2005). Nursing care planning guides for adults in acute, extended, and home care settings (6th ed.). Philadelphia, PA: Elsevier Health Services.WebMD. (2008, September). Dirty truth hand washing. [Video file]. Video posted to http://www.webmd.com/video/dirty-truth-handwashing