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Running head: PRACTICES & QUALITY HEALTHCARE

DELIVERY

Practices & Quality Healthcare Delivery

Name

Institution

PRACTICES & QUALITY HEALTHCARE

DELIVERY 2

Introduction

There are many theories in the Nursing profession. The philosophies in the Nursing act as

a foundation for building a conceptual framework, used as a reference in various settings in a

clinic. Medics and other staff members use the structure to provide an approach for the

organization, analysis and in decision making. Nursing theories also guide on how the

professionals should interact with other health workers to ensure delivery of high-quality

standard services to patients. Moreover, the philosophies offer an initial approach to practices

aimed at controlling the spread of infection and as an outcome, improve the quality of medical

care delivery.

According to Parker and Smith (2010), nursing theories are in three broad categories.

Grand, Practice, and middle range theories are the three types of philosophies that exist. This

paper will discuss some of the Middle-range approaches that aim at improving infection control

practices and overall standard improvement in health facilities. Using these theories, I will

develop a method that aims at enhancing IPC policies.

The Parent Theories

Newman’s theory of expanding consciousness proposes that it may not be possible to

regulate, confine or ply variables to comprehend the whole of a phenomenon. Margaret Newman

developed this theory in 1959, and it has been in use since then in the nursing profession (Parker

& Smith, 2010). Newman reveals that an invalid and nurse establish a conjoint relationship for

the patient to have a meaningful experience at the facility. This philosophy aids in instituting

standard care and controlling the spread of diseases at the hospital setting. The theory focuses on

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how an invalid and medics can increase consciousness through acknowledging changing patterns

of the person-environment interaction.

Figure 1: Diagram of Newman's theory of expanding consciousness.

Another philosophy is the environment theory by Florence Nightingale focuses on the

environment which is a crucial aspect in enhancing invalid care (Jackson, Lowton, & Griffiths,

2014). A significant feature of this theory is the sanitation of the room with an aim to prevent the

transfer of hospital-associated diseases and infections.

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Figure 2: Nightingale's environmental theory conceptual framework

Rationale Used in Choosing the Parent Theories

Studies show that merely having cognizance of the significance of infection control and

infection is not enough to ensure that health workers employ their knowledge into practice.

Research by Pittet shows that although over 90% nurses reported that washing of hands before

contact with an invalid is “vital” less than 60% of the practitioners indicated to “always” practice

that exercise (Pittet, 2008). The researcher concludes that alongside knowledge, behavioral

motivation is a core aspect to guarantee productive infection prevention and control.

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Development of my Theory

My theory involves the integration of competency development and human behavior for

improved infection control practices and quality healthcare delivery. Borrowing from

Nightingale’s Environmental theory and Newman’s philosophy of expanding consciousness, it is

evident that human competency and behavior plays a significant role in disease control and

prevention. Research is one of the best ways of improving standards in a medical facility. It can

aid in reducing the spread of infections. Good education also promotes innovation and invention

which help improve the overall quality of medical care. Therefore knowledge is also an external

factor that influences IPC practices and standards in healthcare facilities.

Many studies show that human behavior and competency are crucial for the prevention

and control of diseases in a hospital. One of these studies is by O’Brien, Richards, Walton,

Philips, and Humphreys in 2009. The philosophers conclude that having apt cognition serves a

good beginning for establishing the right attitudes of infection control and prevention. The

Comprehensive Centers for Disease Control and Prevention guidelines support this claim by

stating that health workers should have an understanding of the infection prevention and control

principles and practices for efficacy purposes (O'Brien, Richards, Walton, Philips, &

Humphreys, 2009).

Another such research is by Ward in his theory of Planned Behavior. Wards Theory of

Planned Behavior (TBP) has a linkage to disease interception and control processes. The

implementation of septicity prevention and control practices bears influence from the

practitioner’s attitudes. A health worker attains work attitudes during the learning process. An

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environment that provides negative influences in culture molding can be poor IPC practices by

supervisors and other healthcare workers. A student’s knowledge of the necessity of practicing

good IPC can be affected, and in return, he will adopt the poor enactments (Ward, 2013).

The theory of planned behavior explains how other external factors outside the classroom

influence performance of a worker. The work environment experiences influences from other

workers and cultures in the organization. Therefore, a student can acquire all the right practices

at school only to find a work culture where colleagues do not practice the recommended

approaches. The Theory of Planned Behavior explains that as a result, the scholar can adapt the

poor practices despite having being taught the right methods in school.

Fig 2: Visual diagram of my theory

Education

Perceived level

of control

Attitudes towards

IPC

Subjective Norm

Generate an

intention to

perform good

IPC practices

IPC behavior

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Combining the Planned Behavior Theory with the education theory during learning will

help to improve Infection Control Practices. Students should learn how to cope with the external

influences they are bound to encounter in at the workplace once they are out of school. The

curriculum should, therefore, provide for the students to interact with various situations in their

workplaces and get training on how to deal. Such exercise will help the learners acquire skills

that are necessary to overcome external to the influences that they might face once they venture

into the workplace.

My theory is, therefore, an improvement of the Theory of Planned behavior. The

philosophy does not only focus on other external influences at the workplace but also on how

students can learn on how to cope with these influences through education. My theory will aid in

improving IPC practices and standards in overall health facility practices.

Research questions

1. What is the relationship between a person’s attitude towards an act and the intent to

perform right infection and control practices?

2. What is the interrelationship between subjective norms and the plan to implement right

infection and control practices?

3. What is the relationship between the perceived level of control and intention to perform

right infection and control practices?

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Hypotheses

1. There will be a positive relationship between an individual’s attitude towards an act of

implementing right Infection and Control Practices and the behavioral intention to do so.

2. There is a positive correlation between the subjective norms to perform right infection

and control practices and the plan to do so.

3. A positive interrelationship exists between perceived levels of control to utilize the

correct infection prevention and control policies and the behavioral intention to do so.

Summary

Nurses have a chance to change the medical care system by improving standards at the

health facilities. The enforcement of disease prevention and control practices is a way in which

the professionals can improve overall quality. The existence of extensive research and nursing

theories provides core structure in the discipline that nurses can implement. Nurses who operate

in clinical care have a responsibility of preventing the occurrence and spread of infections. The

health care providers should monitor and control hygiene practices and educate patients on how

to avoid the transfer of diseases to others.

This paper focuses on how two theories, the theory of competency development and that

of planned behavior. Basing the foundation on the principles of these two philosophies, I came

up with an approach. The method focuses on how students can learn about external factors while

still in school to help them cope with the various challenges they are bound to encounter in the

workplace. It is important to merge the two theories because education alone does not guarantee

the improvement of standards in a workplace and neither does the human behavior. The

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proposed philosophy will hopefully help to achieve improved infection control practices and

quality in the delivery of medical care.

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References

Jackson , C., Lowton, K., & Griffiths, P. (2014). Infection prevention as "a show": A Qualitative

Study of Nurses' Infection Prevention Behaviors. . International Journal of Nursing

Studies, 400-408.

O'Brien, D., Richards, J., Walton, K. E., Philips , M. G., & Humphreys, H. (2009). Survey of

teaching/ learning off healthcare-associated infections in UK and Irish medical schools.

Journal of Hospital Infection, 171-175.

Parker, M., & Smith, M. (2010). Nursing theories and nursing practice (3rd Ed.). Philadelphia:

Davis Co.

Pittet , D. (2008). The Lowbury lecture: Behaviour in infection control. Journal of hospital

infection, 1-13.

Ward, D. J. (2013). The application of the theory of planned behaviour to infection control

research with nursing and midwifery students. Journal of clinical nursing, 296-298.

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