Abouthand

Introduction

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Good health is as a result of combination of many factors, one of these factors is hand hygiene. The hands are probably the most used body organ. A day barely passes without holding multiple objects with our hands; we greet people, hold money, eat and clean our houses with our hands. It is therefore apparent that our Hands are at a higher exposure to germs than any other part of our body. It is also very easy for the germs picked up by our hands to be passed on into our body systems via oral transmission. This is due to the fact that we continuously use our hands, when eating for example; we may ingest the germs with the food we eat.

The most prone internal organ for infections passed on through our hands is the stomach, many people complain from time to time of stomachaches and minor diarrhea, these ailments are all attributable to poor hand hygiene, it is therefore of very high importance to maintain a good hand hygiene, we should wash our hands constantly with a stipulated medical hand wash, for example a dettol hand wash, this should come before and after we have used our hands for various activities, for example after visiting the toilet, before and after a meal. This will ensure that our hands are clean and that germs may not be transferred from our hands to our mouths when we use our hands. Hand hygiene should start from our health professionals; nurses are health experts and are therefore expected to portray a good example to the other people. This paper will research on the standards of nurses hand hygiene in a Chicago hospital.

Statement of purpose

Nurses as health professionals should promote a healthy living practices to the citizens. One of the ways of doing this is promoting hygienic practices like hand hygiene. This should be done at both the place of work and at the home place. In other words am saying that nurses should be ambassadors of promoting healthy living practices. The patients can easily copy what the nurses do in the hospital and consequently reduce their chances of getting infections ensuing from poor hand hygiene. This paper will carry out a research on the hygienic practices of nurses at a Chicago health facility to establish whether they are carrying on the gospel of proper hygiene or they just preach and not follow it, what the bible may term as preaching water and drinking wine. Setting a good example to the subjects who are the patients and the other citizens should be ethical practices by the nurses, by emulating the nurses they should get a low chance of catching a hand transmitted infection among other infections that are as a result of a poor hygiene living.

Importance of maintaining hand hygiene

Good hand hygiene will enable patients keep away ailments that result from poor hand hygiene, they will be saved the costs of treatment and more productivity can be realized from the healthy population as a result of maintaining hand hygiene.

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Problem statement

Hypothesis: most nurses in the Chicago health facility have not embraced proper hygienic practices, like hand washing.

There have been a high and rising number of infections resulting from poor hand hygiene in Chicago recently. The nurses themselves have not also been left out by the infections, last month only; two nurses were admitted in the health facility complaining of severe stomachache, stomach ailments are mostly as a result of using unclean hands for ingesting food. This raised a high health alert. If the infection swept through the health professionals then it is likely that the ramifications to the general citizens may be great. A lot of expenses and other facilities have been used for treating infections resulting from poor hand hygiene.

The probable cause of the widespread stomach infections in the Chicago area is poor hand hygiene. Many stomach ailments are caused by ingesting germs into our body systems through the food we eat. The hands are the organs used for eating; as such many of those germs may be picked up through the hands and transferred to our mouths. If we do not maintain good hand hygiene then we are at a risk of being bombarded with an array infections and as a result the government will channel a great amount of resources towards the treatment of infections which could otherwise be prevented at virtually no cost; just by giving our hands a good hygiene which any one can do at a very low effort if any.

When a high number of citizens are suffering from infections then the productivity of the workforce is set at minimum, the standards of living are also expected to go down as the citizens will be unable to work to meet their daily needs. Many people may take hand hygiene as a trivial matter; however the ramifications which may ensue from the same are far reaching In addition to the decline in the economy, the pain borne by individuals suffering from stomach infections is hard to bear. The infections inflict suffering and threaten the general body fitness. The benefits of preventing these infections are therefore real; this should start with our health professionals, the nurses for this case setting a good example by maintaining proper hygienic standards.

Nursing theorist

Dorothea Orem self care theory

Self care refers to those individual practices that are done independently to promote the general good health of the person. Hand washing as one of those practices. General well being of individuals can be enhanced by regular washing of the hands. Many people take it as a triviality however it can save them many costs. Self care can only be achieved when the individuals have agency with self care. This is the personal initiative to pursue the self care practice. When individuals do not have the initiative to perform self care practices, then a deficit arises in self care and this may lead to ill health of the individuals.

When the individuals are ill, this is the point at which the nurse is expected to step in, he/she should meet the healthcare needs of such individuals by teaching, supporting guiding or providing an environment for the patients to achieve self care practice. The nurses can also offer a full compensatory assistance to the patients to enable them to fully recover, however as the old saying goes, when an hungry man requests for a fish from you, you should also provide him with a fishing rod and also teach him how to fish, this way you would have fully assisted him, this should also be the case with nurses and the patients on self care. This can be achieved by the nurses offering what is referred to as the partial compensatory assistance where the patient also plays some role in his/her recovery process; he or she will subsequently be able to develop a self care program to safeguard himself/herself. Nurses should therefore offer education to the patients on self care practices.

Another way of assisting the patients achieve self care is by setting a good example to them. Nurses should be among the first to embrace self care practices. It is unexpected of them to forsake this and also to suffer from infections related to lack of proper safe care practices.

Literature review

I reviewed five journals on hand hygiene by health care experts. Larson (1995) provides the guideline for the nurses to ensure good hand hygiene. He talks about the aspect of the nurses setting a good example for the patients and the overall citizens. Nurses should never fail to observe good hand hygiene; they should wash their hands with proper antiseptics which destroys the germs on their hands. The writer also puts across that cases of infections to healthcare providers including the nurses resulting from poor hygiene should be on the minimal. This should set an example to the patients on the hygienic standards expected of them in order to curb ill health.

According to Pittet & Boyce (2002), hand washing is one of the most effective means of preventing infections. Most stomach infections are as a result of poor hand washing practices. Many people including the nurses usually ignore this especially when they have left the toilet. The writer also says that before ingesting anything into the mouth, individuals should ensure that their hands are clean. Nurses should be on the frontline in self care practice to set an example for the general citizens to emulate. Hazy & Wang (1998) conducted an observation on the hand washing habits in several healthcare facilities. In the observation they found out that the nurses too do not observe self care as it regards their hand wash, they observes that many nurses did not wash their hands continuously after leaving the rest rooms. The postulate that this habit by the nurses could have worsened the situation for the patients as the nurses used the same hands to administer prescriptions to patients.

According to Perneger & Mourouga et al. (1999), a survey they carried out in a hospital educating nurses indicated that the instructors themselves and the trainee nurses did not observe proper hand hygiene. This set a bad example to patients because they are bound to emulate the practices of their healthcare providers. Pittet (2000), provides recommendations on improving hygiene inside the hospitals, she says that the hygiene standards in hospitals should be high in order for the patients to learn from the same. This will go a mile in preventing the infections which are caused by poor hygienic practices. Larson & Kretzer (2000), provide guidelines to the patients on how to improve their general fitness. They state that good hygienic standards can keep most of the stomach infections at bay. They observe hand washing as a paramount hygienic practice. It is what many people take for granted though they can reap many benefits as a result of implementation of the self care procedure. They also observe in the article that the self care hygienic practices should start by the healthcare professionals, this way they will set a good example to the citizens and many ailments will be avoided, this way substantial resources will be available for developmental purposes.

Expected outcomes

It is expected that the nurses in the Chicago health facility do not observe hygienic hand wash facilities to the letter. With only last month two cases of nurses suffering from stomach infections in the hospital, the hand washing by the nurses in the hospital are in doubt. It is also evident from the high and increasing cases of stomach infection admissions in the hospital, that the hospital facility has not fully embraced the campaign to promote healthy hygienic practices in the state. From the literature review which indicated many nurses as preaching water and drinking wine, they preach hand hygiene but themselves do not embrace what they stand for, by this it is expected also from the literature that the nurses have not fully complied to self care.

Research design

The participants of this research undertaking will be nurses from a central Chicago health facility. The data collection endeavor will approximately be in a week’s period. A preliminary visit will be conducted to the health facility prior to the research; to get the permission to carry on the research in the facility and also to familiarize with the respondents. In week of the data collection, a sample of ten nurses will be randomly selected from the nurses’ population in the hospital as a representative. The methods of data collection that will be use will be interviews and observation. The interviews will be conducted with the nurses to establish their level of compliance to self care practices. Questions that may be too personal will be avoided in the interviews. The observation technique will be applied on the sample in that: The hand washing patterns of the nurses will be observed. The observation will be concentrated on the nurses after leaving the rest room, during meals and when administering prescriptions to patients.

The data will be recorded in note form for analysis. Tables will then be drawn with the number of the nurses who have shown compliance to hand wash in the various observations subsections; after leaving the rest room, prior to meals or when ingesting anything into their mouths and when administering prescriptions to patients. After the analysis the findings will be projected to the population, this will be based on the compliance of the nurses to hand wash. Their move to promote self care practices by the patients will then be established which will indicate the level of self care in the state, recommendations on improvement will then be provided.

Conclusion

Hand hygiene is one self care practice that can go long way in keeping most many ailments at bay. Nurses should work relentlessly in promoting the self care practices, they need to set a good example by themselves adhering to hygienic practices like hand wash. This way a healthier population will be achieved and greater economic growth realized from energy of the citizens and the resources which will now not be channeled to healthcare.

References

Larson, E.L. (1995). Guideline to hand washing and hand antisepsis in health care setting. Am J infect control, (23): 251-269

Pittet, D. & Boyce, J. (2002). Guideline for hand hygiene in health care settings. Am J infect control, (30): 21-46

Hazy, J. & Wang, C. et al. (1998). An observational study of hand washing and infection control practices by healthcare workers. Am J infect control, (19): 858-860

Perneger, T.V & Mourouga, P. et al. (1999). Compliance with hand washing in a teaching hospital. Ann intern med. (130): 126-130

Pittet, D. (2000). Improving compliance with hand hygiene in hospitals. Infect control Epidemiol, (21): 381-386

Larson, E. & Kretzer, E. K. (2000). Behavioral interventions to improve infection control practices. Am J infect control. (26): 245-253

Created by Chris Irvine and Kara Crowley (Winter 2013)

A knowledge based society, or '21st century society', is one in which its members, through Lifelong learning, share innovations and expertise within a community of experts and non-experts, in the spirit of apprenticeship. This results in a network of knowledge which is created, shared, used and protected by the network itself. Knowledge is used to inform and improve ourselves and others both culturally and materially, with the goal of building a sustainable society. ^[1] 21st Century Learning skills are skills necessary in a knowledge-based society, such as information and communication skills (including information processing and research tools),thinking and problem solving skills (including using technological tools such as spreadsheets to solve problems and think creatively) and interpersonal and self-directional skills (such as e-learning and collaboration). ^[2] Educational assessment, according to the British Columbia Ministry of Education, is the 'process of gathering evidence of what a student knows, understands, is able to do and is working towards.' ^[3] In a knowledge-based society, with its network of both technology and people, current assessment tools require upgrading to ensure that learners are prepared for a rapidly changing and ever-connected community, society and world. It is important to understand the culturally significant values that are currently driving the need for knowledge and to consider the direction of the greater society before generating tools to measure the progress of learners in that society. In order to do that we must consider the needs of a 21st century learner in a knowledge-based society.

• 4Assessment for,as, and of learning

Needs of a knowledge-based society

• Numeracy skills: how to apply mathematical concepts to problem solving and everyday life.
• Literacy skills: functional literacy: able to learn from what they read
• Critical thinking skills: search skills to access information, critical thinking skills to analyze and evaluate info and problem solving skills to utilize information.
• Creativity and Innovation: able to generate ideas, see things in a different way from others, to approach new learning from different direction
• Technological literacy: able to use technology to enhance learning and increase productivity.
• Communications Literacy: being able to relate ideas to others in person, on paper, or with technology.
• Media Literacy: using media to access, assess and analyze information and use new media forms to communicate.
• Collaboration and teamwork: knowledge based societies are interactive and require multiple people working in diverse ways to be innovative.
• Personal organization: personal possessions, organizational materials, time management
• Motivation, Self-Regulation and Adaptability: Being able to set and accomplish goals, when and how to apply effort, making decisions, prioritizing choices, making responsible decisions to enable independence and skill transfer to many occupations.
• Ethics, Civic Responsibility, Cross-cultural awareness: treating others, our environment and our society respectfully and obeying laws are essential to a fully functioning society.

Current assessment tools

In schools, teachers generate criteria based on learning outcomes for the subject and grade and on expected levels of performance. In the early years, performance scales and written reports outline progress in relation to expected development of students in similar age ranges. In grades 4-12, letter grades indicate performance in relation to learning outcomes. Teachers may use performance standards which describe expected levels of achievement in reading, writing, numeracy and social responsibility.Assessment methods and tools recommended up until the present have included observation, student self-assessments, daily practice assignments, quizzes, samples of student work, pencil-and-paper tests, holistic rating scales, projects, oral and written reports, reviews of performance and portfolios. Evaluation is based on criteria which is based on learning outcomes. Norm-referenced evaluation (basic skills tests, diagnostic tests) is also permitted to be used for large-scale system assessments.^[3]

Goals of 21st century assessments

Today's students need to collaborate with educators and make use of technology to get immediate feedback in order to improve outcomes. Technology allows educators to assess a student’s progress far more regularly than is possible with traditional classroom assessments and to identify and address each student’s challenges as they arise. This is in contrast to a system where assessment through tests and exams measures what a student learned at the end of an instructional unit, by which time it is often too late to address shortcomings. Having said that, measurement and assessment must not only be a tool to help the student learn but also to measure achievement for those outside the system, be it post-secondary education institutions or potential employers. However, what gets measured will impact upon both teaching and learning. Some of the skills discussed earlier are difficult to measure so it is important that a balance be struck that ensures a student’s progress is properly measured and yet does not stifle, or discourage some of the creativity and courage we are trying to engender in our students. The climate of assessment moves from exams and toward smaller more regular assessments. Data accessible to learners informs progress, with standards acting as anchors to learning. Rather than focusing on product based evaluations, performance and self knowledge are refined over time. Students are assessed before and during learning so that feedback may be provided that can be used to improve work and deepen understanding. In addition to quizzes, tests and worksheets, conferences, notes, self-reflection, journals and rubrics and checklists are used. Students are encouraged to assess themselves and their peers to enhance engagement and awareness of their own learning. Assessment is part of the learning process so that teachers and students are working together to monitor progress. ^[4]

Assessment for,as, and of learning

There are three distinct but inter-related purposes for classroom assessment: assessment for learning, assessment as learning, and assessment of learning.

Assessment for Learning

In assessment for learning, teachers use assessment as a research tool to find out as much as they can about what their students know and are able to do, as well what presumptions and misunderstandings they may have. Teachers also use assessment for learning to boost student's motivation and commitment to learning. ^[5]. Examples of 21st century assessment for learning tools, which include both diagnostic tests and formative assessments, are eportfolios, teacher observations, class discussions, and works in progress with comments, think-pair-share, journals, observation checklists, concept maps, and rubrics.

Assessment as Learning

Assessment as learning focusses on students and emphasizes assessment as a process of metacognition. Assessment as learning comes from the constructivist idea that learning is an active process that occurs when students interact with new ideas. It is based on research about how learning occurs and is characterized by students reflecting on their own learning and making adaptations, adjustments, and changes to their thinking. ^[5]. Examples of 21st Century assessment as learning tools include self-assessments, peer assessments, student-teacher conferences, teacher observations with feedback and interim product analysis. ^[6]

Assessment of Learning

Assessment of learning refers to strategies intended to corroborate what students know, show whether or not they have met curriculum outcomes or the goals of their individualized programs, or to confirm ability and make decisions about student's future programs or placements. It is intended to show evidence of achievement to other educators, parents, students themselves, and sometimes outside groups (e.g., educational institutions). ^[5]. Examples of 21st Century Assessment of Learning tools are eportfolios, with 'best piece' samples to show progress, open-ended response questions, descriptions of observations in Science experiments, historical role-playing arguments about the impact of decisions on current life, the writing process applied to poetry, long-term projects and problem-based reports. ^[7]

Current or traditional assessment practices are teacher focused, done with tests, quizzes and worksheets, completed outside of the learning and teaching activities and are done at the end of the learning activity for grading purposes. ^[8] Most of these tools would be considered as Assessment 'of' learning. 21st Century assessment tools will emphasize assessment 'as' and assessment 'for' learning tools.

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Assessment directions in B.C.

According to the Curriculum and Assessment Framework Advisory Group of British Columbia, formed in November 2011, all assessment activities should support ongoing learning and focus on five cross-curricular learning competencies (communication, critical thinking, creative thinking and innovation, personal responsibility and well-being and social responsibility) along with learning standards for the age and subject (under development). Assessment materials should allow multiple ways to both assess and show learning, with opportunities for student self-assessment and assessment for learning. The group suggested developmental continua be developed for cross-curricular competencies, with performance standards in use changing to match the change in focus.

• There should be provincial assessments at the elementary and secondary levels.
• Provincial assessments should be used to provide feedback for learning
• Provincial assessments should allow multiple formats, including performance tasks, inquiries and class-based assessments
• Literacy and numeracy should be stressed at the elementary level
• Competencies and key learning areas should be emphasized at the secondary level ^[9]

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Reporting

The language of 'reporting' should be shifted to 'communicating student learning' according to the advisory group. Teachers are encouraged to report at 'key times of the year' (p.7) about cross-curricular competencies and key learning, using performance scales. Self-assessment is encouraged, as well as using diverse measures of performance, such as portfolios, work samples and other evidence.

Conversations are continuing in regional meetings at present to determine the appropriate use of letter grades, cross-curricular competencies, aboriginal perspectives on learning, curriculum and how to assess personalized learning.

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The Question of Support for Educators

Worries About Hand Sanitizer Overuse

According to the British Columbia Teachers Federation,school districts and teacher education programs will need to provide systemic supports to educators if the transition to 21st century learning is to be successful. They include formative assessment for learning supports in a climate where large scale testing is not supported.^[2]

References

Apple (2008). “Apple classrooms of tomorrow—today. Learning in the 21st century”. Retrieved February 8, 2013 from http://ali.apple.com/acot2/global/files/ACOT2_Background.pdf

Intel (2010). Intel Teach Elements: Assessment in 21st century classrooms. Santa Clara, CA.:Intel. Retrieved Feb. 10, 2013 from http://www.intel.com/education/video/assess/content.htm

Open Colleges (2013). 'Components of a 21st century classroom'. Image retrieved from:http://www.opencolleges.edu.au/infographic/21st_century_classroom.html

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Premier's Technology Council (2010).A vision for 21st century education. Victoria, B.C.:Author. Retrieved Feb.4, 2013 fromhttp://www.gov.bc.ca/premier/attachments/PTC_vision%20for_education.pdf

Western and Northern Canadian Protocol for Collaboration in Education (2006). Rethinking classroom assessment with purpose in mind. Retrieved Feb 17, 2013 from www.wncp.ca/media/40539/rethink.pdf

1. ↑Palinkas, József (2011). Knowledge-Based Society. Paper presented at the World Science Forum. Budapest, Hungary. Retrieved February 7, 2013, from http://www.sciforum.hu/previous-fora/2003/permanent-update/knowledge-based-society.html)
2. ↑ ^2.02.1Naylor, Charles (2011). 21st century learning—Widening the frame of focus and debate: A BCTF Research discussion paper. Vancouver, B.C.:Author. Retrieved Feb. 01 from http://www.bctf.ca/uploadedFiles/Public/Issues/21CL/21CL-DiscussionPaper.pdf
3. ↑ ^3.03.1British Columbia Ministry of Education (1994). Assessment Handbook Series. Retrieved from B.C. Ministry of Education website: http://www.bced.gov.bc.ca/classroom_assessment/abouthand.htm
4. ↑Intel(2010). Intel Teach Elements: Assessment in 21st century classrooms. Santa Clara, CA.:Intel. Retrieved Feb. 10, 2013 from http://www.intel.com/education/video/assess/content.htm))
5. ↑ ^5.05.15.2 Western and Northern Canadian Protocol for Collaboration in Education in Education (2006). Rethinking classroom assessment with purpose in mind. Retrieved from www.wncp.ca/media/40539/rethink.pdf
6. ↑ Roberts, Clive (2011) 21st century learning - assessment for learning. Retrieved January 31, 2011 from http://digitallearningworld.com/tag/21st-century-pedagogy.
7. ↑ HP (2001). 21st century learning and assessment. Tech & Learning. HP author.
8. ↑Intel (2010). Intel Teach Elements: Assessment in 21st century classrooms. Santa Clara, CA.:Intel. Retrieved Feb. 10, 2013 from http://www.intel.com/education/video/assess/content.htm)
9. ↑British Columbia Ministry of Education (2012). Enabling innovation: Transforming curriculum and assessment. Retrieved Feb. 7, 2013 from http://www.bced.gov.bc.ca/irp/docs/ca_transformation.pdf

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