Nursing Evaluation Plan

The problem I focused on during my practicum was the high rate of hospital-acquired infections (HAIs) in the surgical ward. These infections increase patient suffering, lengthen hospital stays, and raise healthcare costs. My planned intervention was a structured hand-hygiene improvement program designed to reduce infection rates and improve patient safety. The intervention included four main parts: brief staff education sessions, visible reminders such as posters and badge cards, weekly audits of staff compliance with hand hygiene, and leadership support to ensure sanitizer dispensers and sinks were always accessible. Implementation began with training during the first week, then placement of reminders and initiation of audits in week two, followed by three months of observation, feedback, and leadership involvement. This evaluation plan defines the outcomes I expect, describes how I will measure them, and shows how I will use the findings to strengthen practice.

Part 1: Evaluation of Plan

Defining the Outcomes

The outcomes of the intervention are clear, measurable, and time-bound. First, I aim to raise hand-hygiene compliance among staff from a baseline of about 50% to at least 90% within three months. This outcome focuses on direct staff behavior, which is the most visible measure of change. Second, I expect a reduction in HAIs in the surgical ward of at least 30% within three months, compared with the three months prior to the intervention. This outcome reflects the real impact on patient health. Third, staff knowledge about hand hygiene should improve by at least 25%, measured by comparing pre- and post-training test scores. Finally, staff attitudes toward safety and hygiene should also improve, with at least 80% of staff giving positive responses on a brief survey about safety culture. These outcomes are connected to each other: increased knowledge supports behavior change, which should improve compliance and eventually reduce infection rates.

Evaluation Plan Design

To measure compliance, trained observers, an infection control nurse, and a peer observer will use the World Health Organization (WHO) “Five Moments for Hand Hygiene” checklist. Baseline data will be collected in the week before training, followed by weekly audits during the three months of the intervention. HAIs will be measured using monthly infection control records, focusing on the rate of infections per 1,000 patient-days. I will collect baseline HAI data for three months before the project and compare it with the three months of the intervention.

Knowledge will be measured with a short multiple-choice quiz given to staff before the training, immediately after the training, and again at the three-month mark. This will show both immediate learning and retention. Staff attitudes will be measured using an eight-item Likert scale survey that asks about safety culture, leadership support, and teamwork. The survey will be administered before the training, at six weeks, and at three months.

In addition to numbers, qualitative information will be gathered. A short focus group of six to eight staff members will be held halfway through the project to discuss barriers and facilitators to hand hygiene. Open-ended feedback will also be invited at the end of the project. Research shows that implementation strategies using a mix of education, reminders, and audit with feedback are more effective than single strategies. This justifies using both numbers and staff perspectives to assess effectiveness (Fontaine et al., 2024).

Data Collection, Analysis, and Success Criteria

Compliance rates will be calculated as percentages of observed opportunities. HAI data will be analyzed by comparing infection rates before and after the intervention. Knowledge scores will be analyzed using paired t-tests to see whether the differences are statistically significant. Compliance percentages will be compared using chi-square tests, while survey scores will be summarized as means and percentages of positive responses.

Success will be defined as compliance reaching or exceeding 90%, HAI rates decreasing by at least 30%, knowledge scores increasing by at least 25%, and positive attitude scores reaching at least 80%. Qualitative data from focus groups and feedback will be analyzed for common themes, such as barriers to hygiene or effective motivators. These results will explain why certain goals were met or not met. Studies show that electronic monitoring with feedback, when combined with education, often improves compliance and can reduce HAIs (Knudsen et al., 2023; From-Hansen et al., 2024).

Limitations and Mitigation

There are several limitations that may affect results. One is the Hawthorne effect, where staff may perform better only when they know they are being observed. To reduce this, observations will be frequent, unannounced, and spread across different shifts. Another limitation is the possibility of other infection control initiatives running at the same time, which may confound results. Any such initiatives will be documented and considered in the analysis. Staff turnover or high workload may also reduce compliance. To address this, leadership support is needed to ensure supplies are available and that staff are not overburdened. A qualitative study highlights that leadership, team norms, and workload are strong determinants of compliance (Alshagrawi & Alhodaithy, 2024). These factors will be carefully monitored.

Practicum Hours Submission

Throughout the practicum, I have tracked my hours using the Capella Academic Portal (CAP). For this assessment, I will submit my CAP practicum log showing at least 40 confirmed hours. Only confirmed hours will count for grading, and I will ensure the log is attached when submitting the final project.

Part 2: Discussion

Advocacy — Nurse’s Role in Leading Change

Nurses are natural advocates for change because they are close to both patients and staff. In this project, my role is to teach staff, serve as a role model, and use data to advocate for continued support from leaders. For example, I can present improved compliance data to the nurse manager and medical director to argue for sustained resources, such as sanitizer refills or time for refresher training. Evidence-based nursing leadership is linked to better staff performance and patient outcomes. Research shows that leaders who use evidence and data in advocacy are more effective in securing organizational support (Välimäki et al., 2024).

Interprofessional Collaboration and Benefits

This project also requires collaboration across roles. Infection control specialists, physicians, supply staff, and hospital leadership all play a part. With collaboration, the intervention is more likely to be integrated into daily practice. The health system benefits from fewer infections, safer patients, and lower treatment costs. Studies have found that combining strategies such as education, reminders, and audits works better when supported by interprofessional teamwork (Fontaine et al., 2024).

Future Steps — Improvement and Technology

For greater impact, the project can be extended beyond the surgical ward to other high-risk areas such as intensive care units. Long-term follow-up should also be conducted for 6–12 months to test sustainability. The new opportunities are provided by technology. Electronic hand hygiene monitoring systems (EHHMS) have the potential to monitor compliance in real time and give personal feedback to the employees. Studies show that these computer systems can help keep good habits going and stop infections from spreading, especially when hospital leaders support the program and teach staff how to use it (Knudsen et al., 2023; From-Hansen et al., 2024). We could also use phone apps, special computer screens for managers, and automatic pop-up reminders. When new employees start working here, we'll make sure they learn proper hand washing techniques right away. This should help the improvements stick around for years to come.

Reflection on Leading Change and Transferability

Leading this project taught me how to plan, gather information, and determine whether our changes actually worked. I also learned how to share results with people in a way that gets them excited about making changes. This experience has improved my confidence in leading quality improvement projects and advocating for patient safety. The cycle of defining outcomes, measuring progress, and adjusting interventions can be applied to many other issues, such as fall prevention, medication safety, and patient education. The skills I have gained here will guide me in future leadership positions and help me contribute to a culture of safety and quality improvement.

Evidence Integration and Professional Communication

Throughout this plan, I integrated evidence from diverse sources to support my methods and decisions. The updated Medical Research Council framework provides guidance on developing and evaluating complex interventions (Skivington et al., 2021). A recent meta-analysis confirmed that multi-strategy interventions improve nursing practice outcomes (Fontaine et al., 2024). Evidence-based leadership studies highlight the role of nurses in guiding organizational change (Välimäki et al., 2024). Recent studies on electronic monitoring systems provide insights into future steps (Knudsen et al., 2023; From-Hansen et al., 2024). Finally, some studies looked into why healthcare workers follow or don't follow safety rules. These studies found that things like how busy people are at work and whether the team gets along well really matter (Alshagrawi and Alhodaithy, 2024). When you put all this research together, it helps make a stronger plan and shows how it might affect other areas, too.