Theory-Guided Practice: Application of the Goal Attainment Theory in the Infection Prevention and Control

Introduction

In a clinical setting, it is paramount for a professional nurse to prevent nosocomial or healthcare related infection (McKenna, Pankhihar, & Murphy, 2014). This aspect prevents the spread of illness and promotes quick recovery among the affected patients. Infection control practice in nursing entails addressing some of the critical factors which are related to the spread of infections whether patient-to-patient, from patient to staff, from staff to patient or from staff to staff (Mayberry, 1991). Infection prevention and control inside a healthcare facility are achieved through hand hygiene, sterilization, cleaning, disinfection, isolation and quarantine, vaccination of health workers, monitoring an infection, training the healthcare workers on how to control an outbreak, antimicrobial surfaces, and personal protective equipment.

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It is possible to achieve these objectives in a clinical setting using the Goal attainment theory by Imogene King (Raj, 2011). The theory explains the growth in which the patient and the healthcare worker must experience to attain the desired goals in life. In the model, there are three systems which must work harmoniously, and they are personal, interpersonal and social aspects. Based on King's argument, human beings are social creatures who must come together and work as a team to achieve the common goals and make good decisions (Kim & Kollak, 2006). Therefore to successfully address control and prevent the spread of infections in a healthcare facility and beyond, the nurse, patients, and other healthcare staff must work together to achieve this reality. The nursing goals, in this case, are to attain, maintain and regain the healthy state of their clients by minimizing all the illness-causing agents and creating a conducive environment for the patient's recovery (Raj, 2011). The goal attainment theory can be attained through Joint Goal Setting by Nurse and Client, training of the staff and proper communication where critical information is quickly relayed to all the parties involved.

To come up with the goal attainment theory as a useful model to control and prevent the spread in health care institutions, I had to put into consideration the six criteria used to select an appropriate theory. The following is how each standard helped me arrive at the conclusion of the Goal Attainment Theory as the best theory.

Clinical setting- the control of infection is to occur in a clinical environment where patients who seek health services in a hospital would be protected from acquiring or transmitting illness and germs. Therefore, the theory in which I had to choose should be applicable in a clinic setting and should meet the desired results comfortably (McKenna, Pankhihar, & Murphy, 2014). Goal attainment theory, in this case, was ideal for it would be used in a health facility and could reach the objectives specified through collaboration and the setting of the goals together.

Origin of the theory- the source of the method entails determining under which basis the theorist came up with the model. It is a known fact that approaches which have been designed by 'armchair theorist' are less attractive when it comes to practical application by the nurses. Having this knowledge is useful as one has to bear in mind how the theory came into existence, whether it was through reintroduction where deduction and addition played a part, or it is a theory that has never been challenged and thus lacks credibility (McKenna, Pankhihar, & Murphy, 2014). However, looking at the Goal attainment theory, it can be determined that it has been existence for a long time and thus has been proven over time as credible and one that relies on scientific data.

Paradigms as a basis for choice- every nursing theory has been established to have its one or more of the following paradigms; interactional, system, developmental and behavioral. Having that in mind was paramount at selecting the ideal theory which can be used to control and prevent infections in the clinic (McKenna, Pankhihar, & Murphy, 2014). The best approach, in this case, would have to incorporate two or more paradigms to yield the desired results. In the goal attainment theory, the system, interaction and behavioral standard come into play.

Simplicity- in a world where being a professional nurse entails encompassing many aspects of the practice, selecting a theory that is simple and easy to remember to both the professionals and the clients was paramount. Complex theoretical frameworks only complicate the art of patient care and create room for errors. Therefore, the model which must be put in place to prevent the spread of infection in a hospital must be simple enough to be remembered and implemented with ease (McKenna, Pankhihar, & Murphy, 2014). The goal setting theory is not only easy to formulate and perform but also easy to remember because it involves the clients when setting out the goals to be met.

Patient's need- the primary consideration when selecting a theory should be the one that best suits the patient. In this case, the patients need is to have a quick recovery and return to their usual way of life. Therefore as a professional nurse, it was ideal to consider which theoretical framework would maximize the patient-nurse interaction to continually monitor and adjust to the evolving needs of the patients (McKenna, Pankhihar, & Murphy, 2014). The goal objective theory provides such a structure where the patient and the healthcare professionals have a chance to interact and discuss the best ways to prevent the spread of infections in the facilities. Through the interactions, the nurses can establish what the clients do not like and the areas that they support or propose an adjustment.

Understandability- closely related to simplicity but must be easy to understand by both the nurses and the clients. The theory selected to create a framework that controls an epidemic such as spreading of infection must not be complicated to grasp by busy nurses as well as the ailing patients (Mayberry, 1991). Therefore, the goal attainment theory avoids jargons and complex terminologies which cannot be understood by the clients, instead it helps in the establishment of clear procedures and guidelines which are to be used in a clinical setting to prevent the spread of the infectious diseases (McKenna, Pankhihar, & Murphy, 2014).

Conclusion

Conclusively, based on the six criteria that should guide a nurse when choosing an ideal theory to control the spread of an infection in a health institution, the goal attainment theory emerges as the best suited. This is because it is simple, involves the concerned parties, lays down clear guidelines that are easy to understand and addresses the needed and the concerns of the patient as they arise (Raj, 2011). On top of that, the theory embodies the critical aspects of human interaction required to accomplish common goals. These are personal aspects where a nurse understands their role, personal growth, and development of the patient (Kim & Kollak, 2006). The other element is interpersonal where group responsibilities are laid out and lastly the social element which entails understanding the factors which could inhibit the client's decision making and thus come up with appropriate strategies to address the limitations.

References

Kim, H. S., & Kollak, I. (2006). Nursing theories: Conceptual & philosophical foundations. New York, NY: Springer Pub. Co.

Mayberry, A. (1991). Merging nursing theories, models, and nursing practice: More than an administrative challenge. Nursing Administration Quarterly, 15(3), 44-53. doi:10.1097/00006216-199101530-00008

McKenna, H. P., Pankhihar, M., & Murphy, F. (2014). Fundamentals of nursing models, theories and practice.

Raj, D. E. (2011). Chapter-01 Introduction to Nursing Theories. Nursing Theories, 1-16. doi:10.5005/jp/books/11394_1