Critique of Research Paper - Report Example

CRITIQUE OF RESEARCH PAPER ON “ATTITUDES AND PERCEPTIONS TOWARD HAND HYGIENE AMONG HEALTHCAR WORKERS CARING FOR CRITICALLY ILL NEONATES: A research on the topic “Attitudes and Perceptions toward Hand Hygiene among Healthcare Workers Caring for Critically Ill Neonates,” has been carried out by a group comprising Drs. Carmen Lucia Pessoa-Sliva, Klara Posfay Barbe, Reicardo Pfistor, Thomas V Perneger, Didier Pittet, and RN Sylvie Touveneau. The research seeks to identify beliefs and perceptions that are associated with hand hygiene among neonatal healthcare workers, with a view to improve the system and encourage promotion of hand hygiene behavior of healthcare providers. The abstract establishes the background of the research, and clearly states its objective, methods adopted, research findings, and conclusions. The paper adequately recognizes the need for increased consciousness in the care for neonates, particularly infants with low birth weight, who stand at a high risk in terms of healthcare associated infections. The paper highlights the major influencing factors that contribute to poor compliance of hand hygiene practices, and emphasise the need to overcome healthcare associated infections. The objective of the study is to identify beliefs and perceptions associated with hand hygiene among neonatal healthcare workers. It also aims at evolving relevant strategies to overcome the present limitations in the area. The research underlines the fact that compliance with hand hygiene in neonatal settings is less than 50% and even after concerted efforts to promote it in all settings, there is only a marginal improvement. The authors have effectively correlated the prevailing situation with the problems healthcare providers experience in handling challenging situations. Thus the study has appropriately considered both the pros and cons which renders it a balanced impression. The research team has reviewed a good number and variety of literature that is significant in terms of its relevance to the topic. This includes articles and books by some of the major writers in the field of health and paediatric care, such as Pittel D. Boyce, Larson EL McGinley, Cohen B. Saiman, Larson F. Kretzer, Conner M Norman, Azjen I, Seto WH, Ching IY, and others whose findings have influenced healthcare practitioners tremendously. A range of sources have been used by the authors in terms of literature review which makes the research very exhaustive. Interests of a diverse group have thus been considered to make the research relevant to a larger number of stakeholders. The researchers have also paid due care in ensuring that the literature are recent and are relevant to the present context, and also that they are related to the policies and basic concepts of hand hygiene and hospital methods that is followed by individual healthcare service providers. The research is based on the principle that “perceived control is the variable that contributed most to the understanding of intentions towards the respective behavior.” (p.6). This theory of reasoned action and planned behaviour models as predictors of healthcare workers’ use of glove has already been tested by Levin. (30). The researchers have used logistic regression analysis to investigate the cognitive factors associated with intention to comply with hand hygiene. In bi-variants and multivariate models, intention to comply with hand hygiene, risk perception, and motivation are entered as dichotomous data. The cognitive factors have been measured by multi item questions, and entered as continuous values. All tests were bi-polar and the analysis has been conducted using Stata software (version 7). The study has been conducted in the neonatal unit of the University of Geneva Hospitals, Geneva, Switzerland, which caters to a population of approximately 800,000. About 700 neonates are admitted to the intensive care unit annually. The clinical staffs include 17 physicians and 84 Registered Nurses. The institution is fully equipped with hand hygiene facilities and the sample size is appropriate for the research approach. All the participants in the study are healthcare providers and the study represents all key indicators. The study design has been appropriate as the 74-items questionnaire has been individually distributed anonymously and returned by mail; 80 healthcare providers present during the study period have been included in the survey. The element of anonymity generates answers without bias. The method of evaluation of cognitive variable factors, based on the theory of planned behavior by five groups of multi-item questions, is appropriate as the study has been able to identify the key factors. Motivation to improve hand hygiene was assessed by asking participants whether they thought it was possible to improve their personal compliance. Healthcare workers were also questioned about possible reasons for difficulty to comply with hand hygiene, which were also measured using 7-point bi-polar scale. This seems to have facilitated a realistic assessment of the situation from the perspectives of both the providers and the clients of the hospital. The research has also been significant in identifying certain factors that culminate from the human tendency to depend on assumptions rather on scientific proof. For example: The social cognitive models, developed during the latter half of the 20th century, were born from the assumption that an individual’s perceptions have a strong impact on his or her behavior and can accurately predict human behavior. In other areas of healthcare promotion, the application of social cognitive models in intervention strategies has produced consistent results that reflect positive behaviour. The manner in which the research focused on the framework of the theory of planned behavior, to evaluate cognitive determinants of hand hygiene behavior, has enabled the identification of areas where the behaviour pattern could be influenced and improved upon. In addition, the research has recognized areas that need specific emphasis to explain behaviours and behavioural intentions in diverse social situations to understand need for adherence to hand hygiene among nurses. Considering the advancement in neonatal medical care and drawing wisdom from past experiences, it is possible to prevent infections that arise from unhygienic practices of the employees of the hospital. Strictly adhering to the requirements is a moral and ethical obligation on the part of the healthcare providers. The research points to vital issues like social desirability bias and generalisation with other healthcare workers as some of the limitations in the effective implementation of a definite policy or guidelines on hygiene behaviour. It arrives at the conclusion that compliance with hand hygiene varies significantly among healthcare workers within the same institution. Thus it accentuates the key role of individual factors in determining behaviour. Work cited: Levin, PF. Test of the Fahbein and Alzen models as predictors of health care workers’ glove use: Research in Nursing Health. 1999 Read More