Effects of Handwashing in the Prevention of Cross-Infection - Literature review Example

Proposal for Literature Review On Effects of hand washing in the prevention of cross infection Background to the study This is a proposal for writing literature review as dissertation. The topic chosen is from the field of Adult nursing - effects of hand washing in the prevention of cross infection. This topic has been studied by some researchers as it is most effective way of controlling microbial count and decreasing nosocomical infections. One of such work is done by Pittet et al in which they have found that the main source of cross-infection in hospitals is due to the transmission of microorganisms from the hands of health care workers and hand washing can prevent it. They have done an observational study of the predictors of noncompliance with hand washing during routine patient care. This study was done in Teaching hospital in Geneva, Switzerland and comprised of Nurses, physicians, nursing assistants and other health care workers. They have found moderate compliance with hand washing which may decrease quality of patient care and for improving it educational programs may be useful. Another study done by G Kampf and C Ostermeyer analysed 41 experiments using EN 1500 hand disinfection procedures. They found that most alcohol-based hand gels are significantly less effective. They calculated RFs for both hand disinfection and hand wash and found similar results for both. In a study done on nursing, medical, physiotherapy, radiology, and orderly staff members M Graham in which patient contacts and hand decontamination episodes were observed. They found that the frequency of hand decontamination is below levels as recommended by infection control authorities. Slight increase in hand washing compliance was observed by increasing the accessibility of hand decontamination facilities. Another paper by Dinah and Angela specifies that gram-negative bacteria is maostly responsible for nosocomical infections and colonization takes place before infection. Staff’s hands are found to be the main carrier of its spread and hand washing as the main method of prevention. An article by Texier has also focused on strategies for effective hand hygine considering it the most important step in prevention of cross infection. Simmons et al have also found poor hand washing practices although it is the most important step for preventing nosocomial infections. The health care workers overestimate their frequency of washing hands that can be observed. Some nursing journals like Nursing Education Today, American Journal of Infection Control also carry articles on this subject. These articles show the importance of hand washing in preventing infection. They also indicate the lack of awareness in health care professionals towards it. That is why there is a need to bring all the research and studies done on this topic at one place to highlight its importance and also support it with data. Aims This study aims to find out all available research done in the field of adult nursing that relates to effects of hand washing in the prevention of cross infection. This is an important topic in the field of adult nursing as negligence in this field can be detrimental to the profession of adult nursing. The study will bring out all the research based data in one place for a comprehensive and compact information source. Although such information is scattered in various journals and research papers but getting all the information in one place will be much more comprehensive and practical. This will also speed up the continuing education process of the nursing professionals. Objectives The objective of this study is to bring more professionalism in the field of nursing. For this continuing education is very important. There is lot of research going on in this field and the nurses need to be updated on it. But there profession itself is very demanding and they are always short of time. That is why a comprehensive and compact information source is what they need and that is what this research can provide. The topic of this research is related to cross infection. Prevention of cross infection is absolutely important for enhancing the recovery process and to prevent further complications. It also helps in controlling the spread of diseases. Hand washing is a commonly known procedure but it is not taken seriously as it is a very casual and non-technical process. If the information and data on this topic can be collected and made available for a ready reference, it can improve the recovery process of patients as the nurses become more aware. It also prevents growth of new diseases in the same patient or new patients. Thus this research will aid in improving medical care. Methodology Since it is a research of literature review, we need to first select a type of literature review. It is basically of two types:- 1. A systematic literature review 2. An extended literature review. A systematic literature review takes on primary source as the answer to the research question. It considers all other primary studies also as answers to the research question. In an extended review, a different method is used. It studies different aspects from the literature to illustrate different points and themes. Although it has a research question and the search method is systematic, still has a different approach than the systematic literature review. This study will adopt the extended review style. This will help in presenting a wider aspect of the research topic. Since the aim is to provide a compact study related to the research question, a place where all the professionals related to the field of nursing can find relevant matter, the extended style will help explore various angles related to this topic. Search strategy To search for the relevant material, a systematic strategy will be adopted. First, a list of all the nursing institutes will be drawn. All these institutes have their own publications and bulletins. From these publications, we would search for the topics related to effects of hand washing in the prevention of cross infection. The selected articles will be chronically arranged. A summary of the selected article and its views and arguments will be presented. Any data given or graphs used will be replicated. Apart from the universities and nursing institutes, there are many other medical journals. A similar search will be made there as well. Many medical researches might have also covered this topic. A search would be made in the research papers that are focused on cross infection. This would show us whether they have considered the research question in their research or not. Thus the paper will be divided into three sections – articles from nursing institutes, articles from other journals and magazines and articles from medical researches. The last chapter will have an analysis of all the articles compiles. It will point out the similarities and differences. It will also highlight any unique point noted by any of the articles. This will be followed by a concluding summary. An index will be given at the end of the paper to help locate any particular article. Thus it will act as a concise guide to the research question to anyone looking for relevant matter. Key words According to the research question - effects of hand washing in the prevention of cross infection we will have two basic key words – Effects of hand washing and prevention of cross infection. While some articles can have the complete phrase that is a combination of the two and also our research question, there would be some articles that would cover only either of the phrases. We will go through those articles as well because it would help us to find out whether they consider the other part relevant or not. If there is an article on the effects of hand washing but does not consider it as a method to prevent cross infection, it must be considering some other aspect related to hand washing. We can put that aspect alongside the research question according to our extended review style. Similarly an article talking about prevention of cross infection might not mention about hand washing as a measure. In such a case, it must be giving some other ways to prevent cross infection. It must also provide some data related to it. This will be helpful to compare with data that is completely on prevention of cross infection by hand washing. Inclusion/exclusion criteria Our inclusion and exclusion criteria will be based on the key words. As mentioned before the study will include all the articles that have the given key words. Apart from the key words, the other criteria of inclusion would be the source. We have selected three different sources - – articles from nursing institutes, articles from other journals and magazines and articles from medical researches. The study will not go beyond these sources. Any article that would be taken up will have to be from any of the three sources only. There may be similar articles on websites and blogs but that would not form a part of the study and hence will be excluded. Reliability and Validity Keeping in mind the reliability and validity of the matter presented, the study has selected the sources. Since these will be approved works by institutions of repute, they should be considered reliable and valid. Without such sources, the study in itself can not be considered reliable and valid. It will stick to only the published material from the selected sources. Any paper submitted for consideration or manuscripts will not be included. Limitations of study This study is related to cross infection but it will restrict itself to the effects of hand washing. There are other methods to prevent cross infection, but this study will not consider them. There are other factors also that cause cross infection but this study will not get into those areas. Thus it will have certain limitations but it will be a focused study on the chosen topic. There is always a possibility of taking up other topics as further research. Timetable for completion The entire project will be divided into three parts :- collection of material, compilation of material and analysis. Each step will be completed in one month’s time. One month will be kept as technical details like permission seeking and printing. Therefore the entire project will be completed in four months time. It can be charted out as follows:- Permission seeking – 2 weeks Collection of material- 4 weeks Compilation of material – 4 weeks Analysis – 4 weeks Editing and printing – 2 weeks Total – 16 weeks Ethical considerations Since the study is about literature review, we will have to be careful regarding permissions to use and quote the articles. There may be some restriction in some of the internal researches, for that we will need special permission. We may need a request from the University to grant permission in places where we may not get direct access. We will also have to ensure that the material is used solely for the use of this research and is not quoted or reproduced any where else for a different purpose. There should be no bias regarding the material based on race or ethnicity of the researchers. Value of the study A literature review as dissertation provides a comprehensive study on the given subject. Nursing being a very important link in the field of medical care giving requires continuous education. Such a review will make the education process easier. It can be used by nursing education institutes for educating their students. It can also be used by the nurses and other professionals attached to medical care to educate themselves. The role of a nurse is the most vital link in delivery of medical care. If they are unaware of the consequences of effects of hand washing in the prevention of cross infection, they may overlook its importance and hence cause more damage than the anticipated benefit. References. Pittet, D., Mourouga, P., Perneger, T.V., 1999, Compliance with handwashing in a teaching hospital, Infection Control Program, Ann Intern Med 1999, Jan 19, 130(2) Kampf, G., Ostermeyer, C., 2003, Inter Laboratory reproducibility of hand disinfection reference procedure of EN 1500, J Hosp Infect, 2003, April. Kampf, G., Ostermeyer, C., 2002, Inter Laboratory reproducibility of hand hygiene reference procedure of EN 1499 and EN 1500, Hosp Infect, 2002, Nov Graham, M., 1990, Frequency and duration of handwashing in an intensive care unit, Am J infect Control, 1990, April Simmons B., Bryant, J., Neiman, K., Spencer, L., Arheart, K., 1990, The role of hand washing in prevention of endemic intensive care unit infections, Infect Control Hosp Epidemiol. 1990 Nov Thunberg, S. Cross-infection prevention, basic hygiene practices and education within nursing and health care in Latvia: a Swedish–Latvian practice development project.  Nurse Education Today, Volume 23, Issue 6, Pages 404-411 H. Wong, T., Tam, W., Handwashing practice and the use of personal protective equipment among medical students after the SARS epidemic in Hong Kong.  American Journal of Infection Control, Volume 33, Issue 10, Pages 580-586 DINAH G. & ANGELA C., 1994, Gram-negative bacteria. The challenge of preventing cross-infection in hospital wards: a review of the literature Journal of Clinical Nursing 3 (6) LeTexier, R., 2000, Preventing Infection Through Handwashing Bibiliography: Gould DJ. ,1997,Giving infection control a big hand. Community Nursing Notes.;15:3-6. Stucke VA. Microbiology for Nurses: Application to Patient Care. 7th ed. London: Bailliere Tindall. Global consensus conference: final recommendations. 1999, AJIC.;27:503-513. US Congress Office of Technology Assessment. Impacts of Antibiotic Resistant Bacteria. ,1995, OTA-H-629. Washington (DC): US Government Printing Office; 1995 September. Garner JS, Favero MS., 1986, CDC guidelines for the prevention and control of nosocomial infections. Guideline for handwashing and hospital environmental control. AJIC.;14(3):110-115. Reybrouck G., 1983, The role of hands in the spread of nosocomial infection. J Hosp Infect.;90,30,63-64. McKane L, Kandel J., 1996, Microbiology Essentials and Application. 2nd ed. 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