Evidence-Based Practice: Hand Hygiene in Healthcare Settings - Essay Example

Evidence-based practice: Hand Hygiene in Healthcare Practice Evidence-based practice: Hand Hygiene in Healthcare Practice Part A Visual Representation of the Research A1 Article: Chavali, S., Menon, V., & Shukla, U. (2014). Hand hygiene compliance among healthcare workers in an accredited tertiary care hospital. Indian Journal Of Critical Care Medicine, 18(10), 689-693. doi:10.4103/0972-5229.142179. A2 Introduction The researcher gave the background information regarding the status of healthcare-associated infections. The study has the objective of showing the existence of bacteria on hands of healthcare workers (HCW) and educate them on hand hygiene using alcohol-based rub. The topic of study reflects the relationship between the amount of bacteria on hands of HCW and the rate of infections. It seeks to provide evidence on how hand hygiene contributes to the reduction of bacteria numbers on hands. A3 Literature Review In hospitals, Healthcare-associated infections (HAIs) are a major concern. The focus on HAIs is on the rise due to its responsibility for the high rates of mobility and morbidity of patients increasing the cost medication. The case of HAIs is true in most countries across the world. The sources used in the research report are current and highly reliable. An example is the health Organization (WHO) publication on the guidelines on hand hygiene in health in 2009. Publications by the Centre for Disease Control (CDC) are present in the bibliography. Multi Drug Resistant Organisms (MDROs) are very dangerous and need viable strategies to limit their adverse effects. The research proposes hand hygiene among HCW as one of the methods to counter the spread of MDROs. A4 Discussion of methodology Its aim is demonstrating how the populations of microbes contribute to HAIs and the effect washing hands with alcohol-based liquids would have on such infections. The number of people used in the study is 60, which is relatively low. All workers within the hospital environments should participate in the study as this gives a clear picture. The target of the study is in line with the objectives as the HCW are the major casualties in cases revolving around HAIs and in particular MDRO and microbial infections. A5 Data Analysis The researcher presented the data from the study in form of numbers in a table. Each group of subjects’ classification was in terms of the years of experience. Numbers and not percentages used in the result enhanced the accuracy giving the real picture. Use of percentages usually alludes to generalization, which may be inconsistent. Involvement of subjects with uniform experience would add to the appropriateness of the study A6 Researcher’s conclusion On conclusion, the researcher captures the main topic of study. Recommendation of continued education on the importance of consistent hand hygiene forms the major point in this section. Q3 In line with the results of the research, the conclusion presented by the researcher is in line. Continued education is effective in ensuring health workers comply with the expected standards of hand hygiene. The HCWs were conscious of the significance of hand hygiene in controlling infections but failed to comply. Hand hygiene reduces the population of bacteria in hands, which may be a prerequisite to infections in hospitals. Bacteria were present in each of the HCWs hands proving risk of exposure in hospitals. Q4 Considering the nature of the research, there must be ethical issues experienced. Some of the subjects may intentionally avoid contact after being enlightened on the dangers of not practicing hand hygiene. The case may compromise the service to the patients in the infectious disease section of the hospital and amounts to unethical behavior among hospital stuff. Another ethical issue that may arise during the study is the intentional exposure of other HCWs to bacteria by those in charge of culturing them. Harming others emanate from existing grudges between health workers. The misuse of the bacterial cultures by workers may also arise. Some workers may decide to conduct parallel experiments with the cultured bacteria from the hands of other workers. Bacteria from such experiments may get their way back to the environment causing more harm. It is important that the researcher find strategies to navigate through such unethical conducts. Q5 The study uses correlational research technique. The two variable involved are hand hygiene and the population of bacteria in the hands of health care workers. Hand hygiene and bacterial population on the hands of health workers relate to each other negatively. Hand hygiene practices and bacterial population are inversely proportional. Other types of research designs would be appropriate to add value to the study and make the formulated recommendations more viable than just washing hands. Experimental design of research would be more effective in this kind of study. It would give the specific bacteria found on the hands of health workers. Correlational study only confirms the presence of bacteria but does not specify the species of the bacteria involved. Part B- Annotated Sources Akyol, A. D. (2007). Hand hygiene among nurses in Turkey: opinions and practices. Journal of Clinical Nursing, 16(3), 431-437. doi:10.1111/j.1365-2702.2005.01543.x Akyol aims at finding out opinions and practice of nurses of washing hands during patient care. It borrows the idea that microorganisms’ transmissions occur via the nurses hands in hospitals. From the 129 nurses involved in the study, the level of knowledge concerning HH was very low. Akyol’s study is highly relevant because it is important that hospitals find and implement programs that encourage nurses to practice HH at all times. Chavali, S., Menon, V., & Shukla, U. (2014). Hand hygiene compliance among healthcare workers in an accredited tertiary care hospital. Indian Journal Of Critical Care Medicine, 18(10), 689-693. doi:10.4103/0972-5229.142179. The study design was to find out effect of HH on the bacterial population on the hands of HCWs. It established that HH help reduce the number of bacteria and other microbes on hands and assist in reduction of HAIs. Expanding the subjects under study to cover the whole staff in the hospital would give real situation. The result of the study is very relevant in enhancing HH. Eveillard, M., Raymond, F., Guilloteau, V., Pradelle, M., Kempf, M., Zilli-Dewaele, M., &. Brunel, P. (2011). Impact of a multi-faceted training intervention on the improvement of hand hygiene and gloving practices in four healthcare settings including nursing homes, acute-care geriatric wards and physical rehabilitation units. Journal of Clinical Nursing, 20(19/20), 2744-2751. doi:10.1111/j.1365-2702.2011.03704.x The research had the objective of investigating the effect of multi-face training program in hand hygiene and glove use compliance. The study is unique from others because researchers considered the results prior to and after HH intervention program. From the study, there was a notable increase in compliance after the intervention programs. It indicates that HH compliance is paramount in the fight against some infections. Gould, D., Gammon, J., Donnelly, M., Batiste, L., Ball, E., Carneiro De Melo, A. S., & Halablab, M. (2000). Improving hand hygiene in community healthcare settings: the impact of research and clinical collaboration. Journal Of Clinical Nursing, 9(1), 95-102. doi:10.1046/j.1365-2702.2000.00334.x The research program has the objective of tackling hand hygiene in healthcare system based in communities. Nurses belonging to different grades formed the subject of the study. The research indicated that cross infection was prevalent in situations where the nurses failed to adhere to hand hygiene practices. The paper is very relevant and can be helpful in formulation of policies regarding HH. Due to the restricted coverage in testing the program, the research results cannot apply to other areas not covered during the study. Gül, A., Üstündağ, H., & Zengin, N. (2012). Assessing undergraduate nursing and midwifery students compliance with hand hygiene by self-report. International Journal of Nursing Practice, 18(3), 275-280. doi:10.1111/j.1440-172X.2012.02041.x The research looked into the compliance level to hand hygiene (HH) among nursing and midwifery students. Nurses and midwifery are in touch with patients and it is vital that they have high compliance rate to HH. At the end of the investigation, the researcher established that the level of compliance was relatively high especially after contact with dirty areas. The study only involved a small population of 387 students and the result may not be true for all the nurses in the country. Involving a more nurses, particularly the ones already practicing would give clear information vital for policy formulation. The study is relevant because it gives information on how the students are prepared to handle HH when they leave college. Kelcíkova, S., Skodova, Z., & Straka, S. (2012). Effectiveness of Hand Hygiene Education in a Basic Nursing School Curricula. Public Health Nursing, 29(2), 152-159. doi:10.1111/j.1525-1446.2011.00985.x Objective of the study is to ascertain the effectiveness of foundational nursing training in relation to hand hygiene. It also looked into skills and attitudes towards HH by the students. Poor HH compliance, according the researchers is widespread among healthcare professionals. The participants in the research were nursing students in praxis. The results for the study are likely to be correct due to the large number of studies involved. Result from the study indicated that inadequate compliance among students contributes to low compliance among health professionals. The results coincide with earlier findings of inefficient levels of HH knowledge and compliance by students while undergoing training. Liu, W., Liang, S., Wu, S. V., & Chuang, Y. (2014). Hand hygiene compliance among the nursing staff in freestanding nursing homes in Taiwan: A preliminary study. International Journal of Nursing Practice, 20(1), 46-52. doi:10.1111/ijn.12120 In this research, the authors seek to establish the level of compliance of nurses to hand hygiene practice. The topic is in relation to the increasing cases of HAIs in recent past. To establish the percentage compliance, the location of the research was in Long Term Care Facility. The researchers have full knowledge of the importance of hand hygiene. They research involve only two centers in the study in a country of millions of people. The result of the research may not give a clear picture of the real situation. Study of compliance level is relevant in formulation of policies aimed at regulating the rate of HAIs in the centers across the country. In this study, high rates of compliance existed among nurses than their assistants Mathai, A. S., George, S. E., & Abraham, J. (2011). Efficacy of a multimodal intervention strategy in improving hand hygiene compliance in a tertiary level intensive care unit. Indian Journal of Critical Care Medicine, 15(1), 6-15. doi:10.4103/0972-5229.78215 The three researchers set the study to investigate compliance to HH, hindrances and effectiveness of intervention strategies. Based in the Intensive Care Unit (ICU) of a hospital, the scope of the study was relatively wide because all the workers within the ICU were involved. The study was relevant to nurses who are in constant contact with patients. Picheansathian, W., Pearson, A., & Suchaxaya, P. (2008). The effectiveness of a promotion programme on hand hygiene compliance and nosocomial infections in a neonatal intensive care unit. International Journal of Nursing Practice, 14(4), 315-321. doi:10.1111/j.1440-172X.2008.00699.x The place of the study was a university hospital in Thailand with the objective of identifying the impact of program of hand hygiene promotion. It also looks at the effect of the promotional program on nosocomial infections in neonatal intensive care unit. From the results, the research was relevant because a drop HH compliance among the nurses improved by a large margin. HH in neonatal care is important because the newborns are more susceptible to infections relative to grownups. Polat, S., Parlak Gürol, A., & Çevik, Ü. (2011). Hand hygiene compliance of nurses: A 5-unit observational study in North-Eastern Anatolia. International Journal of Nursing Practice, 17(4), 435-440. doi:10.1111/j.1440-172X.2011.01954.x The researchers, through the study aimed at establishing the level of adherence of nurses to HH in Neonatal Intensive Care Units (NICUs) located in five hospitals. It involved 72 nurses who were under monitoring. From the study, the researchers found that most nurses washed their hands but not with alcohol based hand rub. HH was prevalent before attending to patients. The study is relevant as HH is vital in reducing transmission of infections in NICUs. B1 The objective of the research studies contained in this paper had the goal of analyzing the effectiveness of hand hygiene practice by healthcare workers (HCW) in health care settings. The researchers majored on the effect washing hands would have on the prevalence of hospital-acquired infections (HAIs) in various sections of the hospitals. The focus group among the HCWs was the nurses as they have frequent personal interactions with patients. B2c The tools adopted by the researchers were slightly different, but the conclusion remained the same in most of the studies. The variables under study were the frequency of hand hygiene practice and population of bacteria on the hands and how it relates to cases of HIAs. A significant proportion of the studies relied on the compliance to hand hygiene as a tool for accessing its impact on HIAs. Other researchers focused on educating the HCWs on the importance of hand hygiene and then accessed the impact of training the workers, in particular, the nurses. The different tools used aimed at giving information on whether hand hygiene can effectively curb the rising incidences of hospital-acquired infections. B2d Tools adopted by the researchers during their studies were appropriate as they directly accessed the eventual effect of hand hygiene practiced on bacterial population on hands. Bacterial population is inversely proportional to the hand hygiene compliance. B3 All the articles include in this paper looked into the relationship that exists between hand hygiene practice by health care workers and prevalence of HIAs. Focus was on reducing bacterial population in the hands of nurses through hand hygiene compliance and the accessing the overall impact on the spread of infections in the hospitals. The article authored by Chavali and colleagues is considerably similar to some rest as it focused on providing evidence that bacteria exist on the hands of HCWs and education. They narrowed their study to hand hygiene compliance and education (Chavali, Menon & Shukla, 2014). Other authors adopted different approach to studying the topic. For instance, they based their research on the views and opinions gathered from nurses (Akyol, 2007). The opinions of nurses give a picture of the situation but are not as effective as the practical approach designed by other researchers. B4 The problem of HIAs can effectively undergo elimination by proper and consistent hand hygiene practice by HCWs. Educating the HCWs on the effectiveness of hand hygiene will be a boost to the fight against prevalence of HIAs. Alcohol-based hand rub is effective and convenient for nurses as is apparent from the studies. THE hand hygiene practice should extend to the patients as well. B5 Theoretical model in nursing research has many benefits to both the researcher and the quality of the research done. The first importance of a theoretical model is that it provides information on research organization before the actual study begins. The overall organization of a study affects directly on the efficiency of the research process and the reliability of the results. Theoretical model of research assists the authors in interpretation of the findings of a study. In cases of improper interpretation of the results, inappropriate policy formulation may occur. Theoretical models of nursing research depend on evidence derived from earlier related studies. It gives the researcher an edge in predicting the outcome and possible interpretation of the findings. Theoretical model ensures that the researchers are conversant with what to expect from a study. References Akyol, A. D. (2007). Hand hygiene among nurses in Turkey: opinions and practices. Journal of Clinical Nursing, 16(3), 431-437. doi:10.1111/j.1365-2702.2005.01543.x Chavali, S., Menon, V., & Shukla, U. (2014). Hand hygiene compliance among healthcare workers in an accredited tertiary care hospital. Indian Journal Of Critical Care Medicine, 18(10), 689-693. doi:10.4103/0972-5229.142179. Eveillard, M., Raymond, F., Guilloteau, V., Pradelle, M., Kempf, M., Zilli-Dewaele, M., &. Brunel, P. (2011). Impact of a multi-faceted training intervention on the improvement of hand hygiene and gloving practices in four healthcare settings including nursing homes, acute-care geriatric wards and physical rehabilitation units. Journal of Clinical Nursing, 20(19/20), 2744-2751. doi:10.1111/j.1365-2702.2011.03704.x Gould, D., Gammon, J., Donnelly, M., Batiste, L., Ball, E., Carneiro De Melo, A. S., & Halablab, M. (2000). Improving hand hygiene in community healthcare settings: the impact of research and clinical collaboration. Journal Of Clinical Nursing, 9(1), 95-102. doi:10.1046/j.1365-2702.2000.00334.x Gül, A., Üstündağ, H., & Zengin, N. (2012). Assessing undergraduate nursing and midwifery students compliance with hand hygiene by self-report. International Journal of Nursing Practice, 18(3), 275-280. doi:10.1111/j.1440-172X.2012.02041.x Kelcíkova, S., Skodova, Z., & Straka, S. (2012). Effectiveness of Hand Hygiene Education in a Basic Nursing School Curricula. Public Health Nursing, 29(2), 152-159. doi:10.1111/j.1525-1446.2011.00985.x Liu, W., Liang, S., Wu, S. V., & Chuang, Y. (2014). Hand hygiene compliance among the nursing staff in freestanding nursing homes in Taiwan: A preliminary study. International Journal of Nursing Practice, 20(1), 46-52. doi:10.1111/ijn.12120 Mathai, A. S., George, S. E., & Abraham, J. (2011). Efficacy of a multimodal intervention strategy in improving hand hygiene compliance in a tertiary level intensive care unit. Indian Journal of Critical Care Medicine, 15(1), 6-15. doi:10.4103/0972-5229.78215 Picheansathian, W., Pearson, A., & Suchaxaya, P. (2008). The effectiveness of a promotion programme on hand hygiene compliance and nosocomial infections in a neonatal intensive care unit. International Journal of Nursing Practice, 14(4), 315-321. doi:10.1111/j.1440-172X.2008.00699.x Polat, S., Parlak Gürol, A., & Çevik, Ü. (2011). Hand hygiene compliance of nurses: A 5-unit observational study in North-Eastern Anatolia. International Journal of Nursing Practice, 17(4), 435-440. doi:10.1111/j.1440-172X.2011.01954.x Read More