Hand hygiene and infection control.
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem. For this assignment, you will create a clinical guiding question know as a PICOT question. Hand hygiene and infection
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The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. Use the \”Literature Evaluation Table\” (PLEASE SEE ATTACHMENT) to complete this assignment. The “Literature Evaluation Table” needs to be filled in and completed for this assignment. 1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue. 2.Followi ng the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. Hand hygiene and infection control.The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study). 3. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include THREE quantitative and THREE qualitative peer-reviewed research articles to support your nursing practice problem. ***Please make sure there are 3 Quantitative articles and Three Qualitative articles*** Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the articleHand hygiene and infection control.. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.Hand hygiene and infection control.
The clinical issue of interest is hospital acquired infections (HAIs). These are illnesses caused by fungal, bacterial and viral pathogens that are largely spread within the healthcare setting. Hand hygiene and infection control.The most common of these diseases are urinary tract infection (UTI), pneumonia, bloodstream infection (BSI), catheter-associated urinary tract infections, and surgical site infection (SSI) among others. Hand hygiene and infection control.HAIs are usually associated with diarrhea, fever and vomiting, headache, urination difficulties, shortness of breath, fever, and wound discharge which onset at least 48 hours after admission to 3 days following a patient’s discharge. More often than not, these health conditions are linked to the mutations of organisms into multi-drug resistant organisms like methicillin-resistant Staphylococcus aureus. This has greatly crippled the efforts to eliminate and prevent these infections.Hand hygiene and infection control.
However, hospital acquired infections can be prevented using hand hygiene intervention. This entails washing hands with clean running water and soap as well as rubbing alcohol-based formulation with the recommended concentrations and practices. Hand hygiene has been considered to be the most effective strategy towards the fight against HAIs with multiple studies demonstrating its impacts in the healthcare sector in curbing these diseases. Hand hygiene and infection control.Appropriate hand washing involves wetting hands followed by application of enough soap to lather followed by rubbing alms together, the back of the hands, interlinking fingers and then cupping them. Thumbs are cleaned last and finally the palms are rubbed with fingers. It is important to follow the seven steps to achieve the effectiveness of the practice.Hand hygiene and infection control.
PICOT Question: In acute care inpatients (P), does hand hygiene (I) compared to no intervention (C) reduce the rate of hospital acquired infections (O) within 6 months? (T)
Criteria | Article 1 | Article 2 | Article 3 |
APA-Formatted Article Citation with Permalink | Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection. Critical care nurse, 37(3), e1-e8. https://doi.org/10.4037/ccn2017694 | Sickbert-Bennett, E. E., DiBiase, L. M., Willis, T. M., Wolak, E. S., Weber, D. J., & Rutala, W. A. (2016). Reduction of Healthcare-Associated Infections by Exceeding High Compliance with Hand Hygiene Practices. Emerging infectious diseases, 22(9), 1628–1630. https://doi.org/10.3201/eid2209.151440
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Herbeć, A., Chimhini, G., Rosenberg-Pacareu, J., Sithole, K., Rickli, F., Chimhuya, S., … & Fitzgerald, F. C. (2020). Barriers and facilitators to infection prevention and control in a neonatal unit in Zimbabwe–a theory-driven qualitative study to inform design of a behaviour change intervention. Journal of Hospital Infection. https://doi.org/10.1016/j.jhin.2020.09.020 |
How Does the Article Relate to the PICOT Question? | It provides evidence-based information on hand hygiene essential in answering the PICOT question. | Provides literature for understanding my topic of interest. | Informs on the designation of behavior change interventions such as hand hygiene to reduce HAIs |
Quantitative, Qualitative (How do you know?) | It is a quantitative research. It uses statistical data and research methods | Qualitative, uses observation | Qualitative, uses non-statistical data |
Purpose Statement | The article seeks to investigate how patients hand washing reduces HAIs | The study determines the reduction of Healthcare-Associated Infections by Exceeding High Compliance with Hand Hygiene Practices | The study provides an understanding of the drivers of prevention interventions to improve infection prevention and control (IPC). |
Research Question | Does increased access to hand hygiene products and patient education improve patients’ hand hygiene and reduce the transmission of HAIs? | Does increased hand hygiene compliance decrease healthcare-associated infection rate? | What are the barriers/facilitators to IPC in a neonatal unit in Harare, Zimbabwe? |
Outcome | There are significant correlations between hand hygiene and rates of infection after intervention | Hand hygiene reduces HAI rates. | Enablers improve prevention of HAIs |
Setting
(Where did the study take place?) |
adult 36-bed Cardiothoracic postsurgical step-down unit | University of North Carolina Hospitals | Neonatal and maternity units |
Sample | N-54 patients
n-33 staff |
n-4,000 | Sample: N=15 (N = 4 physicians, N = 4 general nurses, N = 6 nurse midwives, N = 1 cleaner) |
Method | Mixed method involved anonymous 6-question survey for staff and patients in form of a questionnaire | Longitudinal | Interviews, ethnographic observations |
Key Findings of the Study | After the implementation of hand hygiene interventions, rates of both infections declined significantly and patients reported more staff offering opportunities for and encouraging hand hygiene | There was a significantly increased hand hygiene compliance rate (p<0.001) and a significantly decreased healthcare-associated infection rate (p = 0.0066). | Enablers: awareness of IPC improves prevention of HAIs.
Barriers: lack of resources, no formal feedback on performance, limited knowledge of guidelines discourage compliance to positive practices. |
Recommendations of the Researcher |
There is need for further studies considering both the community and hospital potential exposure to infections |
Further research on the topic | Recommendations for further research |
Criteria | Article 4 | Article 5 | Article 6 |
APA-Formatted Article Citation with Permalink | Nekkab, N., Astagneau, P., Temime, L., & Crépey, P. (2017). Spread of hospital-acquired infections: A comparison of healthcare networks. PLoS computational biology, 13(8), e1005666. https://doi.org/10.1371/journal.pcbi.1005666 | Staniford, L. J., & Schmidtke, K. A. (2020). A systematic review of hand-hygiene and environmental-disinfection interventions in settings with children. BMC public health, 20(1), 195.
https://link.springer.com/article/10.1186/s12889-020-8301-0 |
Grayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., … & National Hand Hygiene Initiative. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. The Lancet Infectious Diseases, 18(11), 1269-1277. https://doi.org/10.1016/S1473-3099(18)30491-2 |
How Does the Article Relate to the PICOT Question? | Provides evidence on the spread of HAIs and the effective interventions | It reviews the effectiveness of hand hygiene, a relevant source of information for my clinical problem. | P rovides informational evidence of the impacts of hand hygiene in hospitals which makes it a relevance source of data for my research. |
Quantitative, Qualitative (How do you know?) | Quantitative, uses statistical data and analytic methods | Qualitative, reviews past research non-statistically | Quantitative, provides statistical evidence of research |
Purpose Statement | The paper compares health networks on the spread of HAIs healthcare networks in order to reduce HAIs | The article informs the development of a future multi-faceted intervention to improve public health, a systematic literature review was conducted on behavior change interventions designed to increase hand-hygiene and environmental-disinfecting in settings likely to include children. | The study assesses outcomes and effectiveness of National Hand Hygiene Initiative (NHHI) |
Research Question | Does social network analysis help in reconstructing | Does hand-hygiene and environmental-disinfection interventions in settings with children reduce infections? | Is NHHI compliance by Australian health-care workers effective in reducing the risk of health-care-associated infections? |
Outcome | Hand hygiene reduces infection rates | Hand hygiene reduces infection rates | |
Setting
(Where did the study take place?) |
French healthcare system | Ebsco Medline and Web of Science databases | national health-care facilities |
Sample | HAI-specific network (HAISN) (n = 1266), suspected-HAI network (SHAIN) (n = 1975), and general network (GN) (n = 2063) | n-29 articles | N-105
N-937 |
Method | Social network analysis | Systematic review | Longitudinal study |
Key Findings of the Study | 1266 hospitals and 3722 connections for 13627 patient transfers
General network (p = 0.81, p = 1, p = 0.99 respectively, Wilcoxon rank sum test), or between the 1975 suspected-HAI network hospitals and the same hospitals in the general network (p = 0.99, p = 1, p = 0.99, Wilcoxon rank sum test). |
Interventions that included techniques targeting four or more theoretical domains and all the capability-opportunity-motivation components were descriptively more effective. | Improved hand hygiene compliance was associated with declines in the incidence of HA-SAB (incidence rate ratio 0·85; 95% CI 0·79–0·93; p≤0·0001): for every 10% increase in hand hygiene compliance, the incidence of health-care-associated Staphylococcus aureus bacteraemia (HA-SAB) decreased by 15%. |
Recommendations of the Researcher | There is need for further studies considering both the community and hospital potential exposure to infections | Interventionists to consider the appropriateness of interventions in their development, feasibility/pilot, evaluation, and implementation stages. | Need for implementation of hand hygiene practices in all settings of care |