Clinical issue and research question
Clinical issue: Lack of Hand hygiene as source of hospital-acquired infections (HAIs) for both patients and nurses.
Research question: Is handwashing the best method to reduce HAIs in the hospital?
The main aim was to analyse literature review relevant to the research question. Therefore the paper shows how the search process was carried out to identify the sources supporting the clinical issue. The literature was obtained from Medline and CINAHL after entering the keywords related to the clinical issue. The database displayed more than fifty sources but I selected six sources that hand relevant information to the clinical issue. The sources had current information and their abstracts revealed the entire process used in carrying out the research.
According to Haverstick et al., (2017), HAIs are dangerous and they can automatically lead to increased mortality rates. The author argued that one patient out of ten patients in a healthcare unit is in a position to be affected by hospital-acquired infections. The research carried out reveals that more than ten thousand patients in Australia have hospital-acquired infections. More than 400,000 patients die each year in the whole world because of HAIs. There is a common mode of transmitting these kinds of diseases. The common aspect is the issue of human contact and mostly via the contaminated hands in the hospitals. Haverstick et al., (2017) supported how the patients and nurses are at high chances of spreading these illnesses. The research revealed that most of the hospitals lack adequate tools for supporting hand hygiene. Most of the places constructed for handwashing are far from the patient’s beds. Through this analogy, you find that it is problematic for the patients to access the sinks because of mobility issues. Besides, the researchers argue that postsurgical intravenous catheters may deter the patients from accessing the places designed for hand washing. All these barriers according to the research shows how there is a decreased aspect of hand hygiene.
On another hand Fox et al., (2015) carried out research which revealed the relevant information related to the clinical issues. The author cited that more than 2.5 million cases reported in America arise as a result of Hospital-acquired diseases. The main objective of the research was to determine the morbidity and mortality rates related to the HAIs. The research shows that nurses are the only healthcare providers who can control and prevent hospital-acquired infections. The author carried out systematic research that compared various variables. The author compared two hospital-acquired diseases and how they are accelerated by the issue of hand hygiene. Besides, the author argued that the issue of HAIs and hand hygiene is yet to be handled in most of the healthcare centres. On another hand, various researchers revealed that more than 45% of the total hospitals in Australia re yet to recognize the issue of hand hygiene in the healthcare unit. The researchers carried out a survey and found that one healthcare unit out of ten was not familiar with issues related to hospital-acquired infections. Through this analogy, the researchers supported that patients and nurses are at risk of spreading the concept of HAIs. Besides, other researchers elaborated that in Australia we have more than 10,000 healthcare units lacking properly installed hand washing units (Cheng, Wong, Wong, & Yuen, 2019). Through this failure, most of the people have dying due to increased aspect of Hospital-acquired diseases. The ministry of health in Australia is working hard enough to provide appropriate tools needed to deter the spread of these conditions between the patients in healthcare centres. According to the results, it was clear that the rates of infection in the selected area were attributed to hospital-acquired infections which were spread by contaminated hands.
Literature search process
Besides Maroldi et al., (2017) cited that HAIs is the major concern in the whole world. The author also said that no healthcare unit in the whole world that can be said to be free from hospital-acquired infections. To support this evidence, the author conducted research which provided strong information related to the question of the study. The literature, therefore, supports a qualitative study carried out to show how healthcare staff understands the issue of HAIs in Brazilian municipalities. During the study, the research was categorized into four sections. Each part was used to address a certain aspect related to the research topic. The first part was based on low-risk perception and the second one on the issue of weakness in knowledge. Thirdly, the author named section as lack of training and the last part named as infrastructure limitations. All these sections tried to point some of the factors accelerating the issue of HAIs. The author, therefore, concluded by showing how a lack of adequate resources as the major aspect facilitating hospital-acquired infection in healthcare centers.
Improving hand hygiene is a key responsibility among all the clinical nurses and patients who are in the hospital care setting. The hand hygiene techniques such as regular washing of hands by use of soap and water has been seen as best methods that lower the rate of hospital acquired infections sin the hospital. Most of nurses, staff and patients should use hand cleaning process to ensure that the rate of infection decreases (Boyce et al, 2019). Through improvement and maintenance of hand hygiene techniques, the health care professionals will be able to improve the quality of health and wellbeing.
A review of this particular research has indicated the importance of hand hygiene, various problems in implementing hand hygiene and strategies needed to be carried out in order to ensure total compliance with the practices. Some of the hand washing, methods such as use of soap has-been revealed to have some side effects on the skin. It normally brings about itching of the skin if used for a longer period of time. According to the review, there also exist various barriers such as lack of compliance, lack of hand washing machines, minimal interventions and funds. Results in this particular study showed that a 66 nurse’s staff and patients do not use hand washing methods. The qualitative study has also offered the need to understand the effects of creating educational programs on improving hand hygiene among the participants. The research centered its main findings in the effects of using hand hygiene monitoring system and use of increased promotional operations that are used in advancing the technology of washing hands. According to findings, the hand washing methods and compliance rates were approximated by utilizing direct observation strategies. This was aimed at improving the performance of the clinical practice and lower the healthcare associated infections (Gould, Moralejo, Drey,Chudleigh, & Taljaard, 2017).
Literature review
The study installed the AHHHMS as complementary strategies to improve the health care. The implementation of the pan was based on a multimodal program where leadership support was enhanced in achieving the goals of the research. The key performance indicators indicated that hand hygiene improved the quality of life and lowered the rate of healthcare infections. The current body of literature offers relevant insight into many challenges existing in the implementation of hand hygiene techniques in order to prevent hospital acquired infections. Many of these particular studies have been carried on various nations. Other kinds of research would literally offer critical data on barriers to these methods.
This vital study would primarily utilize mixed methodologies such as qualitative designs and explanatory design (Wetzker et al, 2016).This type of design methodology will enhance the retrieval of diverse quantitative and qualitative information on the impacts of using other methods such as alcohol killing bacteria agents in reducing the infections other medicinal interventions. This kind of research will involve participants such as nurses and patients. Nurses are expected to fill out the given questionnaires regarding the number of patients suffering from hospital acquired infections in wards and acute care centers. Direct observation techniques will be used for the researchers to collect information regarding how many patients and nurse consistently use the hand hygiene. The research assistants will also collect the information in an independent manner regarding the rate of compliance of both nurses and patients. It is clear that the research study according to the literature will be important since, all patients will be given a document stating how often they utilize hand cleaning methods in the hospital on a daily basis. This information will be kept on record by the research staff for a total of two months.
The listed research participants will be well aware of the hand cleaning hygiene’s as they will mainly be engaged in a team .Personal interviews and questionnaires will be offered so that ideas and opinions regarding the methods of hand hygiene can be acquired. Their compliance rate and views towards use of technologically based hand washing devices in the clinical settings will also be recorded. This research study will be important in future since it will offer maximum discussions on how to further lower the rate of hospital based infections. It will also fulfil its research objectives since people will have the required information and knowledge on how best to prevent the infections. Patients ill have maximum education on how to conduct and continuously maintain hand hygiene (Maroldi et al, 2017). This will reduce the infections while they are being treated and under care in the clinical settings. This will be accomplished to improve the health care settings, public health and quality of life. According to the literature review it is quite imperative to ensure compliance and maintenance of hand washing techniques to reduce hospital related infections. In order to offer more critical information on this particular clinical issue, the following studies need to be carried out: what are the other hygiene techniques important to lower the rate of hospital based infections? What are the best method to ensure compliance?
Factors contributing to HAIs
It is critical to note some of the strengths of the research. The data collected in the study is not directly associated to personal lives of any participant. The ideas and opinions collected from the personal interviews and observations are also confidential and will not be used against any participant in future.
The literature has analysed various aspects related to a clinical issue. According to the sources, there is a need to provide an appropriate training session which could focus on the transmission of microorganism in hospitals (Cheng et al., 2019). The sources emphasize the need for creating awareness and need to ensure primary healthcare provides solutions to the issue discussed. Improving the relevant instruments is one of the main aspects supported by the literature to solve the issue.
On another hand, the literature supported how hand hygiene protocol has helped nurses and patients to curb the issue of hospital-acquired infections. From the literature review, it is clear that supporting the idea of healthcare improvement and the quality of healthcare can help in eliminating these conditions.
A key area that was not well addressed in the existing literature review is the compliance issue among nurses and patients in the clinical setting aimed at improving hand hygiene. Other aspects that need more research in future includes the ways that need to lower the challenges in compliance and how hospital acquired infections can be overcome.
Further research to be conducted
From the literature, further research needs to be carried out. The study should aim at monitoring the issue of hand hygiene both before and after the treatment of the patients. The sources should ensure they account for the issue of hand hygiene after the patient uses everything in the hospital until he or she returns home. On another hand, the sources also have to carry out research which will outline how nurses respond to the issue of hand hygiene. The researchers should come up with a research design that will discuss the cleaning and how to disinfect the clinical apparatus before and after handling patients. Besides, the researchers should provide knowledge on how nurses can help patients to observe the concept of hand hygiene both in hospital and also at home.
Ethical considerations
Some of the ethical considerations needed to be identified in this particular research include the patients being able to morally follow the standards put in place by the hospital to maintain the hand hygiene. This might include complying with the moral rules of conduct in washing their hands regularly on the assigned areas (Maroldi et al, 2017). Another ethical consideration involve the ability of the nurses and patients to be given equal opportunity and personal consent to be part of the research group.
References
Boyce, J. M., Laughman, J. A., Ader, M. H., Wagner, P. T., Parker, A. E., & Arbogast, J. W. (2019). Impact of an automated hand hygiene monitoring system and additional promotional activities on hand hygiene performance rates and healthcare-associated infections. Infection Control & Hospital Epidemiology, 40(7), 741-747.
Cheng, V. C. C., Wong, S. C., Wong, S. C. Y., & Yuen, K. Y. (2019). Directly observed hand hygiene–from healthcare workers to patients. Journal of Hospital Infection, 101(4), 380-382.
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., … & Bader, M. K. (2015). Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses’ hand washing. American Journal of Critical Care, 24(3), 216-224.
Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., & Taljaard, M. (2017). Interventions to improve hand hygiene compliance in patient care. Cochrane database of systematic reviews, (9).
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.
Maroldi, M. A. C., da Silva Felix, A. M., Dias, A. A. L., Kawagoe, J. Y., Padoveze, M. C., Ferreira, S. A., … & Figueiredo, R. M. (2017). Adherence to precautions for preventing the transmission of microorganisms in primary health care: a qualitative study. BMC nursing, 16(1), 49.
Maroldi, M. A. C., da Silva Felix, A. M., Dias, A. A. L., Kawagoe, J. Y., Padoveze, M. C., Ferreira, S. A., … & Figueiredo, R. M. (2017). Adherence to precautions for preventing the transmission of microorganisms in primary health care: a qualitative study. BMC nursing, 16(1), 49.
Wetzker, W., Bunte-Schönberger, K., Walter, J., Pilarski, G., Gastmeier, P., & Reichardt, C. (2016). Compliance with hand hygiene: reference data from the national hand hygiene campaign in Germany. Journal of Hospital Infection, 92(4), 328-331.
