Infection Control Strategies to Prevent Healthcare-Associated Infections
Infection control refers to the process of preventing the healthcare-associated infections or nosocomial infections. These are the infections which are spread and acquired at the healthcare facilities. Ordinarily, healthcare facilities are places which are visited by different caliber of people each of whom having a certain condition or illness that might be easily spread to others within the same environment. Hospital-Acquired Infections can be transmitted from the patient to another patient, patient to a healthcare provider, healthcare provider to a patient, or healthcare provider to another healthcare provider. Infection control is therefore part of the hospital infrastructure which should be provided by all the healthcare facilities (Barnes, Morgan, Harris, Carling & Thom 2014). Infection control can be of great value because it can play a significant role in preventing the spread of viral, bacterial, and fungal infections which can be easily spread from one person to the other within the healthcare facility. Research has established that infection control can be accomplished by adopting a wide range of strategies including hand hygiene, disinfection, cleaning, sterilization, and training in infection control, outbreak investigation, and quarantine, and isolation, surveillance for infection, post-exposure prophylaxis, and vaccination (Srigley, Furness, Baker & Gardam 2014).
The essay will apply the PICO framework of the Population/Patient; Comparison; Intervention; and Outcome. PICO framework will be applied because it will help in carrying out an objective appraisal that can be relied upon to understand the resources used in the paper (Townsend, Loudoun & Lewin 2016). Three articles will be selected and utilized for analysis. Each of the articles will be analyzed by focusing on its summary, critical appraisal, identification of the strengths and limitations, and illustration of its relevance to the research topic. It is therefore clear that the analysis will be of great contribution because it will help in providing an in-depth appraisal of the articles to determine how significant and relevant it is in clinical practice. After analyzing each article, a comprehensive conclusion will be generated to help in responding to the clinical question raised.
The study will be done in a systematic manner. Meaning, each activity will be carried out by following a well outlined procedure. The clinical question which will be used in the paper is ‘Does hand hygiene policy helps to minimize infection control on health care sector?’ To respond to this question, a search will be conducted at the Wollongong University Library to identify the most appropriate articles which can be used. The search will be carried out in the following databases: Google Scholar, PubMed, PMC, and Wiley Online Library because they are the most appropriate sources which contain the required articles which should be used in the study (Zohrabi 2013). When carrying out the search, appropriate key words will be used. These include infection control; Hospital-Acquired Infections; nosocomial infections; hand hygiene; hand hygiene; and hand washing. These are the most suitable search terms which will help in narrowing down the search to specific articles which will be relied upon to respond to the clinical question. However, to select the articles, an inclusion and exclusion criteria will have to be applied. For an article to be included, it has to be published between the year 2010 and 2017. Besides, the article should be a credible resource which was published by reputable scholars and peer-reviewed. Lastly, the included article will have to be a research carried on infection control. Any article which does not meet the inclusion criteria will have to be excluded because it will be deemed unfit for the topic.
Application of PICO Framework to Analyze Relevant Articles
Shinde, M.B. & Mohite, V.R., 2014. A study to assess knowledge, attitude and practices of five moments of hand hygiene among nursing staff and students at a tertiary care hospital at Karad. International Journal of Science and Research (IJSR), 3(2), pp.311-321.
The research was conducted by Mahadeo, Shinde and Vaishali, Mohite to study the conduct of nurses and nursing students during the moments of hygiene. The research established that hand hygiene is one of the most important and effective prevention strategies for the infectious diseases acquired at the healthcare facilities. Therefore, to study more about the use of hand hygiene in the prevention of Hospital-Acquired Infections (HIAs), the researchers had to carry out an extensive study in which the attitudes, competence, and practices of the practitioners were to be assessed. The research was conducted using a cross-sectional study in which the sample population of 100 nurses and 100 student-nurses were used as participants.
Data analysis was done using a z-test because it was the most appropriate tool to be used in comparing the percentage of the responses provided by the participants. According to the findings, the nurses and students have varying practices, attitudes, and competencies regarding the use of hand hygiene in the prevention and control of HAIs. The study revealed that, according to the World Health Organization, the process of hand cleaning should be performed during five different moments both before and after coming into contact with a patient (Bucher, et al 2015). Hence, to be safe, the healthcare provider should observe hygiene by properly washing the hands whenever necessary. However, this, according to the findings, is not always properly done by the healthcare providers especially the nursing staff.
This is a properly conducted research. During the studies, the researchers took the necessary steps to ensure that a high quality work which can be relied upon is done. The design of the paper demonstrates that it had a good and appropriate methodology which would be effective in collecting and analyzing data to be used to respond to the research question. With the aim of assessing the practices, perceptions and competencies of the nurses and student-nurses during the implementation of hand hygiene, the researchers appear to have been focused on the goals right from the beginning of the research (Vayena, Salathé, Madoff & Brownstein 2015).
The effectiveness of the research methodology enabled the researchers to adequately respond to the research question. Everything was done as per the expected standard. For example, when it comes to the recruitment of the participants, an appropriate sampling technique was adopted to help in identifying and selecting a sample of 100 student-nurses and 100 nurses who have been engaging in the use of hand hygiene in the prevention and control of HAIs. Data analysis was also appropriately done because z-test was the most suitable instrument for comparing the findings generated from the participants. If it were not for these efforts, the researchers would not have managed to generate the valid and reliable findings that were generated upon the successful completion of the research.
Systematic Procedure for Conducting the Study
Just like any other study, this research had strong and weak areas which were identified. This is necessary for all studies because research is a diverse and broad activity which involves a wide range of strategies. This notwithstanding, it is important to note that the strength of this study is that it was done by using qualitative research methods which was properly done by selecting a sample size to represent the entire population. What was done right is that the researchers used appropriate strategies to recruit the participants. For a participant to be selected to participate in the research, they had to meet all the criteria which had been set for inclusion (Vayena, Salathé, Madoff & Brownstein 2015). Otherwise, they had to be excluded from participating in the study. The recruitment process made the research to be accurate and bias-free.
However, the research had dome limitations which made it difficult to accomplish its objectives and adequately respond to the research questions. The cross sectional design used in the research was not perfect because it made the researchers to restrict the scope of the study. The setting of the study was made in one institution that would not represent the true picture of the general society (Vayena, Salathé, Madoff & Brownstein 2015). Therefore, if the researchers were interested in carrying out a research whose results can be generalized, they would have increased the number of participating nurses, student-nurses, and the institutions. It would make the research to be more representational than it currently is.
The findings of this research are relevant and applicable to nursing practice. They can be relied upon to help in understanding the research topic and making the necessary improvements on the concept of hand hygiene (Kao, et al 2015). The finding on the performance of the nurses and student-nurses can be of great contribution if applied in real practice. It can help in creating a behavior change on the nurses and student-nurses regarding the way they should handle hand hygiene when attending to patients. When the nurses are adequately informed, they can be empowered to make important decisions on how to deal with hand hygiene before performing a cleaning procedure; before touching a patient; or after serving a patient; coming into contact with the patient’s body fluids, and touching the surroundings of the patient (Higgins & Hannan 2013). It can be important if the nurses and student-nurses are informed to observe hygiene during these moments because it can be of great help in controlling any infection that might be contracted due to various bacterial, fungal, and viral infections.
Article I – ‘A Study to Assess Knowledge, Attitude and Practices of Five Moments of Hand Hygiene Among Nursing Staff and Students at a Tertiary Care Hospital at Karad’
Luangasanatip, N., Hongsuwan, M., Limmathurotsakul, D., Lubell, Y., Lee, A. S., Harbarth, S., & Cooper, B. S. (2015). Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. The BMJ, 351, h3728.
The purpose of this research was to carry out a comparative analysis of the effectiveness of interventions applied in improving hand hygiene in the healthcare facilities. The researchers were concerned about a missing gap in knowledge because not much research has been done on this particular area. In the past, studies have been conducted to assess the strategies which can be used to prevent and control the HAIs from causing trouble in the healthcare facilities across the country. In 2005m the World Health Organization (WHO) came up with guidelines which should be applied by the healthcare providers who are interested in controlling and preventing the HAIs (Dai, Milkman, Hofmann & Staats 2015).
To conduct the studies, the researchers opted to use a network meta-analysis and systematic review to gather information that would be relied upon to provide the required data on the research topic. The review was done by retrieving data from the following data bases: EPOC register, Cochrane Library, Centre for Reviews and Dissemination, Cochrane Library, Medline, NHS Economic Evaluation Database, NHS, CINAHL, and Embase. From these databases, a total of 3639 randomized, non-randomized trial studies were gotten before sieving them and narrowing down the search to 41 studies which had met the inclusion criteria. The results demonstrated that a compliance with the WHO-5 can be of great contribution in the enhancement of hand hygiene amongst the healthcare providers who are attending to the patients (Rubin & Babbie 2016). Nonetheless, the researchers concluded that the effectiveness of the WHO-5 can be increased if the healthcare providers if the healthcare providers are provided with the necessary rewards, incentives, and accountability strategies to motivate them to comply.
The research is a product of high quality work. When carrying out their studies, the researchers decided to use a systematic review and network meta-analysis. These are commendable strategies which should be applied in research because they can help in providing valid and reliable findings. The use of this design enabled the researchers to collect reliable data because it had to be based on the comparison and analysis of information from different sources. The data used in the research are good because before using an article, the researchers had to ensure that it meets the inclusion and exclusion criteria (Bryman 2015).
Critical Appraisal of Article I
The use of systematic review and network meta-analysis made it easier for the researchers to get the most important information which would be used in adequately responding to the research question. The findings provided regarding the compliance of the healthcare providers with the hygiene standards were generated as a result of a rigorous process of systematic review (Denscombe 2014). It enabled the researchers to accomplish the objective of the study which was to evaluate the efficacy of the interventions so far used in enhancing hygiene in the healthcare facilities (Kvale, et al 2016). The proper manner in which the research was done demonstrates that the scholars were adequately prepared for the task. This is why they managed to spend their time to conduct extensive studies before generating the findings and conclusions.
The research had strengths and limitations which, in one way or the other, determined and influenced the success of the study. The most outstanding strength of the research was evidenced in its design. The use of systematic review and network meta-analysis greatly contributed to the success of the research. It enabled the researchers to collect and get access to information from different sources. After identifying the sources, only the best few were chosen to be used in the study. This was a good thing to do because it gave researchers an opportunity to only use the best and most reliable information which can be used to respond to the research question (Flick 2015). Systematic review is a good methodology which should be used in such like studies because it eliminates any bias and enables the researchers to collect valid, accurate, and reliable data.
However, the limitation of the research is that the use of systematic review and network meta-analysis is a complex activity which might be challenging at times. First, it involved a wide range of activities which might require expertise training that might be lacking in some researchers. Besides, it is a tedious process which requires lots of time to be properly done (Rossman & Rallis 2016). During a systematic review, enough time should be allocated to choose the research topic, identify the databases, select the search terminologies, select, and choose the most appropriate information to use in the study, and finally synthesize the data before generating the results. All these might not be effectively done if there are time constraints.
The findings of this research are relevant and can be of great contribution if applied in clinical practice. The finding which was produced in the study is that the use of WHO-5 in promoting hand hygiene can be effective in promoting compliance by the healthcare providers. This finding can be generalized and used by the practitioners to improve the quality of healthcare services (Ford, Boyer, Menachemi & Huerta 2014). For example, a promotional campaign can be rolled-out to sensitize the healthcare providers to comply with the hand hygiene standards which are recommended for use right before and immediately after attending to patients, coming into contact with their surroundings and body fluids (Grol, Wensing, Eccles & Davis 2013). If the findings of this research are applied by all the healthcare providers, the rate of compliance with hand hygiene standards can increase thus resulting into the reduction and eventual elimination of HAIs.
Strengths and Limitations of Article I
Gould DJ, Moralejo D, Drey N, & Chudleigh JH., 2010, Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews 2010, Issue 9. Art. No.: CD005186. DOI: 10.1002/14651858.CD005186.pub3.
https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0013303/
The purpose of this research was to study the types of interventions which can be applied by the healthcare providers in order to improve the compliance with hand hygiene strategies when providing services to the patients. According to these researchers, hand hygiene is the most effective strategy which should be applied when controlling the healthcare associated infections. The researchers hold the view that the infections are dangerous because they lead to morbidity and mortality within the healthcare facilities. HAIs are so contagious and can be spread so quickly from one person to the other (Smiddy, O’Connell & Creedon 2015).
When conducting the studies, the researchers decided to use a systematic review. This is a design in which different information sources are analyzed to generate the required data. Therefore, in order to get access the most relevant information, the researchers had to set an inclusion and exclusion criteria before accessing data from the following electronic databases: BNI, CINAHL, EMBASE, PubMed, and MEDLINE. After carrying out an objective data analysis, it was established that there is need to improve the quality of hand hygiene compliance (Robson & McCartan 2016).
The research was appropriately done because everything was done in compliance with the required standards. The use of systematic review was of great help because it enabled the researchers to do a perfect job. The findings were accurate, reliable and valid because they represent a true picture of what happens at the healthcare facilities across the country (Gross 2015). It is true, as established in the research, that, as it is today, not much has been done to increase the rate of hand hygiene compliance by the healthcare providers. It should however be done because it a strict compliance with the hand hygiene guidelines will help in providing a short and long-term solution to the persistent problem of healthcare associated infections.
The main strength of the research is that it was done using a systematic review. Here, a large number of sources were reviewed and used to provide the information which was analyzed and used to generate the findings and conclusions for research (Levy & Lemeshow 2013). The benefit of systematic review is that it is accurate, valid and reliable because it is a combination of data from different sources. It achieved all these because the data was reviewed by independent reviewers who had no influence and would not interfere with the findings (Peersman 2014). During the study, a total of four controlled clinical trials and randomized controlled trials were used after meeting the inclusion criteria which had been set by the researchers.
However, the limitation of the study is that it was a tedious process which involved lots of activities. These required enough time to be effectively conducted. For example, after identifying the databases and the sources, the articles had to be reviewed by independent reviewers who were supposed to be sourced and provided with enough time and support to successfully complete the review process (Holloway & Wheeler 2013). This is a clear proof that the review process was so complicated and demanding.
The findings of this research are relevant to clinical practice. Hand hygiene is an important strategy that should be applied by all the healthcare providers. The healthcare providers should be encouraged to comply with hand hygiene strategies discussed in the paper because they can help in improving the safety of the healthcare workers and patients. When the healthcare workers comply with the recommended hand hygiene strategies, they can help in providing services which are safe to everyone within the hospital (DiCenso, Cullum & Ciliska 2011). Compliance can be a short and long-term strategy for addressing the problem of healthcare associated infections which have been resulting into mortality and morbidity despite the fact that it is preventable and controllable.
References
Barnes, S.L., Morgan, D.J., Harris, A.D., Carling, P.C. & Thom, K.A., 2014. Preventing the transmission of multidrug-resistant organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions. Infection Control & Hospital Epidemiology, 35(09), pp.1156-1162.
Bucher, J., et al., 2015, Hand washing practices among emergency medical services providers. Western Journal of Emergency Medicine, 16(5), p.727.
Bryman, A., 2015, Social research methods. Oxford: Oxford university press.
Dai, H., Milkman, K.L., Hofmann, D.A. & Staats, B.R., 2015. The impact of time at work and time off from work on rule compliance: The case of hand hygiene in health care. Journal of Applied Psychology, 100(3), p.846.
Denscombe, M., 2014, The good research guide: for small-scale social research projects. London: McGraw-Hill Education (UK).
DiCenso, A.; Cullum, N. & Ciliska, D., 2011, Implementing evidence-based nursing: some misconceptions. Evidence Based Nursing 1 (2): 38–40.
Flick, U., 2015, Introducing research methodology: A beginner’s guide to doing a research project. New York: Sage.
Ford, E.W., Boyer, B.T., Menachemi, N. & Huerta, T.R., 2014, Increasing hand washing compliance with a simple visual cue. American journal of public health, 104(10), pp.1851-1856.
Grol, R., Wensing, M., Eccles, M., & Davis, D. (Eds.), 2013, Improving patient care: the implementation of change in health care. John Wiley & Sons.
Gross, R., 2015, Psychology: The Science of Mind and Behaviour 7th Edition. New York: Hodder Education.
Higgins, A. & Hannan, M.M., 2013, Improved hand hygiene technique and compliance in healthcare workers using gaming technology. Journal of Hospital Infection, 84(1), pp.32-37.
Holloway, I., & Wheeler, S., 2013, Qualitative research in nursing and healthcare. New York: John Wiley & Sons.
Kao, Y.L., et al., 2015, Using ATP bioluminescence technique to enhance respiratory therapist opportunity hand washing compliance. Journal of Microbiology, Immunology and Infection, 48(2), pp.S162-S163.
Kvale, E. A., et al., 2016, Patient?centered support in the survivorship care transition: Outcomes from the Patient?Owned Survivorship Care Plan Intervention. Cancer, 122(20), 3232-3242.
Levy, P. S., & Lemeshow, S., 2013, Sampling of populations: methods and applications. New York: John Wiley & Sons.
Peersman, G., 2014, Overview: Data Collection and Analysis Methods in Impact Evaluation. In Methodological Briefs: Impact Evaluation 10. UNICEF Office of Research: Florence.
Robson, C. & McCartan, K., 2016, Real world research. John Wiley & Sons: Hoboken.
Rossman, G.B. & Rallis, S.F., 2016, An Introduction to Qualitative Research: Learning in the Field. Thousand Oaks: SAGE Publications.
Rubin, A. & Babbie, E.R., 2016, Empowerment Series: Research Methods for Social Work. Boston: Cengage Learning.
Smiddy, M.P., O’Connell, R. & Creedon, S.A., 2015, Systematic qualitative literature review of health care workers’ compliance with hand hygiene guidelines. American journal of infection control, 43(3), pp.269-274.
Srigley, J.A., Furness, C.D., Baker, G.R. & Gardam, M., 2014. Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study. BMJ quality & safety, 23(12), pp.974-980.
Townsend, K., Loudoun, R. & Lewin, D., 2016, Qualitative research in HRM: innovation over stagnation. Handbook of Qualitative Research Methods on Human Resource Management: Innovative Techniques, p.1
Vayena, E., Salathé, M., Madoff, L. C., & Brownstein, J. S., 2015, Ethical challenges of big data in public health. PLoS Comput Biol, 11(2), e1003904.
Zohrabi, M., 2013, Mixed method research: Instruments, validity, reliability and reporting findings. Theory and Practice in Language Studies, 3(2), 254.
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