Hand Hygiene: Preventing Healthcare-acquired Infections

Purpose of the Study

The purpose of this article is to display how healthcare-acquired infections can be prevented through proper hand hygiene. The authors of this article explain what healthcare-associated infections (HAIs) are, how HAIs specifically respiratory infections and ventilator-associated pneumonia are acquired, how they can be prevented, and how these costly these infections are to treat. They also discuss how HAIs can increase the mortality rate as well as morbidity (Finco et al., 2018). The article provides evidence based practice research on how HAIs can be reduced significantly when proper hand hygiene is performed (Finco et al., 2018).

Research on Hand Hygiene Program Effectiveness

Research for this study took place at three intensive care units. According to Finco et al. (2018), a time-series was performed on the effects of hand hygiene program that was initiated in hospitals. “Outcome indicators were collected in the three ICUs…,” according to Finco et al. (2018). The researchers also used infection data that was collected over an eighteen month period, before and after the hand hygiene program was initiated. Additional data was gathered for this study, was obtained from the patient’s demographic and clinical characteristics, what kind of infection patients acquired as well as type of microorganism, complications, and death rates (Finco et al., 2018). During the pre-intervention period, a collection of best practices, according to WHO guidelines and national, as well as international literature, was established and used throughout this study(Finco et al., 2018). During the intervention phase of this study, direct monitoring of hand hygiene being performed was observed (Finco et al., 2018).

During the data analysis phase, researchers used an interrupted time series (ITS) method (Finco et al., 2018). According to Finco et al. (2018), an ITS is an autoregressive integrated moving average method with 1 lag model that creates an underlying trend that is interrupted by an intervention at a known time. This allows researchers to recognize the effects of an intervention and the trend of infection (Finco et al., 2018).

For this study, univariate analysis was also used including t-test statistic, Mann-Whitney U analysis, and Chi-square test (Finco et al., 2018). My evaluation on the evidence presented for this study is that the evidence did support the outcome of the study and futures studies performed. The protection of the human subjects and cultural considerations were addressed when researchers used demographic and clinical characteristics of the human. One strength of this study is that based on the in person monitoring of hand washing. I am sure this information provided employers of the hospitals involved in the study, constructive information so that they could re-educate their staff. One limitation of the study, I believe, is the study of ICUs only. I believe the study should have been performed on other units also because ICUs are not the units to acquire HAIs.

The evidence reiterates that current nursing practices are best practice when used. The study reveals that when hand hygiene is performed, it decreases HAIs. Education needs to continue within the healthcare field as well as with patients on proper hand hygiene. It informs us that best nursing practices are not being followed and that the patient-centered care is not being provided. The purpose of the qualitative research article chosen is to display health care workers’ noncompliance with hand hygiene. The study is supported by data retrieved by methodically searching, reviewing, and discussing the results of several qualitative articles regarding this topic, according to Smiddy, O’ Connell, & Creedon, (2015). A total of ten similar qualitative studies were used to compare and try to determine the noncompliance of hand hygiene by health care workers. 

The data from the articles used in the study were reviewed by two independent individuals using a standard quality assessment scale according to Smiddy et al., 2015. The Critical Appraisal Skills Programme was also used during this study (Smiddy et al., 2015). The information from each article was repeatedly read and recurrent themes were identified (Smiddy et al., 2015). After each theme was identified in the articles, certain factors were compared and discussed. The themes recognized provided information to researchers on similar factors that affected hand hygiene by health care workers.

Factors Affecting Hand Hygiene Guidelines

During this study I believe the information provided by the ten articles regarding health care workers noncompliance with hand hygiene guidelines does support each of the selected four areas above. Health care-associated infections is a major concern. The researchers were able to conclude reasoning as to why workers are non-compliant. Motivational factors such as social influence, acuity of patient care, self-protection all contribute to the none compliance of hand hygiene (Smiddy et al., 2015). Another factor, perceptions of the work environment (i.e. Resources, knowledge, information), also contributed to noncompliance of hand hygiene guidelines (Smiddy et al., 2015). The protection of human subjects and cultural considerations were addressed by the identifying the different factors that contributing to the finding in each article. The motivational factors and perceptions of the work environment include social influence, self-protection, and organizational culture (Smiddy et al., 2015).

One strength in this study was identifying the factors that were most commonly found in the ten articles used for this study (Smiddy et al., 2015). One limitation that was found in the study was the lack of credibility of the information provided in the articles (Smiddy et al., 2015). The evidence gathered for this study informs current nursing practice that proper hand hygiene to prevent infection is not occurring. This study shows evidence on the noncompliance of hand hygiene guidelines by health care workers. It provided some reasons (i.e. social influence, acuity of patient care, and knowledge) as to why some health care workers are non-compliant (Smiddy et al., 2015).

References

1. Finco, G., Musu, M., Landoni, G., Campagna, M., Lai, A., Cabrini, L.,…Galletta, M. (2018). Healthcare-associated respiratory infections in intensive care unit can be reduced by a hand hygiene program: A multicenter study. Australian Critical Care, 31(6), 340-346. Retrieved from: https://wwwsciencedirectcom.wgu.idm.oclc.org/science/article/pii/S1036731416302077?via%3
2. Smiddy, M., O’Connell PhD. R., Creedon PhD, S.. (2015). Systematic qualitative literature review of health care workers’ compliance with hand hygiene guidelines. American Journal of Infection Control, 43, 269-274. Retrieved from: https://www-sciencedirect-com.wgu.idm.oclc.org/science/article/pii/S0196655314013285?via%3Dihub