Research Critique Guidelines – Part II Use this document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the studies in your responses. Quantitative Studies Background 1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question. How do these two articles support the nurse practice issue you chose? 1. Discuss how these two articles will be used to answer your PICOT question. 2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question. Method of Study: 1. State the methods of the two articles you are comparing and describe how they are different. 2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method. Results of Study 1. Summarize the key findings of each study in one or two comprehensive paragraphs. 2. What are the implications of the two studies you chose in nursing practice? Outcomes Comparison 1. What are the anticipated outcomes for your PICOT question? 2. How do the outcomes of your chosen articles compare to your anticipated outcomes? © 2019. Grand Canyon University. All Rights Reserved. Literature Evaluation Table Student Name: Summary of Clinical Issue (200-250 words): Hand washing is one of the basic hygiene practices. However, many individuals often ignore this simple practice. Notably, patients in long-term and acute care facilities are vulnerable to infections associated with healthcare settings and patient handling. Since the hands of the health care workers drive and promote infections among critically ill patients, hand washing remains the foundation in the infection control programs (Shobowale, Adegunle & Onyedibe, 2016). While the World Health Organization (WHO) recommends a five-moment of handwashing practice concerning patients' healthcare, many health care facilities do not comply with hands hygiene. It is noteworthy that hand washing significantly decreases the risk of infectious cross-transmissions. Even though infections related to the healthcare setting are preventable by strictly observing basic practices such as hand washing, they continue to increase mortality and morbidity in addition to the treatment costs. Centers for Diseases Control (CDC) argues that strict adherence to hand hygiene in healthcare facilities significantly improves infection control within the facilities (CDC, 2020). The research shows that germs that causes severe infections are present in healthcare centers and that individuals within these premises including patients, visitors, and the health workers should wash their hands to reduce the risk of getting infections (Mathur, 2011). Of importance, health care practitioners should observe frequent hand washing especially just before coming into contact with a patient and immediately after any contact with the patient as a way of protecting both the patients and themselves from acquiring the infections. © 2019. Grand Canyon University. All Rights Reserved. PICOT Question: For the patients in long-term and acute care facilities (P), how does enhancing hand washing procedure compliance among health practitioners (I) compared to not complying with the procedure (C) reduce infections acquired in hospitals (O) for the period of hospitalization (T)? Criteria APA-Formatted Article Citation with Permalink How Does the Article Relate to the PICOT Question? Article 1 Article 2 Article 3 EL-Kass, G Agarwal, N., Ashraf, S., Hussain, S., Hussain, R. & et al. (2010). Hand Hygiene in Long-Term Care Facilities A Multicenter Study of Knowledge, Attitudes, Practices, and Barriers. Infection Control & Hospital Epidemiology, 31(7), 758-762. DOI: 10.1086/653821 Menon, V., Shukla, U., & Chavali, S. (2014). Hand hygiene compliance among healthcare workers in an accredited tertiary care hospital. Indian Journal Of Critical Care Medicine, 18(10), 689-693. DOI: 10.4103/09725229.142179 Taghizadeh, R., Ghalebi, N., Farhoudi, F., Hoshangi Davani, M., & Sajadi, G. (2016). Impact of WHO Hand Hygiene Improvement Program Implementation: A QuasiExperimental Trial. Biomed Research International, 2016, 17. DOI: 10.1155/2016/7026169 Permalink: https://www.researchgate.net /publication/44628028 Hand Hygiene in Long-Term CareFacilities_A_Multicente r_Study_of_Knowledge_Atti tudes_Practices_and_Barriers Permalink: https://www.ncbi.nlm.nih.gov /pmc/articles/PMC4195200/ Permalink: This article relates to the PICOT question as it examines the advancement of hand hygiene activities within healthcare The article evaluates the compliance to hand hygiene amongst nurses and other healthcare practitioners, The article examines the effects of the implementation of the Hand Hygiene Improvement Program by the World Health Organization. 2 https://www.hindawi.com/jo urnals/bmri/2016/7026169/ facilities for long-term illness interventions. particularly in the Intensive Care Unit. Quantitative, Qualitative (How do you know?) This is a quantitative study as it premises on question survey guided by the CDC framework. The experiment is a quantitative study since it uses a direct observation research method. Purpose Statement The purpose of the study was to expedite the timely creation of programs focusing on enhancing hand hygiene practices within the health facilities for long-time care. What are the inconsistencies in knowledge concerning attitudes to hand washing among nurses and other practitioners? What are the existing hurdles to compliance with handwashing guidelines? The majority of the participants asserted their familiarity with the CDC guidelines of 2002. Besides, nearly all participants claimed to have a positive attitude concerning the CDC guidelines while believing that they are important to the nursing centers. The study involved 17 nursing centers across the United States To evaluate the compliance of nurses and surgical physicians in ICU to hand hygiene Research Question Outcome Setting (Where did the study take place?) The research is quantitative because of the extensive use of direct observation study approach. To examine the impacts of the adoption of multimodal Hand Hygiene enhancement strategies by the World Health Organization. Do the surgical physicians in ICU and other nurses comply with the hand hygiene guidelines? How does the adoption of the multimodal handwashing advanced strategy by the World Health Organization reduce the rate of infections among healthcare workers? Continuous training is important for ensuring adherence to hand washing protocols and sustained performance. Healthcare-related infections dropped significantly from about 5 to 3.5 per every 1000 inpatient days following the adoption of the wide hand washing or hygiene program The researchers recorded their observations in the surgical Intensive care Unit of a The researchers observed hand hygiene practices at Nemazee Hospital, which is a tertiary 3 registered tertiary healthcare facility. academic facility located in southern Iran in June 2015. Sample The survey involved a total of 1145 participants working in nursing facilities from different states within the United States. The researchers observed a sample of 28 nurses and 10 physicians in the facilities. Researchers observed a sample of 14 healthcare workers Method The survey focused on 52 questions on the CDC guidelines of 2002 on handwashing The method involved a survey before the study and direct observations on situations concerning hand hygiene. Observed compliance with handwashing etiquette among healthcare workers within 14 wards. Key Findings of the Study ✓ Lack of washing sinks, paper ✓ Compliance with the hand ✓ The off-ratio practice of towels, and soap, as well as etiquette among nurses handwashing etiquette was hand rubs with alcohol, were before sterilized procedures high before touching a some of the barriers to was below 40%. patient. handwashing within nursing ✓ Compliance with the ✓ There was an improvement in home setups. procedures after the contact hand hygiene compliance ✓ Most of the participants with a patient was 93% apart from the risk following demonstrated their familiarity against 62% compliance body fluid exposure. with the CDC guidelines on before coming into contact handwashing but only 33% with a patient. scored above 85% on ✓ While physicians' adherence knowledge queries. rate was 87%, the compliance rate among the nurses was 63%. ✓ Because of the increasing ✓ Healthcare administrators ✓ There should be elder population residing in should ensure continuous comprehensive hand hygiene long-term healthcare centers, training verbal reminders and training programs across the employees for nursing homes performance feedback for the world particularly within the should receive adequate realization of sustained nations with low-compliance education on hand hygiene. Recommendations of the Researcher 4 ✓ There should be solutions to practical barriers to hand hygiene practices. compliance to hand hygiene following the training. 5 rates and high-rate of healthcare infections. ✓ Recommended increased local and oriented research for the promotions of hand hygiene. Criteria APA-Formatted Article Citation with Permalink How Does the Article Relate to the PICOT Question? Article 4 Article 5 Article 6 Kirzner, D. et al. (2010). Focus Group Study of Hand Hygiene Practice among Healthcare Workers in a Teaching Hospital in Toronto, Canada. Infection Control & Hospital Epidemiology, 31(2), 144-150. DOI: 10.1086/649792 Gould, D., Middleton, S McInnes, E. & Phillips, R. (2014). A qualitative study of senior hospital managers’ views on current and innovative strategies to improve hand hygiene. BMC infectious diseases, 14(1), 611. Askarian, M., Palenik, C., McLaws, M., & Farahangiz, S. (2015). Iranian healthcare workers’ perspective on hand hygiene: A qualitative study. Journal Of Infection And Public Health, 8(1), 72-79. DOI: 10.1016/j.jiph.2014.05.004 Permalink: https://www.cambridge.org/c ore/journals/infectioncontrol-and-hospitalepidemiology/article/focusgroup-study-of-handhygiene-practice-amonghealthcare-workers-in-ateaching-hospital-in-torontocanada/642C1C757DEF2A6 DD682F6D1BE2C3514 Permalink: Permalink: https://bmcinfectdis.biomedc entral.com/articles/10.1186/s 12879-014-0611-3 https://www.sciencedirect.co m/science/article/pii/S187603 411400077X This article discusses the different ways of promoting hand hygiene among healthcare providers. This article explicates the role of healthcare facilities' managers on the implementation of handwashing practice. This article examines the handwashing hygiene from the healthcare workers' viewpoint while the authors provide recommendations on ways of enhancing compliance. 6 Quantitative, Qualitative (How do you know?) This is qualitative research because its design employs focus group discussions. Through the use of face-to-face interviews, the study design demonstrates that this is a qualitative investigation. Purpose Statement This study aimed to comprehend the behavioral determinants of handwashing hygiene within healthcare centers. Research Question What are the behaviors that determine healthcare workers’ compliance to hand hygiene? The purpose of this study was to identify the views of the strategic management on the contemporary and innovative strategies on improving compliance to hand hygiene. What are the contemporary and innovative ideas that improve compliance to hand hygiene? Outcome The outcomes of this research include restricted access to supplies as an obstacle to handing hygiene and that the practice of hand hygiene in healthcare facilities aims to ensure personal protection. Also, Teamwork and role models enhance hand hygiene. This research establishes that the leaders are the influencers of cultural change and that they should link the five moments throughout the patient’s journey. 7 The research is a qualitative study because it involves qualitative study methods including in-depth interviews and focuses group discussions. The purpose of this study was to establish different hand hygiene aspects from the viewpoint of healthcare workers. What are the underpinning factors that hinder or promote compliance with hand hygiene among health care workers? Among the outcomes of this research include the association between hand hygiene compliance and environmental conditions, the connection between hand hygiene compliance and personal attributes as well as the influence of health systems on the compliance with hand hygiene. Also, the research established the application of improved supervision and ideal policies on the enhancement of hand hygiene compliance. Setting (Where did the study take place?) The researchers carried out this study at the University of Toronto in Mt. Sinai Hospital The researchers conducted their experiments at 350 beds referral hospitals in Australia's city of Sydney. Sample The research used a sample size of 153 health care practitioners representing the main participant care jobs group. This study involved 13 participants from various strategic healthcare positions including hospital executives, managers and clinical officers with a minimum of 12 months of experience in the health care field. Method The researchers collected the The researchers employed semidata through focus group dialogs. structured audio-recorded interviews extending for a maximum of 30 minutes. The research established that ✓ Hand hygiene practices from there was a significant gap in the top management to other knowledge of hand hygiene. health workers would However, the participants' influence compliance to hand workloads including hygiene protocols among all interruptions and urgent care the health workers, patients, made it difficult to observe and hospital visitors. complete adherence to hand ✓ Application of standard hygiene demands. The research education approaches, also found that the participants reminders of the Five perceived hand hygiene Moments of WHO and guidelines as extremely signage were not conservative. Further, the implemented and hence the Key Findings of the Study 8 The researchers conducted this research in two different hospitals including a private and a public hospital between August 2012 and October the same year in Shiraz, Iran. The sample size of the research comprised of 80 healthcare workers from the surgery and Intensive Care Units. The participants included 6 attending physicians, 14 surgical ward nurses, 6 nursing and 20 medical students and 24 support staff as well as 16 nurses from the Intensive Care Unit (ICU). The research method involved 6 high-level face-to-face interviews and 8-focus group discussions. The primary findings of the research included the following: ✓ Physicians were the only group that knew the WHO Five Moments for hand washing. ✓ The majority of the participants were concerned with the amount of time required to finish the hand hygiene pre and post patient contact. Recommendations of the Researcher participants argued that they used need to refresh and renew the gloves as self-protective focus, content and delivery measures for long while washed strategies. their hands mainly after contacting a patient or body fluids. Finally, the research established that the peers' adherence to handwashing practices encouraged the participants to ensure hand washing frequently. ✓ Healthcare facilities and ✓ The facilities should tailor hospitals should conduct the hand hygiene five healthcare workers’ training moments to particular on the strategies to manage settings and roles. workloads to enhance ✓ Practical leadership and adherence to hand hygiene organizational support including role modeling and ✓ demonstrations on hand hygiene. ✓ Plans to reinvigorate and strengthen the hospital's hand hygiene practices. 9 ✓ Other healthcare workers asserted that handwashing was a protective measure against infections after coming into contact with body fluids, surfaces, and patients. ✓ Hospital managers should include both continuous interactive training and hand hygiene audit systems to ensure rapid response and high-level compliance. ✓ Increasing resources, application of peer pressure to encourage the adherence to hand hygiene by changing the social norms while emphasizing the need for high-level hand hygiene among patients. ✓ The emphasis that all patients deserve high hand hygiene compliance. 10 References Centers for Disease Control and Prevention. (2020). Clean Hands Count. Retrieved 30 January 2020, from https://www.cdc.gov/features/handhygiene/index.html Mathur, P. (2011). Hand hygiene: Back to the basics of infection control. The Indian Journal Of Medical Research, 134(5), 611. DOI: 10.4103/0971-5916.90985 Shobowale, E., Adegunle, B., & Onyedibe, K. (2016). An assessment of hand hygiene practices of healthcare workers of a semi-urban teaching hospital using the five moments of hand hygiene. Nigerian Medical Journal, 57(3), 150. DOI: 10.4103/03001652.184058 11
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