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.
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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
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