Infection Prevention and Control Care

Infection Prevention and Control Care

Introduction

This paper will focus on the discussion and appraisal of eight different peer reviewed articles on “Infection Prevention and Control Care”. Furthermore, the aim of this assignment is to determine whether proper hand washing reduces the possibility of infection in a clinical area or not. Besides, the paper focuses on identifying the suitable literature whereby the technique illustrated by Bettany Saltikov (2012) is followed to accomplish the objectives of the paper. I chose this paper because, in my management placement, I often observe nurses not adhering to the protocol for hand hygiene, which could enhance the infection prevalence in clinical places (Public Health Agency of Canada). Prevention and control care has a significant benefit to health care stakeholders, patients and medical practitioners. Moreover, prevention is cheaper and better than cure. Thus, a further research on the field of prevention is vital in improving healthcare and nursing practice at large (Smith et al., 2008). Despite all people being vulnerable to infections, adults of who are aged 65 years and above are extremely vulnerable to infectious illnesses (Smith et al., 2008).        

The CASP (Critical Appraisal Skill Programme) tools will be employed in analyzing the quantitative and qualitative research methods in the articles. Besides, the 7s model will be applied in the demonstration of factors that can hinder the achievement of best practice.  

In the search for the articles, the keywords used will be “hand washing,” “hand gel” and “infection” or “disease”.  Furthermore, the CINAHL (Cumulative Index to Nursing and Allied Health) was used as literature database because it is considered a comprehensive database for nursing literature. In addition, the search will be limited to publications of English language and information that has been published for the last 10 years. This approach is vital in ensuring that the information reviewed is up-to-date.

Appraisal of the Eight Articles Using CASP Tools

Chau, J.et al. (2011). “An Evaluation of Hospital Hand Hygiene Practice and Glove Use in Hong Kong.” Journal of Clinical Nursing, 20(9/10), pp.1319-1328

Research design

In this article, Chau and his colleagues have adopted a suitable research design as it addresses the objectives of their research as intended. The study aimed at identifying omissions in glove use and hand hygiene practice among hospital employees in Hong-Kong. As such, the researchers chose an observation study, which is non-blinded in identifying glove use and hand hygiene in four clinical areas within an acute hospital. These areas were surgical wards, emergency, accident and medical wards. Besides, this design was also applied in two areas within two rehabilitation hospitals. This approach enabled the researchers achieve their aim in a suitable way.

Sample

Researchers gathered their data in a manner that addressed the issue of study. A non-probability method of quota sampling is used in the study to ensure that the entire population understudy was represented fairly. Moreover, the stratified sampling technique used in the study needed 36, 77 and 93 samples every stratum to attain a 70 % compliance rate. 

Measurement Methods

Data analysis has been conducted in rigorous manner. This goal has been achieved using a proper method of measurement.  An observational checklist that has two sections is employed in recording activities observed from the health workers. Some of these activities include antiseptic hand rub, hand washing and donning gloves among others. Consequently, data analysis is conducted using the SPSS-PC version 16.0. Moreover, the respondents’ compliance and performance is summarized by means of descriptive statistics such as frequencies, standard deviations and means among others. Furthermore, the ANOVA technique has been used in determining differences between scores of performance among respondents.   

Findings

These researchers provide a clear findings’ statement of their study. Discussion of the results has been performed in relation to the objective of the study. In their findings, the researchers note that the compliance of hand hygiene is 74.7% out of the 1037 observed episodes. Thus, these findings are explicit in that they demonstrate a high compliance rate of employee to hand hygiene.  

Gemma, et al., (2012). “Features of Educational Interventions the Lead to Compliance with Hand Hygiene in Healthcare Professional within a Hospital Care Setting. A BEME Systematic Review: BEME Guide No. 22.” Medical Teacher, 34(6), pp.406-420

Research Design

In their study, researchers based their study on the data obtained from a search, which was divided into two parts. The first part involved an electronic investigation of 16 relevant educational and health databases. The second section involved the augmentation of this investigation by means of hand searching of high-yield article or journals and screening the included papers’ reference lists alongside the relevant systematic reviews. In addition, the search integrated various approaches apart from combining free text word and index terms. Moreover, the search approaches lacked language barriers and did not incorporate methodological filters as they would restrict the outcomes to a certain study design. As such, the researchers’ study design managed to meet the aims of their study.     

Sample

In this article, data has been gathered in a manner that addresses the issue of research. Moreover, the researchers have justified their selected method of data collection in that the use of methodological filters was ignored as it could restrict the study outcomes to specific study designs. Besides, the method for collecting the samples for study has been made explicit.

Measurement Methods

Researchers have provided an in-depth illustration of the process of evaluation. The article reveals how data was extracted and analyzed. Data was obtained from every full text paper and evaluated in relation to the modified Kirkpatrick Framework of hierarchical results of 1967. Contrastingly, the researchers claim that secondary measures were also employed in data analysis, but do not highlight them. However, the use of Kirkpatrick Framework helps in highlighting how the data analysis was conducted.

Findings

The article offers a clear statement of findings. Researchers noted that the low rates of hand washing have a high chance of increasing.  Moreover, the researchers have discussed the results in relation to the original research question.

Garus-Pakowska, A et al., (2013). “Observance of Hand Washing Procedures Performed by the Medical Personnel after the Patient Contact. Part II.” International Journal of Occupational Medicine & Environmental Health, 26(2), pp.257-264

Research Design

Garus-Pakowska, Sobala and Szatso have used a research design, which is relevant to the objectives of their study. In this study, participants have are exposed to a direct quasi-participatory observation and observations noted. As such, the research design employed by these researchers differs from that employed by Chau and his colleagues.   

Sample

Researchers conducted their study on 188 individuals that included doctors and nurses. However, the article does not reveal the method employed in selecting the respondents. On the contrary, the article provides a clear view of how the data collection was accomplished. Respondents were left to conduct their operations as usual without being informed on what the issues on which they were evaluated. Observations were then made in relation to various procedures followed by participants in washing their hands. Therefore, the data collection method employed by researchers addresses the issue of study, which was to observe the hand washing steps taken by medical personnel after contacting patients, in a perfect manner.   

Measurement Methods

One of the equipment that researchers employed in measuring the period taken by respondents in performing the hygiene procedures was the electronic stop-watch. Besides, statistical inference of the study has been done at the significance level of P <0.05. Furthermore, two sided tests have been used in the verification of the study’s statistical hypotheses. In relation to this, logistic regression framework has been used in evaluating the hand washing hygiene procedures. On the other side, the random effect framework has been used in accounting for the within-individual correlation.       

Findings

In this article, the researchers’ findings are explicit and in line with the issue of study. For instance, the researchers have noted that the level of adherence to hygiene procedures prior to contact with patients is 67.2%, while the rate of compliance to hygiene steps after contact with patients is 69.9%.

Ott, M & French, R. (2009). “Hand Hygiene Compliance among Health Care Staff and Student Nurses in a Mental Setting.” Issues in Mental Health Nursing, 30(11), pp.702-704

Research Design

This article has a suitable research design, which has enabled the researchers address their issue of study in a proper way. Researchers accomplished their study by conducting a literature review, which was aimed at assessing the various interventions that can be adopted to improve the compliance to hand hygiene among healthcare employees.  

Sample

The article highlights a clear method of data collection. Data was obtained by conducting a literature review, which helped in the identification of the various interventions that can be employed in increasing healthcare workers’ compliance to hand hygiene. Besides, the form of data gathering is clear as it involved notes.

Measurement Methods

Analysis of data was sufficient. Researchers evaluated data from various sources, which helped them in establishing their findings. Moreover, the researchers offer a clear illustration on how the information presented in the article was obtained from original sources. Thus, the measurement techniques employed by researchers were rigorous.

Findings

Findings presented in the article are clear. Researchers identified that little research has been conducted to assess the practice of hand hygiene in psychiatric facilities. Furthermore, the researchers noted that infection prevention in these facilities is often ignored because such facilities lack adequate diagnosis measures, resources and personnel.

Fitzpatrick et al., (2011). “A Novel Educational Pogramme to Improve Knowledge Regarding Health Care-Associated Infection and Hand Hygiene.” International Journal of Nursing Practice, 17(3), pp.269-274

Research Design

The researcher design that has been adopted by the researchers in this article addresses the study issue perfectly. Researchers based their study on a web-based educational programme, which was performed in an ICU (Intensive Care Unit). This approach was essential for the realization of the aims of the study.

Sample

Data was gathered in a manner that addresses the issue of study. Participants were given pretest consisting of 20 questions to help their baseline knowledge concerning hand hygiene and healthcare-associated infections. Besides, the methods of data collections such as pretests are explicit.

Measurement Methods

This article offers a thorough explanation of the analysis process. Researchers performed pre and post-test evaluations to enhance the accuracy of their findings. In relation to this, comparison was done between the pretest results and posttest outcomes to identify the improvement in the levels of hand hygiene compliance and knowledge on HAI.

Findings

The findings presented in the article are clear. In their findings, researchers noted that the there is an improvement in the level of compliance to hand washing hygiene. Besides, researchers have offered adequate discussion on their findings.

Kilpatrick et al., (2012). “Importance of Hand Hygiene During Invasive Procedures. Nursing Standards” 26(41), pp. 42-46.

Research Design

Kilpatrick and his colleagues have employed a relevant research design in their study. Researchers accomplished their study by conducting a literature review, which was aimed at assessing the various interventions that can be adopted to improve the compliance to hand hygiene among healthcare employees.  

Sample

The article shows a clear method of data gathering. Data was acquired by conducting a literature review, which helped in the identification of the various interventions that can be employed in increasing healthcare workers’ compliance to hand hygiene. Besides, the form of data gathering is clear as it involved notes.

Measurement Methods

Researchers conducted a thorough review of several articles, which were the subjected to a tough scrutiny to obtain the information needed. This process helped in ensuring that the information provided was accurate and detailed. 

Findings

This article has a finding statement, which is clear. The researchers noted that hand hygiene is a significant process in the prevention of infection. Besides, the article points out that hand hygiene helps in ensuring the safety of patients. As such, the article presents a finding that matches the issue of study.

Van, D et al., (2012). “A Comparison of the Hand Hygiene Knowledge, Beliefs and Practices of Italian Nursing and Medical Students.”  Journal of Advance Nursing 68(3), pp.569-579

Research Design

In this article, researchers have adopted a suitable research design in meeting their study aims. The study aimed at examining the Italian medical and nursing students’ hand hygiene beliefs, knowledge and practices to identify if differences among these variables occur between disciplines in the undergraduate set-up. Researchers conducted their study based on the HHQ (Hand Hygiene Questionnaire). As such, the objectives of the research were attained easily using this approach.

Sample

The method employed in collecting data was vital in addressing the needs of the study issues. Researchers used questionnaires, which were distributed to the medical and nursing learners who were on their clinical practicum in the setting of the hospital between 2007 and 2008. This undertaking was done in consultation with the coordinators of the clinical placement. In addition, the sample consisted of 119 medical students and 117 nursing students. This sample represented response rates of 91.5% and 80.7% for medical and nursing students respectively. Such a high response was appropriate in the realization of reliable study outcomes.

Measurement Methods

The researchers have offered a detailed illustration on the tools that were used in analyzing data. For example, one score was granted for each correct answer in the category of knowledge. Consequently, the overall score was determined suing the knowledge tool known as KSCORE. High value on the KSCORE indicated that the leaner had high knowledge levels in relation to hand hygiene. Thus, the researchers managed to perform an accurate measurement of the variables that they were studying.

Findings

Researchers have offered adequate information in their discussion of the findings. Besides, they have presented the limitations that their study had. For instance, the researchers noted that the outcomes of their study could not be extrapolated to other healthcare. As such, the article lacks any aspect of biasness.

Zomer et al., (2013). “A Hand Hygiene Intervention to Decrease Infections among Children Attending Day Care Centers: Design of a Cluster Randomized Controlled Trial.” BMC Infectious Diseases, 13(1), pp.1-7

Research Design

This study employed a research design that was appropriate for the realization of the aims of the research. In this article, the study has been tested in terms of a two-arm cluster controlled trial, which is randomized. This test was performed among 71 child Day Care Centers (DCCs). 36 intervention DCCs obtained the intervention, whereas 35 DCCs continued with the normal practice. As such, the researchers managed to assess the effectiveness of the hand hygiene intervention in DCCs.

Sample

Researchers in this article have managed to collected data in a manner that addresses the issue of research. First, they have revealed the setting where the data is to be gathered. In relation this, the study was performed among the DCCs in Rotterdam-Rijnmond, Gouda and Leiden regions of Netherland. Moreover, the researchers have provided a justification for their use of 20DCCs sample size. This action was adopted to enable the researchers detect the increase in the HH compliance level from 30% to 60%.    

Measurement Methods

Researchers in this article have offered a detailed explanation of the data analysis procedures. First, descriptive analyses were used in assessing the impact of the intervention adopted on the observed hand hygiene compliance. This assessment was also conducted on the observed on the incidence of respiratory and gastrointestinal infections in children. Furthermore, researchers have also explained how the calculation of compliance with the guidelines of HH has been performed. All these measures illustrate that the article contains adequate information on data analysis of data on the research issue.

Findings

Researchers have offered a detailed illustration of their findings. In addition, they have also pointed out the principle limitation of their research. In relation to this, the researchers have noted that the study’s main limitation is the Hawthorne effect, which affects the observation of the HH compliance. Hawthorne effect occurs when individuals alter their behaviors when they are aware that they are being observed.    

Use of 7s Model in Implementing Hand Hygiene in Hospitals

7s framework refers to a model of a firm’s effectiveness that explains that there are seven internal elements that require alignment and reinforcement to enable organizations be successful in executing their operations (Dewing, 2007). The seven element of the 7s model are grouped into hard and soft elements. Hard elements include strategy, systems and structure. On the other hand, the soft elements are shared values, staff, style and skills (Moray, 2000).

Strategy refers to the plan developed to maintain and establish competitive advantage over a firm’s rivals (Flin et al., 2009). As such, hospitals should be focused on developing strategies that promote the safety and protection of patients in relation to infectious illnesses. Such approaches should be based on hygiene measures such as hand washing and wearing of gloves among others

Systems are the daily or usual operations and steps that members of staff engage in to complete task. All systems in the setting of healthcare need to be integrated with measures that are aimed at ensuring safety and protection of infectious illnesses. Hand hygiene should be embraced at all stages of activities conducted by nurses and other medical practitioners. For instance, hand hygiene should be maintained prior to and before handling patients.

Structure is the manner in which an organization is structured. Firms are often organized in a way in which the junior staff report to the senior ones. As such, the supervisory role should be observed in the healthcare setting to ensure that hand washing policy is followed by all nurses (Sax et al., 2013). Thus, a supervisor should be appointment to facilitate the implementation of this policy. This step is significant in ensuring that nurses adhere to the hand hygiene policy.         

Shared Values refers to the firm’s core values that are integrated in the general work ethic and corporate culture (Storr & Kilpatrick, 2013). Healthcare setting should embrace values that promote the well-being of patients. This approach is vital in eliminating negative attitude on the part of workers in relation to hand hygiene (Reason, 2000). Consequently, such employees can handle their patients with adequate care and caution in hygienic conditions.  

Staff involves workers and their potentials. Healthcare facilities should aim at recruiting workers that have adequate qualifications and relevant skills (Syndor & Perl, 2011). This approach is significant in ensuring that activities are performed in a fast and efficient manner. Thus, issues of time wastage can be eliminated (Smith et al. 2008). Besides, such workers often have high regard of hygiene and can help in promoting hand washing as safety procedures.   

Style refers to the leadership technique that a firm uses. Firms should adopt transformational leadership technique as it helps in developing a proper relationship between the management and workers (Gurses et al., 2012). Such a relationship is vital in ensuring that employees comply with hygiene measures without supervision because they feel as part of the system or organization’s success.

Skills are the workers’ competencies. Healthcare setting should adopt measures that are aimed at imparting adequate hygiene skills to their employees (Edward et al., 2012). Training programs that emphasize the benefit of hygienic measures such as glove wearing and hand washing should be introduced in these organizations (Ward, 2012).   

In conclusion, the eight articles have pointed out the significance of hand washing as a means of infection protection and control in the health care facilities. The use of the 7s framework is significant in overcoming barriers such as time and attitude to the implementation of hand washing policy in healthcare settings. Moreover, the use of key words such as “infection”, “hand washing” and “hand gel” is vital in locating suitable sources for addressing the literature review on hands washing as a best practice in healthcare settings.

References

Anderson J, Gosbee LL, Bessesen M, William L. (2010). ‘Using human factors engineering to improve the effictiveness of infection prevention and control,’ Critical Care Medicine, vol. 38, pp. 269-81

Chau, J.et al. (2011). ‘An Evaluation of Hospital Hand Hygiene Practice and Glove Use in Hong Kong.’ Journal of Clinical Nursing, 20(9/10), pp.1319-1328

Dewing, J (2007). Values underpinning help, support and care. In: Neno R, Aveyard B, Heath H (eds) Older people and mental health nursing: a handbook of care. Blackwell, Oxford, pp 40–51.

Edwards, R et al. (2012). Optimisation of infection prevention and control in acute health care by use of behavior change: a systematic review. National Center for Infection Prevention and Management: London, UK.

Fitzpatrick P et al., (2011). “A Novel Educational Pogramme to Improve Knowledge Regarding Health Care-Associated Infection and Hand Hygiene.” International Journal of Nursing Practice, 17(3), pp.269-274

Flin R, Winter J, Sarac C, Raduma M. (2009). Human factors in Patient Safety Review of Topics and Tools: Report for Methods and Measures Working Group of WHO Patient Safety. World Health Organization.

Gemma, D et al., (2012). ‘Features of Educational Interventions the Lead to Compliance with Hand Hygiene in Healthcare Professional within a Hospital Care Setting. A BEME Systematic Review: BEME Guide No. 22.’ Medical Teacher, 34(6), pp.406-420

Garus-Pakowska, A et al., (2013). ‘Observance of Hand Washing Procedures Performed by the Medical Personnel after the Patient Contact. Part II.’ International Journal of Occupational Medicine & Environmental Health, 26(2), pp.257-264

Gurses AP, Ant Ozok A, Pronovost PJ. (2012). ‘Time to accelerate integration of human factors and ergonomics in patient safety,’  BMJ Qual Saf, vol. 21, pp. 347-351.

Harbarth, S (2012). What can we learn from each other in infection control? Experience in Europe compared with the USA. The HealthCare Infection Society. Geneva, Switzerland; Elsevier Ltd.

Moray, N (2000). ‘Culture, politics and ergonomics,’ Ergonomics, vol. 43, pp. 858-868

Kilpatrick K et al., (2012). ‘Importance of Hand Hygiene During Invasive Procedures. Nursing Standards’ 26(41), pp. 42-46.

Public Health Agency of Canada. Essential Resources for Effective Infection Prevention and Control Programs: A Matter of Patient Safety: A Discussion Paper.

Ott, M & French, R. (2009). ‘Hand Hygiene Compliance among Health Care Staff and Student Nurses in a Mental Setting.’ Issues in Mental Health Nursing, 30(11), pp.702-704

Reason, J (2000). ‘Human Error: Models and management,’ BMJ vol. 320, pp. 768.

Sax, H. et al., (2013). Implementation of infection control best practice in intensive care units throughout Europe: a mixed-method evaluation study.

Smith, PW et al., (2008). SHEA/APIC Guideline: Infection Prevention and Control in the long-term care facility. Omaha, Nebrska Medical Center.

Storr, J, Wigglesworth, N & Kilpatrick, C. (2013). Integrating human factors with infection prevention and control. The Health Foundation Inspiring Improvement

Syndor, ERM & Perl, TM. (2011), ‘Hospital Epidemiology and Infection Control in Acute-Care Settings. vol 24, no. 1; pp. 141-173.

Van, D et al., (2012). ‘A Comparison of the Hand Hygiene Knowledge, Beliefs and Practices of Italian Nursing and Medical Students.’  Journal of Advance Nursing 68(3), pp.569-579

Ward, DJ (2012).  ‘Attitudes towards infection prevention and control: An interview study with nursing students and nurse mentors,’ BMJ vol. 21, pp. 301-306.

Zomer et al., (2013). ‘A Hand Hygiene Intervention to Decrease Infections among Children Attending Day Care Centers: Design of a Cluster Randomized Controlled Trial.’ BMC Infectious Diseases, 13(1), pp.1-7

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