In a time when Healthcare-associated Infections (HAIs) have become a global concern, there is a universal consensus on the importance of hand washing in both clinical and non-clinical settings. However, research in this field are yet to reach an agreement on whether hand sanitizers work more effectively than soap and water for healthcare workers during patient care. In this light, the current paper summarizes two articles exploring the subject of hand washing and hand sanitizers. More specifically, this paper will rate and evaluate the strength of evidence found in both articles. The principle aim of this paper is to widen understanding regarding the issue at hand in a bid to direct related research work accordingly.
The first article under evaluation is titled Hand Hygiene – Evaluation of Three Disinfectant Hand Sanitizers in a Community Setting (Babeluk et al., 2014). As the title predicts, this article proceeds from research crystalizing the correlation between improvements in hand hygiene and reductions in the rate of transmission of infectious diseases. Further, the authors of this article hold that hand disinfectants are more effective than soap and water as they contain additional skin care products (Babeluk et al., 2014).
Before proceeding to rating and evaluating the evidence used in this article, it is imperative to point the validity of the research direction the paper takes. This paper derives its research objective from pinpointing research gaps in prior literature exploring the subject. That is, the authors identified that hand sanitizers are more effective than soap and water in hand washing driven by the desire to reduce disease transmission. In addition, they postulate that although high-quality disinfectants are more effective than water and soap, there exists notable differences in the efficacy of these products (Babeluk et al., 2014). Moreover, the subjects selected for this study had no prior training in hand hygiene. This sampling criteria made sure that the participants well represent the non-healthcare community.
Now moving to rating and evaluating the evidence used herein, this article chooses both certified and non-certified products in accordance to applicable European standards. Two of the chosen products are certified and one is uncertified. In this sampling, the article excels in representing the entire population of hand sanitizers as they fall in either certified or non-certified categories. Inarguably, representative sampling is of indispensable value in cementing the validity, reliability, and universality of research findings.
The evidence used in evaluating the efficacy of the three disinfectants is great. After identifying the sanitizers to compare, the authors measure the correlation between the use of each disinfectant and reduction in bacterial transmission before and after education on their use. In doing this, the authors make one assertion clear; the efficacy of a sanitizer is a function of not only the contents therein but also the degree at which the user is able to apply the instructions of use. In fighting the transmission of bacterial infections, training in hand hygiene is as important as the content and quality of disinfectants. Even further, the researchers were keen to use the mean, standard deviation, and Student’s t-test in their evaluation of efficacy of each disinfectant (Babeluk et al., 2014). Principally, the use of these statistical tools eliminate the chances of researchers’ subjective bias in the interpretation of results. In a scale of 1 to 10, the evidence used in this article can be rated at a score of eight.
The second article is Chen et al’s Effectiveness and Limitations of Hand Hygiene Promotion on Decreasing Healthcare-Associated Infections (Chen et al., 2011). Ideally, this article seeks to identify the impact of implementing hand hygiene programs on the prevention of HAIs. Also, the study examines the cost-effectiveness of hand hygiene programs. Hence, the scholars here as in the first article agree that there exists a relationship between hand washing and the reduction in the transmission of HAIs. But most notably, this article moves a step further by investigating the economic feasibility of implementing hand washing programs. In that tune, one can easily decipher that the researchers were concerned that there exist so much empirical findings pointing the impact of hand washing in reducing HAIs yet a disturbing population of hospital units have not implemented the proposed requirements probably because of fear of economic infeasibility.
In their attempt to illuminate the darkness surrounding hand washing and its implementation in the healthcare community, these researchers deployed a quasi-experimental study design to assess the effectiveness of hand washing in reducing HAIs as well as the cost effectiveness of HHPs. In reporting the findings of their investigation, the research point that HAIs decreased by 8.9% following the implementation of HHPs. In terms of cost-effectiveness, the implementation of HHPs had a net benefit of US$5,289,364 (Chen et al., 2011).
The evidence engaged to reach these conclusions are remarkably reliable, but also lacking as far as objectivity is concerned. To begin with, for instance, the compliance to hand hygiene programs was measured by the use of hand rub products and direct observation. On the one hand, measuring compliance using the consumption of hand rub products operates on the assumption that the products are only being used for hand washing and not for any other purposes. On the other hand, determining compliance by direct observation creates space for researcher bias and other types of human error.
But despite these shortcomings, the evidence engaged is also objective. For instance, the use of Poisson regression analyses to evaluate the trends and densities of HAIs during both pre-intervention and intervention periods eliminate subjectivity. Similarly, a decline of HAIs, methicillin-resistant Staphylococcus aureus, and the occurrence of bloodstream makes it easy to quantify the benefit-cost ratio of HHPs (Chen et al., 2011). Every infection has a known cost-average in any hospital unit. Hence, any percentage reduction or increase in infection can be translated to either economic burden or relief without much struggle. In a scale of 1 to 10, the evidence used in this article can be accorded a rating of six.
In conclusion, the two articles do justice to the global concern of hand washing and its relationship with HAIs. For example, the first article excels in showing that hand sanitizers are more efficient than water and soap. Even further, the article empirically points that the efficacy of different disinfectants vary depending on whether they are certified or not as well as their contents. The second article shows that hand washing plays a huge role in reducing HAIs besides having considerable economic benefits. In terms of the strength of the evidence used, the two articles are keen to ensure that sampling is remarkably representative of the population. Even further, the evidence is statistically sound. The two articles engage statistical tools and instruments in analyzing collected data all in a bid to ensure validity, reliability, and universality of data.
References
Babeluk, R., Jutz, S., Mertlitz, S., Matiasek, J., & Klaus, C. (2014). Hand hygiene – evaluation of three disinfectant hand sanitizers in a community setting. PLoS ONE, 9 (11), 1-7.
Chen, Y-C., Sheng, W-H., Wang, J-T., Chang, S-C., Lin, H-C., Tien, K-L., Hsu, L-Y., & Tsai, K-S. (2011). Effectiveness and limitations of hand hygiene promotion on decreasing healthcare-associated infections. PLos ONE, 6 (11), 1-9.
