Introduction
Hand hygiene is largely recognized as an effective method for minimizing incidences of hospital-acquired infections (HAIs). However, despite the development of various guidelines to improve hand hygiene, the compliance with these guidelines as well as the best practices pertaining to hand hygiene by the healthcare providers is suboptimal. As a result of poor compliance, incidences of HAIs have continued to increase thereby raising huge concerns due to the associated consequences such as increased length of hospital stay and health spending. As such, there is a huge need to assess and understand the various factors that hinder optimal compliance with the stipulated guidelines as well as best practices related to hand hygiene in order to develop innovative strategies that could be used in improving hand hygiene. Hence, there is a need to critically analyze various studies in order to evaluate the validity as well as the usefulness of the study findings with regard to the topic.
PICOT question
“Among hospitalized patients, does optimal compliance with the hand hygiene guidelines by the healthcare professionals as compared to the usual care help in minimizing the rates of hospital-acquired infections?”
P- Hospitalized patients
I- Optimal compliance with the hand hygiene guidelines by the healthcare professionals
C- Usual care
O- Minimizing the rates of Hospital-Acquired Infections
Thus, formulating an appropriate and searchable clinical or PICOT question forms the beginning point for carrying out a quality and meaningful research in regard to hand hygiene aimed at developing evidence-based interventions to foster optimal compliance with the stipulated guidelines on hand hygiene among the healthcare professionals.
According to Centers for Disease Control and Prevention (2016), optimal compliance with the stipulated guidelines on hand hygiene by the healthcare professionals is associated with a substantial decline in the rates of HAIs. Similarly, Salama et al. (2013) asserts that adherence with the recommendations and guidelines pertaining to hand hygiene greatly minimizes incidences of HAIs and subsequently leads to better outcomes among hospitalized patients.
On the other hand, it is important to critically analyze the evidence obtained from various studies in order to evaluate their usefulness and subsequently utilize the best available evidence to support the intervention. For instance, the critical appraisal of the articles below shows the relevance as well as the usefulness of the articles pertaining to the topic.
Qualitative study
The study “A qualitative study of senior hospital managers’ views on current and innovative strategies to improve hand hygiene” by McInnes et al. (2014), sought to explore the views of the senior hospital managers with regard to the current as well as the innovative strategies for enhancing hand hygiene compliance.
Problem statement
As such, the clinical problem that led to this study was the continued increase of the HAIs mainly as a result of poor compliance among the healthcare providers with the stipulated guidelines as well as best practices pertaining to hand hygiene. On the other hand, the research problems that led to this study was the lack of information on the contributing factors for non-compliance and the strategies that could be used to enhance hand hygiene compliance based on the perspectives of the senior hospital managers (McInnes et al., 2014). Hence, the study focused on exploring the perceptions of the hospital managers with regard to current as well as the innovative strategies that could be utilized in enhancing hand-hygiene compliance. Thus, understanding of these strategies based on the perspectives of the hospital managers could help in developing evidence-based interventions to improve compliance and consequently minimize incidences of HAIs and enhance the patient outcomes. The author established the significance of this study by analyzing the level of compliance among the healthcare professionals with guidelines as well as the best practices related to hand hygiene and the knowledge gap that exists, specifically in relation to the perspectives of the hospital managers on the issue.
Purpose and research question
The purpose of this study was to explore the perception of the senior hospital managers with regard to the current as well as the innovative strategies for enhancing hand hygiene compliance. As such, the study’s purpose is explicitly stated, hence helping in understanding the researcher’s aim for conducting the study. Although, the research questions are not explicitly stated, some of the research questions include;
What are some of the factors that contribute to non-compliance with hand hygiene practices?
What is your view on the current strategies for enhancing hand-hygiene compliance?
What are the some of the strategies needed in order to improve compliance?
Apparently, the purpose as well as the research questions are in line with the problem. Thus, the purpose as well as the research questions helped the researcher to focus on the problem and avoid any deviations, hence resulting to effective understanding of the phenomenon and establishment of relevant findings that could be used in addressing the issue. Moreover, the qualitative methods utilized were quire appropriate for answering the research question and establishing pertinent findings.
Literature review
Although the study report does not provide an explicit section for literature review, the author cited various studies relevant to the study’s phenomenon of interest and incorporated a review of literature in the background section that helped in understanding the clinical as well as the research problem. In regard to this, the author incorporated various types of literature including; guidelines pertaining to hand hygiene, statistics of the prevalence of HAIs and information obtained from previous studies pertaining to the compliance/non-compliance of the healthcare professionals with the hand-hygiene practices and the associated consequences (McInnes et al., 2014). Apparently, most of the references used in this study are current and authored within the last five years though some of the studies incorporated in the review of literature were conducted within the last ten years. The researcher clearly indicated the weaknesses of the existing studies, particularly with regard to perspectives of the hospital managers on the issue of hand hygiene. Overall, the literature review provides sufficient information that helps in building a logical argument and underscoring the significance of the study.
Conceptual/theoretical framework
The specific perspective as well as the theoretical framework that guided the study was not stated in the study report.
Quantitative study
The study “Perceptions of hand hygiene amongst health care workers in Sibu, East Malaysia” by Birks et al. (2011), sought to examine the perception of the healthcare professionals with regard to hand washing and other pertinent hand hygiene practices.
Protection of Human participants
The researcher undertook the necessary actions in protecting the participants. In relation to this, approval to carry out the study was granted by the University Ethics Committee in which the study was carried out (Birks et al., 2011). In addition, participation in the study was entirely on voluntary basis and the participants were equipped with all the relevant information pertaining to various aspects of the study. On the other hand, the author identified various benefits that accrue from participating in the study but did not identify the risks for participating in the study. Although, informed consent was not sought from the participants, returning the questionnaire was inferred as consent.
Data collection
The study’s key variables are clearly identified and well defined. As such, the study’s key variables include; hand hygiene and the healthcare professionals’ perspectives. The study used structured questionnaires in collecting the relevant data. Specifically a questionnaire acquired from the WHO (World Health Organization) that helped in collecting the relevant data on the perceptions of the participants with regard to hand hygiene (Birks et al., 2011). In addition, the appropriate survey tools, particularly the Likert scale was used to collect the needed data from the participants.
Data management and analysis
The data collected was collated and tabulated into the appropriate computer programs, specifically the Microsoft Excel spreadsheet. Subsequently, the tabulated data was analyzed using the descriptive analysis techniques (Birks et al., 2011). As such, the use of computer programs in data analysis helped in enhancing the accuracy of the analysis as well as the findings, hence enhancing the study’s credibility as well as truthfulness of the obtained findings. Nonetheless, the study report did not indicate the measures used by the researcher in minimizing biasness and its associated effects. Hence, the use of suitable methods in data management and subsequently analysis enables the investigator to come up with useful and meaningful findings.
Findings/Interpretation of findings
Apparently, the study findings are clearly and consistently described. Based on the method used in data collection as well as analysis, it is quite appreciable that the study findings are valid and are an actual reflection of the reality. Hence, the findings obtained from this study are credible as well as truthful. As such, the study established that most of the participants understood the significance of hand hygiene and recognized the need for education and training in enhancing hand hygiene. Moreover, almost all the participants recognized the need to comply with the stipulated recommendation on hand hygiene. However, a significant number of the participants the involvement of patients especially in reminding the healthcare providers on the performance of hand hygiene was an ineffective method for maintain appropriate hand hygiene (Birks et al., 2011).
Although, the study limitations are not explicitly stated and described in the study report, one of the key limitation for this study is the use of a small sample population. In regard to this, the sample size used was relatively small for a quantitative study, and this might limit the generalizability as well as the applicability of the findings (Polit & Beck, 2013). The study findings are presented in a coherent and logical manner whereby this helps in understanding the phenomenon.
Overall, the findings obtained from this study indicate that healthcare professionals understand the importance of maintaining appropriate hand hygiene practices as an effective way for preventing hospital-acquired infections. In addition, the findings indicated the need for education and training in enhancing hand hygiene. As such, the findings could be used to improve education as well as training of the healthcare profession with regard to hand hygiene practices in order to foster the maintenance of these practices and minimize incidences of hospital-acquired infections.
Conclusion
Evidently, hand hygiene is one of the most effective method that can be used in preventing incidences of hospital-acquired infections. However, although most of the professionals acknowledge the significance of hand washing as well as other hygiene related aspects in preventing HAIs, the level of hand hygiene is suboptimal. Therefore, assessing and understanding the factors that hinder effective maintenance of the hand hygiene practices based on the perspectives of the hospital managers as well as the healthcare professionals is an effective strategy that would help in developing evidence-based interventions to enhance hand hygiene.
References
Birks, M., Coyle, M., Porter, J., & Mills, J. (2011). Perceptions of hand hygiene amongst health care workers in Sibu, East Malaysia. International Journal of Infection Control, 8, 10-13.
Centers for Disease Control and Prevention. (2016). Reduction of Healthcare-Associated Infections by Exceeding High Compliance with Hand Hygiene Practices - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC. Retrieved from https://wwwnc.cdc.gov/eid/article/22/9/15-1440_article
McInnes, E., Phillips, R., Middleton, S., & Gould, D. (2014). A qualitative study of senior hospital managers’ views on current and innovative strategies to improve hand hygiene. BMC infectious diseases, 14(1), 1.
Polit, D. F., & Beck, C. T. (2013). Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins.
Salama, M. F., Jamal, W. Y., Al Mousa, H., Al-AbdulGhani, K. A., & Rotimi, V. O. (2013). The effect of hand hygiene compliance on hospital-acquired infections in an ICU setting in a Kuwaiti teaching hospital. Journal of infection and public health, 6(1), 27-34.
