NUR-550 Literature Review – Resubmission

Submit your literature review from NUR-550 for your NUR-590 instructor to review. If your NUR-550 instructor indicated areas for revision be sure to incorporate these improvements prior to submitting your paper for this assignment.

You will use the revised literature review for your final written paper in Topic, 8 detailing your evidence-based practice project proposal.

Benchmark-Evidence-Based Practice Project: Literature Review

Nurses and other healthcare providers must implement interventions that improve quality of care while reducing adverse events such as hospital acquired infections in order to achieve patient safety (HAIs). Nurses must apply and leverage existing evidence-based practice interventions such as hand hygiene protocols and measures such as handwashing with soap and water alongside sanitizers in the prevention and mitigation of hospital acquired infections (HAIs). Hospital-acquired infections are responsible for a significant portion of mortality and morbidity, as well as poor patient outcomes and an increased cost burden of care. The purpose of this paper is to provide a review of the literature on articles that support the PICOT statement on using soap and water in addition to sanitizer to reduce hospital acquired infections among healthcare workers over a six-month period. The paper discusses the literature review search methods, synthesizes relevant articles based on the PICOT question, compares the articles, and makes recommendations for future research on ways to reduce hospital acquired infections.

PICOT Statement

Among healthcare workers in different settings (P), how does hand hygiene practices like handwashing with soap and water alongside using hand sanitizer (I), compared to handwashing with soap and water alone (C), reduce hospital acquired infections (O), within six months (T)?

Search Methods

Effective search for articles entails using appropriate approaches and terms. In this case, I used the university library to get to the databases of journals and their published peer reviewed articles. Using terms like peer review and scholarly works on hospital acquired infections (HAIs), I got the articles that I will be analyzing in this paper. I ensured that these articles have been published in the last five years and were relevant to nursing use and content. I also ensure that they were on the aspects in my PICOT question and statement and supported my EBP project.

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Synthesis of Literature

Article 1

The first article by Ni et al. (2020) explores an intervention project on hand hygiene improvement in a large healthcare facility in China. The objective of the article is to investigate the importance of implementing a hand hygiene initiative among healthcare workers to reduce and prevent hospital acquired infections. Using a qualitative design, the authors provide a summary of the effectiveness of the implementation of the hand hygiene measures in a 2500-bed teaching hospital. The findings from the study emphasizes the significance of implementing evidence-based practice interventions to prevent infections and enhance patient safety. The article recommends having handwashing measures that will reduce infections by healthcare workers. The article supports the PICOT as it explores the benefits of using translational research to implement hand hygiene measures. The article also supports the project by providing insightful information about the effectiveness of hand hygiene measures by healthcare workers in different settings.

Also Read: NUR 590 Topic 2 Discussion Question 2

Article 2

Zhao et al. (2017) discuss the need to make hand hygiene interventions more appealing to nurses. The authors’ goal is to improve understanding of the types of interventions that can persuade nurses to adopt effective hand hygiene measures by using a discrete choice experiment. The study, which was conducted in three tertiary settings with 200 nurses participating, demonstrates that healthcare providers can develop effective interventions that encourage these professionals to practice handwashing. The authors demonstrate that with better training and awareness, nurses can make better decisions and take effective actions to prevent hospital acquired infections by outlining five different interventions. The article supplements the PICOT by providing additional information on various approaches that nurses can use to prevent hospital acquired infections within a specific time frame.

Article 4

The by Staniford et al. (2020) is a systematic review of hand hygiene and environmental-disinfection interventions to improve hygiene in children’s settings. The authors identify interventions like behavioral change as essential in enhancing hand hygiene measures in these settings.  The findings show that these interventions are effective and supported by research. The article supports the PICOT as it demonstrates the need to integrate research-supported interventions in hand hygiene. The article also supports the need to use different approaches focused on health populations like nurses.

Article 5

The fifth article is by Moura et al. (2017) who explore the use of translational research in attaining hand hygiene compliance. The authors discuss interventions that support hand hygiene measures, especially in healthcare setting in low-income areas and regions. The findings from the study show that most of the interventions reviewed are effective in supporting hand hygiene measures and preventing hospital acquired infections. The article supports the EBP project by illustrating the significance of hand hygiene compliance among healthcare workers. The article supports the PICOT by offering more insightful view of interventions like handwashing with soap and water alongside sanitizer. The article shows that compared to no interventions, these strategies have the potential to improve care delivery.

Article 6

The article by Hillier (2020) is about effective use of hand hygiene practices to prevent and control infections. The aim of the study was to demonstrate to nurses and other healthcare workers correct procedure required for effective hand hygiene. The author also emphasizes the importance of nurses having current knowledge on evidence-based guidelines like increased use of sanitizers alongside washing hands with soap and water. The findings show that the use of hand hygiene measures and guideline is critical for healthcare workers to control and stop the spread of emerging diseases like the Coronavirus disease of 2019 (COVID-19). The study supports the PICOT since it shows that evidence-based interventions can increase compliance to hand hygiene measures among nurses and other healthcare workers.

Article 7

The seventh article by Akanji et al. (2017) is about the effectiveness of instituting formal hand hygiene education and feedback on compliance to hand hygiene standards by nurses to reduce and prevent hospital acquired infections. The aim of the study was to synthesize evidence to show the effective use of formal hand hygiene. In their findings, the authors assert the need for increased engagement of nurses to provide feedback on the most appropriate interventions to enhance hand hygiene measures and reduce and prevent HAIs. The article is important since it offers more insight on some of the protocols and measures that healthcare workers can use like using sanitizers alongside soap and water in handwashing.

Article 8

In their study, Azar et al. (2017) explore the use of agile implementation model in reducing central line-associated bloodstream infections (CLABIs) which are some the leading types of HAIs. The objective of the study is show how healthcare providers can use agile methodology to reduce and prevent CLABIs. Their finding indicate that healthcare workers can use agile model to reduce HAIs. The article supports the PICOT as illustrates the various interventions that healthcare workers can execute to prevent and reduce possible catheter-line infections which are common among the HAIs. The article allows for the development of translational approaches to improve quality care delivery.

Comparison of the Articles

The articles share a common aspect that entails approaches to reducing and preventing the occurrence of HAIs. The articles are also similar because their focus is to enhance patient safety and improve the quality of care. The articles also emphasize the need for healthcare workers to apply evidence-based interventions in mitigating hospital acquired infections. A majority of the articles use systematic reviews to show the various interventions based on evidence that can enhance quality care and lead to reduced chances of adverse medical events. A systematic review allows one to assess evidence from multiple sources to attain validity and reliability of their findings. The articles also have similarities as they make effective review of literature to demonstrate that HAIs are a public health concern but healthcare workers, particularly nurses, can develop EBP measures to enhance hand hygiene practices and embrace effective interventions. The articles share a common aspect of hand hygiene and other associated components that can lead to a reduction of HAIs).

The main themes of the article include hygiene, handwashing, need for patient safety and use of translational research and evidence-based project interventions for improved patient care and quality. The articles use different methods as some are systematic reviews while others are primary studies on their respective subjects. The articles have a common conclusion that stakeholders should develop more interventions to reduce and prevent HAIs, especially the use of evidence-based practice interventions. Each article has its unique limitations. However, a majority identify the need for more resources for better research studies in the future on how to prevent HAIs. No controversies exist in the article as in each, the researchers followed set guidelines to enhance validity and reliability of their findings.

Suggestion for Future Research

Based on the review and analysis of the literature, it is evident that more studies should be conducted to evaluate the effectiveness of hand hygiene measures like handwashing with soap and water alone or with sanitizer. Gaps in effective research demonstrating the relationship between enhanced hand hygiene measures and poor patient information is essential in demonstrating the need for all stakeholders to adhere to hand hygiene measures and not just healthcare workers alone.

Conclusion

Hospital acquired infections (HAIs) remain a patient safety concern that impacts quality care and safety, especially for inpatient patients in different health care settings. While nurses play a critical role in care delivery, they should not be the only professionals required to improve their hand hygiene measures to reduce and prevent HAIs. The findings show that nurse practitioners and other healthcare workers can prevent and reduce HAIs through effective use of EBP interventions on hand hygiene. The articles demonstrate the need for improved care quality for better patient outcomes.

References

Akanji, J., Walker, J. &Christian, R. (2017). Effectiveness of formal hand hygiene education and

feedback on healthcare workers’ hand hygiene compliance and hospital-associated. JBI Database System Review and Implementation Repository, 15(5): 1272-1279. doi: 10.11124/JBISRIR-2016-003019.

Azar, J., Kelley, K., Dunscomb, J., Perkins, A., Wang, Y., Beeler, C., … & Boustani, M. (2017).

Using the agile implementation model to reduce central line-associated bloodstream infections. American journal of infection control, 47(1), 33-37. doi: 10.1016/j.ajic.2018.07.008.

Hillier, M. D. (2020). Using effective hand hygiene practice to prevent and control infection.

Nursing Standard. doi: 10.7748/ns.2020.e11552

Moura, M. L., Fenley, J., Baraldi, M. & Boszozowski, I. (2017). Translational Research in Hand

Hygiene. Current Treatment Options in Infectious Diseases, 7(1). DOI:10.1007/s40506-015-0041-9

Ni, L., Wang, Q., Wang, F., Ni, Z., Zhang, S., Zhong, Z., & Chen, Z. (2020). An interventional

implementation project: hand hygiene improvement. Annals of Translational Medicine, 8(18). doi: 10.21037/atm-20-5480

Setty, K., Cronk, R., George, S., Anderson, D., O’Flaherty, G., & Bartram, J. (2019). Adapting

translational research methods to water, sanitation, and hygiene. International journal of environmental research and public health, 16(20), 4049. https://doi.org/10.3390/ijerph16204049

Staniford, L. J. & Schmidtke, K. A. (2020). A systematic review of hand-hygiene and

environmental-disinfection interventions in settings with children. BMC Public Health, 20(195). https://doi.org/10.1186/s12889-020-8301-0

Zhao, Q., Yang, M. M., Huang, Y. Y. & Chen, W. (2017). How to make hand hygiene

interventions more attractive to nurses: A discrete choice experiment. PLoS ONE 13(8): e0202014. https://doi.org/10.1371/journal.pone.0202014

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