NUR-550 Literature Review – Resubmission

NUR 590 Topic 1 Assignment

NUR-550 Literature Review – Resubmission

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Setty et al. (2019) write about adapting translational research methods in water, sanitation, and hygiene. The study’s goal was to delineate existing translational research principles from various professions, including healthcare workers, on the importance of implementing interventions in care practice. The authors propose interventions to improve hand hygiene using a narrative review approach. The article’s findings highlight the need for increased hand hygiene measures in hospitals and other health care settings to reduce infections and improve patient safety. The article supports the PICOT by emphasizing the importance of using translational research approaches to improve healthcare hand hygiene measures. The article will also help the project by improving effective understanding of various approaches to hand hygiene in a variety of settings.

Assessment Description

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.


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.


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.

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).

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.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

NUR-590 Course Objectives

In this course, the learner will:

  1. Explore research articles, nursing and related theories, applying levels of evidence, and theoretical frameworks to identify quality research studies.
  2. Demonstrate understanding of scientific inquiry, knowledge generation, utilization, and dissemination in advanced nursing practice.
  3. Evaluate the evidence for potential solutions/innovations that can potentially solve a health care issue and improve patient outcomes.
  4. Identify gaps in nursing knowledge and evidence-based practice that can potentially be resolved by planning and implementing a practice change project proposal.
  5. Evaluate health policy and advocacy issues for the purpose of improving health care outcomes.
  6. Propose quality improvement initiatives that advance the delivery of safe, high-quality health care.
  7. Design culturally appropriate clinical prevention interventions and population-based care that reduces risks, prevents disease, and promotes health and well-being. NUR-550 Literature Review – Resubmission
Optional: Grammarly

For additional information, the following is recommended:

NUR-550 Literature Review – Resubmission

Grammarly is an online writing assistance app that reviews written submissions and suggests context-specific corrections for grammar, spelling, word usage, wordiness, style, punctuation, and plagiarism. The reasoning for each suggested correction is provided, allowing users to make informed decisions about how to correct writing issues.

Grammarly can be installed as free browser extension, though Grammarly Premium requires an annual subscription. This subscription is not a GCU-required purchase.


Summarize the intervention you are proposing based on the PICOT you created for NUR-550. How does this help the population of interest, your setting, and your role? Using the PICOT format, explain how the problem you chose to investigate is amenable to a research-based intervention. With your response, include your PICOT statement.

Will educating nurses to perform continuous compression during defibrillation with no shock pauses for patients in cardiac arrest increase the likelihood of spontaneous recovery? The most recent guidelines emphasize the importance of performing chest compressions at an appropriate rate and depth, with complete recoils and minimal pauses (Luo et al., 2021). Because of this, pauses during resuscitation can exceed the recommended guidelines of 5-10 seconds during defibrillation. Charging defibrillators before analyzing heart rhythms may reduce no-flow time during rhythm check pauses during cardiac arrest resuscitation (Kemper et al., 2019). High-quality chest compressions have been identified as a key determinant of successful resuscitations (Luo et al., 2021). Mechanical chest compressions can be provided by devices such as the LUCUS device, allowing for continuous compressions to occur during shock administration. Educating nurses on the importance of continuous, uninterrupted compressions may help eliminate or reduce long pauses during resuscitation efforts. Furthermore, educating nurses on available technologies to help reduce pauses during resuscitation, ultimately improving patient outcomes by increasing perfusion.

Because the American Heart Association recently emphasized compressions as the first response action for patients in cardiac arrest, this topic warrants further investigation. Compressions allow for perfusion, which increases the patient’s chances of survival. As an ER nurse, the pauses are kept to a minimum, and human error is minimized to the greatest extent possible. Human errors such as equipment malfunctions, improper equipment use, and a general lack of understanding that defibrillation can occur concurrently with compressions are all factors that can affect a patient’s outcome.

APA Writing Style

APA Style is required for all writing assignments in this course, where indicated. Please prepare these assignments according to the APA Style Guide, located in the in the Student Success Center.

You may want to consider purchasing a copy of the APA style guide as this will be a useful resource throughout your program.

University Policy Handbook

Read the Code of Conduct and Academic Standards section of the University Policy Handbook.

The Writing Process

View “The Writing Process” media presentation for information on how to strengthen your writing for future assignments.

Reading a Scientific Article

Read “Reading a Scientific Article,” located on the GCU Library website.

GCU Library: Persistent Links

Review “Persistent Links,” located on the GCU Library website, to learn how to locate persistent links for library articles, videos, etc.

Evidence-Based Practice Project Proposal –Assignment Overview

Learners are required to develop an evidence-based practice project proposal. The project begins in NUR-550 and culminates in NUR-590. The project will be completed in sections throughout both courses and culminate in NUR-590, during which the project elements are synthesized into a final written paper that details the evidence-based practice project proposal.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments. This document serves only to provide context for the overall project and how the assignments interact. Refer to each assignment in the classroom for


Writing Center

Refer to the resources located in the Writing Center for PowerPoint guidelines, APA style, writing and library tutorials, and research and writing assistance.

Advanced Practice Nursing: Essential Knowledge for the Profession

DeNisco, S. M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. ISBN-13: 9781284176124

View Resource

GCU Library Research Guides: Citing Sources

Reference the “GCU Library Research Guides: Citing Sources” resource, located on the GCU Library website, for information on how to cite sources properly.

Evaluating Sources: What Is a “Scholarly” Source?

Read “Evaluating Sources: What Is a ‘Scholarly’ Source?” located on the GCU Library website.

APA Writing Checklist

Use the “APA Writing Checklist” to act as a checklist for each paper you will write throughout your GCU graduate program.

GCU Library: General Research Guide

Review the “General Research” guide, located on the GCU Library website.

Centre for Evidence Based Medicine: About Us

Read “About Us” page of the Centre for Evidence Based Medicine (CEBM) website.

Evidence Based Medicine

Explore the Evidence Based Medicine page of the University of Illinois Library of the Health Sciences website. Use this website as a resource for y


Striving for Evidence-Based Practice Innovations Through a Hybrid Model Journal Club: A Pilot Study

Read “Striving for Evidence-Based Practice Innovations Through a Hybrid Model Journal Club: A Pilot Study,” by Wilson, Ice, Nakashima, Cox,


Evidence-Based Practice Tutorial

Read the Evidence-Based Practice tutorial, located on the Duke University website.

Evidence-Based Practice in Nursing and Healthcare : A Guide to Best Practice

Read Chapters 1-3 in Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice.

A Leader’s Guide to Implementing Evidence-Based Practice: Lead the Way to Healthcare Quality and Safety

Read “A Leader’s Guide to Implementing Evidence-Based Practice: Lead the Way to Healthcare Quality and Safety,” by Tucker and Melnyk, from


Evidence Based Medicine Toolkit

Explore the “Evidence Based Medicine Toolkit,” by Buckingham, Fisher, and Saunders (2012), located on the University of Alberta website.


Centre for Evidence Based Medicine: Resources

Explore the Resources page of the Centre for Evidence Based Medicine (CEBM) website.


Explain the importance of a “spirit of inquiry” in an evidence-based culture and what you can do as an advanced registered nurse to encourage this within your practice or organization. In response to your peers, compare the role and implementation of EBP in your specialty area with another advanced registered nurse specialty.

Once a search is carried out to find relevant articles within a chosen topic, a literature review helps bring together what is already known about a topic, facilitating new learning opportunities (Watts, 2020). Gaps in current knowledge can be identified, or theories and academic opinions may raise new research areas during critical analyses. The initial question asked may evolve or change altogether when researching a posed question. Other themes or questions that may surface during the research journey, adding curiosity to what should be researched next. This “spirit of inquiry” is essential to our knowledge base and our peers well.

Nurse leaders have considerable influence on implementing evidence-based practice (EBP) in their departments, units, and organizations; however, resistance to change can stall innovations (Tucker & Mazurek Melnyk, 2019). Effective leadership requires an understanding of change theory, how change is facilitated and blocked, successful change steps, and strategies to promote each step. Implementation for promoting EPB falls into seven categories: leadership, coaching, communication, reinforcements, recognition, measurement, and reporting. Different strategies may be needed at each stage of change to promote and sustain the change. Nurse leaders can successfully implement EBP changes by being knowledgeable about a proposed change, partner with staff, engage the help of mentors or change agents, work with senior leaders, thank and celebrate all staff in the process, and disseminate findings.


Tucker, S., & Mazurek Melnyk, B. (2019). A leader’s guide to implementing evidence-based practice: Lead the way to healthcare quality and safety. American Nurse Today14(6).

Watts, K. (2020). How to conduct a literature review. Podiatry Review77(1), 14–15.

APA Writing Checklist

Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.

☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.

☐  The title page is present. APA format is applied correctly. There are no errors.

☐ The introduction is present. APA format is applied correctly. There are no errors.

☐ Topic is well defined.

☐ Strong thesis statement is included in the introduction of the paper.

☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.

☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.

☐ All sources are cited. APA style and format are correctly applied and are free from error.

☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.

Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.

Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.

Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.

☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.