Sickbert-Bennet et al. (2016), in their study, investigate the relationship between infection prevention and hand hygiene. Hospital-associated infections (HAI) are one of the primary causes of mortality and morbidity among hospitalized patients. The purpose of the study was to achieve high hand hygiene compliance among healthcare workers. The objective was to investigate whether hand hygiene persistence among health specialists, including advanced practice providers, nursing assistants, and physicians, lead to the reduction in the prevalence of HAI. The research question of the study is, “Does handwashing compliance among healthcare workers decrease HAI?”. The second study by Fox et al. (2015) examines the new protocol of hand hygiene for registered nurses as they are leading physical care providers for hospitalized patients. The study’s purpose and objectives were to investigate the effectiveness of new hand hygiene protocol for reducing HAI and improving persistence among nurses in the intensive care unit. The paper’s research question is, “To what extent is new hand hygiene protocol effective for decreasing HAI and improving nurses’ compliance.” Nurses can use the information from these studies as a guide for their practice.
The article by Sickbert-Bennet et al. (2016) will be used to claim that hand hygiene among health workers is enough to decrease nosocomial infection and reduce the length of hospital stay. According to Sickbert-Bennet et al. (2016), implementing hand hygiene among health workers only is enough to decrease the prevalence of HAI hospital-wide. The interventions and comparison groups in the study include hand washing and hospital patients, respectively, which are similar to those identified in the PICOT question. The article by Fox et al. (2015), however, shows that hand hygiene from patients and health workers can reduce the prevalence of HAI and reduce hospital stay. Fox et al. (2015) claim that nurses are the primary health providers, so if they are compliant with hand washing, along with patients’ compliance, the risk of acquiring disease can be reduced. The interventions and comparison groups in the PICOT question are similar to those in the research that include new handwashing protocol and hospital patients. Thus, by summarizing the information from the articles for the PICOT question, it can be said that using hand hygiene, either by nurses or patients, can reduce HAI.
The methods of the study by Sickbert-Bennet (2016) include the analysis of the hand hygiene technique implemented in Hospitals of the University of North Carolina from 2013 until 2015. The observation’s key features were to focus on cleaning hands before entering and leaving rooms of the patients and asking all healthcare workers to provide feedback to each other. In the study, “comprehensive surveillance for device-associated and non–device-associated HAI was assessed by four infection preventionists according to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network case definitions and included all hospital locations and all infections” (Sickbert-Bennet, 2016, p. 1628). The authors examined the compliance of hand hygiene for a given period by using a linear model. During the 17 months, over 400000 observations were made by unique observers. The benefit of the method is a long observation period, while the limitation lies in the presence of other factors such as drug prescription that might contribute to the reduction of HAI.
The study methods by Fox et al. (2015) include analysis of the health condition of 27-bed patients at Mission Hospital, California, for ten weeks. All registered nurses for instructed verbally by their team members and were monitored on proper hand hygiene compliance. A computerized medical record was used to remind nurses about the patient hand hygiene protocol (PHHP). By the end of the training period, the study results were assessed by auditing and observation methods (Fox et al., 2015). The benefit of the technique is that observation helped shift nurses’ focus from themselves to patients. However, the limitation includes decreased confidence in the protocol’s effectiveness because the results were compared not to a randomized control group, but preintervention results.
The study results by Sickbert-Bennet et al. (2016) suggest that hand hygiene compliance among healthcare workers improved by 10%, while the overall prevalence of HAI decreased by 6%. When hand hygiene guideline was published for the first time in 2002, the compliance was low (around 40%). When compliance increased to medium level (about 66%), the percentage of HAI infections reduced. The research results by Fox et al. (2015) indicate that there were 38% fewer cases with catheter-associated urinary tract infection after protocol using period. The compliance by nurses also increased from 48% to 75%. Both studies might be useful for all healthcare workers that deal with hospital patients as hand hygiene compliance significantly reduces the prevalence of HAI.
The PICOT question’s anticipated outcomes were that hand hygiene reduces nosocomial infection no matter if used by patients, nurses, and workers, or by healthcare workers only. The findings of the chosen articles suggest that the anticipated results of the PICOT question are accurate. The evidence suggests that the reduction in HAI cases is observed if both patients and nurses use hand hygiene and if only nurses follow the protocol. Thus, it is true that encouraging patients, their families, and nurses can reduce HAI, but it is enough to train healthcare personnel to achieve the same result.
References
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennet, Y. P., Nelson, C., Kirkwood, P., Jones, L., & Bader, M. K. (2015). Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses’ hand washing. American Journal of Critical Care, 24(2), 216- 224.
Sickbert-Bennett, E. E., DiBiase, L. M., Schade Willis, T. M., Wolak, E. S., Weber, D. J., & Rutala, W. M. (2016). Reduction of healthcare-associated infections by exceeding high compliance with hand hygiene practices. Emerging Infectious Diseases, 22(9), 1628-1630.