While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students

Criteria

Article 1

Article 2

Article 3

Article 4

Author, Journal (Peer-

Reviewed), and

Permalink or Working Link

to Access Article

Manfred Mortella, Hanan H.Balkhy, Elias B.Tannous, Mei Thiee Jong; journal.

https://doi.org/10.1016/j.jsha.2013.04.003

Ejemot-Nwadiaro RI, Ehiri JE, Arikpo D, Meremikwu MM, Critchley JA. Journal.

doi: 10.1002/14651858.CD004265.pub3.

Chigozie Jesse Uneke, Chinwendu Daniel Ndukwe, Patrick Gold Oyibo, Kingsley Onuoha Nwakpu, Richard Chukwuka Nnabu, Nittita Prasopa-Plaizier

https://doi.org/10.1016/j.bjid.2013.04.006

Jamie Mackrill, Carolyn Dawson, Bruce Garvey, Dinah Gould.

Infection, Disease & Health;

https://doi.org/10.1016/j.idh.2016.12.004

Article Title and Year

Published

Physician ‘defiance’ towards hand hygiene compliance: Is there a theory–practice–ethics gap? ; 2013

Hand washing promotion for preventing diarrhea; 2015

Promotion of hand hygiene strengthening initiative in a Nigerian teaching hospital: implication for improved patient safety in low-income health facilities; 2014

Exploring new approaches to improve hand hygiene monitoring in healthcare; 2017

Research Questions

(Qualitative)/Hypothesis

(Quantitative), and

Purposes/Aim of Study

Is there a gap between hand hygiene theory, its practice and the ethical issues related to hand hygiene.

Hypothesis: Consistency of physicians at King Abdulaziz Cardiac Center in regards to hand hygiene and practices.

Purpose: Identify ethics where the article identifies w crisis in regards to theory and practice integrated and health care providers.

Does washing hands prevent diarrhea cases among children?

Hypothesis: Reduction of approximately 1.8 million deaths brought about by diarrhea in both low and middle income countries and how promotion of hand washing can play a crucial role in its reduction.

Purpose: assessment of hand washing effects as a method of diarrhea intervention in both children and adults.

implication for improved patient safety in low-income health facilities

Hypothesis: How health care-associated infections have remained a consistent hazard for patients that are hospitalized in low income countries.

Purpose: Promotion of World Health Organization Hand Hygiene guidelines so as to promote compliance among health care workers thus improving patient’s safety.

What is the current process for monitoring Hand Hygiene

How can Hand Hygiene monitoring be improved?

Hypothesis: Role played by engineering and Morphological Analysis in developing and improving Hand Hygiene monitoring efficacy in healthcare.

Purpose: Ensuring that optimal hand hygiene practices are followed

Design (Type of Quantitative,

or Type of Qualitative)

Quantitative

Quantitative

Cross Sectional Intervention

Post hoc thematic analysis

Setting/Sample

King Abdulaziz Cardiac center

Child day-care centers, schools and hospital.

Sample: 22 Random controlled trials

Federal Teaching Hospital located in South-Eastern Nigeria

Health Care facilities

Sample: 20 interviewees

Methods:

Intervention/Instruments

Intervention

Intervention and instruments

Intervention and evaluation

Instruments

Analysis

Evaluation of the five Hand Hygiene recommendations by WHO

Assessed trial eligibility, data, and assessed risk of bias. Incorporation of incidence rate ratios using generic inverse variance technique as well as random-effects model with ninety five percent confidence intervals

Implementation of Epi Info software to analyze data collected through Hand Hygiene Observation Form provided by WHO hand hygiene evaluation tools

Thematic analysis as provided by Braun and Clarke

Key Findings

The compliance rate of the hand hygiene by physicians was below 60%.

Promotion of hand hygiene reported a reduction of one-third of diarrhea cases in high income countries. Further, hand washing pattern in
USA improved after promotion of the importance of hand washing. Finally, when hand hygiene education and soap was provided, the rate of hand washing increased.

After the training of 202 health care workers, some of the main issues that were identified include lack of adequate water supply, lack of awareness, lack of soap and towels, no proper guidelines governing hand hygiene and disinfection practices.

The article have indicated that multidisciplinary collaboration using Morphological Analysis to appraise, develop, and improve Hand Hygiene monitoring would be beneficial as it would allow different stakeholders to be involved

Recommendations

Adoption and endorsement of evidence based policies by health care workers.

Promotion of hand washing as a technique to reduce diarrhea cases in many countries as it reported a record of 30% reduction rate. Also, adopt policies that monitor and continue to educate the public on the importance of maintaining washing habits.

Adoption of alcohol hand rubs in hospitals to improve hand hygiene compliance. Also, hand hygiene sensitization campaign as well as conducting training in the workplaces can improve hand hygiene in low-income health facilities.

Morphological Analysis can be used to investigate strategies for system improvements for hand hygiene monitoring in any hospital setting.

Explanation of How the

Article Supports

EBP/Capstone Project

The article is quite useful in that it provides evidence the compliance rate of physicians in regards to hand hygiene. In addition, the authors of the article have conducted research on the health care facility and identified that most physicians are not conversant with hand hygiene policies are advocated by World Health Organization

The strength of the article is the evaluation of the effects of hand washing as a technique of reducing diarrhea cases among children. The article has provided evidence on the results presented before hand hygiene and after its adoption and indicated a 30% reduction rate.

The article is useful as it has proved that it is possible to achieve hand hygiene provide adequate sensitization is conducted. Further, the article has taken a different approached and identifies a different reason as to the main contribution to poor hand hygiene as lack of facilities.

The article is important as it has highlighted the importance of Hand Hygiene monitoring process.

Criteria

Article 5

Article 6

Article 7

Article 8

Author, Journal (Peer-

Reviewed), and

Permalink or Working Link

to Access Article

Mona F. Salama, Wafaa Y. Jamal, Haifa Al Mousa, Khaled A. Al-AbdulGhani, Vincent O. Rotimi.

Journal of Infection and Public Health

https://doi.org/10.1016/j.jiph.2012.09.014

Adam Biran, Wolf-Peter Schmidt, Kiruba Sankar Varadharajan, Divya Rajaraman, Raja Kumar, Katie Greenland, Balaji Gopalan B, Robert Aunger, Val Curtis.

The Lancet Global Health

https://doi.org/10.1016/S2214-109X(13)70160-8

Jane Kirk MSN, Anson Kendall MBA, James F. Marx, Ted Pincock, Elizabeth Young, Jillian M. Hughes, Timothy Landers.

American Journal of Infection Control

https://doi.org/10.1016/j.ajic.2016.03.005

Nohemi Sadule-Rios, Graciela Aguilera

Intensive and Critical Care Nursing

https://doi.org/10.1016/j.iccn.2017.02.005

Article Title and Year

Published

The effect of hand hygiene compliance on hospital-acquired infections in an ICU setting in a Kuwaiti teaching hospital; 2013

Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial; 2014

Point of care hand hygiene—where's the rub? A survey of US and Canadian health care workers' knowledge, attitudes, and practices; 2016

Nurses’ perceptions of reasons for persistent low rates in hand hygiene compliance; 2017

Research Questions

(Qualitative)/Hypothesis

(Quantitative), and

Purposes/Aim of Study

How does the complexity process associated with ICU impact hand hygiene adherence.

Purpose: Measuring the rates of compliance associated with Hand Hygiene before and after a campaign to educate healthcare workers about hand hygiene. Also investigate the infection rates in the ICU before and after an intervention.

Can Hand washing with soap reduce diarrhea and respiratory infections?

Purpose: Determine whether scalable village based intervention on emotional drivers of behavior as opposed to knowledge could improve hand washing behavior.

Importance of hand hygiene at that promotes compliance within a health care facility

Purpose: Determine the importance of hand hygiene in Canadian health care workers was important in regards to improvement of their hand hygiene compared with their U.S. counterparts.

What are barriers that result to low hand hygiene compliance rate among health care staff in the Critical Care Unit.

Purpose: To explore nurses’ perceptions for low rates in hand hygiene compliance in the Critical Care Unit and the recommendations to be adopted for improvement.

Design (Type of Quantitative,

or Type of Qualitative)

prospective, interventional

Random allocation

cross-sectional examination

exploratory, descriptive survey

Setting/Sample

ICU of Mubarak Al-Kabir Teaching Hospital

Sample: 23-bed adult medical ICU and a 14-bed cardiac care unit

Chittoor District in India

Sample: 14 villages randomly selected

Canadian health care facilities

Sample: 300 health care workers

452 beds Magnet hospital

Methods:

Intervention/Instruments

Observation method

intervention

Survey questionnaires

Observation method and Survey questionnaires

Analysis

Data collected was analyzed using one-sided P-value that had a confidence level of 95% where all statistical calculations were performed by SAS systems for Windows.

The data collected was analyzed using cluster level analysis for the intervention as well as cluster randomized trial

Incorporation of incidence rate ratios using generic inverse variance technique

Descriptive statistics were used to summarize the responses from the questionnaire items with SPSS

Key Findings

Hand hygiene compliance by nurses was better compared to doctors. Educational intervention resulted to increased Hand Hygiene compliance. Intervention resulted in statistically significant reduction in nosocomial infections.

primary outcome measure was the proportion of key events where hand washing with soap was observed

Out of the 300 staff interviewed, 57.1% were from the United States and 42.9% were from Canada. The two both agreed that they were more likely to use alcohol based hand rub to clean their hand.

The article identified several reasons as to why the compliance rate of hand hygiene is low as overworking and understaffed. In addition, the staff identified inability to access sinks as a major result as to the low rate

Recommendations

Hand Hygiene observation as well as orientation tools play a crucial role in improving Hand hygiene compliance hence all health care facilities should adopt and implement such strategies to ensure patients safety.

Intervention on school-aged children suggests that hygiene promotion might need to be planned long term, with the full potential perhaps only realized once schoolchildren become parents.

More education is required to define what Point of Care is and how it differs from the patient environment. “Improvising learning tools, such as diagrams and figures that clearly identify patient and health care zones, will assist in health care provider education.

Ensure that health care facilities have enough staffs to avoid overworking a particular staff as this could impact service delivery to patients

Explanation of How the

Article Supports

EBP/Capstone Project

The article is useful as it has proved that it is possible to achieve hand hygiene compliance all that should be done by health care facilities is ensuring they educate the importance of hand hygiene around their working places.

The article provides important data that indicate behavior change intervention that were based on emotional drivers plays an important role in increasing the prevalence of hand hygiene. Therefore, we should continue publicizing the importance of hand washing to always keep our hygiene at check.

The article is quite useful in that it provides evidence the compliance rate of physicians in regards to hand hygiene. The survey helped us to better understand the reasoning behind health care workers' preference for soap and water.

The strength of the article is the ability to identify some of the main reasons that results to poor service delivery and low compliance rate in regards to hand hygiene. In addition, most health care facilities will often be understaffed and the few staff stationed at the facility are expected to handle the huge patient number. As a result, in most cases they will tend to overlook Hand hygiene policies.