Does Nursing Compliance with Hand Hygiene Protocols Reduce the Spread of Hospital Infections in Australia?

Does Nursing Compliance with Hand Hygiene Protocols Reduce the Spread of Hospital Infections in Australia?

Background

In Australia, patients and regulators are increasingly concerned about healthcare-associated infections. Not only is this due to the issue’s magnitude in terms of medical costs and mortality but also the realization that most illnesses are preventable (Boyce & Pittet, 2012). Notably, the Australian medical community is witnessing an unprecedented spread of drug-resistant infections in healthcare institutions. At the same time, their understanding of infectious diseases’ pathophysiology is rapidly improving. Compounding factors like these necessitate a review of preventive measures in the modern-day healthcare. Undisputedly, the World Health Organization has provided clear evidence suggesting that strict adherence of hand minimizes the cross-transmission of infectious ailments (Sax et al., 2013). Therefore, a time has come for the government to formulate and implement basic infection prevention policies in hospitals.

Healthcare-associated infections (HCAIs) are diseases that patients get while in the hospital. Such illnesses can lead to a prolonged stay at a medical institution, gradual recovery, low morale, and increased stress. High-risk patients for HCAIs in Australia include the elderly and those that have had an operation (Larson et al., 2011). Individuals with underlying medical conditions or weak immune systems are vulnerable as well.  

PICO Question

According to Fineout-Overholt et al. (2015), PICO is an evidence-based model used to frame, locate and assess a research question. It has four elements namely research problem, intervention strategies, projected outcome, and time. When a researcher defines clinical questions in terms of patient predicament, it is easier to locate clinically relevant literary evidence (Faggion & Tu, 2012).

The Research Question: Does Nursing Compliance with Hand Hygiene Protocols Reduce the Spread of Hospital Infections in Australia?

Problem/Patient—Hospital Acquired Infection.

Indicator/Intervention—Hand Hygiene.

Comparison—Non-Adherence.

The Outcome of Interest—Reduced Infection.

Search Strategy

Planning for a search strategy involves identification of major research question elements and translation of natural language terms to descriptors. Specifically, a search strategy refers to an arrangement of terms as used in a database. Essentially, it indicates how different terms combine so that the researcher can retrieve the nest outcome.  An adoption of a distinct strategy for each study is necessary since all databases work differently.

Of keen to note is that journal authors view similar concepts differently, hence the importance of search tailoring. Therefore, my aim (as a researcher) is to examine each of the PICO concepts and derive a list of different ways of their literature appearance. However, I must be careful because search strategies evolve through trial and error.

For the problem and intervention strategy, the researcher uses MeSH and CINAHL.  In particular, CINAHL is a definitive research tool for healthcare professional because researchers get an easy and fast access to evidence-based sheets, top medical journals and quick lessons (Skalicky et al., 2012). On the other hand, MeSH (Medical subject headings) refers to an NLM-controlled vocabulary thesaurus that index PubMed articles.

A simplified database search strategy should begin with ‘P’ and ‘I’ in elements of PICO evidence-based model as shown in table 1.

Natural Language	Mapping Terms to Database Vocabulary
Problem—Hospital Acquired Infection	MeSH—Cross Infection CINAHL—Cross Infection
Intervention strategy—Hand Hygiene	MeSH—Hand Disinfection CINAHL—Handwashing

Table 1.0: Database Search Strategy

Furthermore, the search strategy entails an access of information from PubMed (also referred to as Medline) and CINAHL. As initial article databases, they are ideal for scope search especially for questions on health sciences. Also, I will review information from PsychInfo to complement my literary work.

            After an initial search, I will narrow my search strategy with terms for study type, time factors, and potential outcome. Alternatively, I can view article abstracts, discussions, and results to determine outcome elements and comparisons. Most sites have research filter tools useful in narrowing or expanding research (see appendix 1 for Prisma flow chart specifications).

References

Boyce, J. M., & Pittet, D. (2012). Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. American journal of infection control, 30(8), S1-S46.

Faggion, C. M., & Tu, Y. K. (2012). Evidence-Based Dentistry: A Model for Clinical Practice. Journal of Dental Education, 71(6), 825-831.

Fineout-Overholt, E., Melnyk, B. M., & Schultz, A. (2015). Transforming Health Care from the Inside Out: Advancing Evidence-Based Practice in the 21st Century. Journal of Professional Nursing, 21(6), 335-344.

Larson, E. L., Aiello, A. E., Bastyr, J., Lyle, C., Stahl, J., Cronquist, A., ... & Della-Latta, P. (2011). Assessment of Two Hand Hygiene Regimens for Intensive Care Unit Personnel. Critical Care Medicine, 29(5), 944-951.

Sax, H., Allegranzi, B., Chraïti, M. N., Boyce, J., Larson, E., & Pittet, D. (2013). The World Health Organization Hand Hygiene Observation Method. American Journal of Infection Control, 37(10), 827-834.

Skalicky, S. E., Holt, P. E., Giblin, M., Taylor, S., & Conway, R. M. (2012). Australian Cancer Network Clinical Practice Guidelines for the Management of Ocular and Periocular Melanoma: an evidence‐based literature analysis. Clinical & Experimental ophthalmology, 36(7), 646-658.