Project #52525 - Evidence based nursing

I just need my reference page in APA with citations included in the reference page.

 

B1 Hand hygiene is a primary issue in healthcare. Hospital acquired infections affect 1 in 10 hospitalized patient in the U.S. which 90 percent of those infections are preventable with proper hand washing techniques. Lack of compliance and education amongst healthcare workers is still a huge issue today. Hospital acquired diseases result in longer hospital stays, increased costs to treat the infections and patient dissatisfaction (Pittet, D 2012). Intravascular device related infections and infections acquired through the respiratory tract are the most nosocomial related infections in cortically ill patients. (Kate Stenske KuKanich, 2013). Some methods to reduce or prevent nosocomial infections due to inadequate hand hygiene include washing hands often, removing jewelry when washing hands and using sanitizing hand gel when soap and water is not readily available (pearson MD, 2007) Hand hygiene compliance is still a big issue in healthcare today despite interventions and education.

 

 

 

B2. See attachment for matrix

 

 

 

 

 

B3a-

 

Traore, O., Hugonnet, S., Lübbe, J., Griffiths, W., Pittet, D. (May, 2007). Liquid versus gel hand rub formulation: a prospective intervention study. Critical Care. Vol. 11, No. 3. doi: 10.11861cc5906

 

 

 

 

This article discusses ways to improve hand hygiene by utilization of gel sanitizer hand hygiene performance by health care workers in outpatient clinics may be enhanced through increasing the use of gel sanitizer and utilizing informational posters as well as having better access to sinks and gel dispensers. This article describes if utilization of hand sanitizing gel being readily available during outpatient client visits to a clinic; then there is a meaningful decrease in spreading of infectious diseases in healthcare environments.

Factors associated with hand hygiene practices in two neonatal intensive care units. COHEN, BEVIN; SAIMAN, LISA MD, MPH; CIMIOTTI, JEANNIE RN, MSN; LARSON, ELAINE RN, PhD (June 2006) Pediatric Infectious Disease Journal. 22(6):494-498.

 

 

 

 

The article inspects the significance of hand cleanliness in health care circumstances, depicts viable hand-cleanliness systems, comparing and contrasting the clinical cost of sanitizing hand-rubs with hand washing | It recognizes the different expert and authoritative organizations to fitting practice among medicinal services workers. The article is literature review of an assortment of research studies identified with hand hygiene. It closes with the methods prescribed to enhance measures particularly in spots with restricted offices and resources. The article is an impression of the imperativeness of legitimate hand cleanliness in health awareness related settings.

To Ask or Not to Ask?: The Results of a Formative Assessment of a Video Empowering Patients to Ask Their Health Care Providers to Perform Hand Hygiene. Garcia-Williams, Amanda MPH; Brinsley-Rainisch, Kristin MPH; Schillie, Sarah MD, MPH, MBA; Sinkowitz-Cochran, Ronda MPH (June, 2010) Journal of Patient Safety. 6(2):80-85.

 

 

 

 

 

 

 

 

 

In this study, patients and HCPs described their perceptions about the commonality of hospital acquired infections as well as the perceived benefits of hand hygiene. Consistent with previous work, HAIs were generally viewed as somewhat common with all participants having very positive perceptions of the benefits and importance of HH patients with previous HC experience had lower levels of perceived risk of HAIs than those without such experience, an observation that may appear counterintuitive.

 

 

 

Assessment of Hand Hygiene Resources and Practices at the 2 Children's Hospitals in Greece. Gilboy, Nicki RN, MS, CEN, FAEN; Howard, Patricia K. PhD, RN, CEN (Ocrober, 2014) Pediatric Infectious Disease Journal. 33(10):e247-e251.

 

 

 

 

This study involved three inpatient units in Greece to enable hand hygiene by utilizing activity and education sections of the units received a state of-the-craftsmanship system, with guideline, upgrades, and enhancing work place safety. The study results show the included estimation of specific parts of social effect and organization under control cleanliness change strategies,. This study shows the basic general estimation of convincing power in patient safety.

 

 

Decreasing Hospital-Associated Rotavirus Infection: A Multidisciplinary Hand Hygiene Campaign in a Children's Hospital. Zerr, Danielle M. MD, MPH; Allpress, Amanda L. BA; Heath, Joan RN, BSN, CIC; Bornemann, Rena MD; Bennett, Elizabeth MPH, CHES(May 2005) Pediatric Infectious Disease Journal. 24(5):397-403.

 

 

 

 

ICU in the childrens Hospital compared the impacts of handwashing frameworks in three critical care units samples were collected from chosen healthcare workers for this study. Handwashing remains the easiest and best method for lessening nosocomial diseases in the ICU, on the other hand, getting healthcare workers to comply is still low nationwide. It is not difficult to perceive how hand washing compliance is low, particularly between procedures. With that being said, it is imperative that healthcare workers perform good hand hygiene practices between each patient.

 

 

Griffith, C. and Redmond, E. Evaluating hygiene behaviour in the hospital setting and the impact of hygiene behaviour. J Infect. (2011); 43: 70–74

 

 

 

 

This article discussed the # of episodes of hand hygiene and HAIs. Expanded hand cleanliness consistence decreased infectious diseases in hospitals. Positive abnormality brought about noteworthy change under control cleanliness episodes. Only tallied number of hand cleanliness no report about the nature of occurrences.

 

 

 

 

Improving Hygiene in Home Deliveries in Rural Ghana: How to Build on Current Attitudes and Practices.

 

Hill, Zelee PhD *; Tawiah-Agyemang, Charlotte MSc

 

Pediatric Infectious Disease Journal. 29(11):1004-1008, November 2010.

 

 

 

This article discussed delivery practices in Ghana to analyze behaviors for interventions.

 

Information on the pervasiveness of clean delivery practice, collected through a demographic examination system, were evaluated for 2631 women who delivered at home within a 1-year period. Delivery surfaces, hand-washing, and cord cutting and tying appear applicable for most of the women. Changing cord care practices is difficult unless replacement products are furnished.

 

 

 

 

 

Pittet, D. Improving adherence to hygiene practice: Emerg Infect Dis. (2012); 7: 234–240

 

 

 

 

 

This article discusses barriers to appropriate hand hygiene and risk factors for

 

 

noncompliance and proposes strategies for promoting hand hygiene. As stated in the article circumstances influencing decreased compliance, described in observational studies of hand hygiene behavior, included being a physician vs a nurse; being a nursing assistant vs a nurse; being male; working in an intensive care unit (ICU); working during weekdays vs the weekend; wearing gown and gloves; using an automated sink; and having opportunities for hand hygiene per hour of patient care.

 

 

 

 

 

Decreasing Hospital-Associated Rotavirus Infection: A Multidisciplinary Hand Hygiene Campaign in a Children's Hospital. Zerr, Danielle M. MD, MPH; Allpress, Amanda L. BA; Heath, Joan RN, BSN, CIC; Bornemann, Rena MD; Bennett, Elizabeth MPH, CHES(May 2005) Pediatric Infectious Disease Journal. 24(5):397-403.

 

 

 

 

 

This is one of the few studies performed in either pediatric or adult settings that has demonstrated continued increases in hand hygiene and corresponding decreases in hospital-associated infection after a hospital-wide intervention. The study is novel in that we evaluated the impact of hand hygiene on hospital-associated rotavirus infection as a hospital-wide measure of hospital-associated infection. The researchers found that physician versus nurse care providers and contacts with the environment versus the patient were associated with lower odds of hand hygiene.

 

 

 

 

 

Fuller C, Michie S, Savage J, McAteer J, Besser S, et al. (2012) The Feedback Intervention Trial (FIT) — Improving Hand-Hygiene Compliance in UK Healthcare Workers: A Stepped Wedge Cluster Randomised Controlled Trial. PLoS ONE 7(10): e41617. doi:10.1371/journal.pone.0041617

 

 

 

 

 

Hand hygiene (HH) is one of the most effective methods of infection control programs, but compliance is generally poor. Hand hygiene improvement interventions must include control of compliance, which is mostly conducted by direct observation ( Fuller C, 2012) obedience to hand hygiene suggestions is the most important way to prevent and control the spread of healthcare associated infections (HCAI);yet, hand hygiene practices is poor worldwide. Observational HH data was collected from two wards including a pediatric intensive care unit and a neonatal intensive care unit, during a month, 1-hour observations period by a doctor from pediatric infectious disease department working with infection control team.

 

 

 

 

B3b. Recommendation- All of the researchers in these articles talked about effective hand hygiene practices to prevent infectious diseases including hospital acquired infections using alcohol based hand gel and actually washing hands with soap and water are essential for patient safety. Decreasing the spread of diseases would decrease significantly if all healthcare workers would take time to use aseptic technique between each patient. The articles all discussed an increase in hand hygiene compliance overall.

 

 

 

B3c. Tools- Researchers in these chosen articles utilized related tools to plan and inspect the data. Yet individual researcher had their own experiments in regards to hand washing examination and utilization. The general result for each individual researcher came to terms that performing proper hand washing is effective in decreasing infectious diseases.

 

 

 

B3d. Research Results

 

 

 

Most of the studies utilized direct observation for the research Duncan, JM. (2007). Many observers chose to only observe health care workers entering and leaving a patient room to protect patient privacy. By utilizing this approach the observer might have missed hand washing possibilities when staff were in a patient room. Some researchers utilized a control group. It is not difficult to justify that their interventions were favorable by using a control group to compare results.

 

 

 

 

 

 

 

B4. Evidence Summary

 

The dominant part of research articles on hand washing shows how handwashing is the absolute best approach to prevent the spread of infection. Nearly 1 in 20 patients in hospitals in America develop a disease while in an inpatient setting (Huis, 2012). The primary idea is healthcare workers must appropriately perform hand hygiene between each patient. The second idea is that healthcare companies and inpatient units must make supplies for hand hygiene promptly accessible. For the hospital environment, staff should be furnished with hand sanitizing gel, and hand soap. All of the articles that I audited likewise brought up the requirement for employee training about hand hygiene to build employee consistence of the most indispensable approach to patient safety and patient consideration. People are more likely to comply with hand hygiene if resources and supplys are readily available (Pittet, 2012).

According to (Traore; Hugonnet; Lübbe, Griffiths; & Pittet, 2007) Utilization of hand sanitizing gel being readily available during outpatient client visits to a clinic; then there is a meaningful decrease in spreading of infectious diseases in healthcare environments. (Gilboy; Howard; & Patricia, 2006) discussed methods prescribed to enhance measures particularly in spots with restricted offices and resources. The article is an impression of the imperativeness of legitimate hand cleanliness in health awareness related settings. (Garcia-Willams; Brinsley-Rainisch; Schillie & Sinkowitz-Cochran, 2010) talked about how patients and HCPs described their perceptions about the commonality of hospital acquired infections as well as the perceived benefits of hand hygiene. Research by (Cohen; Bevin; Saiman; Cimotti; & Larson, 2006) shows the basic general estimation of convincing power in patient safety by utilizing activity and education sections of the units received a state of-the-craftsmanship system, with guideline, upgrades, and enhancing work place safety. Research by (Zerr; Heath; Bornemann; & Bennett, 2005) states that handwashing remains the easiest and best method for lessening nosocomial diseases in the ICU, on the other hand, getting healthcare workers to comply is still low nationwide. (Griffith & Redmond, 2011) discusses the # of episodes of hand hygiene and HAIs. (Hill; Tawiah-Agyemang; & Charlotte, 2010) talks about delivery practices in Ghana to analyze behaviors for interventions. Information on the pervasiveness of clean delivery practice was collected through a demographic examination system. (Pittet, 2012) notes barriers to appropriate hand hygiene and risk factors for noncompliance and proposes strategies for promoting hand hygiene. Hand hygiene (HH) is to research by (Fuller; Michie; Savage; McAteer; Besser, et al., 2012) discusses one of the most effective methods of infection control programs, but compliance is generally poor. Hand hygiene improvement interventions must include control of compliance, which is mostly conducted by direct observation ( Fuller et al., 2012) obedience to hand hygiene suggestions is the most important way to prevent and control the spread of healthcare associated infections (HCAI);yet, hand hygiene practices is poor worldwide. The majority of these articles showed increases in hand hygiene compliance. Some differences in the articles were how the information was collected. Some researchers used observational and some interventional studies. The main goal for each of the articles was to show hand hygiene compliance among health care workers.

 

 

 

 

 

 

 

 

 

 

B5. Nursing Strategy

 

 

 

My recommendation is education on hand hygiene. I suggest that nursing staff in inpatient, home health, and in the community focus on washing their hands appropriately and often. It is such a straightforward idea, yet numerous healthcare workers still don't consent. Not washing hands properly could be due to healthcare workers being exhausted. Nursing staff could convey germicide gel sanitizer at all times so that it is on hand when needed . I also recommend frequent in-services to educate on hand hygiene importance.

While health care workers are aware and recognize the imperativeness of hand cleanliness in preventing the spread of infection, they ordinarily overestimate their own particular individual compliance. The procurement of thorough and target information helps health care workers comprehend the truth of their individual and associate performance. While most discovered it at first to be surprising open information offering was an impetus for development. Instructors suggest that hand hygiene be performed right before patient contact rather than 10 or 15 minutes after caring for the patient. At the point when people are exhibited with legitimate information, they may reason and feel forced to comply in light of the fact that they accept that hand cleanliness is a paramount venture to protect their patients. By observing, it provides feedback to an individual, ( Pittet, 2012) . Interventions can prevent unessecary costs and time (Larson, et al., 2010) . By utilizing quantitive data, it explores the perception and expectations of healthcare workers, (Griffith & Redmond, 2011) . A multi-level/multi model strategies would seem to bring about change to hand hygiene practices, (Garcia-Williams, 2010) . Focus groups also helps to explore determinants of hand hygiene behavior. Interpretation of the results may provided enviornmental hand hygiene compliances in certain clinics or hospitals, (Gilboy; Nicki, 2014) .

 

 

 

 

 

 

 

 

B6. Theoretical Model

A theoretical framework provides an understandable and organized way of foreseeing related events or measures appropriate to a discipline (Fawcett, 2005). This model suggests a hypothesis for a problem and presents the researcher with choices for change. A poorly defined study that gathers information that is nonessential to the aim of the study can misuse credible resources and time. The study general credits to incite respectability to the study allowing it to be used for examination.

 

 

 

 

 

 

 

References

 

 

 

Cohen, G., Bevin, D., Saiman, H., Cimotti, I., & Larson,B. (2006). Factors associated with hand hygiene practices in two neonatal intensive care units. Pediatric Infectious Disease Journal.

 

Fawcett,A., Fuller, C., Savage, J., McAteer, K., Besser, T., et al. (2012) The Feedback Intervention Trial (FIT) — Improving Hand-Hygiene Compliance in UK Healthcare Workers, Pg 4-7.

 

Garcia-Williams, T. Brinsley-Rainisch, G., Schillie, M., Sinkowitz-Cochran, P. ( 2010). To Ask or Not to Ask?: The Results of a Formative Assessment of a Video Empowering Patients to Ask Their Health Care Providers to Perform Hand Hygiene. Journal of Patient Safety.

 

Gilboy, D., Nicki, L., Howard, C., Patricia, K.( 2014) Assessment of Hand Hygiene Resources and Practices at the 2 Children's Hospitals in Greece. Pediatric Infectious Disease Journal. page 7-10.

 

Griffith, E., Redmond, L. (2011) Evaluating hygiene behaviour in the hosital setting and the impact of hygiene behaviour. pg 17-19.

 

Hill, Z., Tawiah , A., Charlotte , J. (2010) Attitudes and Improving Hygiene in Home Deliveries in Rural Ghana: How to Build on Current Practices. Pediatric Infectious Disease Journal, pages 45-53.

 

 

Huis, F. (2012). Alcohol-based hand gels and hand hygiene in hospitals. The Lancet, 1511-1511.

 

 

Larson, et al., (2010) Improving Hand Hygiene Practice Through Utilization of Automated Hand Hygiene Monitoring and Feedback Technology. American Journal of Infection Control, E153-E154.

 

 

Pittet, D. (2012) Improving adherence to hygiene practice: Emerg Infect Dis, pg 54-60.

 

 

 

Traore, K., Hugonnet, Lübbe, J., Griffiths, W., Pittet, D. (2007). Liquid versus gel hand rub formulation: a prospective intervention study. Critical Care. Vol. 11, No. 3.

 

 

Whitby, L., Pessoa-Silva, F., McLaws, W., Allegranzi, D., Sax, C., Larson, D., et al.(2010) Behavioural considerations for hand hygiene practices: the basic building blocks. J Hosp Infect, pages 1–8.

 

 

 

 

 

 

Zerr, N., Heath, S., Bornemann, F., Bennett, O. (2005). Decreasing Hospital-Associated Rotavirus Infection: A Multidisciplinary Hand Hygiene Campaign in a Children's Hospital Pediatric Infectious Disease Journal, pg 16-20.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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