BENCHMARK- EVIDENCE-BASED PRACTICE PROJECT: LITERATURE REVIEW NUR 590

The attainment of patient safety requires nurses and other healthcare providers to establish interventions that will enhance quality care and minimize adverse events like hospital acquired infections (HAIs). Nurses must apply and leverage existing evidence-based practice interventions that include hand hygiene protocols and measures like handwashing with soap and water alongside sanitizers in the prevention and mitigation of hospital acquired infections (HAIs). Hospital acquired infections constitute a significant part of mortality and morbidity as well as poor patient outcomes and increased cost burden of care. The purpose of this paper is to offer a literature review of the articles that support the PICOT statement on using handwashing with soap and water alongside sanitizer compared to handwashing with soap and water alone to reduce hospital acquired infections among healthcare workers in a period of six months.  The paper addresses the search methods used in review of literature, synthesizes relevant articles based on the PICOT question, compares the articles and makes suggestions for future research on ways to mitigate 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.

Article 2

The second article is by Setty et al. (2019) on adapting translational research methods in water, sanitation and hygiene. The goal if the study was to delineate existing translational research principles from different professions that include healthcare workers on the importance of applying the interventions in care practice. The authors use a narrative review approach to suggest interventions that can improve hand hygiene. The findings from the article demonstrate the need for increased hand hygiene measures in hospitals and other health settings to reduce infections and enhance patient safety. The article supports the PICOT by illustrating the importance of using translational research approaches in improving hand hygiene measures in healthcare. The article will also support the project by enhancing effective understanding of different approaches to hand hygiene in multiple settings.

Article 3

The article by Zhao et al. (2017) discusses the need to make hand hygiene interventions more attractive to nurses. Using a discrete choice experiment, the authors’ aim is to improve understanding about the kind of interventions that can make nurses embrace effective hand hygiene measures. Conducted in three tertiary settings where 200 nurses participated, the study shows that healthcare providers can develop effective interventions that attract these professionals to embrace handwashing. Outlining five different interventions, the authors show that with better training and awareness, nurses can make better decisions and take effective actions to prevent hospital acquired infections. The article supports the PICOT by giving more information on different approaches that nurses can use to prevent hospital acquired infections within a certain period.

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.

Conclusion

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.

References

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. https://doi.org/10.3390/ijerph16204049

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). https://doi.org/10.1186/s12889-020-8301-0

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. https://doi.org/10.1371/journal.pone.0202014

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.

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.

Assessment Description

For this assignment, you will synthesize the independent evidence-based practice project proposal assignments from NUR-550 and NUR-590 into a 4,500-5,000-word professional paper.

Final Paper

The final paper should:

1. Incorporate all necessary revisions and corrections suggested by your instructors.
2. Synthesize the different elements of the overall project into one paper. The synthesis should reflect the main concepts for each section, connect ideas or overreaching concepts, and be rewritten to include the critical aspects (do not copy and paste the assignments).
3. Contain supporting research for the evidence-based practice project proposal.

Main Body of the Paper

The main body of your paper should include the following sections:

1. Problem Statement
2. Organizational Culture and Readiness
3. Literature Review
4. Change Model, or Framework
5. Implementation Plan
6. Evaluation Plan

Appendices

The appendices at the end of your paper should include the following:

1. All final changes or revisions for the drafts that will be included in the appendices of your paper.
2. Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper. In each preceding course you have been directed to the Student Success Center for assistance with APA style, and have submitted the APA Writing Checklist to help illustrate your adherence to APA style. This final paper should demonstrate a clear ability to communicate your project in a professional and accurately formatted paper using APA style.

General Requirements

You are required to cite 10-12 peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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 required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

1.1: Translate research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice.

5.1: Design ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care.