Infectious Diseases
Does hand washing prevent Infection transmission among healthcare workers
Instructions:
Topic and research question. You have selected a health, safety or nursing topic and written a quantitative research question to guide your literature search and find an answer to a problem.
Research summary table contains details about steps of the research process: purpose, sample, sample characteristics, sampling method, design, level of evidence, key results and types of research limitations. After completing the table you will be able to compare and contrast different research methods and how each study could help you answer the research question, plan for future research and guide changes in nursing practice.
Research summary paper is a professional paper that presents a problem, research question and literature search strategies; and analyzes how different studies used different research methods to answer your research question, identify future research needs and guide you in making nursing practice changes. The key is to analyze the research process and not present each study separately.
Paper outline, which includes the grading rubric criteria:
* Present the topic/problem as part of the introductory paragraph. Give statistical details to indicate the severity of the problem. Explain how the problem is relevant to nursing practice. Finally, describe the purpose of the paper. Remember, do not use the word ‘introduction’ as a heading.
* Selection of Articles: present the research question, describe the literature search strategies, explain how and why you selected the four single research studies
* Analysis of Research Purposes: present a general analysis statement. Give brief details from the studies to further explain the general statement. Explain how the information could be used to change the research question and plan future research.
* Analysis of Study Samples: present a general analysis statement about studies samples, sample size and sampling methods. Give brief details to illustrate your general statement. Based on your analysis how would you change the research question and plan for future research.
* Analysis of Study Designs: present a general analysis statement about studies designs. What was similar, what was different. Based on your analysis, what changes would you make for future research and why?
* Level of Evidence: describe the levels of evidence presented by the four single research studies. What was similar, what was different. Based on the level of evidence, what types of future research is needed? How would the level of evidence influence nursing practice and why?
* Analysis of Findings: Overall, describe the studies findings? How would the findings answer your research question and why? Based on overall findings what future research and nursing practice action needs to occur and why? Did the findings generate new ideas? how?
* Analysis of Research Limitations: Describe the main categories of research limitations. For example the three main research limitations included: sample size, sample criteria and data collection. Offer specific recommendations to minimize the research limitation in future research.
* Present a conclusion paragraph. All professional papers have an introduction and conclusion. Review APA manual for quidelines about the paper introduction and conclusion.
Paper length: 4-6 pages, not including title page and references
Follow APA guidelines for paper. Use at least level one headings to organize the paper and provide a logical flow of ideas.
Submit TWO SEPARATE documents to Dropbox, to avoid a high Turnitin score:
* First, submit research summary table with title page
* Second, submit the research summary paper
Submit a permalink for each article in the reference section, so instructor can readily access the selected artcile
Read APA manual, chapter 2: manuscript structure and content and chapter 3: writing clearly and concisel
Do not use bullet points or lists of information in the body of the paper. Quotes, if any, should be limited to one short quote related to a definition of a concept, because the focus of graduate writing is paraphrasing, synthesis, analysis, critique and interpretation of facts. Strive to paraphrase rather than use quotes.
Solution.
Does hand washing prevent Infection transmission among healthcare workers
Research summary table
| Author, year of publication | purpose | sample | Design | Level of evidence | findings | limitations |
| Chen et al (2011) | To establish the cost effectiveness of hand hygiene programs in community teaching hospitals, where health care infection burden is high | 8,420 hand hygiene opportunities were observed in two periods. Pre-intervention period 1999-2004; and 2004 to 2007 in a 2,200 bed capacity hospital | Comparison study design of effectiveness of hand hygiene promotion on effectiveness and limitations on decreasing healthcare-associated infection (HAI) | VI: evidence from a single comparison study | Hand washing hygiene increased after intervention from 43.3% to 95.6% (p<0.001). There was an 8.9% decrease observed in HAI, decline on occurrence of bloodstream, methicillin-resistant Staphylococcus aureus, extreme drug resistant acinetobacter baumannii and ICU infections. The net benefit of the hand hygiene program was $5,289,364 with a benefit cost ration of 23.7 | The study was only limited to one hospital. There was no other similar or dissimilar hospital to compare the findings with |
| Stone et al (2012) | Evaluate the impact of an initiative called “cleanyourhand campaign” on alcohol hand hub and soap procurement; establish trends of infection associated with healthcare, and; establish the relationship between procurement and infection. | 187 acute trusts in England and Wales were assessed in the study | Descriptive and comparative design to investigate the national cleanhands campaign effect on staphylococcus aureus and clostridium difficile in hospitals in England and Wales. | VI: evidence from different trusts in England and Wales | Increase in procurement of alcohol hand rub and soap from 21.8ML to 59.8ML per patient bed. The methicillin-resistant staphylococcus aureus rate decreased from 1.88 to 0.91 per 10,000 day beds. C. difficile rates fell from 16.75 to 9.49 | The study did not provide room for future evaluation of the campaign. The campaign itself was political and there is no guarantee of the program’s sustainability. |
| Kirkland et al (2012) | Investigate the impact of hospital-wide initiative of hand hygiene on infection that is associated with health care. | Series of interrupted 3 years with multiple interventions that were sequential and; 1 year intervention period. Monthly observation of hand hygiene compliance and rates of healthcare associated infections | Descriptive and Comparative study to investigate the impact of hospital-wide imitative on hand hygiene with healthcare related infection | VI: evidence from study of a single hospital | Hand hygiene compliance increased from 41% to 87% during the intervention and further increased to 91% to the following year. In the additional year, nurses recorded a greater increase in HH at 93% compared to physicians at 78%. Healthcare associated infections decreased significantly from 4.8 to 3.3 (P<0.01). the rates of S.aureus associated with operating room rose while infectious S.aureus fell | The study was only carried out in one hospital. Furthermore, there was not control setting. |
| Chun et al (2016) | Investigate the impact of hand hygiene in tertiary hospital in South Korea on the rate of hospital methicillin-resistant staphylococcus aureus (MRSA)and the economic impact of the program/intervention | Monthly procurement of hand sanitizers per 1000 patient days by the hospital was calculated. Monthly incidences of MRSA were recorded as well | Descriptive study to study the impact of hand hygiene on the rate of hospital MRSA | VI: evidence from one tertiary hospital in South Korea | hand hygiene campaign led to increased compliance among health workers incidences of MRSA occurrences | The study was only based on one hospital |
Summary
Infectious diseases are common in daily human lives. They are often transmitted via different agents; they may be waterborne, airborne or transmitted through body contact between two or more people. The devastating issue with infectious diseases is that, upon their occurrence, many people are affected at once and as a result, the casualty numbers are often huge.
According to the Center for Disease Control CDC (2016), 2,700 cases of hepatitis A were reported in 2011 in the United States; about 0.7-1.4 million people are suffering from chronic hepatitis B; 2.5-2.9 million people are suffering from chronic hepatitis C. In 2011, about one-third of the world’s population was suffering from tuberculosis; every year, about 36, 000 people in the US lose their lives from influenza and pneumonia.
The nature of the infectious diseases and their magnitude upon occurrence dictates that, the diseases are better prevented rather than treatment. Since ancient times, infectious diseases have always been the worst nightmare of many health practices. Smallpox and chicken pox for example have been documented to have significantly killed millions of people in the world, back in the days before their vaccines and treatments had been discovered.
Indeed the field of medicine has advanced and developed preventive and curative measure for most infectious diseases known in the world today. Yet prevention of the diseases still remains the major priority. Other than vaccination; hand washing is one of the most significant methods of preventing the transmission of infectious diseases among the human population. It has been widely advocated and adopted as well. since health care workers comes to contact with patients suffering from infectious diseases quite often, it is suspected that transmission of in infectious diseases among and between healthcare and other patients is probably high. This paper therefore seeks to investigate if hand washing prevents transmission of infectious diseases among health care workers.
The research question for the study is, “does hand washing prevents infection transmission among health workers”. The literature search strategy was based on the intervention strategies that essentially had impact or effect on transmission of infection among all the health workers. All the four studies were conclusive as long as the impact or influence of hand washing technology on infection transmission is concerned. The four research studies were selected since they all presented previous research, evidence and finding on the impact of hand washing technology on infection transmission. Furthermore, the studies were mostly conducted on health teaching or medical settings in which the exposure and vulnerability to health risks on transmission is essentially high.
The purpose of this study is to investigate the influence of hand wash technique in prevention of infection transmission among health workers. All the studies reviewed in this study have addressed the same question. However, most of the studies used in this paper have more or less focused on the hand wash campaign strategy and its influence on infection and transmission among health workers. The information from the previous studied can help to shape the study by improving the research question specifically by deciding and improving on the quality of independent variables that should be included in the study.
From the studies reviewed in this paper, most of the samples of the studies in this topic are essentially not definite. Most of the researches are based on non-determinate independent variables such as observation of the frequency of hand wash techniques. The studies are based on monthly observation and record over certain period of time.
Almost all of the studies that were reviewed in this paper had adopted both descriptive and comparative research design. Descriptive statistics allows analysis of prevalence the independent and the dependent variable in a particular research study. The comparative research design may take several forms with different tests of significance level, but they reveal the actual relationship between dependent and independent variables of the studies.
The level of evidence provide among the studies reviewed in the study revealed a rather low level of evidence. The researches were essentially limited to few hospitals or healthcare institutions; which provided fewer options of comparison or control studies.
Generally, the findings of the studies indicated a positive influence relation between hand washing techniques with reduction of infection especially of common diseases among healthcare workers in almost all the hospitals or health care institutions samples for the study.
The major limitations observed among the studies reviewed in the paper include low level of comparison. Three studies limited their researches to one institution. Comparison of at least two or more studies provides comparison opportunity to reveal clearly the significance of the studies.
Conclusion
Infectious diseases are among the leading causes of death in the world. There have been interventions both curative and preventive that have since been developed to take care of the infectious diseases. Top priority however has been given to prevention of infectious diseases. Hand washing is among the most important, basic and economical prevention techniques.
From the studies that have been reviewed in this paper. There is a general positive influence of hand washing among health workers on prevention of infectious diseases. In some cases the influence may not be essentially significant but, there is generally a positive effect.
Different methods have been used by past studies to explore the topic. The two fundamental research designs according to the studies reviewed include meta-data analysis and causal-comparative. The two however can be used in combination to yield better results.
References
Center for Disease Control CDC (2016). Statistics of Infectious diseases. Retrieved Nov 7, from www.jonhopkinsmedicine,org/healthlibrary/conditions/infectious_diseases/statistics_of_infectious_diseases_85P00650/
Chen, Y. C., Sheng, W. H., Wang, J. T., Chang, S. C., Lin, H. C., Tien, K. L., … & Tsai, K. S. (2011). Effectiveness and limitations of hand hygiene promotion on decreasing healthcare–associated infections. PLoS One, 6(11), e27163.
Chun, J. Y., Seo, H. K., Kim, M. K., Shin, M. J., Kim, S. Y., Kim, M…. & Kim, H. B. (2016). Impact of a hand hygiene campaign in a tertiary hospital in South Korea on the rate of hospital-onset methicillin-resistant Staphylococcus aureus bacteremia and economic evaluation of the campaign. American Journal of Infection Control.
DOI: hppt://dx.doi.org/10.1016/j.ajic.2016.07.009
Kirkland, K. B., Homa, K. A., Lasky, R. A., Ptak, J. A., Taylor, E. A., & Splaine, M. E. (2012). Impact of a hospital-wide hand hygiene initiative on healthcare-associated infections: results of an interrupted time series. BMJ quality & safety, qhc-2012. doi:10.1136/bmjqs-2012-000800
Stone, S. P., Fuller, C., Savage, J., Cookson, B., Hayward, A., Cooper, B., … & Roberts, J. (2012). Evaluation of the national Cleanyourhand campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene: four year, prospective, ecological, interrupted time series study. BMJ quality & safety, qhc-2012 doi: http://dx.doi.org/10.1136/bmj.e3005 (Published 03 May 2012) Cite this as: BMJ 2012;344:e3005
