What is the PICOT question?
Do the use of hand hygiene and aseptic techniques result in reduced infection and mortality in a 6-month period compared to the lack of sanitation practices in patients aged 50-60 years old at risk of hospital-acquired infection and subsequent mortality?
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- P- (Patient, population, or problem): Patients aged 50-60 years old at risk of hospital-acquired infection and subsequent mortality
- I- (Intervention): Use of hand hygiene and aseptic technique
- C- (Comparison with other treatment/current practice): Lack of sanitation practices such as hand washing, hand sanitizer, PPE, etc.
- O- (Desired outcome): Reduced rates of infection and mortality
- T- (Time Frame): 6-month period.
What is the practice issue/problem? What is the scope of the issue? What is the need for change?
The elderly is one of the fastest growing population and the most common users of the health care system in the United States. However, this age group is also the most susceptible to hospital-acquired infection (HAI). The risk of developing HAI is linear with age. In fact, the overall burden of infections in nursing homes exceeds that of acute care locations. The incidence rates (around 10-11%) and resistance of healthcare-associated infections are higher amongst the elderly due to existing health risk factors and a lack of knowledge about appropriate prevention methods (Katz & Roghman, 2016).
Reduction in HAI is amongst the top priorities for healthcare providers and regulators. Hand hygiene is seen as one of the most effective methods of preventing infections based on a myriad of medical and scientific literature. However, while there are existing guidelines for staff (with appropriate literature for support), there are often no hand hygiene practices in place for patients. Hands can carry microbial flora which then leads to transmission and infection, with research suggesting that often patients receive infections from their own pathogens.
Many patients, particularly in geriatrics, lack the knowledge or capacity to administer hand hygiene techniques, especially in highly contagious hospital settings. Therefore, the need for change would be to create an intervention that would introduce hand hygiene guidelines aimed at patients and would guarantee a level of compliance (Prasad, Chok, & Wilkes, 2017). Since at-risk patients, similar to staff, are in a healthcare setting, they should follow similar safety protocols for their well-being.
What is the practice area?
How was the practice issue identified?
- Safety/risk management concerns
- Unsatisfactory patient outcomes
- Difference between hospital and community practice
What evidence must be gathered?
- Literature search
- Patient Preferences
Search terms/How to narrow the search?
Hand hygiene, handwashing, aseptic technique, patient safety, hospital-acquired infection, patient guidelines
Katz, M. J., & Roghmann, M.-C. (2016). Healthcare-associated infections in the elderly: What’s new. Current Opinion in Infectious Diseases, 29(4), 388–393. Web.
Prasad, A., Chok, H. N., Wilkes, L. (2017). Hand hygiene practices amongst patients. International Journal of Infection Control, 12(2), 1-8. Web.
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