Introduction
Hospital-acquired infections (HAIs) can be considered one of the most problematic issues of the modern healthcare sector because the corruption of treatment results under the impact of infectious diseases or other complications that might emerge in hospital settings. Regarding a significant scope of the problem, there are multiple attempts to introduce an appropriate and effective solution to the given problem to ensure that the incidence of HAIs will be significantly reduced. Development of this sort of strategy focused on the prevention of nosocomial diseases acquires the top priority for the healthcare sector and improvement of the health of the nation. For this reason, the following study supported by the PICOT question and investigation of credible sources can have a beneficial impact on the development of hygiene promotion which is one of the ways to improve the situation.
PICOT Question
The outlined significance of the problem of HAIs and the negative impact they have on outcomes precondition formulation of the following PICOT question:
In adult post-surgery patients with diabetes (P), does the provision of two-step interventions for hand hygiene promotion (I) instead of general instructions (C) reduce the incidence of HAIs (O) two weeks after surgery (T)?
The choice of the population is preconditioned by the fact that even though HAIs can affect all groups of patients, it is critical to investigate high-risk individuals who have chronic health conditions as they are associated with the high nosocomial diseases’ rate. At the same time, the size of risks is strictly interconnected with the experience of surgical interventions which means that there is the necessity to investigate the cohort that combines two risk factors. That is why post-surgery patients with diabetes are selected for the project.
Among a number of possible strategies that are available nowadays for specialists to struggle against HAIs, the intervention for the planned study is focused on helping hospitalized high-risk patients to develop healthy habits related to handwashing and hand hygiene. Nurses will provide education about this method, various types of hand hygiene products, and how to use each option in different situations. In the end, all patients will receive standardized printed materials presenting this information in a well-organized way.
To determine the effectiveness of the selected approach, the results of participants with another group which will receive no in-depth education, handout materials, and personalized instructions about the use of various options for cleaning hands will be compared. With that in mind, they will be free to choose the approaches to be used based on the general rules of hand hygiene and their own knowledge.
The study will measure and compare incidence rates of nosocomial infections in the comparison and intervention groups to conclude about the effectiveness and applicability of the selected approach. Considering that some patients admitted to hospitals can already have some “hidden” infections, all individuals to be included in the study will be thoroughly examined before the start of the experiment. A significant reduction in HAIs and improvement of hand hygiene can be expected.
Regarding the nature of the selected population, it is critical to consider the first few weeks after the surgical interventions as the possible period for the evaluation. For this reason, it is planned to conduct the assessments of patients’ health status on the fourteenth day after surgical operations to collect information and process it in terms of the study.
Qualitative Research Critique
The following two studies are selected as the theoretical framework for the project devoted to the investigation of HAIs. The first one revolves around the topic of patient safety and specific measures implemented to prevent the spread of infections in intensive care and surgical units. In the qualitative study by Hor et al. (2017) the authors demonstrate the contribution of logistics in healthcare settings to successful infection prevention efforts.
The discussed clinical problem preconditioned the aim of the study as it is inextricably connected to the existing differences between the recommended hygiene practices for providers and their actual uses. Explaining the clinical problem, Hor et al. (2017) state that the average hand hygiene compliance rates do not exceed 40%, which indicates that perfect compliance is not possible due to everyday practical issues. It means that the paper tries to encourage healthcare workers to analyze their efforts aimed at infection prevention and learn more about current questions.
The experimentation’s decision to apply qualitative research methods is justified by the nature of the research problem and the role of subjective experiences in it. To support their discussion of the clinical topic, Hor et al. (2017) cite almost thirty peer-reviewed sources that utilize both qualitative and quantitative methods of research. Some of them are presented by studies with high levels of evidence such as systematic reviews, and experimental studies can also be found among references.
Acquired results indicate a range of themes relevant for the issue such as the use of personal protective equipment, hand hygiene, task distribution in teams, aseptic techniques, and the so-called from clean to the dirty principle of conducting examinations (Hor et al., 2017). Researchers also define two practitioner-perceived problems in infection prevention. They are the multitude of “things other than hands” that are not cleaned regularly and the presence of ignored boundaries related to different body parts or wounds of the same patient (Hor et al., 2017, p. 555). In such a way, they shed light on why health workers remain ineffective while struggling against HAIs.
Quantitative Research Critique
Another paper is a quantitative study that aims at establishing whether increasing access to hand hygiene products and educating patients could reduce cases of HAIs. The study focused particularly on infection cases of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile (Haverstick et al., 2017). According to Haverstick et al. (2017), one in every 25 patients in an acute care setting will have HAI at one point during their hospital stay. In 2011, 75,000 patients died from HAIs-related complications, while 722,000 patients were affected by this problem (Haverstick et al., 2017). These numbers underline the importance of the study. In such a way, it is directly related to the PICOT question mentioned above and can be used to improve understanding of the issue.
Using surveys as the primary data collection tool, the researchers managed to collect information among the staff and patients. The primary goal was to determine whether health workers educated patients about the necessity to observe hand hygiene and establish a correlation between this process and HAIs (Haverstick et al., 2017). Using SPSS, the authors formulated results showing that the explanation of the importance of hand hygiene and ensuring access to hand sanitizers reduced HAIs significantly. The results indicated that unit-specific HAI rates decreased by 70 percent in 19 months after the intervention (Haverstick et al., 2017). The findings are valid and an accurate reflection of reality because they confirm the claims made in the available literature review on the subject.
Mainly, conclusions formulated by the authors are applicable to general nursing practice. Observing hand hygiene has been shown to reduce HAIs, and nurses should implement this practice for better patient outcomes. Further studies should focus on monitoring patients’ application of hand hygiene practices especially during critical times such as after visiting the restroom, before and after leaving the room, and before and after handling food. The utilization of this paper’s results regarding the formulated PICOT question can help to drive the evidence-based change aimed at the improvement of outcomes among patients with various health complications.
PICOT and Theoretical Framework
In such a way, both qualitative and quantitative studies outline the existing positive correlation between the education about hand hygiene provided to patients and the reduction of HAIs’ incidence. It offers multiple opportunities for the improvement of outcomes and the cultivation of better treatment results. Regarding the formulated question, findings revealed by the discussed articles can be utilized to cogitate about the most effective solution and implementation of a particular evidence-based change that will have a positive impact on patients with diabetes who have undergone surgery. Additionally, both Hor et al. (2017) and Haverstick et al. (2017) are sure that there is a critical need to devote attention to the situation because of the tendency towards further deterioration; that is why additional knowledge provided both to the staff and patients supported by handouts can be considered a potent tool to improve the functioning of units and achieve better results. The given assumption becomes central for the implementation of the suggested intervention into real-life conditions.
Evidence-Based Change
Regarding the discussed takeaways and information provided by the studies, it is also possible to outline how the proposed investigation, PICOT question, and relevant information, can help to drive evidence-based change in existing health units. The fact is that one of the central reasons for the emergence of HAIs, their development, and complications among patients is the disregard to the hand hygiene patterns and the lack of knowledge related to this problem. Thus, to improve outcomes, the alteration of existing practices is demanded. It can be achieved via the introduction of additional seminars and training for nurses. They should be explained how to engage in the needed prevention activities and how to educate patients about the most effective hand hygiene methods and substances that can be used to avoid possible complications and achieve better results. This evidence-based practice change is expected to significantly reduce the HAIs’ incidence in various hospitals across the state and improve the quality of people’s lives.
Conclusion
Altogether, the problem of HAIs remains topical for the modern healthcare sector as results of treatment are often corrupted by nosocomial diseases. For this reason, the given project is focused on the investigation of how the increased attention to hand hygiene among post-surgery patients with diabetes can minimize the number of undesired complications and precondition better treatment results. The selected studies help to formulate the theoretical framework and create the basis for the investigation via the provision of credible information about the effectiveness of particular measures and statistical data needed to drive the evidence based-change.
References
Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection. Critical Care Nurse, 37(3), e1-e8.
Hor, S. Y., Hooker, C., Iedema, R., Wyer, M., Gilbert, G. L., Jorm, C., & O’Sullivan, M. V. N. (2017). Beyond hand hygiene: A qualitative study of the everyday work of preventing cross-contamination on hospital wards. BMJ of Quality and Safety, 26(7), 552-558. Web.