Literature Review
While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.
A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:
- Title page
- Introduction section
- A comparison of research questions
- A comparison of sample populations
- A comparison of the limitations of the study
- A conclusion section, incorporating recommendations for further research
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
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. Please refer to the directions in the Student Success Center.
Running head: PICOT STATEMENT PAPER
PICOT STATEMENT PAPER
PICOT Statement Paper
Professor’s Name
Student’s Name
Course Title
Date
Introduction
Hand Hygiene (HH) is one of the most effective ways of reducing hospital transited infections (HTIs) in the healthcare setting. However, most healthcare professionals fail to comply with the international standard guidelines for hand hygiene negatively affecting the health and safety of patients. Poor HH of health workers has led to increased mortality rates among patients admitted in hospitals. More awareness needs to be created among the healthcare workers about the importance of HH to reduce the increased mortality rate. Healthcare agencies need to take the responsibility of ensuring their staffs are fully aware and adhere to World health Organization (WHO) guidelines for hand hygiene (Sadule-Rios
&
Aguilera, 2017).
PICOT Statement
For healthcare workers in Hospital does alcohol based solutions compared to hand washing protocol prevent hospital acquired infections during the period patients stay in healthcare facilities.
Evidence based solution
Alcohol based solutions have been used widely across the world. Studies show that this approach to HH irritates hands less often, removes germs effectively and requires less time as compared to hand washing. Alcohol based solutions are also more accessible as compared to sinks. This approach to HH is more effective when the hands are not soiled. However, in situations where dirt can be seen on the hands, health workers should clean their hands using water. Alcohol based solutions have good microbial activity against various bacteria and viruses. Multiple studies show that alcohol based solutions are more effective in the healthcare setting as compared to hand washing protocol (Lehotsky et al., 2017).
Nursing Intervention
Patients who have been admitted in the hospitals interact with nurses more often than any other healthcare professional. For this reason, nurses must take precautionary measure to ensure patient security and overall wellbeing. Nurse practitioners should use alcohol based solutions before and after interacting with patients. This will reduce the spread of infections in the healthcares setting. Nurses should also follow the WHO guidelines which require them to wear protective gear before interacting with patients. This will prevent them from acquiring infections from one patient and transmitting it to other patients within the hospital (Garus-Pakowska, Sobala & Szatko, 2013).
Patient Care
One of the most important goals for healthcare facilities is to provide quality services to patients. Without proper HH this goal cannot be achieved. Hospitals should create proper HH guidelines to be followed by all patients admitted in their facility. Healthcare providers should also ensure that their patients are fully aware of these guidelines and ensure they are followed to the latter. Enough alcohol based solutions should be provided to ensure patients adhere to the guidelines (Deochand & Deochand, 2016). The healthcare workers should also ensure that visitors clean their hands before visiting the patients and after leaving wards. This ensures visitors do not bring infections to the patients.
Health care agency
One of the main responsibilities of the healthcare agency is to provide enough alcohol based solutions to both patients and healthcare professionals. Without enough resources they will be unable to follow the WHO HH guidelines. The healthcare agency should also ensure it has enough sinks with running water to ensure that patients and healthcare professionals can clean their hand when they have less supply of alcohol based solutions. They should also ensure they create awareness among their healthcare professionals about the importance of HH. Occasional audits should also be conducted to ensure nurses comply with the set HH guidelines (Chatfield et al., 2016).
Nursing Practice
Most of the hospital acquired infections can be prevented by combining the alcohol based solutions and hand washing protocol. These techniques can complement one another increasing patient safety and care in hospitals. Nurses should comply with the WHO guidelines to reduce spread of infections in the healthcare setting (McLawsa et al., 2014). The implementation of standard HH guidelines will ensure a safe and secure healthcare environment. This will also improve patient outcomes and their overall well being. This can go a long way in reducing hospital stay as a result of hospital acquired infections. All hospital stakeholders need to take the necessary precautions to prevent the spread of these infections.
References
Chatfield, S. L., Nolan, R., Crawford, H. and Hallam, J. S., (2016). Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis. SAGE Open Medicine Volume 4: 1 –9
Deochand, N., & Deochand, M. E. (2016). Brief Report on Hand-Hygiene Monitoring Systems: A Pilot Study of a Computer-Assisted Image Analysis Technique. Journal of environmental health, 78(10). Journal of Hospital infection 97 (2017) 26-29
Garus-Pakowska, A., Sobala, W., Szatko. F. (2013). Observance of hand washing procedures performed by the medical personnel before patient contact part 1.International journal of occupational medicine and environmental health 2013
Lehotsky, A., Szilagyi, L. , Szeremy, P., Weber, G., Haidegger, T. (2017). Towards objective hand hygiene technique assessment: validation of the ultraviolet-dye-based hand-rubbing quality assessment procedure.
McLawsa, M. L., Farahangizb, S., Palenikc, C. Askariand, M., (2014). Iranian healthcare workers’ perspective on hand hygiene: A qualitative study. Journal of Infection and Public Health (2015) 8, 72—79
Sadule-Rios
, N.,
Aguilera, G. (2017). Nurses’ perception of reasons for persistent low rates in hand hygiene compliance. Intensive and Critical Care Nursing 42 (2017) 17-21
Rubic_Print_
Format
| Course Code | Class Code | Assignment Title | Total Points | |||||
| NRS-490 | NRS-490-O502 | Literature Review | 100.0 | |||||
| Criteria | Percentage | Unsatisfactory (0.00%) | Less than Satisfactory (75.00%) | Satisfactory (79.00%) | Good (89.00%) | Excellent (100.00%) | Comments | Points Earned |
| Content | 80.0% | |||||||
| Introduction | 10.0% | An introduction is not present. | An introduction is present, but it does not relate to the body of the paper. | An introduction is present, and it relates to the body of the paper. There is nothing in the introduction to entice the reader to continue reading. | An introduction is present, and it relates to the body of the paper. Information presented in the introduction provides incentive for the reader to continue reading. | An introduction is present, and it relates to the body of the paper. Information presented in the introduction is intriguing and encourages the reader to continue reading. | ||
| Comparison of Research Questions | 20.0% | No comparison of research questions is presented. | A comparison of research questions is presented, but it is not valid. | A cursory though valid comparison of research questions is presented. | A moderately thorough and valid comparison of research questions is presented. | A reflective and insightful comparison of research questions is presented. | ||
| Comparison of Sample Populations | No comparison of sample populations is presented. | A comparison of sample populations is presented, but it is not valid. | A cursory though valid comparison of sample populations is presented. | A moderately thorough and valid comparison of sample populations is presented. | A reflective and insightful comparison of sample populations is presented. | |||
| Comparison of the Limitations of the Study | No comparison of the limitations of the study is presented. | A comparison of the limitations of the study is presented, but it is not valid. | A cursory though valid comparison of the limitations of the study is presented. | A moderately thorough and valid comparison of the limitations of the study is presented. | A reflective and insightful comparison of the limitations of the study is presented. | |||
| Conclusion and Recommendations for Further Research | No conclusion and recommendations for further research are presented. | A conclusion and recommendations for further research are presented, but they are not valid. | A conclusion and recommendations for further research are valid, but they are cursory. | A conclusion and recommendations for further research are valid and moderately thorough. | A conclusion and recommendations for further research are reflective and insightful. | |||
| Organization and Effectiveness | 1 | 5.0% | ||||||
| Thesis Development and Purpose | Paper lacks any discernible overall purpose or organizing claim. | Thesis is insufficiently developed or vague. Purpose is not clear. | Thesis is apparent and appropriate to purpose. | Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. | Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. | |||
| Argument Logic and Construction | Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. | Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. | Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. | Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. | Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. | |||
| Mechanics of Writing (includes spelling, punctuation, grammar, language use) | Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. | Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. | Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. | Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. | Writer is clearly in command of standard, written, academic English. | |||
| Paper Format (use of appropriate style for the major and assignment) | 2.0% | Template is not used appropriately or documentation format is rarely followed correctly. | Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. | Template is used, and formatting is correct, although some minor errors may be present. | Template is fully used; There are virtually no errors in formatting style. | All format elements are correct. | ||
| Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) | 3.0% | Sources are not documented. | Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. | Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. | Sources are documented, as appropriate to assignment and style, and format is mostly correct. | Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. | ||
| Total Weightage | 100% |
Literature Evaluation Table
Student Name:
Change Topic (2-3 sentences):
Criteria
Article 1
Article 2
Article 3
Article 4
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Al Salman, J. M., Hani, S., de Marcellis-Warin, N., & Isa, S. F.
https://doi.org/10.1016/j.jiph.2014.07.019
Hor, S. Y., Hooker, C., Iedema, R., Wyer, M., Gilbert, G. L., Jorm, C., & O’sullivan, M. V. N.
https://qualitysafety.bmj.com/content/26/7/552
Maheshwari, V.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4190714/
Ariyaratne, M. H. J. D., Gunasekara, T. D. C. P., Weerasekara, M. M., Kottahachchi, J., Kudavidanage, B. P., & Fernando, S. S. N.
http://hdl.handle.net/123456789/1854
Article Title and Year Published
2015
2017
2016
2015
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study
The purpose of the research is to establish whether technology can be used to do away with health acquired infections in hospitals.
The purpose of the study was to establish whether HH is enough for the prevention of cross-contamination on hospital wards.
The purpose of the research was to assess the knowledge and attitude of nursing staff and residents towards hand hygiene in relation to reducing hospital-acquired infections.
The purpose of the research was to assess the attitude, knowledge to HH guidelines of nursing students and final year medical students towards hand hygiene in relation to reducing hospital-acquired infections.
Design (Type of Quantitative, or Type of Qualitative)
Qualitative study- case study methodology
Qualitative study design-Ethnography study
Quantitative- a cross-sectional study.
Quantitative- Through a cross-sectional questionnaire-based study that consisted of five parts; attitudes, availability of facilities, demographic information, practices, and assessment of knowledge.
Setting/Sample
The research was carried out in Bahrain; a medical system in the nation was installed and observed for twenty-eight days. Over the twenty-eight days period, comments, suggestions, and remarks on the system were recorded and as a result improvements on the system were made on the course of the system trial.
The study was done in three hospitals in Australia. The specific areas of concern were the general surgical wards and the intensive care units. In order to examine if the infection prevention and control practices were influencing cross-contamination in hospitals, ethnography study was carried out.
The study was carried out in Bhopal city and involved 160 respondents.
The research was done at a university in Sri Lanka. There were 289 participants, of which ninety-three were nursing students and one hundred and ninety-six were medical students.
Methods: Intervention/Instruments
The case study methodology was used in the study. The case study involved studying electronic monitoring systems on HH with the aim of establishing whether health workers maintain good hand washing practices. The research team also used semi-structured interviews in order to establish whether the technology was effective or not at encouraging good hand hygiene among the complex staff members.
The study employed the use of ethnography and the grounded theory approach to collect data for the study. The practices of nurses, medical staff, nursing staff, nursing students, cleaning and clerical staff were observed for a period of twenty four weeks by the research team. In addition, semi structured interviews and reflexive sessions were carried out on selected participants to compliment the observation process.
The study is a non-experimental study as it involves the research team carrying out a cross-sectional study. In the cross sectional study, the research team analyzed the data collected from the healthcare professionals in regards to the attitudes and knowledge of hand hygiene.
A cross sectional questionnaire based study was used in the research. It consisted of five parts; attitudes, availability of facilities, demographic information, practices, and assessment of knowledge
Analysis
By using the system it was observed that hand hygiene complex went from 42% to almost 61% at the start of the use of the system.
The research team carried out a post-intervention analysis.
The Microsoft EXCEL 2010 software was used in the data analysis of the study.
The Microsoft EXCEL 2010 software was used in the data analysis of the study.
Key Findings
By the end of the trail period, it was noted that the compliance to HH had increased to 75%
The results of the study indicated that infection prevention and control practices (IPC) that involved hand wash was the main reason as to why hospital acquired infections in the three hospitals had reduced significantly
The conclusion of the study placed an emphasis on the immediate need for training on hand hygiene in order to trigger the start of an organizational culture that emphasizes on the adoption of practices that lead to the reduction of HAI.
Out of the 289 participants of the study 81% indicated that they had gone through formal training in hand washing practices, 77% had general knowledge on hand washing hygiene, only 34% had a good attitude towards hand washing and less than 32% had good practices of hand washing.
Recommendations
A threat to the credibility that might have been present was selection bias; the monitoring technology was not put all over the complex rather it was only installed in the coronary care unit. It was recommended that the system should be tested in other sections of hospitals
A threat to the study’s internal validity was identified-selection bias. There was a high likelihood that the researchers focused more on the nursing staff and the cleaning staff and it was recommended that future studies should incorporate other staff members to do away with the bias.
According to the study it was found out that healthcare professionals had the knowledge and correct attitude when it comes to hand washing but they generally did not apply the knowledge in their day to day activities. It was recommended that that health professional should be constantly reminded of the importance of health hygiene.
It was concluded that the lack of proper hand washing practices was a major contributor to hospital acquired infections and it was recommended that HH should be emphasized and monitored.
Explanation of How the Article Supports EBP/Capstone Project
The study looks at how nurses HH affects the spread of HAI. It is in line with project’s capstone.
The study looks at how nurses HH affects the spread of HAI. It is in line with project’s capstone.
The article looks at how hand hygiene is important in hospitals. The findings of the study help in supporting the project’s capstone.
The article focuses on the importance of HH which is part and parcel of the study that is being carried out
Criteria
Article 5
Article 6
Article 7
Article 8
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Sendall, M. C., McCosker, L. K., & Halton, K.
https://www.mdpi.com/1660-4601/16/6/1067
Deochand, Neil; Deochand, Michelle E.
https://www.ncbi.nlm.nih.gov/pubmed/27348978
Chatfield, S. L., Nolan, R., Crawford, H., & Hallam, J. S.
https://doi.org/10.1177/2050312116675098
Sarani, H., Balouchi, A., Masinaeinezhad, N., & Ebrahimitabs, E.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804055/
Article Title and Year Published
2019
2016
2016
2016
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study
The study was carried to explore the attitudes cleaning staff in hospitals as HH.
The purpose of the research was to establish whether Hand-Hygiene Monitoring Systems are effective at reducing HAI
The purpose of the research was to capture the experiences of HH among acute care nurses.
The purpose of the research was to identify the knowledge of HH in the fight against HAI present in teaching hospitals affiliated to Zabol University.
Design (Type of Quantitative, or Type of Qualitative)
Exploratory qualitative approach.
Qualitative approach-Observation
Qualitative approach-Interview
A descriptive study
Setting/Sample
Focus groups were used in the study where 12 cleaning staff participated.
The study looked at several implemented HH monitoring systems.
Eight nurses in the US performing various roles were interviewed.
The study was conducted on 170 nurses of two teaching hospitals in Zabol.
Methods: Intervention/Instruments
Focus groups were used for data collection
Observation of HH monitoring systems
Interview
A researcher-made questionnaire was used in the study.
Analysis
An interpretative phenomenological analysis methodology was used
Descriptive and inferential statistics analysis was used
An interpretative phenomenological analysis methodology was used.
Analysis was carried out using descriptive and inferential statistics.
Key Findings
Cleaners in hospital are aware of the importance of HH and they attribute this to the information provided by their leadership.
Results of the study proved that HH protocol and related systems could be used in the fight against HAI.
There was a conflict between the perception of nurses and hospital management as far as HH is concerned.
The results show that less that 50% of the participants had little information as far as the relation between HH and HAI is concerned.
Recommendations
HH training and emphasis needs to be done in order to bring about improvement in HH.
There is a need for the study to be conducted in the real world for a valid conclusion on the subject matter to be done.
Infection prevention management needs to come up with proper training programs for HH for HAI to be done away with.
The recommendation of the study was that there should be more training sessions on HH for awareness to take place.
Explanation of How the Article Supports EBP/Capstone
The research focused on health workers understanding the value of HH which is in line with what the project is about.
The article explores how technology can be used to enhance HH in hospitals. The findings of the study offer insight on how different HH methods can help do away with HAI
The study looked at how nurses perceived HH. The finding of the study is correlated to the project capstone as it provides an insight on how nurses, the primary study subject view HH in the fight against HAI
The study was done to show how HH is important not only for hospitals but for medicine teaching centers. The findings of the study provide relatable information in the fight against the spread of HAI.
References
Al Salman, J. M., Hani, S., de Marcellis-Warin, N., & Isa, S. F. (2015). Effectiveness of an electronic hand hygiene monitoring system on healthcare workers’ compliance to guidelines. Journal of infection and public health, 8(2), 117-126.
Ariyaratne, M. H. J. D., Gunasekara, T. D. C. P., Weerasekara, M. M., Kottahachchi, J., Kudavidanage, B. P., & Fernando, S. S. N. (2015). Knowledge, attitudes and practices of hand hygiene among final year medical and nursing students at the University of Sri Jayewardenepura.
Chatfield, S. L., Nolan, R., Crawford, H., & Hallam, J. S. (2016). Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis. SAGE open medicine, 4, 2050312116675098.
Deochand, N., & Deochand, M. E. (2016). Brief Report on Hand-Hygiene Monitoring Systems: A Pilot Study of a Computer-Assisted Image Analysis Technique. Journal of environmental health, 78(10).
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 Qual Saf, 26(7), 552-558.
Maheshwari, V. (2016). A study to assess knowledge and attitude regarding hand hygiene amongst residents and nursing staff in a tertiary health care setting of Bhopal City. Journal of clinical and diagnostic research: JCDR, 8(8), DC04.
Sarani, H., Balouchi, A., Masinaeinezhad, N., & Ebrahimitabs, E. (2016). Knowledge, attitude and practice of nurses about standard precautions for hospital-acquired infection in teaching hospitals affiliated to Zabol University of Medical Sciences (2014). Global journal of health science, 8(3), 193.
Sendall, M. C., McCosker, L. K., & Halton, K. (2019). Cleaning Staff’s Attitudes about Hand Hygiene in a Metropolitan Hospital in Australia: A Qualitative Study. International journal of environmental research and public health, 16(6), 1067.
© 2015. Grand Canyon University. All Rights Reserved.
© 2017. Grand Canyon University. All Rights Reserved.