Hospital-Acquired Infections: Literature Evaluation Table

Subject:	Healthcare Research
Pages:	2
Words:	1291
Reading time:	5 min
Study level:	College

Summary of Clinical Issue

Hospital-acquired infections (HCAIs) are a fundamental health problem in the world, mainly in the intensive care units (ICUs). Hospitalized patients are susceptible to acquiring HCAIs, such as central line blood infection, surgical site infection, and catheter urinary tract infection when receiving care, jeopardizing patient safety. Research statistics show that the United States diagnoses approximately 1.7 million people with HCAIs per year (Akanji et al., 2017). HCAIs are among the leading causes of mortality in the U.S., with about 90,000 fatalities per annum (Akanji et al., 2017). These infections contribute a significant burden to the national economy with an estimated 35-45 billion dollars every year (Akanji et al., 2017).

Research experts link HCAIs with endemic consequences on worldwide mortality, morbidity, and economy. Healthcare-associated infections’ mortality rate ranges from 12 to 80% based on the setting and the population (Akanji et al., 2017). The negative effects associated with HCAIs necessitate improved interventions to address this problem.

Hand hygiene (hand sanitation) is a vital approach to minimizing health-associated infections. Studies show that despite the increased awareness regarding HCAIs prevention strategies, healthcare professionals continue to experience challenges in complying with hand hygiene protocols. Healthcare practitioners providing care in the ICUs include nurses, doctors, technicians, therapists, and support staff. The hospital environment is full of disease-causing bacteria, thereby a healthcare worker can transfer them to the patients through hand contact.

PICOT Question: Does healthcare workers and patients’ handwashing behavior minimize hospital-acquired infections in an intensive care unit during hospitalization?

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Foà, C., Tura, G. A., Camelli, C., Silingardi, R., Malavolti, M., Kuenzer, E., Carraro, G., De Paolis, B., & Sarli, L. (2017). Hand hygiene in health care settings: The citizens’ point of view. Acta Bio-medica: Atenei Parmensis, 88(1S), 40-53. Web.	Akanji, J., Walker, J., & Christian, R. (2017). Effectiveness of formal hand hygiene education and feedback on healthcare workers’ hand hygiene compliance and hospital-associated infections in adult intensive care units: A systematic review protocol. JBI Evidence Synthesis, 15(5), 1272-1279. Web.	Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ handwashing and reducing hospital-acquired infection. Critical Care Nurse, 37(3), 1-8. Web.
How Does the Article Relate to the PICOT Question?	The article explores the medics’ hand hygiene from a citizen’s perspective.	The study analyzes the effectiveness of standard hand hygiene training and compliance feedback from healthcare workers in the ICU.	The article explores how hand washing reduces hospital-acquired infections.
Quantitative, Qualitative (How do you know?)	Quantitative design-using an anonymous questionnaire	Quantitative design- a systematic review	Quantitative design- 6-question survey
Purpose Statement	The article’s purpose is to examine the citizens’ self-reported handwashing behavior in healthcare facilities and the variables involved using the planned behavior theory.	The purpose of the article is to examine evidence regarding the effectiveness of hand hygiene education and healthcare professionals’ compliance in the ICU.	The study’s purpose is to promote soap’s hand washing to improve the hand hygiene of patients and to enhance patients’ training on how to minimize healthcare-acquired infections.
Research Question	What are the variables involved in citizens’ self-reported hand hygiene in healthcare settings?	What is the effectiveness of standard hand hygiene training in preventing hospital-acquired infections in the intensive care unit?	Does improved access to patient education and hand hygiene products minimize the development and transmission of hospital-acquired infections?
Outcome	Planned behavior theory explains the healthcare hand hygiene behavior adequately.	Hand hygiene is fundamental in the reduction of hospital-acquired infections.	The rate of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci infections reduced considerably following the implementation of handwashing intervention
Setting (Where did the study take place?)	Emilia Romagna Region in Italy	Joanna Briggs Institute	University of Michigan Health System
Sample	195 citizens- 53.6% of them being female.	10 studies	33 staff members
Method	Quantitative study	Quantitative study	Quantitative study
Key Findings of the Study	The study findings indicate that different socio-demographic and socio-cognitive variables, such as gender and subjective norms, influence hand hygiene.	The study findings indicate that hand hygiene reduces the number of healthcare-acquired infections.	The study finding identified a major correlation between hand hygiene and infection rates of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci.
Recommendations of the Researcher	The article recommends a worldwide targeted media campaign to improve hand hygiene. Moreover, experts in infection control should support healthcare workers by providing hand hygiene training.	The article recommends future research to concentrate on improving hand hygiene compliance in healthcare settings.	The article recommends other future studies to focus on observing patients’ hand hygiene pre and post intervention’s implementation.

Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	Ghaffari, M., Rakhshanderou, S., Safari-Moradabadi, A., & Barkati, H. (2020). Exploring determinants of hand hygiene among hospital nurses: A qualitative study. BMC Nursing, 19(1), 1-9. Web.	Augustine, L., McCollum, W., Brown, R., & Mourning-Star, P. (2019). A qualitative case study exploring hand-hygiene standards in an intensive care unit. International Journal of Applied Management and Technology, 18(1), 126-141. Web.	Chatfield, S. L., DeBois, K., Nolan, R., Crawford, H., & Hallam, J. S. (2017). Hand hygiene among healthcare workers: A qualitative meta summary using the GRADE-CERQual process. Journal of Infection Prevention, 18(3), 104-120. Web.
How Does the Article Relate to the PICOT Question?	The article examines the factors that affect hand hygiene for nurses and their influence in reducing hospital-acquired infections.	The article discusses the standards of hand hygiene in an intensive care unit.	The article conducts a systematic review of articles regarding hand hygiene compliance around the world.
Quantitative, Qualitative (How do you know?)	This is a qualitative study because it uses in-depth semi-structured interviews to explore the problem.	Qualitative design- case study	Qualitative design- a systematic review of 36 reports on hand hygiene.
Purpose Statement	The purpose of the study was to evaluate the different aspects of hand hygiene from a nurse’s perspective in Iran.	The study’s purpose is to evaluate how noncompliance with CDC guidelines on hand hygiene affects ICU healthcare-acquired infections.	The study’s purpose was to conduct a systematic analysis of hand hygiene compliance worldwide.
Research Question	What are the determinants of hand hygiene among hospital nurses?	What are the behavioral factors and best practices affecting hand hygiene compliance in the ICU? How can healthcare leadership motivate ICU workers to observe CDC hand hygiene standards?	What is the hand hygiene compliance levels among healthcare workers worldwide?
Outcome	The study identified three critical themes based on the planned behavior theory, including perceived behavioral control, attitude, and subjective norms.	Hand washing was determined to be the most effective intervention to control healthcare-acquired infections in the ICU.	Healthcare workers have adequate training. However, the training content and reach can be improved. Additionally, management support is fundamental in improving hand hygiene compliance, but it is usually missing.
Setting (Where did the study take place?)	Shariati Hospital of Tehran University of Medical Sciences	A private university hospital in Washington, DC.	Worldwide
Sample	16 participants	35 healthcare workers	36 reports
Method	Qualitative study	Qualitative study	A qualitative study involving systematic review of existing evidence.
Key Findings of the Study	The study identified the environment, education, lifestyle, organizational culture, and morality as effective determinants of hand hygiene.	The research findings indicate that insufficient hand hygiene standards can result in healthcare-acquired infections, such as surgical site infections.	The healthcare workers believe they receive sufficient training and sometimes they lack management and support resources. Additionally, personal subjective standards affect hand hygiene.
Recommendations of the Researcher	The study recommends the integration of models and theories for intervention design to enhance adherence to hand hygiene.	The study recommends future researchers concentrate on other technologies that can improve hand hygiene compliance in the ICU, such as video cameras.	The study recommends the need for further research into healthcare traditions that support infection prevention.

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 infections in adult intensive care units: A systematic review protocol. JBI Evidence Synthesis, 15(5), 1272-1279. Web.

Augustine, L., McCollum, W., Brown, R., & Mourning-Star, P. (2019). A qualitative case study exploring hand-hygiene standards in an intensive care unit. International Journal of Applied Management and Technology, 18(1), 126-141. Web.

Chatfield, S. L., DeBois, K., Nolan, R., Crawford, H., & Hallam, J. S. (2017). Hand hygiene among healthcare workers: A qualitative meta summary using the GRADE-CERQual process. Journal of Infection Prevention, 18(3), 104-120. Web.

Foà, C., Tura, G. A., Camelli, C., Silingardi, R., Malavolti, M., Kuenzer, E., Carraro, G., De Paolis, B., & Sarli, L. (2017). Hand hygiene in health care settings: The citizens’ point of view. Acta Bio-medica: Atenei Parmensis, 88(1S), 40-53. Web.

Ghaffari, M., Rakhshanderou, S., Safari-Moradabadi, A., & Barkati, H. (2020). Exploring determinants of hand hygiene among hospital nurses: A qualitative study. BMC Nursing, 19(1), 1-9. Web.

Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ handwashing and reducing hospital-acquired infection. Critical Care Nurse, 37(3), 1-8. Web.