Literature Evaluation Table

Student Name:

Summary of Clinical Issue

Hand hygiene is an important and effective approach towards infection prevention and control. Hand hygiene combined with other interventions such as wearing masks and social distancing have been found to significantly reduce the spread and new incidences of infectious diseases such as influenza, enterovirus, pneumonia, and COVID-19 (Chiu et al., 2020). Maintaining proper hand hygiene reduces the risks of getting, harbouring, or passing germs and other bacteria to people around an individual, as well as the risk of cross-contamination. In this way, hand hygiene prevents infectious diseases from spreading. The risk of exposure to infectious diseases varies across populations. The risk of exposure among healthcare workers and children is higher as compared to other populations. Despite the higher risk of exposure, maintaining hand hygiene among these high-exposure populations faces various barriers and may easily be discarded. This creates a challenge in nursing care as it increases the risk of getting infected, cross-contamination, and pressure on the available resources. As hand hygiene behaviours and compliance with related protocols change over time among healthcare workers and children, it is essential to explore various factors and evidence-based approaches that influence compliance and can improve the effectiveness of hand hygiene in infection prevention and control. This article presents a guiding PICOT question to help address that nursing practice problem and a literature evaluation table.

PICOT Question:

In high-exposure populations such as children and healthcare workers (P), what are the individual, organizational, and environmental factors that influence compliance to and the effectiveness of hand hygiene (I) in infection prevention and control (O)?

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Biezen, R., Grando, D., Mazza, D., & Brijnath, B. (2019). Visibility and transmission: complexities around promoting hand hygiene in young children – a qualitative study. BMC Public Health, 19(1). Permalink: https://doi.org/10.1186/S12889-019-6729-X	Douno, M., Rocha, C., Borchert, M., Nabe, I., & Müller, S. A. (2023). Qualitative assessment of hand hygiene knowledge, attitudes and practices among healthcare workers prior to the implementation of the WHO Hand Hygiene Improvement Strategy at Faranah Regional Hospital, Guinea. PLOS Global Public Health, 3(2), e0001581. Permalink: https://doi.org/10.1371/JOURNAL.PGPH.0001581	Thaivalappil, A., Young, I., Pearl, D. L., McWhirter, J. E., & Papadopoulos, A. (2022). “I Can Sense When My Hands Need Washing”: A Qualitative Study and Thematic Analysis of Factors Affecting Young Adults’ Hand Hygiene. Environmental Health Insights, 16. Permalink: https://doi.org/10.1177/11786302221129955
How Does the Article Relate to the PICOT Question?	The article explores how primary care providers (PCPs) and parents view the practice of hand hygiene, as well as the barriers to promoting hand hygiene among children. It also identifies how knowledge of hand hygiene relates to the PCPs and parents of young children’s views on hand hygiene in disease transmission and promoting hand hygiene among young children.	The study provides a foundation for research on planning and implementing hand and general hygiene interventions in settings with high risks of infectious diseases with a focus on knowledge and attitudes and how to prevent healthcare-associated and postoperative infections within hospital settings through hand hygiene.	The article analyzes factors that influence hand hygiene among young adults and suggests approaches to effectively increase hand hygiene among young adults.
Quantitative, Qualitative (How do you know?)	This is a qualitative study. The authors collect data using in-depth interviews and analyze the data thematically. Interviews and thematic analysis are major features of qualitative research.	The research being conducted is qualitative. In-depth interviews are used by the authors to gather data, which they then evaluate thematically. Thematic analysis and interviews are two crucial components of qualitative research.	This is a qualitative study. The authors collect data using an online qualitative survey design and analyze the data thematically. Qualitative surveys and thematic analysis are major features of qualitative research.
Purpose Statement	The article’s main purpose is to explore the views of PCPs and parents of young children on the practice of hand hygiene in the transmission of diseases in young children.	This study’s primary objective was to gather qualitative data pertaining to the hand hygiene knowledge, attitudes, and behaviours of healthcare professionals in order to inform and direct the implementation of the WHO hand hygiene improvement strategy at Faranah Regional Hospital (FRH).	The purpose of the study was to utilize the Theoretical Domains Framework to determine factors influencing hand hygiene among young adults aged 18 to 25 years old.
Research Question	A total of 15 semi-structured questions, including 10 focused PCPs on hand hygiene in the reduction of respiratory tract and gastrointestinal infections, for example, What do you think of the role of hand hygiene? And If so, do you wash your hands between each child? And 5 questions focused on parents on hand hygiene in the reduction of respiratory tract and gastrointestinal infections, for example, What do you think of the role of hand hygiene? And What barriers or concerns do you have with hand washing?	The study included observing and interviewing the sample as well as the use of focus group discussions.	The study applied the Theoretical Domains Framework (TDF) for qualitative research to develop a questionnaire exploring themes such as attitudes, beliefs, and general perspectives among young adults towards handwashing touching on the COVID-19 pandemic.
Outcome	PCPs and parents agree hand hygiene is critical in reducing disease transmissions. There are multiple barriers to promoting hand hygiene among children.	Compliance with hand hygiene practices among healthcare workers depends on available cues and the adequacy of resources. Attitudes and knowledge contribute to compliance with hand hygiene practices.	Applying behavior change techniques, including tailoring messages and comparing social behaviors, is effective in improving hand hygiene and infection control among young adults.
Setting (Where did the study take place?)	Melbourne, Australia.	Faranah Regional Hospital (FRH), Faranah Town, Faranah prefecture, in Central Guinea.	Canada
Sample	A total of 80 participants, including 30 PCPs (13 females) and 50 parents and carers (47 females).	A total of 38 participants, including medical doctors, nurses, midwives, nursing assistants and laboratory assistants of different ages and years in practice.	A total of 37 participants aged 18 to 25 years old.
Method	The study used a cross-sectional qualitative research method.	A qualitative baseline assessment of knowledge, attitudes, and practices of hand hygiene among healthcare workers was applied.	A qualitative descriptive approach was employed.
Key Findings of the Study	High levels of knowledge relating hand hygiene to reduced disease transmission. Promoting hand hygiene among children faces major barriers, such as variations of hand hygiene habits, visibility of transmission, fear of developing obsessive behaviors, need to build immunity through exposure, and skepticism over the ability to achieve hand hygiene practice among young children. Parents have the highest responsibility in promoting hand hygiene.	Knowledge influences attitudes towards hand hygiene as a part of preventing infections and disease transmission, and attitudes influence hand hygiene practices in the prevention of infections and the spread of infections.	Hand hygiene behaviors and practices among young adults are determined by knowledge, intentions, social norms, and the environment, such as the use of reminders, cues, accessibility, and cleanliness of handwashing facilities.
Recommendations of the Researcher	Promote awareness of hand hygiene in children among PCPs and parents, and role model hand hygiene practices from an early age.	Combine training with the provision of hand hygiene resources to build capacity and involve all healthcare workers in training and the production of hand hygiene products at the local level. Also, have a hand hygiene committee and material support, such as installing hand washing stations in wards, as well as high and long-term commitment stakeholders for sustainable hand hygiene culture.	Employ infrastructure-related interventions, including targeted signage, messages, and reminders to promote effective hand hygiene practices among young adults.

Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	Stangerup, M., Hansen, M. B., Hansen, R., Sode, L. P., Hesselbo, B., Kostadinov, K., Olesen, B. S., & Calum, H. (2021). Hand hygiene compliance of healthcare workers before and during the COVID-19 pandemic: A long-term follow-up study. American Journal of Infection Control, 49(9), 1118–1122. Permalink: https://doi.org/10.1016/J.AJIC.2021.06.014	Tartari, E., Fankhauser, C., Masson-Roy, S., Márquez-Villarreal, H., Fernández Moreno, I., Rodriguez Navas, M. L., Sarabia, O., Bellisimo-Rodrigues, F., Hernández-De Mezerville, M., Lee, Y. F., Aelami, M. H., Mehtar, S., Agostinho, A., Camilleri, L., Allegranzi, B., Pires, D., & Pittet, D. (2019). Train-the-Trainers in hand hygiene: A standardized approach to guide education in infection prevention and control. Antimicrobial Resistance and Infection Control, 8(1), 1–11. Permalink: https://doi.org/10.1186/s13756-019-0666-4	Van Nguyen, H., Tran, H. T., Khuong, L. Q., Van Nguyen, T., Ho, N. T. N., Dao, A. T. M., & Van Hoang, M. (2020a). Healthcare Workers’ Knowledge and Attitudes Regarding the World Health Organization’s “My 5 Moments for Hand Hygiene”: Evidence from a Vietnamese Central General Hospital. Journal of Preventive Medicine and Public Health, 53(4), 236. Permalink: https://doi.org/10.3961/JPMPH.19.319
How Does the Article Relate to the PICOT Question?	The article explores how compliance with hand hygiene practices decreases with time, influencing factors, and management approaches to improve hand hygiene levels.	The article evaluates how effective training trainers on hand hygiene based on evidence-based guidelines can improve the effectiveness of hand hygiene in infection control.	The article identifies the role of knowledge and attitudes among HCWs and how they influence compliance with hand hygiene protocols.
Quantitative, Qualitative (How do you know?)	This is a quantitative study. The authors collect numerical data and apply statistical analyses to the data collected. Results are also presented using statistics.	This is a quantitative study. It collects numerical data, applies descriptive statistics and paired t-tests for data analysis, and presents results in terms of statistics.	This is a quantitative study. It collects numerical data and applies multiple logistic regression analysis and descriptive statistics.
Purpose Statement	The article investigates how compliance with hand hygiene among healthcare workers (HCWs) changes when data-driven feedback interventions are stopped. It also assesses how pandemics such as the COVID-19 pandemic influence hand hygiene behaviors.	The article evaluates the effectiveness of a standardized train-the-trainers (TTT) course in hand hygiene in improving the knowledge and skills of infection prevention and control (IPC) professionals in various settings.	The article assesses the knowledge and attitudes of healthcare workers (HCWs) based on the World Health Organization’s (WHO) “My 5 Moments for Hand Hygiene” in a Vietnamese central general hospital.
Research Question	There is a lack of specific research questions.	There are no clear research questions. The article evaluates a standardized train-the-trainers (TTT) course.	There are no well-defined research questions.
Outcome	Outcomes are presented as primary and secondary. Primary outcomes present overall hand hygiene compliance based on comparison over 3-time phases. The secondary outcomes presented hand hygiene compliance during various shifts, days, and before and after handling patients.	The TTT course significantly improved my knowledge of microbial transmission during healthcare delivery, HAIs, and key principles, and it led to improved hand hygiene practices.	The participants demonstrate appropriate knowledge and a positive attitude towards hand hygiene guidelines.
Setting (Where did the study take place?)	In a surgical department of a hospital in Denmark.	In local hospitals and universities majorly in Iran, Malaysia, Mexico, South Africa, Spain, and Thailand, and other 20 countries.	The Quang Nam Central General Hospital in central Vietnam.
Sample	A total of 72 participants were doctors (n = 19) and nurses (n = 53).	A total of 305 IPC professionals, including nurses, physicians, and other healthcare workers, participated, including 196 nurses, 53 physicians, and 56 other health professionals.	A total of 120 participants, including nurses, physicians, and other healthcare workers.
Method	The article presents a single-centre, investigator-initiated quality improvement project that applies a prospective, observational, extension trial approach.	The study utilized a pre-and post-test design. Questionnaires were used to collect data. The data was analyzed using descriptive statistics and paired t-tests.	The study used a cross-sectional design.
Key Findings of the Study	A decrease in hand hygiene compliance during the pandemic is due to increased workload, stress, lack of time, limited resources, and changes in routine. Stopping interventions also reduces levels of hand hygiene compliance with time.	The TTT course significantly improves participants’ hand hygiene knowledge and skills.	The majority of HCWs had good knowledge of the WHO’s “My 5 Moments for Hand Hygiene”, however, with mixed attitudes towards the WHO’s guidelines. All participants agreed on the importance of hand hygiene in IPC. Time was a major constraint to complying with the WHO’s hand hygiene recommendations.
Recommendations of the Researcher	As HHC compliance among HCWs fades with time, the focus needs to shift towards the management and continuous improvement of initiatives that maintain higher compliance.	The standardized TTT course in hand hygiene can be used to train IPC professionals in different countries with effective outcomes in developing knowledge and skills in hand hygiene and patient safety.	Regular hand hygiene training and monitoring programs to improve knowledge and attitudes to overcome barriers to hand hygiene complaints

References

Biezen, R., Grando, D., Mazza, D., & Brijnath, B. (2019). Visibility and transmission: complexities around promoting hand hygiene in young children – a qualitative study. BMC Public Health, 19(1). https://doi.org/10.1186/S12889-019-6729-X

Chiu, N. C., Chi, H., Tai, Y. L., Peng, C. C., Tseng, C. Y., Chen, C. C., Tan, B. F., & Lin, C. Y. (2020). Impact of wearing masks, hand hygiene, and social distancing on influenza, enterovirus, and all-cause pneumonia during the coronavirus pandemic: Retrospective national epidemiological surveillance study. Journal of Medical Internet Research, 22(8), e21257. https://doi.org/10.2196/21257

Douno, M., Rocha, C., Borchert, M., Nabe, I., & Müller, S. A. (2023). Qualitative assessment of hand hygiene knowledge, attitudes and practices among healthcare workers prior to the implementation of the WHO Hand Hygiene Improvement Strategy at Faranah Regional Hospital, Guinea. PLOS Global Public Health, 3(2), e0001581. https://doi.org/10.1371/JOURNAL.PGPH.0001581

Stangerup, M., Hansen, M. B., Hansen, R., Sode, L. P., Hesselbo, B., Kostadinov, K., Olesen, B. S., & Calum, H. (2021). Hand hygiene compliance of healthcare workers before and during the COVID-19 pandemic: A long-term follow-up study. American Journal of Infection Control, 49(9), 1118–1122. https://doi.org/10.1016/J.AJIC.2021.06.014

Tartari, E., Fankhauser, C., Masson-Roy, S., Márquez-Villarreal, H., Fernández Moreno, I., Rodriguez Navas, M. L., Sarabia, O., Bellisimo-Rodrigues, F., Hernández-De Mezerville, M., Lee, Y. F., Aelami, M. H., Mehtar, S., Agostinho, A., Camilleri, L., Allegranzi, B., Pires, D., & Pittet, D. (2019). Train-the-Trainers in hand hygiene: A standardized approach to guide education in infection prevention and control. Antimicrobial Resistance and Infection Control, 8(1), 1–11. https://doi.org/10.1186/S13756-019-0666-4/FIGURES/3

Thaivalappil, A., Young, I., Pearl, D. L., McWhirter, J. E., & Papadopoulos, A. (2022). “I Can Sense When My Hands Need Washing”: A Qualitative Study and Thematic Analysis of Factors Affecting Young Adults’ Hand Hygiene. Environmental Health Insights, 16. https://doi.org/10.1177/11786302221129955

Van Nguyen, H., Tran, H. T., Khuong, L. Q., Van Nguyen, T., Ho, N. T. N., Dao, A. T. M., & Van Hoang, M. (2020a). Healthcare Workers’ Knowledge and Attitudes Regarding the World Health Organization’s “My 5 Moments for Hand Hygiene”: Evidence from a Vietnamese Central General Hospital. Journal of Preventive Medicine and Public Health, 53(4), 236. https://doi.org/10.3961/

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Question

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

Literature Evaluation Table

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem.

Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:

Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. HAND HYGIENE AND INFECTION CONTROL
Following the PICOT format, write a PICOT question in your selected area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. Note: This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology.
Articles must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. The PICOT question will also provide a framework for your capstone project.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example, Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Literature Evaluation Table