Quantitative Research Critique and Ethical Considerations Quantitative Studies – Hand Hygiene

Quantitative Research Critique and Ethical Considerations Quantitative Studies – Hand Hygiene

Hand hygiene is the most common and effective infection prevention and control (IPC) in controlling and preventing Healthcare-associated infections (HAIs). HAIs significantly affect patient safety and are a risk factor for morbidity and mortality (Haque et al., 2020). HAIs are associated with devices used in patient care procedures, such as catheters and ventilators, or due to infections on surgery sites (Dadi et al., 2021). A majority of HAIs are preventable with proper IPC efforts within the hospital environment. Despite the effectiveness of hand hygiene and IPC in hospital settings, adherence-related protocols fade with time. This makes a lack of adherence to hand hygiene protocols and the associated risk of higher rates of HAIs issues of concern in nursing care settings. Notably, adherence to hand hygiene practices among healthcare workers depends on their knowledge of microbial transmission during healthcare delivery, HAIs, and the key principles of hand hygiene (Tartari et al., 2019). This paper summarizes and compares two quantitative studies to help answer the PICOT question developed and support strategies to improve adherence to hand hygiene and reduction of HAI rates.

PICOT Question

In healthcare workers (P), does hand hygiene education (I) compared to regular hand washing protocols (C) improve adherence to hand hygiene protocols and reduce the rate of hospital-acquired infections (O) over six months?

Background of Studies

Stangerup et al. (2021) in the article, “Hand hygiene compliance of healthcare workers before and during the COVID-19 pandemic: A long-term follow-up study” aim to establish whether compliance with hand hygiene practices among healthcare workers changes with time with a focus on the adherence trends before and during the COVID-19 pandemic. The objective is to identify factors and management approaches influencing hand hygiene adherence among HCWs. The problem of focus in the study is the differences and changes in adherence and compliance to hand hygiene protocols before and during a pandemic. This study is significant to nursing as it helps understand changes in hand hygiene adherence in hospital settings during various times and conditions. The authors developed three hypotheses. Termination of the intervention is hypothesized to make the HCWs less aware of HH during their clinical work routines, reflected by a decrease in HHC. HHC is hypothesized to be higher during the COVID-19 pandemic compared to the pre-pandemic, and “HHC would be higher during daytime and on weekdays because of more staff resources available.”

The purpose of the second study article, “Healthcare Workers’ Knowledge and Attitudes Regarding the World Health Organization’s “My 5 Moments for Hand Hygiene”: Evidence from a Vietnamese Central General Hospital” by Van Nguyen et al. (2020) is to identify the influence of knowledge and attitudes influence the compliance to hand hygiene protocols among healthcare workers. The study specifically focuses on the HCW’s knowledge and attitudes towards the WHO’s “My 5 Moments for Hand Hygiene” in a Vietnamese central general hospital. The main problem identified in the study is how the levels of knowledge and attitudes of HCWs towards hand hygiene protocols influence the compliance levels to such protocols. The study is significant in nursing as it focuses on how knowledge of hand hygiene protocols and HCWs’ attitudes towards such protocols can influence how the HCWs comply to the protocols. The study also identifies the importance of regular training on the protocols, which can improve compliance. The study did not employ specific research questions. It, however, used a hygiene knowledge questionnaire that included 19 true-false statements about the five moments of hand hygiene.

How do These Two Articles Support the Nursing Practice Problem You Chose?

Both articles have identified various factors that influence compliance with hand hygiene among healthcare workers. For instance, Van Nguyen et al. (2020) associate attitudes and knowledge of protocols with the levels of adherence to such protocols. Additionally, Stangerup et al. (2021) link workload, work pressure and stress, time and resource availability, and well as changes in practice routines to reduced levels of compliance. On the other hand, compliance is related to positive attitudes and training to higher levels of compliance (Van Nguyen et al., 2020). The findings of the articles will be used to assess the nursing problem of focus and apply the various recommendations to answer the PICOT question. The articles also present training HCWs as a way of improving knowledge of hand hygiene practices and attitudes towards the set protocols to ensure improved compliance with such protocols and practices.

The interventions and the groups focused on the articles are similar to the interventions and comparison groups identified in the PICOT question. For instance, the article’s population of focus is HCWs, which is also the population of interest in the PICOT question. The main intervention for improving compliance in both articles is training. The PICOT question adopts hand hygiene education as the main intervention and compares it to usual hand-washing practices. Therefore, both articles provide a ready guide to solving the nursing problem focused on in the PICOT question.

Method of Studies

The summarized articles both apply quantitative research methods. The article by Stangerup et al. (2021) applies statistical analyses to the collected data, while Van Nguyen et al. (2020) applied multiple logistic regression analysis and descriptive statistics in their study. As quantitative studies, the authors of both articles collect numerical data and apply statistical analyses to the data collected. Results are also presented using statistics. The main benefit of using quantitative methods is that it allows for empirical testing of developed hypotheses by collecting and comparing data from a large sample that is representative of the population. This supports the generalizability of the findings. However, quantitative methods are prone to structural biases due to incomplete data and biases in the sample selection.

Results of Studies

The results presented in the study by Stangerup et al. (2021) show that compliance with hand hygiene was highest during the pandemic by 58% and lowest past the pandemic by 34%. This shows that compliance is higher during the intervention phase, lower before the intervention, and lowest after the intervention. Compliance is also dependent on workload, work pressure stress, time, and resource availability. The findings of this study have implications for planning hand hygiene interventions and ensuring the continuity of such interventions to support adherence to hand hygiene protocols.

In their study, Van Nguyen et al. (2020) found that a majority of HCWs have enough knowledge and positive attitudes towards the WHO’s “My 5 Moments for Hand Hygiene.” Improving knowledge and attitudes on hand hygiene through training improved adherence to the protocols in high-risk and high-exposure settings. The study has implications on nursing practice on applying multimodal strategies, including regular education and training programs that improve knowledge, attitudes, and practices towards hand hygiene.

Ethical Considerations

Two major ethical considerations in conducting research are informed consent and confidentiality. Informed consent means providing the participants with information related to the study to help them decide whether to participate. On the other hand, confidentiality means that all communications and identities of the participants will remain private. The summarized articles have adequately considered these ethical considerations while conducting their research. For instance, Stangerup et al. (2021) approval from the Ethics Committee and the Danish Data Protection Agency, while Van Nguyen et al. (2020) obtained approval from the Scientific Panel of the Institute for Preventive Medicine and Public Health at Hanoi Medical University according to Decision No. 61/QDYHDP&YTCC, dated 16/06/2015.

Conclusion

Hand hygiene is an important IPC that can effectively reduce and prevent the occurrence of HAIs. However, adherence to hand hygiene protocol among healthcare workers remains a challenge. Through the use of a PICOT question, it is possible to search for peer-reviewed articles that support answering the question and resolving the nursing problem. Quantitative research methods provide high-quality empirical evidence that can be replicated in various nursing practice settings to improve compliance with hand hygiene practices among HCWs.

References

Dadi, N. C. T., Radochová, B., Vargová, J., & Bujdáková, H. (2021). Impact of Healthcare-Associated Infections Connected to Medical Devices—An Update. Microorganisms 2021, Vol. 9, Page 2332, 9(11), 2332. https://doi.org/10.3390/MICROORGANISMS9112332

Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies to prevent healthcare-associated infections: A narrative overview. Risk Management and Healthcare Policy, 13, 1765–1780. https://doi.org/10.2147/RMHP.S269315

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

Van Nguyen, H., Tran, H. T., Khuong, L. Q., Van Nguyen, T., Ho, N. T. N., Dao, A. T. M., & Van Hoang, M. (2020). 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/JPMPH.19.319

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Hand Hygiene

In this assignment, you will write a critical appraisal that demonstrates comprehension of two quantitative research studies.

Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment (or two new articles based on instructor feedback in Topic 1) to complete this assignment.

In a 1,000–1,250-word essay, summarize two quantitative studies.

Use the “Research Critique Guidelines – Part II” document to organize your essay.

You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.