Evidenced Based Practice and Applied Nursing Research
A1 Impact of the Problem on The Patient
Hospital Acquired Infection (HAI) in hospital has affected prolonging hospital stay, higher infection rate and could lead to life threatening for elderly patient and those with comorbidities.
Impact of the Problem on Organization
Hospital Acquired Infection in hospital could has led to law suit for organization due to poor hand hygiene. Hospital could also pay higher rate for patient treatment due to malpractice. Lastly hospital will receive bad reputation and suffer financially.
PICO Components
P- Patient/population/problem
The problem here is the growth of hospital-acquired infections among patients and visitors. Nosocomial infections, often known as hospital-acquired infections, are frequent in intensive care units. It is estimated that 10% of patients admitted to hospitals may develop a nosocomial illness. Healthcare-acquired infections result in a high number of morbidities, fatalities, and hospital costs (Yen, 2019).
I – intervention
Handwashing with soap and water is one of the most basic and successful methods of preventing nosocomial infections in hospitals. Soap destroys germ membranes on hands, limiting their transmission to other parts of the body (Yen, 2019). To prevent nosocomial infections, all patients, visitors, and hospital employees must be educated on the need of hand hygiene.C- Comparison
Due to a shortage of handwashing facilities, several healthcare facilities use masks and alcohol-based sanitizers instead. Because they are more expensive and not always available, they may not be as effective as water and soap.
O- Outcome
Hand hygiene has been proven to lower the prevalence of hospital-acquired diseases by more than 50% when strictly followed. As a result, hospital expenditures will be reduced, patient safety will be enhanced, and health outcomes will improve. Client satisfaction will also improve.
A2. Evidence-Based Questions
Will increased hand hygiene education decrease Hospital Acquired Infection in hospital compare to no education? Does hand washing with soap and water or the use of an alcohol-based hand sanitizer by cardiothoracic surgical step-down unit patients minimize the number of instances of hospital-acquired infections? ( Brown , 2020 )
B. Selection of a Research-Based Article
Article: 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), e1-e8.
B1. Background of the Research-Based Article
The study sought to determine if patient access to hand hygiene items and information may aid in improving patients' hand cleanliness and lowering the risk of hospital-acquired illnesses.
The study concentrated on nosocomial infections caused by Staphylococcus enterococci and Clostridium difficile (Haverstick et al., 2017).
B2. Research Methodology
The cardiothoracic surgery step-down unit at the University of Michigan Health System served as the research site. Patients who took part in the study were unable to reach the sink on their own to wash their hands. A survey was completed by facility employees prior to the intervention's implementation. Unit personnel completed a questionnaire, and patients replied to a survey prior to the intervention, as well as after the first, second, and third months following the intervention, to track the intervention's outcomes. Upon admission to the ward, each patient was given a sanitizer or wipes and a booklet on the significance of hand cleanliness, which the nurse discussed with the patient. The research included all of the patients on the unit (Haverstick et al., 2017).
B3. Level of Evidence in the Research-Based Article
Identify the level of evidence using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model.
Level II study (Dang & Dearholt, 2017).
B4. Analysis of the Data
A comparison of nosocomial infections during the 19 months before and after the intervention was done. Data was analyzed using SPSS version 21. The rates of hospital-acquired infections for the two organisms were compared before and after the intervention. Because of the limited sample size, a non-parametric Wilcoxon rank-sum test was performed. A significance threshold of 0.05 was chosen (Haverstick et al., 2017).
B5. Ethical Considerations
The hospital's institutional review board did not examine the study since it was a quality improvement initiative. Furthermore, no informed consent was sought from individuals. It was also supported by a grant from the University of Michigan Health System for the purchase of hand sanitizers and wipes (Haverstick et al., 2017).
B6. Quality Rating of the Research-Based High quality Article.
(Dang & Dearholt, 2017).
B7. Results of the Research-Based Article
After the treatments, infections caused by Staphylococcus enterococci were decreased by 70%, while infections caused by Clostridium difficile were reduced by 63%. According to the study, rigorous hand cleanliness by patients is an excellent strategy to decrease hospital-acquired illnesses (Haverstick et al., 2017).
C. Selection of a Non-Research-Based Article
Article: Sharma, S. (2018). Hand hygiene and hospital-acquired infections. Medical
Journal of Dr. DY Patil Vidyapeeth, 11(3), 201.
C1. Background of the Non-Research Article
The article's goal is to offer evidence that hospital-acquired illnesses may be controlled simply by practicing good hand hygiene. The paper discusses the relationship between hospital-acquired illnesses and hand hygiene practices, as well as how hand hygiene adherence may be tracked (Sharma, 2018).
C2. Type of Evidence
The clinical practice guideline is a non-research publication.
C3. Level of Evidence in the Non-Research Article
Level III ((Dang & Dearholt, 2017).
C4. Quality Rating of the Non-Research Article
High quality (Dang & Dearholt, 2017).
C5. Author’s Recommendation
To prevent hospital-acquired illnesses, the author suggests that patients and workers be closely monitored for hand hygiene compliance, either by direct observation or technological surveillance. This responds to the EBP issue since it is based on the knowledge that hand cleanliness is important in preventing hospital-acquired illnesses (Sharma, 2018).
D. Recommended Practice Change
I would recommend that patients, visitors, and hospital personnel should be educated and reminded about the significance of hand cleanliness in order to reduce hospital-acquired illnesses. This may be accomplished by posting educational posters in prominent areas across the facility, providing frequent training, and disseminating pamphlets.
D1. Involvement of Key Stakeholders
I would rely on the nurse supervisor, the hospital's director of health and safety, and all of the nurses to assist with the spread of information about the significance of hand cleanliness in the battle against hospital-acquired infection. The head of health and safety would be in charge of organizing hand hygiene training and awareness seminars, as well as providing posters and pamphlets.
D2. Barrier of Implementing the Practice Change
The greatest threat to the practice is resistance to the new standards. Because individuals are accustomed to a specific method of doing things, it may be difficult to persuade them otherwise.
D3. Strategy for Overcoming the Barrier
To overcome opposition, a strong communication strategy should be used to ensure that the message is effectively packaged for the audience.
D4. Outcome to Measure the Recommend Practice Change
If the number of reported cases of hospital-acquired infections decreases after the intervention is implemented at the hospital, it indicates that the intervention was successful.
References
Brown, Roy E. "Evidence Based Practice Question Development & Search Checklist." (2020).
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model and
guidelines. Sigma Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines. Sigma Theta Tau.
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.
Sharma, S. (2018). Hand hygiene and hospital-acquired infections. Medical Journal of Dr. DY Patil Vidyapeeth, 11(3), 201.
Yen, P. (2020). Hospital Acquired Infection Reduction with Hand Washing Compliance. Lynchburg Journal of Medical Science, 2(1), 54.
