Evidence for Practice

Rita Samos is a first-year health science’s student. Rita has commenced her first clinical placement block in an aged care facility.Because of the COVID Pandemic, there is much emphasis on hand hygiene practices. However, Rita has observed that health care providers practices on hand hygiene in the aged care facility were varied. Rita wants to know if health care providers in aged care setting comply with hand hygiene practices as an infection control measure.

Clinical question

In aged care health settings, do health care providers comply with hand washing practices as an infection control measure?

Before conducting the current study authors have identified from the previous studies that individuals may have deficit in knowledge that includes safe practices for maintaining hand hygiene. The criteria for measuring and monitoring the adequacy of the hand washing practices duration of washing hands and lack of knowledge and recommendation regarding hand rub were mostly identifiable factors. However, the study has shown that shared attitude among the nurses is required to be developed for maintaining resident safety (Hammerschmidt & Manser, 2019). In this context, it has been mentioned to raise awareness regarding facilitation of the complaints and the practices related to hand hygiene will be possible if safety culture can be developed. This will bring a shift to the concepts of the nurses in health care setting that would influence them to maintain hygiene for the clients. Taking on a patient centred approach and ensuring the maintenance of personal hygiene is of paramount importance within the health and nursing industries.

Research study

Hammerschmid, J., &Manser, T. (2019). Nurses’ knowledge, behaviour and compliance

concerning hand hygiene in nursing homes: a cross-sectional mixedmethods study. BMC Health Services Research, 19(547), pp. 1-3. Retrieved from https://doi.org/10.1186/s12913-019-4347-z

Short Answer Questions

1. Authorship

Discuss the strengths and weaknesses of:

a. authors’ expertise based on their cited credentials andaffiliations. (4marks)

b. possible conflict of interest in the paper (2 marks)

a. It has been mentioned in the current study, the presence of adequate protective material and easier accessibility impacts upon hand hygiene behaviour of the nurses positively. As argued by Mu’taz et al., (2016), the availability and access to the requirements is not the determinant of changes in behaviour.

b. As observed, the details of the authors depicts that authors have an expertise on patient safety along with the knowledge and expertise in psychology. Therefore, it can be stated that the aspects such as rules and procedures, requirements for hand hygiene are described in depth along with the related behaviours with maintenance of hand hygiene has been supported by the expertise in psychology.

2. Research Question & Justification

a. State the research study’s question/s, aim or hypothesis. (2marks)

b. State the gap and author’s justification/s as to why their study wasneeded(4 marks)

a. Questions

“How do nursing managers perceive nurses’ knowledge concerning hygiene management and infection prevention?”

“Which hygiene behaviors do nurses report / nursing managers observe in their staff?”

“What are the perceptions of nurses and nursing managers of organisational structures and processes supporting hand hygiene? In what way do nurses perceive nursing managers / do nursing managers regard themselves as role models for hand hygiene?”

Aim

To influence practices related to infection prevention in positive manner, focusing on hand hygiene in nursing homes for aged care, by using supportive and educational measures for general practitioners and nurses, so that hygiene practices can be improve and antibiotics are used rationally.

b. It has been identified in the study that there are no transparent outcomes of the change process towards improved hand hygiene. Therefore, the study intended to provide effective understanding of the prevention of infection that focuses on the hand hygiene of the nurses. The impacts of the organisational factor on hand hygiene have also been assessed.

3. Research Design

a. Identify and explain the research design used in the study.(4 marks)

The authors have used a design consisting of mixed-methods along with a “concurrent triangulation strategy” so that analyses can be supported that are gathered from different resource. Independent analysis of both quantitative and qualitative data was conducted by the researchers. At the stage of triangulation, all the sources of data were provided equal weight and combined in the data interpretation.

4. Research Methods

a. Discuss the methods the researchers used for: selecting study participants and collecting and analysing data.(5 marks)

b. What were the strengths and weaknesses of the methods used? (5 marks)

c. What was the possible bias and how did the authors reduce the bias in the method of the research? (4 marks)

a. A collection of nursing has been chosen by the authors upon which, a purposeful sampling has been done (Labrague et al., 2017). Nurses that are working in nursing homes particularly for the old age care and provide basic support of nursing have been selected a survey has been upon with 165 nurses and 27 nurses were interviewed. There were 23 questions in the questionnaire that was provided to the selected participants. The knowledge of the nurses have been analysed through nominal response category.

b. The generalisation process becomes easier as a result of using purposeful sampling though it is vulnerable as error may occur due to the authenticity is dependent upon the choices of the researcher. Survey method is an easier and cost effective approach to collect data where as in depth information regarding the phenomenon being studied cannot be gathered through survey. One of the major advantages of interview is it helps in obtaining in depth data though the data is open to interpretation which may reduce the reliability of the results.

c. There is a possibility of selection bias with the interested nurses in preventing infection that were more likely to participate in the study. Therefore, the authors have has made the results more generalised which achieved to arranging a baseline survey with nurses that have different levels of training.

5. Results and Author Cited Limitations

a. Discuss whether the study findings or conclusions answered the research study’s question/s. (3 marks)

b. State and briefly explain the two limitations of the study cited by the authors. (4 marks)

a. It has been identified from the study that most of the nurses and managers have the knowledge of hand hygiene procedures. There was adequate support of equipments and standards which has immediate the work area and role modelling. The consistency of the managers in role modelling has been refused by the managers. Therefore, it can be stated that the result has answered the questions.

b. Two biases cited by the authors of the study include possibility of the selection biased due to which generalisability of the study may have been compromised. The additional qualitative information could not be obtained from the participants.

6. Application:barriers and enablers

a) Reflecting on the scenario, describe two possible enablers, that may impact on the adoption and use of the evidence (i.e. findings) in practice. (4marks).

a. It has been addressed that it is not a problem to organise and wear protective clothing at the time of nursing. This can be considered the first possible enabler that might have impacted on the adoption and use of the evidence (Piras et al., 2018). Similarly, another finding which is a possible enabler is continuous evaluation of risks in cross infections; less priority was given to the long-term care.

b) Reflecting on the scenario, describetwopotential barriers, that may impact on the adoption and use of the evidence (i.e. findings) in practice. (4marks).

b. At the time the staffs has been motivated so that they apply hand hygiene training practice contents, their compliance have been observed to be strongly influenced by the direct availability of the hand hygiene practice equipments. For instance, the accessibility could have act as a possible barrier in the current study.

7. Application of evidence seeks to use clinical practice guidelines to promote patient outcomes.

a). State two advantages of using clinical practice guidelines in promoting patient outcome in the general clinical setting (5 Marks)

a. Though the patients visit health care organisations with different health issues, they are provided different location, hospital and clinician. Clinical practice guidelines bring uniformity in the process and neutralise the differences to receive the best outcomes.

b. This has been observed to change or alter the standards of caring (Zakeri et al., 2017).

Reference List for Evidence for Practice

Hammerschmidt, J., & Manser, T. (2019). Nurses’ knowledge, behaviour and compliance concerning hand hygiene in nursing homes: a cross-sectional mixed-methods study. BMC health services research, 19(1), 547.

Labrague, L. J., McEnroe‐Petitte, D. M., Van de Mortel, T., & Nasirudeen, A. M. A. (2018). A systematic review on hand hygiene knowledge and compliance in student nurses. International nursing review, 65(3), 336-348.

Mu’taz, M. D., Alrimawi, I., Saifan, A. R., & Batiha, A. M. (2016). Hand hygiene knowledge, practices and attitudes among nurses and physicians. Health, 8(5), 456-462.

Piras, S. E., Minnick, A., Lauderdale, J., Dietrich, M. S., & Vogus, T. J. (2018). The effects of social influence on nurses' hand hygiene behaviors. JONA: The Journal of Nursing Administration, 48(4), 216-221.

Zakeri, H., Ahmadi, F., Rafeemanesh, E., & Saleh, L. A. (2017). The knowledge of hand hygiene among the healthcare workers of two teaching hospitals in Mashhad. Electronic physician, 9(8), 5159.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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