Hand Hygiene
PICOT
The revised PICOT statement for this proposal is: For hospital patients (P), how does the use of a visual cue to stimulate hand hygiene compliance (I) compared to no visual cue usage to stimulate compliance (C) affect hospital acquired infection (O) during their hospital stay while the patient hand hygiene protocol implementation process is ongoing (T)?
Research Critiques
The quantitative study by Doyle et al. (2017) focused on testing whether co-washing could be accepted by patients as a concept to help reduce the risk of infection among hospital patients. The researchers used the survey method to see if patients embraced the concept. Doyle et al. (2017) found that the overwhelming majority of patients approved of co-washing. The findings of the study could be applied in nursing practice in a number of ways. First, co-washing could be adopted by nurses whenever they are treating patients in order to promote the idea of hygiene and effective practice with respect to being mindful about reducing the risk of infection. Mindfulness about washing hands could translate to mindfulness about inserting catheters and maintaining them, where it is common for infections to also occur in hospital settings (Chenoweth & Saint, 2013; Wilde et al., 2015).
One of the problems of this practice, however, is that twice as much hand washing would be occurring, which would mean twice the water expense. If a hospital is concerned about sustainability, washing hands excessively could be viewed as a problem in nursing practice, especially if stakeholders in the facility feel that it is important to conserve water. Sustainable practice is a large focus of much of today’s corporate social responsibility programs, and water conservation is a common feature of sustainable practice policy.
The qualitative study by Srigley, Furness and Gardam (2016) used the systematic review method “to determine the efficacy of patient hand hygiene interventions in reducing HAIs and improving patient hand hygiene rates compared to usual care” (p. 23). The researchers found that patient hand hygiene interventions could be useful in reducing hospital acquired infections, but the quality of evidence identified in their review was low, indicating that stronger research designs are required.
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References
Chenoweth, C., & Saint, S. (2013). Preventing Catheter-Associated Urinary Tract Infections in the Intensive Care Unit. Critical Care Clinics, 29(1), 19-32.
Doyle, G. A., Xiang, J., Zaman, H., Neiman-Hart, H., Maroon, M., Arghami, E., ... & King, D. E. (2017). Patient attitudes and participation in hand co-washing in an outpatient clinic before and after a prompt. The Annals of Family Medicine, 15(2), 155-157.
Ford, E. W., Boyer, B. T., Menachemi, N., & Huerta, T. R. (2014). Increasing hand washing compliance with a simple visual cue. American journal of public health, 104(10), 1851-1856.
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., ... & Bader, M. K. (2015). Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses’ hand washing. American Journal of Critical Care, 24(3), 216-224.
Srigley, J. A., Furness, C. D., & Gardam, M. (2016). Interventions to improve patient hand hygiene: a systematic review. Journal of Hospital Infection, 94(1), 23-29.
Wilde, M. et al. (2015). Self-management intervention for long-term indwelling urinary catheter users. Nursing Research, 64(1), 24-34.
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