Problem Statement
Hospitals are doing their best to improve daily operations, find the best ways to facilitate the safety of patients and reduce the number of healthcare-associated infections. HAIs constitute a real problem for hospital patients who frequently experience a worsening of their illness and death, more extended hospital stays, and additional medical complications (Dimitriadou et al., 2022). In addition to the fact that HAIs have a significant financial implication on healthcare entities, necessitating extra resources, specialized treatment, and more antibiotics, the patient’s quality of life can be affected (Dimitriadou et al., 2022). HAI could lose the reputation of healthcare institutions and lead to public mistrust that subsequently affects patient volume, physician recruitment, and partnerships. What is more, HAIs are also part of the public health crisis of antimicrobial resistance caused by unnecessary and improper use of antibiotics that make the treatment less effective. Health authorities and regulatory bodies are watching healthcare institutions due to HAI.
PICOT analysis and picot question
In addressing the issue of hospital-acquired infection, the research will focus on the population of healthcare workers working in the ICU unit. The intervention is the observation of hand hygiene through washing with soap and water. Comparison is the adherence rate among healthcare professionals and how it affects the prevalence of HAIs. The expected outcome is the reduction of HAIs among ICU patients, and the expected time frame is six months.
Compared to non-adherence, the PICOT question is whether strict adherence to hand hygiene protocols among healthcare professionals working in the ICU unit significantly reduces Healthcare-Associated Infections (HAIs) over six months.
Research-based article Evidence Appraisal
The article is research-based and is about nurses’ opinions about the preventive measures against hospital-acquired infections in the ICUs. The backdrop of the topic shows HAIs as one of the most prevalent problems in healthcare since they are related to morbidity, mortality, and increased healthcare costs (Dimitriadou et al., 2022). The healthcare profession has adopted different prevention strategies, but the ICUs are still experiencing a high incidence of HAIs. This research will discover how ICU nursing staff see and follow measures to prevent hospital-acquired infections.
The study employs the ethnographic qualitative method in the Intensive Care Unit and Cardiac Care Unit of a General Hospital in North Greece (Dimitriadou et al., 2022). Seventeen nurses consented to participate in the semi-structured interview, where they shared their thoughts on infection control and prevention (Dimitriadou et al., 2022). The data was analyzed using inductive and deductive approaches, as thematic analysis was employed. The research followed the COREQ criteria for reporting qualitative research.
Based on the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, the level of evidence for this research-based article would be Level VI: One single descriptive or qualitative study. The JHNEBP model holds the Level VI evidence for those qualitative studies or expert opinions without a critical appraisal and pooling of several studies. Such a level of proof is beneficial when assessing perceptions, experiences, and attitudes, and, therefore, practical solutions to health crises implemented are effective.
The researcher applied thematic analysis to analyze the data from the semi-structured interviews with ICU nursing staff. The recordings were transcribed word for word. The researcher reviewed the transcripts, marking the initial codes, words, or phrases related to the research questions (Dimitriadou et al., 2022). The recording of codes occurred systematically. The authors later organized the codes under broad categories based on the similarity and dissimilarity of the content. The process involved grouping and summarizing the data to identify the main themes (Dimitriadou et al., 2022). In establishing a pattern, the researcher grouped the codes to establish the key themes they could utilize to uncover the concepts that emerged from the data. To ensure the established theme answered their research question, the authors reviewed the data several times and consulted another research expert to ensure credibility and coherence.
In the research-based article, the author considered several ethical issues during the study. Nurses must sign a consent form indicating they had volunteered willingly for the study (Dimitriadou et al., 2022). Signing the consent form indicated they knew what the study entails and could withdraw anytime. To ensure privacy, the participants’ researcher omitted personal information from the transcript and assured the participants that the information provided was for research purposes.
Rating the article using The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP), it can be described as a reliable research article as it results from a qualitative research project that follows all requirements of a peer-reviewed journal. The study discovered how nurses in intensive care units (ICUs) believe in the measures that help prevent hospital-acquired infections (HAIs). Through qualitative interviews with ICU nurses, the research discovered the critical subjects associated with infection prevention practices. These determinants contribute to whether nurses follow or fail to follow these measures and create an appropriate plan for improving these measures.
This article appropriately related the issue of evidence-based practice (EBP) in the context of determinants of nurses’ adherence to infection prevention interventions in ICUs. Knowledge of the views and experiences of nurses is of high value when designing interventions that would improve the prevailing guidelines and cut down the number of HAIs.
Non-Research based article Evidence Appraisal
Haque et al. (2020) highlight infection prevention as a critical element in healthcare facilities and the staggering implications of healthcare-associated infections about increased morbidity and mortality and economic costs. The introduction explains the necessity of successful solutions to the HCAI problem and the negative impact of the disease on patients and healthcare systems.
The article is evidence-based by the narrative overview rather than the research itself. The data presented in this work is the research review of existing publications and expert opinions, which aims to review a specific topic or matter comprehensively. The author utilizes information from sources such as resource studies, clinical guidelines, and expert opinion to support their research and provide reliable information in solving a clinical problem.
According to the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, the level of evidence in the non-research-based article would be categorized as level V. Level V evidence comprises expert opinion, consensus statements, and clinical practice guidelines based on systematic reviews of descriptive and qualitative studies. In this article, the authors rely on expert opinion and consensus statements to support their call for preventing healthcare-associated infections.
The JHNEBP model will examine the quality of the article. A few things will be considered to measure it as a credible source. Factors to consider include clarity, coherence, and reliability of outside sources the authors utilize in their articles. Therefore, since the article meets all these criteria, it is a reliable source for answering the PICOT question.
The selected non-research article answers my EBP question by providing different solutions an organization can adopt to curb the spread of hospital-acquired infection. Some of the methods put forward by the article’s author include hand hygiene, environmental cleanliness, and surveillance. Furthermore, the authors recommend adopting more than one solution to ensure effectiveness. Thus, the article provides solutions organizations can implement to reduce the spread of HAI, ensuring the well-being of their workers and clients.
Practice change recommendation
One possible solution to addressing the spread of HAIs in hospitals is introducing the practice of hand hygiene among healthcare professionals. Nurses can practice hand hygiene by washing their hands with running water and soap (Hague et al., 2020). They can also use alcoholic antiseptic to kill germs in their hands in case running water is not available (Hague et al., 2020). These measures help reduce the spread of HAIs, ensuring the safety of patients and healthcare professionals.
One vital stakeholder in ensuring the success of the implementation of new measures is the healthcare profession, especially nurses. Nurses are healthcare professionals in most contact with patients, checking their vitals, administering medication, and monitoring their health. Thus, their involvement will help reduce the spread of HAIs. Involving nurses in the practice change recommendation would include educating and training them on hand hygiene techniques, preaching compliance, and seeking their opinions on implementation. There is also a need to involve the executive leader in the process as they offer the necessary resources and funding. Their support can guarantee success as they can fund the creation of more water stations for washing hands, fund education programs, and ensure the hospital purchases enough antiseptics. The last important group is the patient family, as they come into contact with the patient when they are helping in performing hygiene, such as bathing the patient. The group will receive education on the importance of observing hygiene and receive feedback on their adherence level performance.
One challenge an organization may encounter when implementing the hand hygiene policy is resistance from healthcare workers. Most healthcare professionals work under pressure due to their workload and must attend to clients seeking their services (Dehghan-Nayeri et al., 2022). Thus, the constant need to clean their hand can seem like an obstacle interfering with their already tight schedule, and other nurses need to be more comfortable with how they operate and may view the near measure as a nuisance.
In order to overcome this barrier, nurses need to know the importance of hand hygiene. The in-charge nurses can also monitor adherence levels among nurses to ensure they adhere to new measures and offer feedback to ensure they are aware of the positive outcome of their actions, improving their motivation levels (Dehghan-Nayeri et al., 2022). The management can also keep the healthcare profession through recognition and offering incentives. Adherence will ensure the safety of both the patient and the healthcare profession.
One expected outcome from my EBP question is the reduction of healthcare-associated infections (HCAIs) among patients. By tracking the rates of HCAIs before and after introducing hand hygiene measures, healthcare facilities can see whether or not the intervention is working.
Conclusion
Hospital-acquired infections can be preventable with proper hygiene observation. Controlling the prevalence of HAIs is essential due to its adverse effects on patients and organizations. Hospital-acquired infections increase the cost of treatment and prolonged hospital stays and can result in the death of the patient. For this reason, organizations are adopting and utilizing EBP to ensure the safety of their clients. Furthermore, controlling the spread of HAIs benefits the organization as it can maintain its reputation, retain its clients, and attract partnerships. Thus, it is why organizations need to reinforce policies on hygiene and monitor compliance levels. Simple practices such as hand hygiene can go a long way in ensuring the health worker’s and patient’s safety.
References
Dehghan-Nayeri, N., Seifi, A., Rostamnia, L., Varaei, S., Ghanbari, V., Sari, A. A., & Haghani, H. (2022). Challenges of and corrective recommendations for healthcare-associated infection’s case findings and reporting from local to national in Iran: a qualitative study. BMC nursing, 21(1), 193. https://doi.org/10.1186/s12912-022-00976-1
Dimitriadou, I., Pittas, S., Sidiropoulos, A., & Zarkali, O. (2022). Perception of Nursing Staff in ICU Regarding Measures to Prevent Hospital-Acquired Infections: A Qualitative Approach. Cureus, 14(12). https://doi.org/10.7759%2Fcureus.33029
Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., … & Charan, J. (2020). Strategies to prevent healthcare-associated infections: a narrative overview. Risk management and healthcare policy, 1765-1780. https://doi.org/10.2147%2FRMHP.S269315
Johns Hopkins Medicine. (n.d.). Hopkins Evidence-based practice model https://www.hopkinsmedicine.org/evidence-based-practice/model-tools
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