PICO Question
PICO(T) Question
In healthcare workers (HCWs) working in intensive care unit (ICU) (P), is the use of a hand-hygiene program (I), more effective in reducing hospital-acquired (HAIs) (O) as compared to use of protective clothing and equipment (C)?
Introduction and Background Information
The occurrence of hospital-acquired infections (HAIs) has established as a significant challenge worldwide. According to World Health Organization (WHO), there are over 7 million HAIs’ cases globally per year (Nair et al., 2014; Shinde & Mohite, 2014).In every 20 people with infections, 2-5 have their illnesses occurring from hospitals (Mahmud et al., 2015). Hence, it leads to deaths of over 100,000 people annually and total costs of over $32 million (Nair et al., 2014). Evidently, HAIs are a serious threat to healthcare and patient outcomes.
According to White et al. (2015), healthcare workers (HCWs)use different strategies to enhance effective control of HAIs in their activities. Mainly, HCWs utilize hand-hygiene, based on guidelines provided by WHO in 2009, to ensure efficiency in preventing microbial activity and movement that may cause outbreak and spread of infections (Sarani et al., 2016).With these guidelines, hospitals and healthcare organizations embark on establishing programs to guide their HCWs in avoiding HAIs outbreak and spread through hand washing and hygiene. This technique entails the use of water, soap, detergents, sanitizers, and clipping nails to ensure disinfection of hands before and after engaging in care provision services (Sarani et al., 2016). More so, the technique involves using various guidelines, as provided by the WHO, in ensuring complete hand wash and total hand hygiene without any chances of harboring microorganisms.
At the same time, HCWs use protective clothing and equipment to enhance prevention of HAIs. These clothing and equipment may include gloves, masks, shoe, head covering,gown, and eye shield(Phu et al., 2016). These clothing and pieces of equipment prevent the ability of microorganism to reach the hands or other body parts of the HCWs during the provision of care services. However, while this option may bear effective results in preventing the spread of infections to the nurses and other care providers, it does a little to ensure safety and reduced HAIs spread among the patients (Phu et al., 2016).
Notably, despite using various clothing and pieces of equipment, lack of effective hand-hygiene practices leads to occurrence of infections in hospitals (Chavali et al. 2014).It is because HCWs regularly use their hands in purposes related to treatment and medication while serving parents. Therefore, this research aims at addressing efficiency of preventing HAIs among HCWsthrough use of a hand-hygiene program. It compares effectiveness of this strategy with use of protective clothing and equipment in serving patients and working in intensive care units (ICUs) among other areas in hospitals.
How the Topic on Hospital-Acquired Infections Prevention Relates to Nursing
The topic on hospital-acquired infections (HAIs) prevention involves use of various strategies, including hand-hygiene and protective clothing, to reduce microbial activity and movement as a way to prevent outbreak and spread of infections (Phu et al., 2016; White et al., 2015). It entails critical involvement of nurse practitioners in ensuring cleanliness and disinfection by either washing their hands routinely or using protective clothing. According to Graveto et al. (2018) and Chavali et al. (2014), with nurses being linked to most of the activities involving cleanliness and also the prevention of infections, this topic appears to be closely related to nursing practice than any other healthcare-related field.
References
Chavali, S., Menon, V., & Shukla, U. (2014). Hand hygiene compliance among healthcare workers in an accredited tertiary care hospital.Indian Journal of Critical Care Medicine,18(10), 689.
Graveto, J., Rebola, R. I. F., Fernandes, E. A., & Costa, P. (2018). Hand hygiene: Nurses’ adherence after training.Revista Brasileira de Enfermagem,71(3), 1189-1193.
Mahmud, M. A., Spigt, M., Bezabih, A. M., Pavon, I. L., Dinant, G. J., & Velasco, R. B. (2015). Efficacy of handwashing with soap and nail clipping on intestinal parasitic infections in school-aged children: A factorial cluster randomized controlled trial.PLoS Medicine,12(6).
Nair, S. S., Hanumantappa, R., Hiremath, S. G., Siraj, M. A., & Raghunath, P. (2014). Knowledge, attitude, and practice of hand hygiene among medical and nursing students at a tertiary health care center in Raichur, India.ISRN preventive medicine.
Phu, V. D., Wertheim, H. F., Larsson, M., Nadjm, B., Dinh, Q. D., Nilsson, L. E., Rydell, U., Le, T. T., Trinh, S., Pham, H., Tran, C. T., Doan, H., Tran, N., Le, N., Huynh, N., Tran, T. P., Tran, B., Nguyen, S., Pham, T. T. … Hanberger, H. (2016). Burden of hospital acquired infections and antimicrobial use in Vietnamese adult intensive care units.PLoSOne,11(1).
Sarani, H., Balouchi, A., Masinaeinezhad, N., & Ebrahimitabs, E. (2016). Knowledge, attitude and practice of nurses about standard precautions for hospital-acquired infection in teaching hospitals affiliated to Zabol University of Medical Sciences (2014).Global Journal of Health Science,8(3), 193-198.
Shinde, M. B., & Mohite, V. R. (2014). A study to assess knowledge, attitude and practices of five moments of hand hygiene among nursing staff and students at a tertiary care hospital at Karad.International Journal of Science and Research (IJSR),3(2), 311-321.
White, K. M., Jimmieson, N. L., Obst, P. L., Graves, N., Barnett, A., Cockshaw, W., Gee, P., Haneman, L., Page, K., Campbell, M., Martin, E., & Paterson, D. (2015). Using a theory of planned behavior framework to explore hand hygiene beliefs at the ‘5 critical moments’ among Australian hospital-based nurses.BMC Health Services Research,15(1).
