Caglar, S., Yildiz, S., & Savaser, S. (2010). Observation results of handwashing by health-care workers in a neonatal intensive care unit. International Journal Of Nursing Practice, 16 (2), 132-137.
The article describes that hospital infections are the primary cause of infant deaths in neonatal intensive care units. Most hospital infections are spread through the hands of healthcare workers. The spread of bacterial infections by hands can be prevented by hand-washing which is the most effective and cheapest method of preventing infection in hospitals. The article provides evidence from previously conducted research by other scholars to prove that neonatal infants in the ICUs have low levels of resistance and poor immunity.
Examples of morbidity and mortality include the deaths of infants in the intensive care unit who die due to infections which develop due to weak immune systems and complications arising from low birth weight which makes them more susceptible to infections. My proposed change is hand hygiene and health care associated infections which are supported in this article.
Galway, R., Harrod, M., Crisp, J., Donnellan, R., Hardy, J., Harvey, A., &… Senner, A. (2003). Central venous access and handwashing: variability in policies and practices. Pediatric Nursing, 15 (10), 14-18.
The article discusses the issue of infections occurring due to central venous access devices (CVADs) in acute child care settings and the importance of hand-wash hygiene to reduce infections. The authors provide a brief review of literature to assert the importance of hand-wash hygiene while handling CVADs to reduce the risks of infection. Examples of incidence provided include the variability of hand washing practice and policies in hospitals related to hand wash hygiene.The article supports my proposed change which centers around the practice of hand washing and hygiene to avoid infections occurring due to CVADs.
Picheansathian, W., Pearson, A., & Suchaxaya, P. (2008). The effectiveness of a promotion programme on hand hygiene compliance and nosocomial infections in a neonatal intensive care unit. International Journal Of Nursing Practice, 14 (4), 315-321.
The article describes the importance of hand hygiene practices for preventing nosocomial infection in neonatal intensive care infants. Statistical evidence by the authors highlights the prevailing 6.4% rate of nosocomial infection is 6.4% occurring in neonatal ICUs. The article supports the importance of appropriate hand wash hygiene practices among nursing personnel, which is consistent with my proposed change.
Correa, J. C., Pinto, D., Salas, L. A., Camacho, J. C., Rondón, M., & Quintero, J. (2012). A cluster-randomized controlled trial of handrubs for prevention of infectious diseases among children in Colombia. Revista Panamericana De Salud Publica, 31(6), 476-484.
The article describes that acute diarrheal diseases (ADD) and acute respiratory infection (ARI) are mainly caused due to infection by hands and can be prevented with substitute alcohol based hand-rubs (ABH) in places with water scarcity. Data and statistics in the article confirm that ADD and ARI are a primary cause of mortality in children below 5 years of age in developing countries. Both diseases are among the first 5 causes of deaths of children between 0-4 years. The article supports the use of alcohol based hand-wash (ABH) as a substitute for washing with water due to water scarcity. It supports my proposed change of the importance of hand hygiene but with a substitute in regions of water scarcity.
Kelcíkova, S., Skodova, Z., & Straka, S. (2012). Effectiveness of Hand Hygiene Education in a Basic Nursing School Curricula. Public Health Nursing, 29(2), 152-159.
The article describes that even though hand hygiene (HH) is the most effective tool for avoiding infections, it is not effectively practiced in hospitals. The article provides a review of literature stating that less than 50% of nurses and physicians comply with HH policies in health care settings. Reasons for non compliance have been cited as general risk factors, personal risk factors and emotional barriers which prevent compliance to HH by healthcare professionals. The article presses on the importance of HH policies for preventing hospital acquired infections which supports my proposed change.
Aiello, A., Coulborn, R., Perez, V., & Larson, E. (2008). Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. American Journal Of Public Health, 98 (8), 1372-1381.
In the article, the author describes the importance of hand-hygiene intervention for preventing infections of the gastrointestinal tract and respiratory system. There is not statistical information to demonstrate the gravity of the due to the dearth of investigations in this area. The article is a review of several studies and supports my proposed change of the importance of hand-wash hygiene for preventing infections.
Eveillard, M., Raymond, F., Guilloteau, V., Pradelle, M., Kempf, M., Zilli-Dewaele, M., & Brunel, P. (2011). Impact of a multi-faceted training intervention on the improvement of hand hygiene and gloving practices in four healthcare settings including nursing homes, acute-care geriatric wards and physical rehabilitation units. Journal Of Clinical Nursing, 20(19/20), 2744-2751.
The authors describe that hand hygiene (HH) and gloving practices are the basis for prevention of pathogen transmission in healthcare settings but has low levels of adherence. The authors provide evidence to prove that adherence of HH by health care professionals is less than 50%. The article provides a brief review of literature to assert the high rate of infection due to lack of HH compliance in geriatric and rehabilitation settings. The authors state that changing gloves is an important aspect of hand hygiene which is not appropriately complied to. The article supports the importance and effectiveness of HH and gloving practices in the healthcare setting which indirectly supports my proposed change of the importance of hand hygiene.
De Wandel, D., Maes, L., Labeau, S., Vereecken, C., & Blot, S. (2010). Behavioral determinants of hand hygiene compliance in intensive care units. American Journal Of Critical Care, 19(3), 230-239.
The article identifies the importance of HH and seeks to understand the barriers which prevent its effective compliance in healthcare settings. The article reports low levels of HH compliance among healthcare workers, between 505 to 60%. The article does not offer any examples of morbidity. It seeks to find the rationale for low compliance of HH with the intention of designing an appropriate strategy to increase HH compliance among health care workers.
Alemagno, S., Guten, S., Warthman, S., Young, E., & Mackay, D. (2010). Online Learning to Improve Hand Hygiene Knowledge and Compliance Among HealthCare Workers. Journal Of Continuing Education In Nursing, 41(10), 463-471.
The article describes the importance and effectiveness of online educational programs for promoting hand hygiene practices among healthcare workers. The article explains that 15%-30% deaths occur annually due to infections resulting from poor hand hygiene. The article reports the poor levels of compliance to hand hygiene among healthcare workers, ranging between 305 and 50%. The article supports the importance of hand hygiene is reducing bacterial transfers, infections and consequent deaths occurring in patients. 97% of the participants involved in the program reported improvements in hand hygiene knowledge and compliance.
Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee (CDC/HICPAC) (2002). Guideline for Hand Hygiene in Health-Care Settings. Web.
The article provides evidence based elaborate and comprehensive guidelines related to hand hygiene in healthcare settings. The report provides systematic data and knowledge about all aspects related to hand hygiene. The report includes detailed information about all aspects of hand hygiene and offers recommendations to enhance compliance to hand hygiene practices by healthcare workers.
The primary aim of the report is to reduce the spread of bacterial infections in patients which lead to infections and sometimes prove fatal. The report offers solutions and practices which improve hand hygiene compliance among healthcare workers. The report also includes information about alcohol based hand-rubs, policies, hand hygiene programs and interventions to improve hand hygiene compliance in healthcare workers and prevent the risk of infections. The article aims at improving hand hygiene and supports my proposed change.
Dilek, A., Ãlger, F., Esen, Ş., Acar, M., Leblebicioğlu, H., & Rosenthal, V. D. (2012). Impact of Education and Process Surveillance on Device-Associated Health Care-Associated Infection Rates in a Turkish ICU: Findings of the International Nosocomial Infection Control Consortium (INICC). Balkan Medical Journal, 29 (1), 88-92.
The article describes ICU based infections occurring due to invasive medical devices such as CLA-BSI, VAP and CAUTI which pose the greatest risk of infection to patients. The rates of infections occurring due to these invasive devices can however be reduced by appropriate compliance to hand hygiene. The article provides evidence from previously conducted studies to prove the prevalence and reduction of infections due to these invasive devices.
The article does not use statistics to demonstrate the gravity of the issue but provides support from studies conducted in this area. The study proves that offering basic education such as hand hygiene for controlling infections in the ICU and through constant performance feedback, it is possible to reduce the rates of device associated healthcare associated infections (DA-HAIs) by 89%. This article supports compliance to hand hygiene which is in support of my proposed change.
Tarricone, R., Torbica, A., Franzetti, F., & Rosenthal, V. (2010). Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy. Cost Effectiveness & Resource Allocation.
The article describes the risks and costs associated with healthcare associated infections occurring due to Central line associated blood stream infections (CLABSI). The article explicitly provides countrywide statistics of losses occurring due to these infections. Deaths in the United States due to HAIs are to the tune of 90,000 with a financial burden of 6.5 billion dollars. The high costs associated with HAIs are high in countries such as England and Italy as well, which demonstrates the gravity of the issue. However, this article does not relate to my proposed change of the importance of hand hygiene and hand wash. It relates to the use of technology used for preventing HAIs in surgical units.
Pellowe, C., MacRae, E., Loveday, H., Reid, P., Harper, P., Robinson, N., & Pratt, R. (2002). The scope of guidelines to prevent health-care-associated infections. British Journal Of Community Nursing, 7 (7), 374-378. 1.
The article describes the importance of safety for the patient as well as the healthcare professional in delivering care to the patient. The article propounds the need for explicit evidence based guidelines to prevent infections in healthcare settings. The authors state that certain devices used in healthcare settings carry the burden of risk to the health giver as well as the patient. Although this article concerns HAIs, it does not relate to my supported change of hand hygiene in healthcare settings to reduce the risk of infections.
Parmeggiani, C., Abbate, R., Marinelli, P., & Angelillo, I. (2010). Healthcare workers and health care-associated infections: knowledge, attitudes, and behavior in emergency departments in Italy. BMC Infectious Diseases, 1035.
The article is a survey to assess the knowledge, attitudes and level of compliance with HAIs among health care workers. The authors state that about 5% to 10% of patients admitted to acute care in hospitals acquire a minimum of one infection. The survey proves that the despite having high level of knowledge about the necessary precautions required for prevention of HAIs, the level of compliance is particularly low. Results from the survey indicate that nurses are more familiar with risks and data associated with HAIs as compared to physicians. The article concerns HAIs but does not support my study of hand wash hygiene to prevent HAIs.
Lam, B., Lee, J., & Lau, Y. (2004). Hand hygiene practices in a neonatal intensive care unit: a multimodal intervention and impact on nosocomial infection. Pediatrics, 114(5), 565-71.
The authors describe the necessity and importance of hand hygiene as the most critical factor in avoiding infections in neonatal ICUs. It is however noted that levels of compliance to hand hygiene are low despite the knowledge that its importance. The authors provide evidence from previously conducted research to support the importance of hand hygiene in preventing nosocomial infection in neonatal patients. It is extremely essential for healthcare workers to wash hands before and after treating patients in order to effectively prevent HAIs. The study indicates that appropriate education programs for HCW can enhance compliance to hand hygiene. The study also found the positive correlation between hand hygiene and reduced infection rate.
Harris, J. R., Cheadle, A., Hannon, P. A., Forehand, M., Lichiello, P., Mahoney, E., Snyder, S. & Yarrow, J. (2012). A framework for disseminating evidence-based health promotion practices. Prev Chronic Dis, 9, 110081.
In the article the authors explain the importance of dissemination which is crucial to the adoption of health promotion practices. The researchers focus on the important roles of dissemination and highlight the importance of the researcher in the process of dissemination. Asserting that a strategic and systematic approach to dissemination is vital for its success, the authors emphasize a close partnership between the researcher and the disseminators.
The flow of an effective dissemination process has been explained in the article. The model of dissemination used is the Health Promotion Research Center (HPRC) according to which the three essential steps for a successful dissemination process are – adoption, implementation and maintenance. The article explains the 7 practical and important roles of the researcher – sorting out the evidence, conducting the research process, gauging organization readiness, balancing reliability, evaluating the research, influencing the external environment and testing the process of dissemination. The article is an effective guideline for the effective implementation of an evidence based program.
Rabin, Borsika A., Brownson, Ross C., Haire-Joshu, Debra, Kreuter, Matthew W., & Weaver, Nancy L. (2008). A glossary for dissemination and implementation research in health. Journal of Public Health Management and Practice, 14(2), 117-123.
The article highlights the importance of dissemination as a major aspect of academia in health related domains. Stating that dissemination is an essential component for the successful outcomes in several facilities, the researchers explain the crucial terms and concepts related to it. The article serves as an essential glossary of all aspects of dissemination and implementation of evidence based research and is highly useful for researchers and students.
The definitions are systematically grouped in five sections – Basic concepts, kinds of research, frameworks and models of dissemination, influential factors of the dissemination process and the evaluation of the dissemination process. The article serves as an essential guide to help new students and researcher understand the precise concepts related to dissemination. The article also aims to enhance communication between stakeholders and researchers for improved outcomes in dissemination of research.