HCM-440 mILESTONE 2
docx
keyboard_arrow_up
School
Southern New Hampshire University *
*We aren’t endorsed by this school
Course
HCM 440-Q5
Subject
Health Science
Date
Jun 21, 2024
Type
docx
Pages
16
Uploaded by maliniroopram
Running Head: HCM-440 Milestone Two
1
Southern New Hampshire University HCM 440 Healthcare Research and Evaluation
Malini Mohabir
June 8, 2024
HCM-440 Milestone Two
2
Source One Al-Maani, A., Al Wahaibi, A., Al-Zadjali, N., Al-Sooti, J., AlHinai, M., Al Badawi, A., Al Saidi, A., AlZadjali, N., Elshoubary, W., Al-Harthi, K., & Al-Abri, S. (2022). The impact of the hand hygiene role model project on improving healthcare workers' compliance: A quasi-experimental observational study.
Journal of infection and public health
,
15
(3), 324–330. https://doi.org/10.1016/j.jiph.2022.01.017
Summary
The implementation of a nationwide hand hygiene (HH) role model project was found to dramatically enhance and sustain compliance rates among healthcare personnel in four hospitals in Oman. The intervention, which comprised HH education and training, staff selection as role models, posting HH messages, and leadership involvement as a role model, significantly increased compliance rates. The research findings indicate that comprehension of healthcare culture and routine follow-ups are critical for maintaining adherence to safe hand hygiene procedures. It was discovered that the intervention was successful in raising compliance rates when combined with the WHO's multimodal approach.
Design
In four hospitals, this quasi-experimental observational study (pre- and post-intervention)
tracked how well healthcare workers (HCWs) adhered to hand hygiene protocols. Baseline, post-
intervention, and sustainability data were available for each of the participating hospitals (15 months) Monitoring of HH Compliance.
HCM-440 Milestone Two
3
Method This research was carried out at four acute care inpatient hospitals that treat patients directly from the emergency room or as referred cases in a variety of medical, mental health, and
surgical specialties. Hand hygiene facilities and hospital structures are comparable among the hospitals that are considered. With four units from each facility included in the nationwide monitoring and follow-up, we concentrated on the project's initial phase. If the project met its goals, the intervention could subsequently be expanded to include the remaining units within each facility. To ensure that the work intensity in the chosen units (intensive care, accident and emergency, medical, surgical, psychiatric, and other) is comparable, the four clinical areas from each institution were chosen based on the services that they offer.
Sample
The sample in this case is Healthcare workers. Data Collection
Five external auditors, who were trained in HH compliance monitoring, were chosen as primary health care infection control nurses to perform the assessment for the units that were included. Making use of Android-based mobile tablet devices, the team employed the digital Observe Solution software version 2.1.0 system, created by BODE Chemie, a division of HARTMANN Group Germany, to track compliance. The World Health Organization (WHO) created the "5 Moments for Hand Hygiene" observation model, which served as the foundation for this study, to gauge hospital staff compliance with hand hygiene protocols. The program, which was first piloted at the training session and then one day before the baseline evaluation of the hospital that was included, was shown to the observers.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
HCM-440 Milestone Two
4
Data Analysis The study examined compliance across many categories and evaluated hand hygiene chances by facility, profession, moment, department, and project stage. To look at the relationship between missed times, hand hygiene kinds, and instances, Pearson's Chi-squared test
was employed. During each assessment phase, the overall compliance was shown as a percentage of all opportunities. Compliance odds ratios with independent variables were evaluated using binary logistic regression analysis, both univariate and multivariable.
Level of Evidence Score
The Level of Evidence is Level 3 and is based on a quasi-experimental observational study.
Source Two
Bredin, D., O'Doherty, D., Hannigan, A., & Kingston, L. (2022). Hand hygiene compliance by direct observation in physicians and nurses: a systematic review and meta-
analysis.
The Journal of hospital infection
,
130
, 20–33. https://doi.org/10.1016/j.jhin.2022.08.013
Summary
In this article it’s noted that the gold standard for monitoring hand hygiene compliance is direct observation; nevertheless, the rate of compliance varies significantly between doctors and nurses, according to a thorough database search.
Design
HCM-440 Milestone Two
5
This study used a systematic review and meta-analysis. Comprehensive and systematic methods of summarizing the available data are known as systematic reviews. They comprise a thorough search method, inclusion and exclusion standards, and an evaluation of the included studies' quality. The plan would be looking through relevant databases for research that fit specific requirements, taking data out of these studies, and compiling the results.
Method
An extensive search of the PubMed, Embase, CENTRAL, and CINAHL databases was carried out. Studies that used direct observation to give estimates for both doctors and nurses were included.
Sample
The samples in this case are physicians and nurses. Data Collection
Bredin and O'Doherty, two independent reviewers, extracted data on study outcomes while Bredin extracted data on study characteristics. A piloted data extraction form was put in place and differences were settled through discussion and consensus. The final report was considered to provide the most comprehensive outcomes data when there were linked studies with numerous reports that corresponded to a study at various points in time. Data were collected on the study identifying features (author, title, publication year, journal, country of origin), study design, study setting, sample size (where the unit of analysis is the number of hand
hygiene opportunities), type of participants, method of observation, compliance measurement tool, observer category and validation, funding, intervention type if used, baseline compliance
HCM-440 Milestone Two
6
rates of physicians and nurses, and compliance rates as per the WHO ‘five moments for hand hygiene’ of physicians and nurses (Bredin et al., 2022).
Data Analysis
To evaluate nurses' and doctors' adherence to hand hygiene, a meta-analysis was carried out. The percentage of all hand hygiene opportunities completed by participants was used to define compliance. For every study, the 95% confidence interval and risk difference were computed. To determine compliance rates, a random-effects proportion meta-analysis was performed. Using the χ2-test, I2 thresholds, and visual inspection, heterogeneity was evaluated. StatsDirect version 3 was used to do the meta-analysis.
Level of Evidence (LOE) Score
The Level of Evidence will be Level 1 and is based on Evidence from objective systematic reviews, meta-analyses of all relevant Randomized Controlled Trials (RCTs), or evidence-based clinical practice guidelines derived from systemic reviews of RCTs. Source Three
Chakma, S. K., Hossen, S., Rakib, T. M., Hoque, S., Islam, R., Biswas, T., Islam, Z., & Islam, M. M. (2024). Effectiveness of a hand hygiene training intervention in improving knowledge and compliance rate among healthcare workers in a respiratory disease hospital.
Heliyon
,
10
(5), e27286. https://doi.org/10.1016/j.heliyon.2024.e27286
Summary
Healthcare workers (HCWs) are key players in stopping the transmission of illness through the practice of hand hygiene (HH), which is an essential component of infection control.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
HCM-440 Milestone Two
7
Inadequate understanding and disregard for HH guidelines, however, cause serious difficulties in
hospital environments. The purpose of this study was to assess how well a HH training intervention improved staff compliance and understanding in a hospital that treats respiratory diseases. Design
The study design used in this case is interventional. There was a pre- and post-training intervention. Between May 24, 2022, and June 5, 2022, pre-training data were gathered for the knowledge assessment, and between February 19, 2023, and March 06, 2023, post-training data were gathered.
Method
A study was carried out on healthcare professionals in a respiratory illness treatment center before and after they received training. The intervention consisted of five days of three-
hour training sessions centered around the "Your Five Moments For Hand Hygiene" guideline provided by the World Health Organization (WHO). These workshops addressed appropriate hand hygiene practices and emphasized the consequences of lack of compliance. Throughout the facility, HH-related educational materials were clearly displayed. Prior to and following the intervention, the compliance rate and knowledge levels were evaluated.
Sample
The sample in this case was the healthcare workers in a respiratory disease hospital.
HCM-440 Milestone Two
8
Data Collection
Data was collected from the same participants both before and after the intervention in order to fully assess its impact. This method made it easier to compare their knowledge levels and HH compliance rate over time simply and thoroughly.
Data Analysis
The survey data was analyzed using STATA (version 16, StataCorp LLC). Descriptive statistics were used to determine the frequency of age, sex, and profession among nurses and PCAs, and cross-tabulation with a chi-square test was used to analyze the improvement of knowledge levels before and after training, with a p-value of <0.05 being considered statistically significant (Chakma et al., 2024).
Level of Evidence (LOE) score
The Level of Evidence is Level 3 and is based on Interventional studies. Source Four
Chaudhary, P., & Gupta, V. (2024). Hand hygiene with interventions: an observational study from a tertiary care institute over 2 years.
Journal of preventive medicine and hygiene
,
64
(4), E488–E492. https://doi.org/10.15167/2421-4248/jpmh2023.64.4.3087
Summary
Healthcare personnel who practice adequate hand hygiene dramatically minimize the transfer of pathogens and hospital-acquired infections (HAIs), according to a retrospective observational study conducted in North India. In accordance with the study, the compliance rates
for total adherence (HHTAR), partial adherence (HHPAR), and complete adherence rate
HCM-440 Milestone Two
9
(HHCAR) were 20.3%, 41.5%, and 61.4%, respectively. ICUs had the highest compliance rates, with nurses and physicians showing the highest levels of compliance. According to the report, regular audits and ongoing observation are required to maintain and enhance proper hand hygiene habits among healthcare personnel.
Design
Hand hygiene (HH) is an important part of infection control procedures (IPCs), and maintaining compliance requires frequent audits and monitoring. Indirect ways of monitoring include automatic sinks and self-reporting by healthcare personnel. Since direct methods minimize the "Hawthorne effect," are economically feasible, and provide precise compliance information, they are regarded as the gold standard. Examples of direct methods include direct observation by qualified auditors. On the other hand, data assessment and auditing need skilled personnel.
Method Over the course of the two-year study, HH in a tertiary care facility was audited in order to assess HH compliance in wards and ICUs. At the same time, more frequent hand hygiene awareness-raising activities were held, and the outcomes of these interventional initiatives were assessed.
Sample
The sample in this case is the healthcare workers of the ICU and wards of a tertiary care hospital in North India.
Data Collection Every day, at least two areas—one from the ICU and the other from the wards—were audited for HH. Random audits were conducted as part of the ICNs' routine environmental and HAI surveillance to reduce the Hawthorne effect. For a minimum of twenty minutes or longer, at
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
HCM-440 Milestone Two
10
least twenty opportunities were recorded. The WHO's five moments and measures for hand hygiene were all followed. The audit parameters were as follows: (a) Hand hygiene complete adherence rate (HHCAR) defined as following all six WHO steps for at least 20 seconds for hand
rub or 40 seconds for hand wash; (b) Hand hygiene partial adherence rate (HHPAR) defined as following at least one WHO step. HH steps were omitted, or the time spent following was not for
appropriate duration. (c) Hand hygiene total adherence rate (HHTAR) = HHCAR + HHPAR .
Data Analysis In healthcare settings, the study assessed hand hygiene adherence rates (HHCAR, HHPAR, HHTAR, profession-specific HHTAR, and moment-specific analysis). It compared the study's first and second years, concentrating on medical professionals, nurses, ward attendants, support staff, and housekeeping personnel. The study also looked at how hand hygiene-focused treatments performed in healthcare settings. The relationship between the different factors was examined using the Chi-square test.
Level of Evidence Score
The Level of Evidence is Level 3 and is based on Interventional and observational studies. Source Five
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. https://doi.org/10.1186/s12913-019-
4347-z
HCM-440 Milestone Two
11
Summary According to a German study, maintaining good hand hygiene is essential to preventing nosocomial infections in nursing home residents. On the contrary, individual and organizational traits like knowledge, conduct, and attitude vary depending on the situation. According to the study, role modeling and equipment availability in the local work environment are crucial for ensuring adherence to hygiene standards. According to the findings, nursing managers should be aware of the influence of their job as role models and should concentrate on developing strategies that make it easier to obtain supplies for hand disinfection.
Design
We used a concurrent triangulation strategy in conjunction with a mixed-methods methodology to assist our analyses across numerous sources. Several researchers conducted independent analyses of both quantitative and qualitative data. During the triangulation phase, the data was interpreted using both sources of information combined and given equal weight. A more thorough, impartial, and perceptive picture of the phenomenon under study is produced by this method of combining data from the study's quantitative and qualitative strands during the interpretation phase.
Method
The goal of the study was to comprehend how organizational traits, specifically hand hygiene in nursing homes, affect compliance with infection prevention management. In addition to asking about knowledge, practices, and adherence to hygienic rules, the survey also asked about managers' and nurses' opinions of role modeling and organizational structures. Manager
HCM-440 Milestone Two
12
interviews and survey data were part of the mixed-methods approach. In order to improve hand hygiene in nursing homes, the research offers a thorough analysis of organizational factors.
Sample
In the sample, women made up the majority. Respondents to the survey were 47-year-old licensed nurses on average. Most nurses at the prison had been employed for more than five years and worked day shifts.
Data Collection The study employed a survey and interview guide to collect data on hand hygiene, infection control, and adherence to hygiene guidelines among nursing staff. In order to learn more about nursing managers' viewpoints on hand hygiene and hygiene management, 36 of them
were interviewed in February and March of 2013. One lead interviewer and one or two nursing observers performed the interviews, which were audio recorded and transcribed using accepted language practices.
Data Analysis A diverse team of nine researchers used IBM SPSS software to evaluate the survey results for the study. Six topics emerged from the analysis: perceptions about nurses' knowledge, the effect of hygiene training, perceptions about their hand hygiene practices, adherence to hygiene regulations, perceptions about organizational elements supporting or impeding hand hygiene, and perceptions about their function as role models. Following that, these themes were applied to content analysis and interview coding, enabling individual interpretation and comparisons among nursing facilities.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
HCM-440 Milestone Two
13
Level of Evidence Score
The Level of Evidence will be Level 3 considering the study is a mixed-method and interventional study. Source Six
von Lengerke, T., Lutze, B., Krauth, C., Lange, K., Stahmeyer, J. T., & Chaberny, I. F. (2017). Promoting Hand Hygiene Compliance: PSYGIENE—a Cluster-Randomized Controlled Trial of Tailored Interventions.
Deutsches Arzteblatt international
,
114
(3), 29–
36. https://doi.org/10.3238/arztebl.2017.0029
Summary
At Hannover Medical School, the Aktion Saubere Hände (ASH) "Clean Hands Campaign" first encouraged staff members to wash their hands. However, in 2013, compliance rates fell again. To investigate long-lasting gains using behavioral psychology-based therapies, PSYGIENE, a cluster-randomized controlled study, was conducted.
Design
The design of the study was a Randomized Controlled Clinical Trial (RCT). Method
The Health Action Process Approach (HAPA) compliance model identifies psychological
determinants of compliance among healthcare workers in ICUs and HSCTUs (
von Lengerke et al., 2017). In the six wards that made up the intervention arm of the trial in 2013, 29 customized behavior modification strategies were applied in educational training sessions and feedback discussions, whereas ASH training sessions were offered in the control arm. Using the gold standard of the World Health Organization, nonparticipating observation of hygienic hand
HCM-440 Milestone Two
14
disinfection was used to calculate the compliance rates for the trial's two main years, 2014 and 2015.
Sample
The sample in this case was the physicians and nurses of 10 ICUs and 2 HSCTUs of the MHH.
Data Collection
Direct observation, self-reported questionnaires, and electronic monitoring systems were used in the study to collect data. With the aid of these techniques, researchers were able to monitor instances of hand hygiene in patient care areas and evaluate the knowledge, attitudes, and practices of healthcare personnel regarding hand hygiene.
Data Analysis
The study analyzed the data and assessed the impact of tailored interventions on hand hygiene compliance in healthcare workers using a combination of descriptive, inferential, and multilevel statistical methods.
Level of Evidence (LOE) score
The Level of Evidence is Level 2 and is based Evidence
from a single-center C-RCT.
HCM-440 Milestone Two
15
References:
Al-Maani, A., Al Wahaibi, A., Al-Zadjali, N., Al-Sooti, J., AlHinai, M., Al Badawi, A., Al Saidi, A., AlZadjali, N., Elshoubary, W., Al-Harthi, K., & Al-Abri, S. (2022). The impact of the hand hygiene role model project on improving healthcare workers' compliance: A quasi-experimental observational study.
Journal of infection and public health
,
15
(3), 324–330. https://doi.org/10.1016/j.jiph.2022.01.017
Bredin, D., O'Doherty, D., Hannigan, A., & Kingston, L. (2022). Hand hygiene compliance by direct observation in physicians and nurses: a systematic review and meta-
analysis.
The Journal of hospital infection
,
130
, 20–33. https://doi.org/10.1016/j.jhin.2022.08.013
Chakma, S. K., Hossen, S., Rakib, T. M., Hoque, S., Islam, R., Biswas, T., Islam, Z., & Islam, M. M. (2024). Effectiveness of a hand hygiene training intervention in improving knowledge and compliance rate among healthcare workers in a respiratory disease hospital.
Heliyon
,
10
(5), e27286. https://doi.org/10.1016/j.heliyon.2024.e27286
Chaudhary, P., & Gupta, V. (2024). Hand hygiene with interventions: an observational study from a tertiary care institute over 2 years.
Journal of preventive medicine and hygiene
,
64
(4), E488–E492. https://doi.org/10.15167/2421-4248/jpmh2023.64.4.3087
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. https://doi.org/10.1186/s12913-019-
4347-z
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
HCM-440 Milestone Two
16
von Lengerke, T., Lutze, B., Krauth, C., Lange, K., Stahmeyer, J. T., & Chaberny, I. F. (2017). Promoting Hand Hygiene Compliance: PSYGIENE—a Cluster-Randomized Controlled Trial of Tailored Interventions.
Deutsches Arzteblatt international
,
114
(3), 29–
36. https://doi.org/10.3238/arztebl.2017.0029