HCM-440 mILESTONE 2.docx

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.

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.

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