NUR 550 Benchmark – Evidence-Based Practice Project: Literature Review

Benchmark – Evidence-Based Practice Project: Literature Review

Nosocomial infections or hospital-acquired infections (HAIs) affect quality care outcomes for patients and increase the cost of care. Evidence-based practice (EBP) interventions like hand hygiene compliance can reduce the prevalence of hospital-acquired infections, especially among older patients who are 65 years and above (Powell-Jackson et al., 2023). Hand hygiene education program for healthcare providers ensures that they have sufficient information and skills to reduce the prevalence of nosocomial infections among older patients. The evidence-based practice project proposal of hand hygiene to reduce healthcare-associated infections will enhance the care experience for the target patients, and lower longer stays in hospitals. The purpose of this paper is to review the literature supporting the implementation of the intervention based on the developed PICOT question and statement.

PICOT Statement & Question

Hospital-acquired infections (HAIs) are a critical patient safety concern in the healthcare systems with over 1.4 million inpatients getting affected. Additionally, evidence shows that close to 50% of hospital admissions lead to healthcare-acquired infections that increase mortality, comorbidity, and cost of care, and lower the quality of care (Stewart et al., 2023). Hand hygiene measures like washing hands with soap and water and alcohol-based sanitizers can reduce the prevalence of these infections among older patients in inpatient settings. Therefore, nurses must comply with hand hygiene interventions to lower the risk of infections among the target patient population.

PICOT Question

Amongst the inpatient geriatric population aged 65 and above (P), does a hand hygiene education program for healthcare providers (I) compared to no education (C) reduce the rate of spreading HAIs (O) in 3 months (T)?

Search Methods

The literature review entails peer-reviewed articles published within the last five years, implying that they provide the latest and most reliable evidence on the issue under research or consideration. The search strategy entailed using credible databases with keywords or terms and filters. These databases include PubMed, CINAHL, Google Scholar, Science Direct, and the GCU library. The search terms included “nosocomial infections,” “hospital-acquired infections (HAIs),” “geriatric population,” “hand hygiene education program and interventions” “nurses reducing infections,” and “patient safety measures.” The strategy also involved using filters with the Boolean operator “AND” being a critical component of the process. The implication is that the search strategy aimed at getting evidence-based practice (EBP) interventions to reduce nosocomial infections.

Article 1

The first article by Harun et al. (2023) evaluates hand hygiene compliance and associated factors among healthcare workers in certain health settings in Bangladesh. The mixed method study involved ten tertiary hospitals in the country and used the World Health Organization’s 5-moment for hand hygiene tool. Through semi-structured interviews, the authors wanted to identify key barriers to hand hygiene compliance. The findings show that only 25% of healthcare workers complied with hand hygiene measures. The article cites workload, skin reactions, insufficient supplies, and lack of facilities as the main barriers to hand hygiene compliance. The article supports the PICOT as it shows that effective implementation of hand hygiene measures among the population reduces infections and improves patient safety.

Article 2

The article by Kim et al. (2023) focuses on the knowledge of hand hygiene measures, attitudes, and barriers based on occupational groups and strategies to enhance compliance among healthcare workers (HCWs). The quantitative study uses 6048 HCWs in four university-affiliated hospitals in South Korea. The survey instrument entailed seven parts consisting of 49 items with self-reported hand hygiene compliance. The findings show that nurses who reported hand hygiene measures compliance were keen on keeping the practice. Furthermore, the study shows that knowledge, attitudes, and behaviors were essential to attaining the highest compliance rates among nurses. The study also illustrates that nurses were willing and ready to comply with hand hygiene measures to reduce infections among patients. The study and its findings support the PICOT as they demonstrate the efficacy of the selected intervention, hand hygiene compliance. The findings show that hand hygiene compliance among HCWs reduces infections in healthcare settings.

Article 3

Sandbekken et al. (2023) investigated behavioral interventions to enhance hand hygiene measures and compliance among nurses in nursing homes in 17 nursing homes in Norway. The qualitative study used direct observations based on WHO’s 5-moments for hand hygiene tool. The article shows that using multimodal interventions based on the tool increased hand hygiene compliance among healthcare workers in the wards under investigation. The authors also found that stimulating HCWs’ motivation on hand hygiene measures enhanced the success of the suggested interventions. The article supports the PICOT question as it demonstrates that having healthcare workers whose conduct aligns with best practices in hand hygiene measures improves patient safety as it lowers the risk for infections. The article shows that the proposed intervention is relevant to reducing infections among the target patient population.

Article 4

The article by Al-Anazi et al. (2022) assessed knowledge, attitudes, and compliance with hand hygiene measures among nurses in secondary care settings in Kuwait. The sample involved 79 nurses who provided feedback and participated in the study. The primary instrument was the WHO’s questionnaire on self-reported compliance to hand hygiene (HH) measures. Through direct observation and self-reported approaches, the researchers found that only 25% of the HCWs complied with hand hygiene measures. The authors observe that improving hand hygiene measures is critical to reducing infections due to the low levels of compliance among HCWs. The article also found that nurses had sufficient knowledge of hand hygiene measures and their benefits but still could not comply due to misconceptions like possible skin reactions and irritation. The article is critical as it supports the PICOT by showing that the intervention is effective and will lead to better patient outcomes and safety.

Comparison of the Articles (Similarities and Differences)

The four articles share certain aspects and also differ on some components, from themes, methods, conclusion, and limitations as well as controversies. Firstly, all the articles focus on one theme, reducing and preventing nosocomial infections emanating from healthcare workers, especially nurses, across diverse healthcare settings. The articles also agree with the conclusions that hand hygiene measures like hand washing and increased compliance will reduce and prevent infections among nurses. The articles also are similar in their interventions with a majority using WHO’s 5-moments of hand hygiene tool as the primary intervention to reduce hospital-acquired infections. Kim et al. (2023) and Al-Anazi et al. (2022) focus on knowledge and attitudes, just like Sandbekken et al. (2023) who also implement a multimodal approach to reducing infections among HCWs. All studies also agree that reducing infection risks among HCWs is critical to preventing transmission to patients due to their delicate nature. All studies had similar limitations like timelines, sufficient resources, and possible implementation challenges due to limited management support.

Conversely, the studies differed in their methods with some using mixed methods and other qualitative as well as quantitative designs. The researchers in their respective articles chose the method based on their resources and benefits accruing from each approach. As such, the articles did not have any controversies in their findings or recommendations. For instance, all recommend future research studies to implement best practices to determine their effectiveness.

Suggestions for Future Research

The analysis of literature based on these four articles shows gaps that require further research. The main gap is the role of hospital management in implementing disciplinary measures based on policy provisions for lack of compliance. While all the articles demonstrate the importance of the right attitudes and knowledge as being sufficient, close to 75% of nurses ignore or do not comply with organizational policy on hand hygiene measures. However, none of the articles explores the reaction of the management to correct the high rate of noncompliance to hand hygiene measures among the providers. Therefore, this area requires further research to ascertain the importance of implementing organizational policies on hand hygiene measures to improve compliance rates.

Conclusion

The reviewed literature aligns with the suggested intervention through the developed PICOT question that hand hygiene education programs will help nurses reduce and prevent hospital-acquired infections (HAIs). The literature shows that compliance measures are critical as they stop the transmission of pathogens from nurses to vulnerable patients because of age. The implication is that these measures are critical to reducing hospital acquired infections among healthcare workers (HCWs).

References

Al-Anazi, S., Al-Dhefeery, N., Al-Hjaili, R., Al-Duwaihees, A., Al-Mutairi, A., Al-Saeedi, R., …

& Sharaf-Alddin, R. (2022). Compliance with hand hygiene practices among nursing staff in secondary healthcare hospitals in Kuwait. BMC health services research, 22(1), 1325. DOI: https://doi.org/10.1186/s12913-022-08706-8

Harun, M. G. D., Anwar, M. M. U., Sumon, S. A., Mohona, T. M., Hassan, M. Z., Rahman, A.,

… & Styczynski, A. R. (2023). Hand hygiene compliance and associated factors among healthcare workers in selected tertiary-care hospitals in Bangladesh. Journal of hospital infection, 139, 220-227. https://doi.org/10.1016/j.jhin.2023.07.012

Kim, J., Yu, S. N., Jeong, Y. S., Kim, J. H., Jeon, M. H., Kim, T., … & Park, S. Y. (2023). Hand

hygiene knowledge, attitude, barriers, and improvement measures among healthcare workers in the Republic of Korea: a cross-sectional survey exploring inter-professional differences. Antimicrobial resistance & infection control, 12(1), 93. DOI: https://doi.org/10.1186/s13756-023-01296-y

Powell-Jackson, T., King, J. J., Makungu, C., Spieker, N., Woodd, S., Risha, P., & Goodman, C.

(2020). Infection prevention and control compliance in Tanzanian outpatient facilities: a cross-sectional study with implications for the control of COVID-19. The Lancet Global Health, 8(6), e780-e789. DOI: 10.1016/S2214-109X(20)30222-9.

Sandbekken, I. H., Utne, I., Hermansen, Å., Grov, E. K., & Løyland, B. (2023). Impact of

multimodal interventions targeting behavior change on hand hygiene adherence in nursing homes: An 18-month quasi-experimental study. American journal of infection control, 52(1), 29-34. DOI: https://doi.org/10.1016/j.ajic.2023.07.005

Stewart, S., Robertson, C., Pan, J., Kennedy, S., Haahr, L., Manoukian, S., & Reilly, J. (2021).

Impact of healthcare-associated infection on length of stay. Journal of hospital infection, 114, 23-31. https://doi.org/10.1016/j.jhin.2021.02.026

 

ORDER A PLAGIARISM-FREE PAPER HERE

Assessment Traits

Benchmark

---

Requires Lopeswrite

Assessment Description

The purpose of this assignment is to write a review of the research articles you evaluated in the Evidence-Based Practice Project: Evaluation of Literature assignment in Topic 5. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.

A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. You will use the literature review from this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.

In a paper of 1,250-1,500 words, select 4 of the 6 articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:

1. Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
2. Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
3. Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
4. Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
5. Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
6. Conclusion – Provide a summary statement of what you found in the literature.
7. Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Refer to “Evidence-Based Practice Project Proposal – Assignment Overview,” located in Class Resources, document for an overview of the evidence-based practice project proposal assignments.

You are required to cite four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN 

3.2: Analyze appropriate research from databases and other information sources to improve health care practices and processes.

Skip to main contentEnable accessibility for visually impairedOpen the accessibility menuOpen the Accessible Navigation Menu

 

Benchmark – Evidence-Based Practice Project: Literature Review – Rubric

BUY A PLAGIARISM-FREE PAPER HERE

LISTGRID

PRINT TO PDF

Rubric Criteria

Total175 points

Criterion	1. Unsatisfactory	2. Insufficient	3. Approaching	4. Acceptable	5. Target
Introduction Introduction	0 points The clinical issue or problem and PICOT statement are omitted.	7 points The clinical issue or problem and PICOT statement are incomplete or incorrect.	7.7 points The clinical issue or problem and PICOT statement are presented. Some aspects are vague. There are minor inaccuracies.	8.05 points The clinical issue or problem and PICOT statement are adequately described.	8.75 points The clinical issue or problem and PICOT statement are thoroughly described.
Search Methods Search Methods	0 points The search strategy and criteria used in choosing and searching for articles are omitted.	14 points The search strategy and criteria used in choosing and searching for articles are only partially described.	15.4 points The search strategy and criteria used in choosing and searching for articles are summarized. More information is needed.	16.1 points The search strategy and criteria used in choosing and searching for articles are described. Some detail is needed for clarity or accuracy.	17.5 points The search strategy and criteria used in choosing and searching for articles is thoroughly described.
Synthesis of Literature Synthesis of Literature	0 points A paragraph for one or more article is missing.	14 points All articles are presented, but the synthesis of literature is incomplete.	15.4 points A summary for each article is presented. The main components (subjects, methods, key findings) are generally discussed. General rationale for how each article supports the PICOT is provided. More information is needed.	16.1 points A paragraph for each article is presented. The main components (subjects, methods, key findings) are adequately discussed, and rationale for how each article supports the PICOT is provided. Some detail is needed for clarity or accuracy.	17.5 points A well-developed paragraph for each article is presented. The main components (subjects, methods, key findings) are thoroughly discussed, and substantial rationale for how each article supports the PICOT is clearly provided.
Comparison of Articles Comparison of Articles	0 points One or more article is missing in the comparison.	14 points All articles are presented, but the comparison is incomplete.	15.4 points A general comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is presented. Some aspects are unclear. More information is needed.	16.1 points A comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is adequately presented. Some detail is needed for clarity or accuracy.	17.5 points A detailed comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is thoroughly presented.
Suggestions for Future Research Suggestions for Future Research	0 points Identified gaps and areas requiring further research are omitted.	14 points Identified gaps and areas requiring further research are only partially presented.	15.4 points Some identified gaps and areas requiring further research are generally discussed. The narrative is generally based on the analysis of the literature. More information is needed.	16.1 points Identified gaps and areas requiring further research are adequately discussed. The narrative is based on the analysis of the literature. Some detail is needed for clarity or accuracy.	17.5 points Identified gaps and areas requiring further research are thoroughly discussed and clearly based on the analysis of the literature. The narrative is insightful and demonstrates an understanding of research analysis necessary for future study.
Conclusion Conclusion	0 points The conclusion is omitted.	7 points A conclusion is presented but fails to present a summary statement of what was found in the literature.	7.7 points The conclusion presents a vague summary statement of was found in the literature. There are inaccuracies.	8.05 points The conclusion presents an adequate summary statement of what was found in the literature.	8.75 points The conclusion is well-developed and presents a clear and accurate summary statement of what was found in the literature.
Ability to Analyze (B) (B) Ability to Analyze (C3.2) (C3.2)	0 points The literature review presented does not demonstrate an ability to analyze appropriate research from databases and other information sources to improve health care practices and processes.	14 points The literature review presented does not consistently demonstrate an ability to analyze appropriate research from databases and other information sources to improve health care practices and processes.	15.4 points The literature review presented demonstrates a general ability to analyze appropriate research from databases and other information sources to improve health care practices and processes.	16.1 points The literature review presented demonstrates an adequate ability to analyze appropriate research from databases and other information sources to improve health care practices and processes.	17.5 points The literature review presented demonstrates a strong ability to analyze appropriate research from databases and other information sources to improve health care practices and processes.
Appendix Appendix	0 points The appendix and required resources are omitted.	7 points The APA Writing Checklist is attached, but an appendix has not been created. The paper does not reflect the use of the APA Writing Checklist during development	7.7 points The APA Writing Checklist is attached and in the appendix. The APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality.	8.05 points The APA Writing Checklist is attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper.	8.75 points The APA Writing Checklist is attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development.
Required Sources Required Sources	0 points Sources are not included.	7 points Number of required sources is only partially met.	7.7 points Number of required sources is met, but sources are outdated or inappropriate.	8.05 points Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.	8.75 points Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.
Thesis, Position, or Purpose Communicates reason for writing and demonstrates awareness of audience.	0 points The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.	9.8 points The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience.	10.78 points The thesis, position, or purpose is adequately developed. An awareness of the appropriate audience is demonstrated.	11.27 points The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.	12.25 points The thesis, position, or purpose is persuasively developed throughout and skillfully directed to a specific audience.
Development, Structure, and Conclusion Advances position or purpose throughout writing; conclusion aligns to and evolves from development.	0 points No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.	11.2 points Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose.	12.32 points The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose.	12.88 points The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and plausible conclusion aligns to the development of the purpose.	14 points The thesis, position, or purpose is coherently and cohesively advanced throughout. The progression of ideas is coherent and unified. A convincing and unambiguous conclusion aligns to the development of the purpose.
Evidence Selects and integrates evidence to support and advance position/purpose; considers other perspectives.	0 points Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.	7 points Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present.	7.7 points Relevant evidence that includes other perspectives is used.	8.05 points Specific and appropriate evidence is included. Other perspectives are integrated.	8.75 points Comprehensive and compelling evidence is included. Multiple other perspectives are integrated effectively.
Mechanics of Writing Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.	0 points Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.	7 points Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.	7.7 points Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.	8.05 points Few mechanical errors are present. Suitable language choice and sentence structure are used.	8.75 points No mechanical errors are present. Skilled control of language choice and sentence structure are used throughout.
Format/Documentation Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline.	0 points Appropriate format is not used. No documentation of sources is provided.	7 points Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.	7.7 points Appropriate format and documentation are used, although there are some obvious errors.	8.05 points Appropriate format and documentation are used with only minor errors.	8.75 points No errors in formatting or documentation are present. Selectivity in the use of direct quotations and synthesis of sources is demonstrated.

© 2024. Grand Canyon University. All Rights Reserved.