Evidence-Based Nursing Practice

Running head: EVIDENCE BASED NURSING PRATICE
INTERVENTIONAL STRATEGIES TO IMPROVE HAND HYGIENE
COMPLIANCE IN ACUTE CARE SETTING
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EVIDENCE BASED NURSING PRATICE1
Table of Contents
Introduction................................................................................................................................3
Discussion..................................................................................................................................3
Significance of issue and need for change.............................................................................3
Review and synthesis of the evidence....................................................................................7
Recommendations for practice...............................................................................................9
Conclusion................................................................................................................................10
References................................................................................................................................11

EVIDENCE BASED NURSING PRATICE2
Introduction
Pathogens are present everywhere and are responsible for causing serious infections
in the healthcare sector. The most common mode of transmission of these pathogens is the
action of people and require hand hygiene for the prevention of such cases. According to the
report, the spread of healthcare-associated infections affect 1 out of 25 patients on a daily
basis; thus, the risk of acquiring the infection is huge in the acute care setting and therefore,
increasing the cost and time (Cdc.gov, 2017). The occurrence of undesirable complications in
the acute care unit has been recognised in the last few decades. The escalation of the issue
had increased at an alarming rate; thus, increasing the death rate in the unit due to nosocomial
infection. It results in patient illness, prolongs hospital stay, the requirement of diagnostic and
therapeutic interventions, bearing the additional cost and in severe cases lead to death
(Scarpignato, Gatta, Zullo & Blandizzi, 2016). The healthcare-associated infections are
detrimental outcomes that indicate poor quality of care; thus, questioning the aspect of patient
safety and efficacy. The aim of the report is to discuss evidence-based recommendations to
acute care settings by reviewing and synthesising evidence for practice.
Discussion
Significance of issue and need for change
The complexity of such cases is becoming common in medical care as the
antimicrobial resistance is rising; thus, leading to adverse effects (Mehta et al., 2014). The
most significant reason that indicates the rise of such cases is hand hygiene of acute care
nurses that need to be focused and changed in order to address the issue. After identification
of the issue, it is important to understand the area of concern and thus, frame a searchable
question. Abbade, Wang, Sriganesh, Mbuagbaw and Thabane (2017) opined that evidence-
based model that uses scientific evidence for decision-making and guidance. The use of PICO

EVIDENCE BASED NURSING PRATICE3
can be used in the aspect that includes elements Problem, Intervention, Comparison and
Outcome. The question is whether the use of hand hygiene interventional strategies used
for reducing the rate of hospital-associated infection in the acute hospital setting. The
elements include:
Elements Terms
P Hospital-associated infection
I Hand hygiene
C Use of mask or other solutions
O Reduce the rate of infection
In order to plan a search strategy, it is critical to identify the elements of the framed
questions and translation of the common terms into MeSH terms or subject descriptors. In
this case, a simple database search strategy was used that included:
Natural Term Descriptor for searching
P (Hospital-associated infection) Cross infection
I (Hand hygiene) Hand washing
Hand disinfection
The use of PubMed or Medline was used for searching. After an initial search, the
scope was narrowed down to other elements, C and O. The evidence were filtered for the
database search. In the case of critical appraisal, the use of CASP helped in the determination
of the final choice of articles. According to Buccheri and Sharifi (2017), the Critical
Appraisal Skills Programme (CASP) supported in the development of an evidence-based
approach in case of health and social care. The aim of the tool is to help people to develop
skills of searching and finding evidence that makes sense to the research and application of
evidence in a practical manner.