Strategies to Control Hospital Acquired Infections: Best Evidence Research

This article discusses the best evidence research on strategies to control hospital acquired infections. It includes a systematic review of three research articles on hand hygiene programs, visitor hand hygiene compliance, and device-related infections. The article also discusses the relevance of these findings to nursing practice and the barriers to implementing these strategies.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student
Name of the University
Author note

Assessment 3
Introduction
Hospital acquired infection or HAIs are one of the major concerns of healthcare
facilities around the world as the data of World Health organization revealed
that more than 10 million people are affected due to HAIs around the world
(Pincock et al., 2012). More than 150,000 reports are registered in Australia
every year within which thousands have to lose their life (Fuller et al., 2012).
Despite living in the 21st century and modern healthcare science technologies,
worldwide presence of hospital acquired infections are the primary reason I am
interested in this aspect of infection and its control (lander4s et al., 2012).
Therefore, I am interested in identifying strategies using which healthcare
facilities can control this phenomenon. The primary aim of this assignment is to
provide details of three best evidences about hospital acquired infection and
validating the research findings collected from those articles.
Best Evidence
Best Practice Level of
Evidence
Study
Design
In-text Citation in
CDU APA 6th
Format
Effectiveness of a
comprehensive hand
hygiene program for
reduction of infection
rates in a long-term
care facility
4 Cross
sectional
study
Schweon, Edmonds,
Kirk, Rowland and
Acosta (2013).
Promoting and
sustaining a hospital-
wide, multifaceted
hand hygiene
program resulted in
significant reduction
3 Uncontrolled
Longitudinal
study
Al-Tawfiq, Abed, Al-
Yami and Birrer
(2013).

in health care-
associated infections
Do hospital visitors
wash their hands?
Assessing the use of
alcohol-based hand
sanitizer in a hospital
lobby
5 Observational
study
Birnbach et al. (2012)
Annotated Bibliography
Schweon, S. J., Edmonds, S. L., Kirk, J., Rowland, D. Y., & Acosta, C.
(2013). Effectiveness of a comprehensive hand hygiene program for
reduction of infection rates in a long-term care facility. American journal
of infection control, 41(1), 39-44. Doi: 10.1016/j.ajic.2012.02.010
The primary aim of the study was to identify the hand hygiene strategies used
in long-term care facilities as researchers are primarily focused about hand
hygiene acute health care facilities and very less studies are variable on long-
term care facilities. From may 2009 to 2011, all the infection and hospitalization
data were collected from a 174 bed long-term care facility where hand hygiene
and healthcare hygiene educations were provided and it was found that rate of
infection decreased d from 0.97 to 0.53 infections per 1,000 resident days. As
well as 54%, compliance rates were observed within that time-period which
indicated 100% compliance has the ability can reduce infection rates to a
considerate level. Therefore, the research article was able to prove the
statement that in long-term as well as acute healthcare facility, hand hygiene
technique has the ability to reduce the rates of infection to a specific level.
Al-Tawfiq, J. A., Abed, M. S., Al-Yami, N., & Birrer, R. B. (2013). Promoting
and sustaining a hospital-wide, multifaceted hand hygiene program
resulted in significant reduction in health care-associated infections.
American journal of infection control, 41(6), 482-486. Doi:
10.1016/j.ajic.2012.08.009
This paper discusses about the hand hygiene and its widespread usage among
healthcare professionals, which is found to be very low and not followed by the
healthcare professionals. Therefore, the objective of this assignment was to
find out the compliance of hand hygiene overtime and provide the rate of
device associated infection so that compliance level could be assessed.
Researchers conducted a descriptive time series related study from October
2006 to December 2011 in a healthcare facility with 350-bed in Saudi Arabia.
They used the multimodal program for the promotion of hand hygiene activities

as well as they calculated the device related infection in the healthcare facility.
Results determined that the multimodal approach helped to promote hand
hygiene as compliance improved from 38% in 2009 to 83% in 2011. As well as
the rate of Ventilator-associated infection decreased from 6.12 to 0.78.
therefore, it was evident that hand hygiene was able to provide holistic
protection from the infection in healthcare facilities.
Birnbach, D. J., Nevo, I., Barnes, S., Fitzpatrick, M., Rosen, L. F., Everett-
Thomas, R., ... & Arheart, K. L. (2012). Do hospital visitors wash their
hands? Assessing the use of alcohol-based hand sanitizer in a hospital
lobby. American journal of infection control, 40(4), 340-343. Doi:
10.1016/j.ajic.2011.05.006
As most of the hand hygiene reports are associated with healthcare
professionals and patients, visitor related reports are very limited. It is assumed
that alcohol-based hand sanitizer increases the hand hygiene compliance rate
in visitors however, to determine the rate of it, the researchers of this research
aimed to find this result. For the purpose, the researchers chose the
observational control study and tested three interventions such as a desk sign
important all visitors to use AHS, a free-standing AHS dispenser present
directly in front of a security desk where the visitors will sign, and a
amalgamation of a freestanding AHS dispenser and a sign. It was observed
that the compliance to hand hygiene improved when AHS dispenser and sign
was used as an intervention and other two failed to improve the compliance
percentage. T5herefore, healthcare facilities should use techniques to
implement visitors HHCD so that holistic control of hospital-acquired infections
could be controlled.
Justifying the Evidence
The article by Al-Tawfiq et al. (2013) was chosen as the best practice regarding
this research aspect as the study design it used in this research was able to
provide a statistical significant and reportable data about the long term care
facilities and the rate of infections after the implementation of hand hygiene
strategy. However, the approach was affected by season changing and
adverse effect of environment therefore; the application of this method on
multivariate setting is questionable (Fuller et al., 2012). Further, the results
found through this result were relevant as most of the long-term healthcare
facilities are not inclusive of hand hygiene technologies. Hence, using such
strategies is useful in increasing the compliance level of hand hygiene strategy
among the healthcare facilities of long-term care facilities (Landers et al.,
2012). Further, the result also revealed that using such techniques was useful
in reducing the rate of infection among the patients as professionals were using
alcoholic hand hygiene solution for disinfection purpose. Moreover, the aim of
this research was to find out research articles and strategies that helped to
identify the importance of hand hygiene and its ability to prevent different

infections that can affect the health of patients by increasing their hospital stay.
This is because this study was included in the best evidence category (Pincock
et al., 2012).
The second article by Birnbach et al. (2012) and its descriptive time series
related study was important for its research purpose as the time and a large
healthcare facility helped to identify the compliance level of patients regarding
hand hygiene as well as identify the level of device related infection and rate of
reduction in those infections due to hand hygiene strategy. This study and its
finding was appropriate to our research aim as it directly provided a link
between health hygiene and its beneficial effect in reducing the rate of
nosocomial infection through hand of health professionals as well as devices
(Allegranzi et al., 2013). This strength of the study was useful in determining
the research aim it was observational as well as case control study where
validation of the research aim was present (Armellino et al., 2013). However,
the longitudinal interventional aspect of the study limited the application of the
study in smaller healthcare facility as the study was not designed for small and
limited healthcare facility (Huis et al., 2012). Therefore, all these aspect of the
research study helped to include this research article in the best evidence
section because it directly mentions the fact that hand hygiene is responsible
for reduction of nosocomial infection and increased compliance can also
reduce the device related infection in healthcare facilities (Fuller et al., 2012).
The third article by Schweon et al. (2013) was about hand hygiene compliance
level among hospital visitors and it is one of the most neglected aspect of hand
hygiene compliance study (Ellingson et al., 2014). There are limited amount of
studies have been conducted in which compliance level of visitors are
assessed. Therefore, the strength of this research was its different approach to
the healthcare associated infection as visitors are important stakeholders if the
healthcare associated infections are taken into consideration (Pincock et al.,
2012). Further, the strength of this research article was its interventions and
comparison between those three interventions so that the most effective
intervention could be identified (Huis et al., 2012). Further, the results were
relevant as of provided the most effective intervention that can decrease the
rate of healthcare associated infection, which is spread by the visitors and the
research was able to provide a clear and effective intervention using which this
target could be achieved (Grol et al., 2013). Therefore, this article was included
in the research as third best evidence article as it was able to provide a
different dimension to the research study and provided an important
intervention using which the rate of hospital-acquired infection could be
decreased (Huis et al., 2012).
Relevance to Nursing and Barriers to Practice
The findings of the systematic review and best evidence researches are
applicable in the nursing practice for healthcare facilities because to control the

rate of healthcare associated infections are very crucial in modern healthcare
facility (Allegranzi et al., 2013). As mentioned in the study of Al-Tawfiq et al.
(2013), first of all the level of compliance of the professionals working in facility
towards the hand hygiene should be assessed and then further interventions to
increase the compliance should be done. For this purpose, all the healthcare
professionals will be asked to join a special educational training session so that
the thought of importance of hand hygiene can be reinforced. Further, the
visitors and their hand hygiene should also be a concern as they also
contribute i8n the rate of infection. For that purpose, the intervention by
Birnbach et al. (2012) should be used as it has the ability to increase the rate of
compliance by 83% and decrease the infection to a major extent. Besides
these, the healthcare facility should also be concerned about the device and
related infection rate as device related infection are a major source of infection
hence, maintaining device related infection at controllable level is important for
every healthcare facilities (Schweon et al., 2013). The barriers in achieving this
could be the lower understanding of the staff and healthcare facilities as well as
the laid-back attitude of the staff regarding hygiene and infection control
(Zellmer et al., 2015). Hence, educational and training sessions are important
for this prospect (Ellingson et al., 2014). Further, proper security and
surveillance should be present in the healthcare facility so that visitors and
infections associated to them could be controlled and prevented (Randle, Firth
& Vaughan, 2013). Therefore, the evidence collected from the research articles
is applicable on healthcare facilities with proper training and educational
sessions.
References
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in significant reduction in health care-associated infections. American
journal of infection control, 41(6), 482-486. Doi:
10.1016/j.ajic.2012.08.009
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Effectiveness of a comprehensive hand hygiene program for reduction
of infection rates in a long-term care facility. American journal of
infection control, 41(1), 39-44. Doi: 10.1016/j.ajic.2012.02.010
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