Hygiene Practices Underlying And Prevention of Healthcare

Running head: EVIDENCE PRACTICE IN NURSING: PICOT QUESTION AND POSTER
EVIDENCE BASED PRACTICE IN NURSING: PICOT QUESTION AND POSTER
Name of the Student:
Name of the University:
Author note:

EVIDENCE BASED PRACTICE IN NURSING: PICOT QUESTION AND POSTER1
Clinical Question
The proposed clinical PICOT question to be considered for the healthcare change
intervention is: “Is the use of alcohol based solution in hand washing more effective than soap
and water hand washing in reducing nosocomial infection infections inside a nephrology unit of
a hospital?” With respect to the same, the PICOT components which will guide decision-making
for initiation of healthcare change intervention are:
 P: Population: Adult patients admitted in the nephrology department
 I: Intervention: Alcohol-based hand rubbing solution as a proposed hand hygiene
practice
 C: Comparison: Soap and water as a hand hygiene practice
 O: Outcome: Reduced rate of nosocomial infections or infection incidences.
Synthesis of Evidence
While the effectiveness of hand hygiene practices underlying the prevention of healthcare
associated infections has been researched in abundance, lack of healthcare staff compliance with
respect to following the same continues to prevail. In addition to established of training or
educational based frameworks, the placement of alcohol-based hand rubbing solution at critical
care locations like patient rooms or the bedside have been proven to improve organizational
compliance to hand hygiene practices (Pires et al., 2017).
Thus, as per the given PICOT question, the proposed healthcare change intervention
necessitates the introduction of alcohol-based hand rubbing solutions, in comparison to water
and soap, as the first line of hand hygiene protocol to be followed immediately after healthcare
professionals have engaged in invasive procedures or interventions involving adult patient

EVIDENCE BASED PRACTICE IN NURSING: PICOT QUESTION AND POSTER2
contact, in the nephrology unit of a chosen healthcare organization. Alcohol-based hand rubbing
solutions have been evidenced to be a financial feasible and ergonomically compliant way with
which nosocomial infections can be controlled at all almost all points of patient care without
causing dryness as compared to traditional hand hygiene practices requiring soap and water
(WHO, 2020).
Barriers
The key cultural or educational barrier which can pave the way for change resistance is
inadequate knowledge or inadequate health literacy across healthcare staff. There continue to
remain misperceptions and unawareness concerning replacement of soap and water with alcohol-
based rubbing solutions since it is commonly believed that the latter is not as clinical effective as
the former (Kingston et al., 2017). Additional organizational and administrative barriers which
can cause change resistance include: lack of hand hygiene protocols at the organizational level,
absence of tenured or champion healthcare professionals for change facilitation and
misconceptions that alcohol-based solutions cause dryness and gloves provide adequate
protection as compared to hand hygiene practices (Bellissimo-Rodrigues et al., 2016).
Project Team
The project team members will comprise of the researcher, the nursing staff, the
operations manager, healthcare administrator and inter-disciplinary healthcare professionals like
physicians, practitioners and nephrologists, to assist in not just evidence based research and
policy formulation, but also to facilitate multidisciplinary approaches to change fulfilment.
Additional key stakeholders who will be involved in the project team will include tenured
nursing staff or healthcare champions who will not only assist in delivering educational protocols