Critique Analysis of Two Research Papers on Infection Prevention and Hand Hygiene Practices among Healthcare Workers

This article offers a critique of two research papers on infection prevention and hand hygiene practices among healthcare workers. The critique analyzes the research design, methodology, strengths, and limitations of each study. The paper provides a summary of both articles and discusses their relevance to the healthcare industry.

Running Head: EDUCATION 1
The process of critique analysis and research
Author's Name
Institutional Affiliation

EDUCATION 2
Introduction
Research plays a vital role in regional and global systems, and research collaborations
enhance the research enterprise of an institute. Research management and critique is essential in
the research industry as it establishes and inspects the research activities and explores the further
growth of research innovation. Research critique allows one to look for democratic conditions
that produce research innovations (Jun Song, & Wei Loong, 2018).
Summary for both articles
The article “Infection prevention as ‘‘a show’’: A qualitative study of nurses’ infection
prevention behaviors” centers on the control and avoidance of healthcare-associated infections is
a significant issue in the healthcare industry worldwide. Despite initiatives and strategies, the
healthcare-associated infections still persist and amount to the significant economic burden on
healthcare. The earlier research is more focused on infection prevention behaviors and guideline
compliance. The current study aims to understand and explain everyday practice and behaviors
from the perspective of the actors themselves. This paper presents Rationalizing dirt-related
behavior and tries to explain infection prevention behavior among nurses at a London University
(Jackson, Lowton & Griffiths, 2014). The study in the next article” A comparative study of hand
hygiene and alcohol-based hand rub use among Irish nursing and medical students “is set in
Ireland, and the focus is on the role of Hand hygiene in averting healthcare related infections.
Hand rubbing using alcohol-based hand rub is considered critical acute-care facilities. The study
compares practices of hand cleanliness among nurses and medical students in Ireland. The
objective of the study is to get an insight on the current hand hygiene practices and make a wider
comprehension of this topic. This observational study is based on a questionnaire which is sent
electronically to the students of nursing and medicine in the Ireland University. Appropriate

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software is used to get the response rate and compliance. Results indicate the problem areas and
the scope for improvement in both disciplines (Kingston, O’Connell, & Dunne, 2018).
The paper offers a critique of two research papers and focuses on the analysis of the
research design and methodology as well as the strengths and limits of each. The critique studies
the strengths and limitations of a research study and is essential in the area of research inquiry as
it identifies the best current practices. The published research may or may not be scientifically
sound and carry little support for their validity. Thus, it becomes essential to critique research to
identify any biases or weakness in its results.
A critique of Infection prevention as ‘‘a show’’: A qualitative study of nurses’ infection
prevention behaviors
Introduction
Problem
The objective of the study was to explain everyday practice and behaviors among
nurses related to healthcare-associated infections. World Health Organization (WHO, 2011)
reports 16 million additional days in hospital due to healthcare associated infections in European
hospitals. The primary study aims to get an insight into the perceptions of risk of infection and
prevention behaviors related to infection. Evidence suggests that one’s own practice against
healthcare-associated infections relies on awareness of risk, social pressure or peer pressure
(Akyol et al., 2006). There is a clear statement of the problem as to why participants look at
others’ behaviors inappropriate but not in themselves. The problem is searchable and can be
investigated through the collection and analysis of data. The background of the research is
relevant to the research question, and the problem of healthcare-associated infections is an
important one for the healthcare industry.

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The article carries background info on the issue of healthcare-associated infections and
gives the significance of the problem discussed. The review of related literature is
comprehensive and makes use of peer-reviewed research articles from recent times. All cited
references are relevant to the problem under research. There are both primary and secondary
sources which have been critically analyzed and compared and contrasted. All sources used are
well within the field, and the abstract gives a clear and concise explanation of the paper. It
explains the why the research was carried out and the main findings and the conclusions.
Hypotheses
The study questions "How to explain infection prevention behavior among nurses and
presents 'Rationalizing dirt-related behavior' as one of the three identified themes.
Method
Identifying the infections simplified behavior as the rules were clear and it was felt
essential to get protection against dangerous micro-organisms (Whitby et al., 2006). Participants
are motivated by rationalized protection and behavior. Twenty interviews were carried out for
fourteen-month period and the transcribed verbatim and analyzed with the framework method.
Participants were registered nurses employed in a critical hospital environment and who were
recruited while studying. There are details regarding the age of the participants, their number
and gender and education.
Research Ethics
King’s College London granted Ethical approval for the sample which was convenient
and purposeful. This interpretative qualitative research makes use of vignettes structured from
nurses' accounts of practice and their reports on infection prevention behaviors.

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The paper offers a description of how the interviews were carried out using a topic guide
and how long they lasted. All interviews were recorded and transcribed verbatim and were
inspected as part of the Framework method (Ritchie and Spencer, 1994).
. While the design of the study is appropriate for answering the research question, the
study could involve more nurse from a different hospital.
The findings focus the theme ‘Rationalizing dirt related behaviors ‘with 3 subthemes -
Rationalizing and rationalizing the irrational, rationalizing or condemning irrational behavior in
others and the display of practice (Jackson, Lowton & Griffiths, 2014). Participants were asked
to explain their own and others’ behaviors in diverse terms.
Results
The study finds that nurses rationalize their own behavior, rational or irrational even if
doesn’t fit the norms of recommended practice. Rationalizing irrational behavior in others was
easier for the nurses (Jackson, Lowton & Griffiths, 2014). The concept of making the right
impression is more like a display of practice in the nursing profession. The results are presented
and explained by taking examples of interviews with different nurses. They are discussed with
reference to the research question.
Discussion
The discussion of the findings is related to the original research question set for the study.
The central theme “Rationalizing dirt related behaviors “and the three subthemes are discussed
based on the presentation of the participants of themselves. The findings advocate that the prime
reason for wearing protective gear and clothing was to give an impression of a well-informed
health practitioner and the practice has lot to do with professional barriers (Twigg, 2000). Use of
protective clothing was often seen as source of guilt as well as offence among the eHealth car

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workers as patients could see them as a sign that they were they were unclean (Van Dongen,
2001). The healthcare workers are anxious about what the protective clothing could convey to
the patient symbolically.
Limitations
The article acknowledges that as a self-report of infection prevention practice can be
flawed and the advocated practice may differ from the actual practice significantly (Jenner et al.
2006) Still, the study offers information on socially desirable responses among nurses and their
practice. The research paper could have used suitable tables and figures for a clear representation
of data. The power of the study can be raised by increasing the sample size and the number of
questions in the questionnaire.
Conclusion and recommendation
The study makes an essential contribution to explaining infection prevention behaviors
among nurses. It points out that as behaviors are complex and multifaceted, just providing
guidance on infection prevention behaviors is not enough. Regular clinical supervisions and
reflective sessions allow healthcare workers would permit the workers to explain their doubts
regarding infection and assess their own behavior adherences to policy requirements (Driscoll,
2000). The research calls for educational interventions based on social understanding and beliefs
regarding dirt and infection.
II. A critique of the comparative study of hand hygiene and alcohol-based hand rub use
among Irish nursing and medical students
Introduction
Problem

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The purpose of the study is to understand if poor hand hygiene can raise healthcare-
associated infection and increase the risk of morbidity and mortality. As there is limited
emphasis on paralleling medical knowledge practices in healthcare related to hand hygiene and
hand rubbing practices, the study was designed to get understanding into the present practices of
hand hygiene among nursing and medical students. Hand cleanliness is looked upon to be the
most essential and practical measure a to avoid the spread of HCAI (Health Protection
Surveillance Centre, 2012). There is a clear statement of the problem and why limited data and
limited studies demand an inquiry and research in this direction.
The article provides adequate background information on the issue of hand hygiene
practices among healthcare workforce and the associated problems in healthcare. There is poor
knowledge among nurses and medical scholars related to hand hygiene (D'Alessandro et al.,
2014). Peer-reviewed research articles are used to create the background of the research. All
cited references are relevant to the problem. Both primary and secondary sources have been
compared and contrasted as well as critically analyzed to add to the literature reviewed, the
discussion and findings. The literature review is broad and provides convincing evidence to
support the assertions. Despite opposing views, there is a strong theoretical framework observed
in the literature review of the paper. There has been no Irish study to explore and compare hand
rubbing practices and hand hygiene among nurses and medical students (Kingston et al., 2017).
Hypotheses
The study questions “Study the current hand hygiene and hand rubbing practices of
nursing and medical students in Ireland” and add to the understanding of the topic of the role of
hand hygiene in averting HAI (Kingston, O’Connell, & Dunne, 2018).
Method

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The observational study makes use of self-reported design and the participants include
nursing and medical students from an Ireland university. The questionnaire is sent to the 342
nurses and 530 medical students electronically. The study went on for two months. The
participants had been trained and educated on hand hygiene education and had received the
training.
The questionnaire was validated at Colombia University, NY and adhered to the US
hand hygiene guidelines (CDC, 2018) and WHO hand hygiene guidelines (WHO, 2009). The
questionnaire was reviewed further by two qualified researchers for content validity. Before
handing over the questionnaire, a pilot study ensured that the questionnaire was reliable and
feasible. The 62 questions need to be answered in yes or no’.
The paper offers a good description of how the interviews were carried out and the data
collected and analyzed. The design of the study is suitable for responding to the research
question. As there is an adequate number of questions and participants, the results are more
comprehensive.
Research Ethics
Research Ethics Committee of the Faculty of Education and Health Sciences approved
the conduction of the study and its design. Code of ethics of the Declaration of Helsinki
overlooked the performance of the research (Declaration of Helsinki, 2013). As it was an
observational study based on an unidentified questionnaire, it was ensured that there were no
risks of any harm for the participants.
The study was carried anonymously to guard the privacy of the participants and maintain
their confidentiality. Consent was voluntary and anonymous for the electronic survey which was
carried out without conflicting the scheduled exam periods for the students.

EDUCATION 9
The findings focus on the important teaching and knowledge resources accessible by the
students; the study explores on both the negative and positive attitudes to hand sanitation and the
actual hand hygiene practice by the nursing and medical students. Their outlooks towards ABHR
hand rubbing were discussed in the results.
Results
The paper offers a clear explanation of the results under the different each section and
focus. The results are given in percentages to reflect and make useful comparisons. The findings
on teaching and learning resources reveal that the nursing students carry higher awareness of
hand cleanliness and sanitization when compared to medical students who were not very familiar
with the WHO hand hygiene guidelines (WHO, 2009). Significant differences are found in both
negative and positive attitudes to hand hygiene. The actual practice of hand hygiene was more
effective in third and 4th-year medical students as related to the 1st and 2nd medical students
(Kingston, O’Connell, & Dunne, 2018). Higher acquiescence for hand rubbing with ABHR was
seen even among medical students. Three tables have been used to clarify the results and provide
better explanations based on answer options and percentage of the nursing and medical students.
The results have been construed keeping in mind the research question and within the conceptual
frameworks. It uses a careful approach to construing results to deal with the potential biases
reacted to a voluntary survey and a self-report design.
Discussion
Elaborate discussions are made on the results to get an in-depth understanding of hand
hygiene practices of students of nursing and medicine and their role in preventing healthcare-
associated infections. (Kingston, O’Connell, & Dunne, 2018).
Limitations

EDUCATION 10
Limitations of the study include the potential biases that are inherent in a self-report
design. In self -report design studies, the results predict the purpose to comply rather than actual
perform (Borg et al., 2009) However, the study makes use of non-judgmental questions to offset
any potential biases. The questions were carefully designed, and neutral response options were
included to avoid inaccurate answers from the respondents. Anonymity and confidentiality were
maintained at all stages. However, the study is reinforced through the use of vignettes to avoid
socially desirable responses. The study can be considerably strengthened by removing any
potential threats internal validity to add to the meaningfulness of this study. The participants
were asked to respond to confidentiality and honestly. However, no other efforts were indicated
to raise internal validity.
Conclusion and recommendation
The study makes a useful contribution to explain current hand cleanness practices among
the health care students. The study is an important one as it adds to the understanding of the
significance of hand hygiene to control HAI (Kingston, O’Connell, & Dunne, 2018). The results
of this study point out that there are still challenges that persist.
It highlights the outlined hand hygiene in the WHO and pays greater attention to
perceived barriers in practicing hand hygiene. Self-protection is a steady stimulus to practice
hand hygiene among medical and nursing students (Smiddy et al.,2015). Nursing and medical
students as the participants in the study show that they carry the primary responsibility of
creating and supporting a clinical learning environment.

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