Hand Hygiene Compliance and Nosocomial Infection: A Focused Search Strategy

Running head: NURSING ASSIGMENT
NURSING ASSIGMENT
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Introduction
Hospital acquired infection or nosocomial infection is one of the critical factor that has
increased the concerns of the Australian government (Sabtu, Enoch & Brown, 2015). As per the
data of Hand Hygiene Australia (2019), more than 165,000 people suffer from such infections
while receiving care in the care facilities and this rate is affecting every 1 in 50 hospitalisations.
The concern could be understood from the fact that the rate of nosocomial infection is higher in
intensive care units of the healthcare facilities compared to other units (Hand Hygiene Australia,
2019). Multiple interventions has been implemented by care service management so that such
infection could be prevented, however, the rate of achievement could not reflect the same
(Iedema et al., 2015). This was the reason hospital acquired infection was chosen as the concern
for the previous assignment and the rate of improvement with adherence to it was planned for
conduction of assessment.
The primary aim of this paper is to use the clinical question used in the previous
assignment to conduct a focused search strategy with identification of inclusion and exclusion
criteria, specific search terms so that set of specific research articles could be found. Finally, the
way this search strategy and PICO analysis helped to develop research problem related
understanding would be included in this continuation assignment.
Background
As per Di Paolo et al. (2019) hospital acquired infections or nosocomial infections are
type of infections that are spread through healthcare facilities while providing or receiving care
within a healthcare facility. These infections are caused by microorganisms that are resistant to

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antibiotics or are spread through activities such as talking, sneezing, coughing and others. As per
Iedema et al. (2015), one of the primary reason that has been found to be responsible for the
highest number of nosocomial infection in patients are improper hygiene status, non- compliance
to the hand hygiene protocol of healthcare process and irregular unhygienic practices that are
practiced by the visitors within care facility (Australian Nursing and Midwifery Journal, 2018).
This indicated towards the gaps and limitations of healthcare facilities or managements to
implement these above- mentioned practices in their care facility so that the risk of such
infections could be minimized (Chowdhary, Sharma & Meis, 2017). Further, it also identified
that if the care facility implements these aspects diligently, then the rate of infection could be
controlled, however, the achievability of this gaol was questionable. Hence, the clinical question
was framed in such a way so that the comparison between compliance of hand hygiene could be
compared to non- compliance of it to analyse the effectiveness of this intervention, in controlling
nosocomial infections (Hand Hygiene Australia, 2019).
This clinical question is important for the development of clinical practice standards and
increasing the knowledge of healthcare professionals working in the healthcare facilities. In a
recent report published in Australian Nursing and Midwifery Journal (2018) identified that
Australian healthcare facilities are suffering from dynamic drop in their health hygiene
compliance strategy. As per this report, if the care professionals are not observed, the rate of
hand hygiene compliance falls from 90% to 30% and this research statistical data completely
denies the governmental data of complete hand hygiene compliance (Australian Nursing and
Midwifery Journal, 2018). Hence, this study clearly identifies that there is a huge gap between
the governmental guidelines and the implementation in care facilities. Due to this, patients as
well as healthcare professionals are suffering from critical infectious diseases that not only

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affecting their health and wellbeing, but also affecting the economy of the country (Australian
Nursing and Midwifery Journal, 2018). Further, the governmental audit report mentioned that the
rate of hand hygiene compliance was found lower in critical care units such as emergency
department (72%), critical care unit (80%) and maternity ward (81%). The lowest compliance
rate was associated with domestic care professionals (72%), medical practitioners (73%), and
student doctor and nurses (79%). Hence, conduction of this research process would be effective
for the clinical process and practice in future.
Search strategy
While developing a search strategy for any clinical question, it is importance to sieve
recent research articles so that evidence based practice could be conducted. In this aspect the
databases in which these research articles would be searched using specific research key terms
becomes critical (Hadi & Closs, 2016). There are multiple databases with thousands of research
articles with primary or secondary research processes however; Pub Med is the database that
would be selected for the conduction of search for this clinical question. As per Coordinators
(2017), Pub Med is a database with thousands of research articles that are tagged with keywords
that indicates their importance in the evidence based practices such as the type of study
conducted by the researcher and their major processes. Further, Pub Med is known to have the
most vast and accurate collection of clinical as well as biomedical research articles. Hence, these
are the aspects that make this scientific database accurate for this search strategy that would help
to answer the research question.
The second step would be determining keywords that would be used for the identification
of keywords so that while search for those research articles, these keywords could be used to