Systematic Review on the Importance of Hand Hygiene in Infection Control and Reduction of Nosocomial Infections

Running head: NOSOCOMIAL INFECTION PREVENTION
Systematic Review on the Importance of Hand Hygiene in Infection Control and
Reduction of Nosocomial Infections
Name of the Student
Name of the University
Author Note

NOSOCOMIAL INFECTION PREVENTION 1
Introduction
The integration of evidence-based practices is considered to be one of the highest
standards in clinical practice. These practices are backed up by pieces of evidence supporting
the clinical judgments and help the health care professionals better adjudge and react to the
situation. Conducting a literature review is the foremost step towards integrating evidence-
based practices in clinical settings. A literature review helps to gather a comprehensive
overview of the concerned research topic. The primary objective of the review of literature is
to describe, enumerate and summarize the research study to evaluate and extract relevant
critical information to support evidence based practices. A systematic review of literature
uses systematic procedures to collect data (secondary), critically appraise the selected
research studies, synthesize research findings and provide an exhaustive and complete
summary of the evidence relevant to the chosen study topic.
The following paper will provide description of the systematic review conducted on
the research topic of the importance of hand hygiene in infection control and reducing
nosocomial infections in clinical settings. Hospital-acquired infection, also known as the
nosocomial infection is a major concern in healthcare settings, primarily determined by the
acquisition of an infection by the patient during their stay in health care settings and care
undertaken by the health care professionals. Few of the common nosocomial infections
include Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus (Farhoudi et
al. 2016). The incidence of nosocomial infections poses a severe risk on the patient’s safety
and health outcome and can lead to consequences of deteriorating health and a longer stay in
the hospital, with increased financial burden due to spending on health care provisions. One
of the most practical solutions to combat and reduce the prevalence rate of nosocomial
infections is maintaining hand hygiene, which helps to cease pathogen transmission and
prevent the incidence of hospital-acquired infections.

NOSOCOMIAL INFECTION PREVENTION 2
PICO Question
In healthcare settings, how do high standards of hand hygiene compliance and proper
hand washing by the healthcare professionals prevent the spread of nosocomial infections
Literature Search
To find the most suitable research studies relevant to the PICO question, a systematic
review of the literature would be conducted. The primary objective of the paper is to ensure
proper identification of studies concerned with the effectiveness of managing standard hand
hygiene compliance to reduce incidence nosocomial infections and synthesize the relevant
evidence extracted from the selected studies. One of the major theme under the concerned
research topic that will be focused upon is hand washing compared with the use of sanitizers
that alcohol-based.
Search Strategy
To conduct the systematic review of literature for selection of the research articles
with high relevancy to PICO question, medical databases such as BioMed Central, PubMed
Central, CINAHL and Cochrane Database of Systematic Reviews will be searched. The
primary objective of the search strategy is to find peer-reviewed published article and
research studies with high relevancy to the chosen research topic. The search in the
mentioned medical databases will be performed with the use of keywords. The set of
keywords include hand hygiene, reduction of nosocomial infections, hospital-acquired
infections, hand washing, alcohol-based sanitizers, infection control, hand hygiene
compliance, and infection prevention. The input of these keywords in the advanced search
option of the databases with the help of Boolean operators will be ensured to increase the
search results and filter them according to for the easier selection of articles and studies with
high relevancy. The use of Boolean operator ‘AND’ between the keywords will present a
higher count in the search results with results that might be relevant or not relevant to the

NOSOCOMIAL INFECTION PREVENTION 3
chosen PICO research question. The use of this Boolean operator helps to gather an overview
of the available literature and determine the inclusion or removal of keywords to increase the
relevancy of the search results. The use of Boolean operator will be ensured to narrow down
the count of search results and to filter the result with lesser number of articles with the
highest relevancy and providing crucial pieces of information on the research question.
The selection of the articles for further evaluation and synthesis of information was
completed with the help of inclusion and exclusion protocol, mentioned below.
Inclusion Criteria
The primary inclusion criterion for the articles found by conducting the systematic
search is the inclusion of only peer-reviewed articles. The date of publishing is an effective
way of ensuring recency in the pieces of evidence provided by the selected research studies.
Only the articles and studies published between the years 2011 to 2020 will be selected for
further evaluation and synthesis of information. The language of publication was limited to
English only in the advanced search option available in the database. No geographical
limitation was set for the selection of relevant articles. This was ensured to increase the
generalisability of the research findings and to get a broader global overview of the evidence
supporting the importance of hand hygiene compliance in preventing the incidence and
reducing the prevalence of nosocomial infections in clinical settings.
The methodological protocol followed by the research studies were also considered
for the further filter of search results. Only the articles that followed the first two levels of the
hierarchy of evidence, that is, methodologies that followed systematic reviews, randomized
control trials, and prospective cohort studies were considered for inclusion in the study and
further evaluation.