Research Critique: Hand Hygiene Compliance and HAI Studies

This report critically analyzes two quantitative research articles focusing on hand hygiene (HH) and its impact on hospital-acquired infections (HAI). The report examines studies by Mete & Akin (2018) and Li et al. (2019), evaluating their methodologies, findings, and implications for nursing practice. The study by Mete & Akin (2018) investigated the effectiveness of HH training, while Li et al. (2019) explored patients' knowledge, attitudes, and practices regarding HH. The report compares the outcomes of these studies, considering ethical considerations and addressing a PICOT question regarding HH's role in reducing HAI. It highlights the importance of HH training for nurses and educating patients about effective HH techniques to minimize infection risks. The report concludes that both nurses and patients require training on HH to reduce the risk of HAI.

Running Head: UTF-8: How about hand hygiene compliance and hospital acquired infection
UTF-8: HOW ABOUT HAND HYGIENE COMPLIANCE AND
HOSPITAL ACQUIRED INFECTION

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Table of Contents
Background................................................................................................................................3
Supporting the chosen topic by chosen two papers....................................................................3
Study method.............................................................................................................................4
Study result.................................................................................................................................4
Comparing outcomes.................................................................................................................5
Ethical considerations................................................................................................................5
Reference list..............................................................................................................................7

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Background
This study is criticizing two quantitative research articles on Mete & Akin (2018) and
Li et al. (2019). Both of these papers have investigated hand hygiene (HH). The article of
Mete & Akin (2018) is about understanding the effectiveness of the HH training. The aim of
this study is to get a better understanding of the importance of training for hygienic hand
wash on the knowledge and practices of HH. On the other hand, Li et al. (2019) have
mentioned that the aim of their research is to obtain a clear insight into the knowledge,
attitude, and practices of patients regarding HH.
Both of these articles are significant to nursing and it can enrich the knowledge of
nurses regarding the importance of maintaining HH by patients and healthcare professionals
to reduce the risks of hospital-acquired infection (HAI). Outcomes of these studies have
successfully met their aims of knowing the importance of HH compliance.
Supporting the chosen topic by chosen two papers
The PICOT question chosen for this assignment is: Does hand hygiene reduces the
risk of hospital-acquired infection? Both articles are related to a quantitative approach, where
each and every aspect can help to realize the importance of HH and its use to eliminate
hospital-acquired diseases. In the research conducted by Mete & Akin (2018), a non-
randomized trial is done in which the effectiveness of HH training of 63 nurses was assessed
before and after testing. Moreover, improvements in the HH actions and their impact on
infections were measured. On the other hand, Li et al. (2019), conducted a cross-sectional
survey that was conducted in a medical hospital to measure their knowledge about HH and
infections. In this study, a random sampling method was applied. In this research, a
quantitative questionnaire is used to conduct a survey to measure knowledge about HH and
HAI, which can be compared with the PICOT question. However, in the study of Mete &
Akin (2018) non-randomized trial was done to select nurses for training. Data were compared

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in a quantitative technique to measure the change in the actions of nurses after training.
Hence, the impact of maintaining HH on HAI is assessed in both studies.
Study method
Nonrandomized, quasi-experimental research design has been followed by Mete &
Akin (2018). Researchers have included 63 nurses as participants of their research process. 5
days of observation have taken place pre and post-test for collecting quantitative data.
According to Marques et al. (2017), this kind of method is effective in understanding the
effectiveness of any training. On the other hand, this study was limited to 63 nurses and it has
a great impact on the result.
However, a cross-sectional survey design has been considered suitable in Li et al.
(2019). Researchers have used a questionnaire for collecting quantitative data from 310
respondents. As stated by Hong et al. (2015), this method can be employed within minimum
time and budget than other quantitative methods. This method was limited to patients and it
has not taken account of the knowledge attitude and practice of healthcare professionals
regarding HH.
After reviewing both of these techniques, it can be said that the study method of Li et
al. (2019) is a more suitable quantitative method as it is time and cost-effective.
Study result
In the study conducted by Mete & Akin (2018), it was found that HH actions in
nurses have increased significantly after the training process as compared to before training.
The result of this study shows that training is essential to increase the skill of nurses and the
safety of patients. On the other hand, the study of Li et al. (2019) shows that the majority of
patients and caregivers believe that hand washing is essential for disease prevention and
recovery.

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The study of Mete & Akin (2018) has significant implications in nursing practice as it
indicates that training regarding proper HH maintenance impacts on their practice and
knowledge level. Moreover, the study of Li et al. (2019) also has implications as it states that
a positive attitude towards the maintenance of HH helps to reduce patient infections. Graves
et al. (2016) stated that HH compliance is necessary for both patients of ICU and general
wards and caregivers.
Comparing outcomes
Though the outcomes of these two research papers are explaining about HH, these are
different as these two papers have focused on different kinds of respondents. The result of Li
et al. (2019) has postulated that patients have a positive attitude towards HH. However, they
have less knowledge about appropriate techniques for hand washing. It has been found that
patients of different departments have different levels of knowledge regarding hand hygiene
compliance. As mentioned by Keller et al.(2018), patients must be given information about
the effective processes of maintaining hand hygiene by hospital staff members. On the other
hand, the outcome of the article of Mete & Akin (2018) that training regarding hand hygiene
can positively influence nurses to comply with hand hygiene principles. As stated by Le,
Lehman, Nguyen & Craig (2019), it is important to educate both patients and healthcare staff
members regarding hand hygiene to reduce the risks of HAI. Hence, it can be stated that the
outcomes of both of these papers are indicating that both nurses and patients need training
about the importance and processes of maintaining hand hygiene. This aspect can help to
reduce the risk of HAI.
Ethical considerations
Both studies have been conducted in an ethical way as concerns from participants
were taken prior to the process of data collection. As opined by Santosaningsih et al.(2017),
collection of concern and providing details about research helps the researcher to eliminate

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legal and ethical issues. Moreover, researchers of both studies opted to maintain the
confidentiality of the data. The raw data and consent forms were kept secret and not
published. Shiju (2017) stated that the publication of personal data without proper concern
from respondents is unethical and hurts sentiments of them. In both studies, healthcare
guidelines and rights of respondents were maintained and protected. As both studies involve
caregivers and patients, thus it is essential to follow policies of healthcare policies. This has
helped to eliminate any risk of legal issues. As stated by Umulisa et al. (2016), conducting
research must have a positive impact on the target population. Both the research will help to
increase understanding about the need for HH and its use to reduce HAI.

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Reference list
Graves, N., Page, K., Martin, E., Brain, D., Hall, L., Campbell, M., . . . Barnett, A. G. (2016).
Cost-effectiveness of a national initiative to improve hand hygiene compliance using
the outcome of healthcare associated staphylococcus aureus bacteraemia. PLoS One,
11(2) doi:http://dx.doi.org/10.1371/journal.pone.0148190
Hong, T. S., Bush, E. C., Hauenstein, M. F., Lafontant, A., Li, C., Wanderer, J. P., &
Ehrenfeld, J. M. (2015). A hand hygiene compliance check system: Brief
communication on a system to improve hand hygiene compliance in hospitals and
reduce infection. Journal of Medical Systems, 39(6), 1-4.
doi:http://dx.doi.org/10.1007/s10916-015-0253-z
Keller, J., Wolfensberger, A., Clack, L., Kuster, S. P., Dunic, M., Eis, D., . . . Sax, H. (2018).
Do wearable alcohol-based handrub dispensers increase hand hygiene compliance? - a
mixed-methods study. Antimicrobial Resistance and Infection Control, 7
doi:http://dx.doi.org/10.1186/s13756-018-0439-5
Le, C. D., Lehman, E. B., Nguyen, T. H., & Craig, T. J. (2019). Hand hygiene compliance
study at a large central hospital in vietnam. International Journal of Environmental
Research and Public Health, 16(4) doi:http://dx.doi.org/10.3390/ijerph16040607
Li, Y., Liu, Y., Zeng, L., Chen, C., Mo, D., & Yuan, S. (2019). Knowledge and practice of
hand hygiene among hospitalised patients in a tertiary general hospital in china and
their attitudes: A cross-sectional survey. BMJ Open, 9(6)
doi:http://dx.doi.org/10.1136/bmjopen-2018-027736
Marques, R., Gregorio, J., Pinheiro, F., Povoa, P., Miguel Mira, d. S., & Luis, V. L. (2017).
How can information systems provide support to nurses hand hygiene performance?

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using gamification and indoor location to improve hand hygiene awareness and
reduce hospital infections. BMC Medical Informatics and Decision Making, 17
doi:http://dx.doi.org/10.1186/s12911-017-0410-z
Mete, K. K., & Akin, S. (2018). Effectiveness of hygienic hand washing training on hand
washing practices and knowledge: A nonrandomized quasi-experimental design. The
Journal of Continuing Education in Nursing, 49(8), 360-371.
doi:http://dx.doi.org/10.3928/00220124-20180718-07
Santosaningsih, D., Erikawati, D., Santoso, S., Noorhamdani, N., Ratridewi, I.,
Candradikusuma, D., . . . Severin, J. A. (2017). Intervening with healthcare workers
hand hygiene compliance, knowledge, and perception in a limited-resource hospital in
indonesia: A randomized controlled trial study. Antimicrobial Resistance and
Infection Control, 6 doi:http://dx.doi.org/10.1186/s13756-017-0179-y
Shiju, D. W. (2017). Intelligent hand hygiene recording and reminding method to check
hospital acquired infections. Research Journal of Pharmacy and Technology, 10(10),
3511-3513. doi:http://dx.doi.org/10.5958/0974-360X.2017.00629.1
Umulisa, S., Musabyimana, A., Wong, R., Adomako, E., Budd, A., & Ntakirutimana, T.
(2016). Improvement of hand hygiene compliance among health professional staff of
neonatology department in nyamata hospital. On the Horizon, 24(4), 349-356.
doi:http://dx.doi.org/10.1108/OTH-07-2016-0038