Research Critique: Hand Hygiene and Hospital Acquired Infections

This report critically analyzes two research articles focusing on hand hygiene and its relationship to hospital-acquired infections. The study investigates the problem of hospital-acquired infections (HAIs) and the significance of health practitioners' hand hygiene practices. The report examines the PICOT question, which explores the impact of hand hygiene on HAIs within hospital settings. It provides a detailed overview of the research methods, results, and ethical considerations of the studies. The findings emphasize the importance of proper hand hygiene training for healthcare professionals, staff, and patients to prevent the spread of infections. The report also compares the outcomes of the two articles and discusses the implications for nursing practice, advocating for enhanced infection control measures and patient safety. The conclusion underscores the necessity of consistent hand hygiene practices by all individuals in healthcare settings to mitigate the risks associated with HAIs.

Running Head: Hand hygiene and hospital acquired infections 1
Hand hygiene and hospital Acquired infections
Student’s Name
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Hand hygiene and hospital acquired infections 2
Hand hygiene and hospital-acquired infections
The research problem identified is whether the health practitioners’ hand hygiene lead to hospital
acquired infections.
Background
This study seeks to criticize two research articles by Mathew Koff, (2014) and Sarit Sharma,
(2018) on hand hygiene and hospital-acquired infections. These two articles analyze that
hospital-acquired infections are associated with poor hand hygiene. According to Sarit (2018),
the hands of a health care worker play an important in the transmission of pathogens in any
health care settings. Sarit’s study aims to determine all the infections from hospitals that are
transmitted only by the health practitioner. Koff (2014) argues that the anesthesia provider hand
hygiene’s compliance determines the transmission of infections during surgeries. This study aims
to determine the importance of hand hygiene in determining the spread of hospital-acquired
infections.
These articles are very significant because both analyze various ways of getting hospital-
acquired infections and, at the same time, provide insight on the ways of practice in the health set
up that shall enable various parties to play their roles effectively. The nurses shall be able to
know various ways of handling patients in the outpatient and inpatient departments, as well as
during surgery. They shall be able to carry out the proposed ways of enhancing proper hand
hygiene practices in these two research articles and why they need to comply with such practices.
Supporting the chosen topic by the chosen two articles
The PICOT question for this paper is whether hand hygiene contributes to Hospital Acquired
Infections in hospital setups. Hospital settings are made up of health practitioners, the staff,

Hand hygiene and hospital acquired infections 3
visitors, and patients. There are various kinds of infections in hospitals that, in one way or the
other affect everybody. Controlling and preventing such infections is of great importance for the
safety and wellbeing of every party (Bearman, Munoz-Price, Morgan, & Murthy, 2017). Quality
risk management, health, and clinical governance can all lead to controlled hospital infections
(Kwok, 2013). In both studies, cross-sectional surveys are done amongst the health care nurses,
members of staff, and the patients. A survey of 50 nurses was done during the operative sessions
and after the postoperative sessions on how they did hand hygiene, Koff, 2014). According to
Sarit (2018), a random survey was done amongst groups of five to 10 nurses on how they carry
out disinfection procedures when handling a patient in the outpatient and the inpatient
department. Nurses were trained in these groups on how to handle patients at all levels and how
frequent sanitization procedures should be done. They were observed two hours later after
training during their active sessions. These two articles are essential to my PICOT questions
since there were assessed hand hygiene practices carried in Hospitals and how such practices
determine the rate of acquisition of Hospital infections.
The study methods used.
In research conducted by Koff, (2014), a randomized interventional clinical trial was done where
3256 participants were involved who had come for treatment. The title given to the study was
‘reduction in 30-day postoperative Healthcare-Associated infections’. In this case, the number of
patients with postoperative Healthcare Acquired Infections 30 days after the operation procedure
were identified. Patients who had prior infections or prior existing decolonization were included
and were equally distributed to study groups that had been given a randomized study design.
New sites of infections /different infection organisms were considered for HCAI analysis.
Secondary outcome measures included looking at the hospital readmission rates within 30 days,

Hand hygiene and hospital acquired infections 4
considering patient’s mortality within 30 days of discharge and looking at the hospital stay
duration 30 days after surgery. Other outcomes measure in this research included looking at hand
hygiene events carried out per hour by utilizing devices during active cases such as the non –
scrubbed personnel times they performed hand hygiene during the operational procedures or
after. The exclusion criteria included pediatric patients, the pregnant, and adjustments made
during the day of the surgical procedures, (Card, 2015).
In the study done by Sarit (2018), a survey was done through descriptive data analysis, and case
reports were used as methods of data analysis in the two means of data collection. The survey
was done on 100 patients who proven to suffer infections during their stay period in the hospital.
Some of these patients suffered varying disorders and diagnosed with different conditions,
especially in the inpatient departments (Charney, 2012). Similar factors that led to infections
were mentioned, and using the case-control studies, the relationship between them was verified
(Keogh & Cox, 2014). They carried out systematic reviews where there was identified from the
records a big number of patients suffering from hospital-based infections. Through meta-
analysis, results from the surveys and reviews of the hospital systems were summed up to bring
the strength to the proposed research question, (Card, 2012).
Study results
In the study carried out by Koff, 2014, the 30days time frame in clinical trials shown that out of
the 3256 participants, 100 of them suffered post-operative infections. Through microbiology,
cultures were determined from those infections, and it was determined that the infection agents
were bacteria and viruses. Four patients were reported to die after severe infection cases due to
viruses spread from the operative rooms. It was found out that the health practitioners’ practices
during surgery were not quality enough to prevent infections to the patients. Poor sanitization of

Hand hygiene and hospital acquired infections 5
surgical tools was reported to be done and poor hand hygiene was as well practiced after the
operation sessions.
In the study carried out by Sarit, 2018, various infections were reported to emerge in hospitals
from the surveys and the systematic reports. The sources of these infections were proven to be
poor hand hygiene and protective equipment by the health practitioners. Poor hand hygiene was
practiced by both the nurses and the patients that contributed to their infections. These results
findings were very vital because they helped in determining the underlying factor towards
hospital infections. Both studies propose the need for proper hand hygiene training to health
practitioners, patients, and all staff to ensure that we halt the phenomena of hospital-acquired
infections. Patients are advised to know the need for good conduct in hospitals to avoid
infections and be keen on health practitioner practices, especially before surgery, (Singh, 2012).
Comparing the outcomes
In both articles, the main issues are hand hygiene. Hand hygiene compliance is a very important
practice in all care settings by both doctors and nurses (KOSUCU, GOKTAS, & YILDIZ, 2015).
It is also a task that should be emphasized amongst the patients in health care settings. This shall
prevent nosocomial infections and others that arise due to multidrug-resistant bacteria, especially
in the operative room and the Intensive Care Unit. There is a need for training health
practitioners on the frequency of cleaning their hands before and after handling patients. This
shall reduce mortal rates due to hospital-associated infections. Patients too should be trained on
how to clean their hands with effective sanitizers and avoid leaning on surfaces while in the
hospital (Ahuja, Thakur, & Ahuja, 2012). Instances of healthcare-associated pathogen
transmission should be avoided. These instances occur in the hands of the health care worker if
the organisms are found in the skin of the patient, or have been shed in the objects surrounding

Hand hygiene and hospital acquired infections 6
the patient. Poor sanitization of tools spreads these pathogens in theatres. To avoid infections
also, it was proposed that proper hand sanitization should be carried out before a health
practitioner contacts a patient, before performing an aseptic task, after exposure to body fluid,
after coming into contact with a patient, and after one comes into contact with the surroundings
of the patient, (Alhassan & Poku, 2018). Alcohol-based sanitizers should be used for cleaning
hands in health care facilities, and to the patients suffering from c.difficile, they should always
clean their hands with water and soap. They should also ensure that their health care provider
uses gloves when taking care for them, ("41.8 Clostridium-difficile-Infektion (CDI) CDI =
Clostridium-difficile-InfektionClostridium-difficile-InfektionInfektionClostridium difficile,").
Ethical considerations
Ethical consideration is very important when carrying out research according to the research
guidelines in every setup (Miller, Birch, Mauthner, & Jessop, 2012).In the two articles, ethical
consideration was identified by seeking the respondents’ consent before involving them in
research. The patients who were unwilling to participate were freely allowed to be excluded in
the research procedure. The hospitals’ managing ethical authorities were sought to give
permission to carry out research in their premises and guaranteed the patients’ data privacy after
assessing their systems (Machanavajjhala & Gehrke, 2016). The respondents’ security was
guaranteed towards physical harm and the data they provided. Their dignity was hilly prioritized
throughout the research period, irrespective of the condition the patients were suffering from.
Healthcare policies were followed to detail in the process to avoid implications of any legal
issues. The research was beneficial for it led to coming up with ways of ensuring patient’s safety
and quality practices in hospitals.

Hand hygiene and hospital acquired infections 7
In conclusion, hand hygiene should be ensured by every person in the healthcare set up. Every
member has a role to play in ensuring that proper sanitization of hands and equipment are done
at all time. The above-proposed ways should be used to ensure hand hygiene. Hospital-Acquired
infections should be prevented and controlled at the highest degree to avoid its associated risks.

Hand hygiene and hospital acquired infections 8
References
41.8 Clostridium-difficile-Infektion (CDI) CDI = Clostridium-difficile-InfektionClostridium-
difficile-InfektionInfektionClostridium difficile. (2014). Checkliste Intensivmedizin.
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Hand hygiene and hospital acquired infections 9
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