Infection Control Literature Review Portfolio - BMS105

This portfolio assignment, completed by a student, focuses on infection control and explores various aspects of literature searching, quality evaluation, and review. The assignment begins with identifying keywords related to infection control, illness, and hand hygiene. It then involves ranking information sources based on their reliability and level of evidence, using guidelines for evidence-based sources. Peer-reviewed journals, particularly systematic reviews, are ranked highest, followed by books, websites, and other sources. The student then details the search strategy used in databases like BMJ, PMC, and Cochrane Library, along with the number of articles found. The assignment also includes the identification of relevant journal articles through the CSU Primo Catalogue. Furthermore, the student evaluates a selected journal article, commenting on the quality of the publication, its currency, funding, study design, strengths, limitations, and implications for the field. The article chosen is a systematic review on hand hygiene interventions in reducing illness absence among children in educational settings. The portfolio incorporates references to support the student's analysis and conclusions. The student identifies gaps in the study and suggests recommendations for future research, such as the need for better-designed randomized controlled trials and the evaluation of cost-effectiveness. The student concludes that the study design is best because it uses a systematic review that is based on the use of randomized controlled trials.

Portfolio
Topic: Infection control
Portfolio Activity 1: Understanding your assignment topic and identifying keywords
Focus areas:
1. Infection control
2. Illness
3. Hand hygiene
Keywords:
1. Infection control
2. Spread of infection
3. Reducing illness
4. Illness
5. Hand hygiene
6. Systematic review
Portfolio Activity 2: Ranking information sources
Information source ranks: Add sources also
Peer reviewed journal (Systematic reviews, randomised controlled trials, cohort studies, and case-
controlled studies)
Books
Editorial/expert opinion
TV/Blogs
Explanation (1 paragraph description of WHY you ranked the sources this way):
In ranking the evidence sources I used Burns, Rohrich, & Chung's (2011) guideline for
rankIng evidence-based sources. Peer-reviewed journals exist as several types mainly: systematic
reviews, randomized controlled trials, cohort studies, and case-controlled studies. This means that

sources are supposed to be ranked based on the level of evidence that exists and how they fall in the
hierarchy table. At the top of the hierarchy, there are systematic reviews where the authors of such
resources systematically research and summarise the relevant studies that have been done on the
topic. These studies are then used in the review to design a study that represents the highest level of
evidence. The reason why this source is regarded as the highest source of evidence is that they
entail a comparison of different research studies. The second level of evidence is the randomized
control trials which entail studies that are scientific experiments that aim to test the effectiveness of
treatment options in studies. These entail two groups, the experimental group and the control group
where the findings of the study are based on the results that are compared between the two groups.
Randomized control trials are the second source of evidence since the follow up in the
research and results that create differences between the two study groups. This makes randomized
control trials the best and second in the level of research since they have limited bias in the study
process while the participants in the study are blinded so that they do not understand what the study
is all about. The next level of evidence is cohort studies which are based on the identification of two
groups of patients or cohorts which are supposed to receive the exposure of interest and one which
is not based on the patient outcomes. In these studies, the focus of the study is that patients with
defining characteristics are put in the same group to assess the results of the study.
The third level is case-controlled research studies where patients who have the outcome of
interest and control patients without the same outcome and looking to see the exposure of interest in
the study. The other level that follows peer-reviewed journals is books that are regarded as credible
based on the authority of the author and in-depth analysis of the topic. Books are high evidence
sources since they are based on the use of different sources to document the evidence level. The
next level is websites that provide different detailed statistical information from surveys and other
types of studies. The newspaper articles are another source of evidence that can be used in the study
since they are based on personal opinions and explanations in lay language. In most cases, articles
do not verify all their sources which makes it difficult for them to be used as the best source of

evidence. Lastly, blogs and TV shows are regarded as personal opinions that are used to reflect the
views of the people who may be experts in the specific field. This means that the information may
not be fully verified.
Therefore, journals are regarded as the highest sources of evidence since they entail the best
and high level of evidence that needs to be used to carry out and present research studies. The focus
of the review was to mainly find peer-reviewed journals that appear as the highest evidence-based
sources. This means that the search will mainly be narrowed down to peer-reviewed articles. In this
case, systematic reviews are the best since they are the highest level of evidence-based on an
analysis of the different research studies that are supposed to be used to compare the findings of
different studies and thus presenting the best evidence that arises as a comparison of different
research studies.
Portfolio Activity 3: Searching databases
The search strategy was based on searching the databases that publish medical and nursing related
studies
Database
Name
Keywords Search Options
Number of
Articles Found
Comments
BMJ
Infection
control
Hand hygiene 7
Only one article was a
systematic review
PMC
Infection
control
Spread of
infection
6 Only 2 systematic reviews
Cochrane
Library.
Infection
control
Hand Hygiene 5 1 systematic review
Medline
Infection
control
Hand Hygiene
4 1 systematic review
Nursing
reference
Infection Hand Hygiene 8 3 systematic review

centre plus control
Portfolio Activity 4: Using the CSU Primo Catalogue
Munoz-Figueroa, G., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising
in infection control. British Journal of Nursing, 27(7), 382-389.
Saito, H., Inoue, K., Ditai, J., Wanume, B., Abeso, J., Balyejussa, J., & Weeks, A. (2017). Alcohol-
based hand rub and incidence of healthcare associated infections in a rural regional referral
and teaching hospital in Uganda (‘WardGel’ study). Antimicrobial Resistance and Infection
Control, 6(129), 1-12.
Willmott, M., Nicholson, A., Busse, H., MacArthur, G. J., & Sara Brookes, R. C. (2015).
Effectiveness of hand hygiene interventions in reducing illness absence among children in
educational settings: a systematic review and meta-analysis. Archives of Disease in
Childhood , 42-50.
Portfolio Activity 4: Evaluating journal articles/ A Review of the:
The authors are scholars and associate researchers from the School of Social and
Community Medicine, University of Bristol, Bristol, UK. They have published several research
studies on a variety of topics but majorly the field of public health. This means that they have
authority on the topic and publishing of research studies. In this case, the study can be regarded as
having adequate authorities and thus good for use within the field of study. BMJ is one of the
leading journals that publish different types of studies on a wide array of medical and nursing-
related topics. It is a weekly peer-reviewed journal and an advocate of evidence-based medicine
through publishing research and clinical reviews on different nursing topics. The journals are
published per topic and even per field of study which makes it easy to search the website. The
article is current since it was published five years ago thus falling within the normal range. In most
cases, cohorts change every seven years which is the reason why it is important to use studies that

fall within this age range. The work on this study was funded by NIHR Research for Patient Benefit
Grant (PB-PG-1207-15212) and of The Centre for the Development and Evaluation of Complex
Interventions for Public Health Improvement (DECIPHer). There was no bias from the funding
body since they had no role in the study design, data collection, analysis or even publishing of the
article. On the other hand, the data in this study was peer-reviewed externally thus the reason why
the article was not commissioned. Thus this study has no conflict of interest whether from the
researcher or the funding body.
This study was based on the use of a systematic review study design which is considered the
highest level of evidence in the hierarchy. Systematic reviews are considered the highest evidence
sources since they entail the researcher searching for studies that have been done on the topic and
the ones that carry the best evidence on the topic. This means that the author searches through
different sources where peer-reviewed journals are published to select the ones that reflect the best
and highest level of evidence (Gopalakrishnan & Ganeshkumar, 2013). More specifically,
systematic reviews and meta-analysis are strong if they are based on data that has been collected
using randomized controlled trials. The data from these studies are compared and presented using
themes that define the different issues that have been raised in the studies. As indicated in the
hierarchy of evidence above, a systematic review is on the top of all peer-reviewed journals since
they entail a comparison of the findings of different researchers on the topic. The study design was
explained well thus making it easy to repeat the study and achieve the same results. This is because
the eligibility of studies and the inclusion/exclusion criteria have been adequately explained to
determine the studies that were included.
The strength of this study is based on its study design which is the use of a systematic
review. This means that the study focussed on analyzing and presenting the best levels of evidence
on the topic. This allowed the researcher to present a more detailed assessment of the interventions
which makes it easy for the authors to express the quality of the findings. Since this was not a new
research study, the authors focussed mainly on gathering different types of studies through rigorous

methods that map out evidence in an unbiased way that makes it easy to assess the quality of any
evidence source and at the same time present the same evidence for use (Mallett, Hagen-Zanker,
Slater, & Duvendack, 2012). This means that the quality of the work can be easily determined since
the steps are clear and the researcher is only supposed to present what has been reported by other
researchers.
This study recognizes that there are gaps in the data and studies that have been done on hand
hygiene among school-age children in educational settings. This is the reason why the authors
propose four recommendations that add implications to the field of nursing. This is the need to have
better designed randomized controlled trials, incorporation of technical advances for outcome
measures, the inclusion of process evaluation in the interventions and an evaluation of the cost-
effectiveness or sustainability of the chosen options. Colquitt (2011) suggest that a good research
study is supposed to add knowledge to existing studeis through building on the gaps that are
identified in others studies. This study proposes that the four gap areas need to be addressed so that
more findings can be found on the topic. Since a good study is supposed to add evidence to the
existing knowledge or proposes new directions for research, then the researchers did well by
identifying the gaps of the study which need to be addressed in future studies.
The major limitation of this study is its failure to distinguish between hand washing with
soap and the use of sanitizers to clean hands. This makes it difficult to determine the relationship
between studies that focussed on any of the above hygiene types. This implies that there are
differences in the elimination of pathogens or achieving the infection control effect which is the
major aim of this study. In this case, it means that the studies could have been different if the study
differentiated between the two terms and hygiene effects. Further, systematic reviews can be limited
by researcher bias during the interpretation of the data that has been presented by other researchers.
In most cases, this limits the nature of data presented by such studies since unlike randomize
controlled trials where there is not bias, it can be challenging for the researcher since the data can be
biased which limits the nature of the study.

Therefore, this study was the best since it was designed using a systematic review that is
based on the use of randomized controlled trials. This makes it the highest level of evidence
according to the ranking of evidence-based. Sources. Thus the reason for choosing this study was
due to its nature of study design that is the best as compared to any other source.

References
Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011). The Levels of Evidence and their role in
Evidence-Based Medicine. Plastic and reconstructive surgery, 128(1), 305–310.
Colquitt, J. A. (2011). Publishing in AMJ--Part 1: Topic Choice. The Academy of Management
Journal, 54(3), 432-435.
Gopalakrishnan, S., & Ganeshkumar, P. (2013). Systematic Reviews and Meta-analysis:
Understanding the Best Evidence in Primary Healthcare. Journal of family medicine and
primary care, 2(1), 9-14.
Mallett, R., Hagen-Zanker, J., Slater, R., & Duvendack, M. (2012). The benefits and challenges of
using systematic reviews in international development research. Journal of Development
Effectiveness, 10(5), 445-455.
Munoz-Figueroa, G., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising
in infection control. British Journal of Nursing, 27(7), 382-389.
Saito, H., Inoue, K., Ditai, J., Wanume, B., Abeso, J., Balyejussa, J., & Weeks, A. (2017). Alcohol-
based hand rub and incidence of healthcare associated infections in a rural regional referral
and teaching hospital in Uganda (‘WardGel’ study). Antimicrobial Resistance and Infection
Control, 6(129), 1-12.
Willmott, M., Nicholson, A., Busse, H., MacArthur, G. J., & Sara Brookes, R. C. (2015).
Effectiveness of hand hygiene interventions in reducing illness absence among children in
educational settings: a systematic review and meta-analysis. Archives of Disease in
Childhood , 42-50.

Appendix
Munoz-Figueroa, G., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising
in infection control. British Journal of Nursing, 27(7), 382-389.

Saito, H., Inoue, K., Ditai, J., Wanume, B., Abeso, J., Balyejussa, J., & Weeks, A. (2017). Alcohol-
based hand rub and incidence of healthcare associated infections in a rural regional referral
and teaching hospital in Uganda (‘WardGel’ study). Antimicrobial Resistance and Infection
Control, 6(129), 1-12.

Willmott, M., Nicholson, A., Busse, H., MacArthur, G. J., & Sara Brookes, R. C. (2015).
Effectiveness of hand hygiene interventions in reducing illness absence among children in
educational settings: a systematic review and meta-analysis. Archives of Disease in
Childhood , 42-50.