HLSC 640: Analyzing Staff Compliance and Education in Research

This annotated bibliography explores the issue of staff non-compliance with mandatory education and training in healthcare settings, focusing on its impact on quality and safety. It analyzes three research articles employing quantitative, qualitative, and theoretical framework approaches. The first study uses a quantitative approach to assess the effectiveness of educational training on hospital-acquired infection compliance, highlighting improvements but also limitations regarding support staff education. The second study, a qualitative analysis, investigates hand hygiene practices among nursing students in Saudi Arabia, revealing the importance of knowledge and training but noting potential biases. The third article discusses a conceptual framework for improving aged care through staff engagement and support, emphasizing the need for organizational change. The analysis identifies gaps in current practices and the importance of continuous education to improve patient outcomes and staff compliance with healthcare standards. Desklib provides access to a variety of solved assignments and past papers for students.

Running head: INTERPRETING HEALTH RESEARCH
STAFF NON-COMPLIANCE WITH MANDATORY EDUCATION
Name of the student
Name of the university
Author note

1INTERPRETING HEALTH RESEARCH
The research question: What are the clinical issues that arises due to the staff non-
compliance with healthcare facility’s quality and safety aspects for which extended
educational and training sessions are required?
Tamilselvi, M., & Srinivas, A. (2016). Compliance, quality system and standards for
control and prevention of healthcare-associated infections. Int J Health Sci Res, 6(7),
253-263. Retrieved from: http://www.ijhsr.org/IJHSR_Vol.6_Issue.7_July2016/38.pdf
This quantitative research was conducted by Tamilselvi and Srinivas (2016), in which
the primary aim of the researchers is to study and evaluate the implementation of quality
system within the multidisciplinary healthcare facilities so that the hospital associated
infection and associated complications could be understood. The research identified the fact
that majority of the healthcare facilities take the help from the healthcare quality system so
that they can understand the lacks of the healthcare system and then implements necessary
changes to improve the healthcare system (Tamilselvi & Srinivas, 2016). However, the
research aimed to understand the process methodological and outcome related aspects that
prevented the healthcare associated infection among the healthcare facilities using the quality
standards (Tamilselvi & Srinivas, 2016). The research included multidisciplinary healthcare
facilities and then used the healthcare facilities, doctors and patients and nursing staff data of
the included hospitals and then assessed their quality standard compliance for prevention of
healthcare associated infections. Further, an educational and training session for quality and
safety related to hospital acquired infection was implemented (Tamilselvi & Srinivas, 2016).
After the implementation of educational session, all the staff and physicians were asked to
take part in a survey, so that their ideologies, mind set and compliance to the hospital
acquired infection policies could be effectively understood (Tamilselvi & Srinivas, 2016).
Hence, the quantitative research focused on the pre-survey and post-survey aspect and then
with the help of informal interview, and personal observation of the healthcare professionals.

2INTERPRETING HEALTH RESEARCH
After the completion of the process, secondary data was collected so that relevant data could
be used for the outcome measurement of the research process (Tamilselvi & Srinivas, 2016).
The results of this quantitative study revealed that with application of educational training for
the standard compliance of Hospital acquired infection was effective and moderate increase
in the compliance level was observed. As per the results of this study, it was observed that
facility, manpower, healthcare professionals, nursing professionals and others were able to
comply with the process effectively so that they can achieve 50 to 70% of the staff
compliance level (Tamilselvi & Srinivas, 2016). As mentioned in this paper, by Tamilselvi
and Srinivas (2016), the researchers understood the importance of education and training in
healthcare facilities and then implemented the training session so that the description and
documentation of the roles and responsibilities of the qualification and competency level
among the staff could be understood. They also aimed to understand the specific needs and
requirements of the nursing professionals to comply with the specifications of hand hygiene
and safety (Tamilselvi & Srinivas, 2016). Hence, all these indicated to the fact that the aim of
researchers for this process was understanding the Cycle of Continuous Quality Improvement
in Healthcare System and assessed the performances, and compliance level of the
professionals for the healthcare infection prevention related guidelines (Tamilselvi &
Srinivas, 2016). Therefore, from the resulted outcome it was observed that with proper
healthcare education, nursing professionals were able to effectively comply to the aspects and
then with proper application of educational sessions nurses were able to overcome their
healthcare complication and implemented modified practice due to which, they were able to
provide 80% patient satisfaction. Hence, from this above- mentioned study, the researchers
were able to identify the positive and progressive effects of healthcare (Tamilselvi &
Srinivas, 2016). However, there were several limitation to this research process as it was seen
that healthcare professionals and supporting staff, that has the responsibility to maintain the

3INTERPRETING HEALTH RESEARCH
hygiene of the healthcare facilities, were not provided with adequate educational and training
sessions so that they can understand the compliance level that would be required for quality
and safety aspects (Tamilselvi & Srinivas, 2016). Further, it was seen that healthcare facilities
did not had such assessment processes happening frequently in the healthcare facilities due to
which healthcare professionals were unable to understand the requirement of compliance to
healthcare standards for better quality and safety (Tamilselvi & Srinivas, 2016). Hence, the
study, was able to identify each and every important aspects which is required to understand
the reason for staff non- compliance and importance of education in the healthcare facilities.
Cruz, J. P., & Bashtawi, M. A. (2016). Predictors of hand hygiene practice among Saudi
nursing students: A cross-sectional self-reported study. Journal of infection and public
health, 9(4), 485-493. DOI: https://doi.org/10.1016/j.jiph.2015.11.010
The second research article that has been included for tis discussion, discusses about
the effects of non-compliance to hygiene and patient safety, due to which mortality and
morbidity rates increases in the neonatal intensive care units (Cruz & Bashtawi, 2016). In this
qualitative research article the primary aim of the researchers was to understand the
importance of knowledge, attitude, practice and training in maintaining the hand hygiene
aspects in the healthcare professionals (Cruz & Bashtawi, 2016). The researchers were able to
identify the fact that majority of the healthcare facilities were able to make their professionals
to comply with the hand hygiene aspect due to their involvement in the educational and
training sessions. This paper has been chosen for the discussion as it mentions of the World
health Organisation and its hand hygiene related aspects so that professionals and their needs
for complying with quality and safety aspects has been discussed. For the identification of the
same, the researchers chosen the healthcare facilities of Saudi Arabia and then implemented
the qualitative, descriptive, cross-sectional study so that nursing professionals and their
ability to comply with the hand hygiene aspects could be easily obtained (Cruz & Bashtawi,

4INTERPRETING HEALTH RESEARCH
2016). The participants that included in the research belong to the Nursing Department of the
College of Applied Medical Sciences of a government-run university of Saudi Arabia. Total
223 nursing professionals were included in the paper which discusses the educational and
training need of the professionals by assessing their knowledge, attitude and the number of
training sessions they have attended in the past 6 months. Hence to assess the level of
understanding and compliance level of the healthcare professionals about the hand hygiene
aspect, the WHO questionnaire related instrument was selected and for the ease of research
the translated version was included in the paper. In this aspect, it should be mentioned that
the researchers conducted the process with proper ethical consideration and in the process,
the respondents were asked to provide informed consent to the researchers so that ethical
compliance to the research process could be achieved (Cruz & Bashtawi, 2016). All the
participants that belong the educational session, 2014 and 2015, were included in the paper
and all of them were provided with 15 to 20 minutes for providing their response to the
researchers in details. After completion of the study, the researchers were able to analyse
their quality knowledge so that they can comply with the hand hygiene and the way they can
conducted the process within the healthcare facility. Within the 223 participants that were
provided with the questionnaire, 112 were males and 111 were females and within that 198
professionals including both males and females were able to provide their responses
sufficiently. The research indicated that majority of the respondents were able to take
educational and training sessions prior to the research process. Analysis of the responses
collected from the research paper mentioned that 67.2% of the respondents were able to
identify the aspects to which they need to comply and implementation of this would be able
to complete the quality and safety related aspects (Cruz & Bashtawi, 2016). Further, 57% of
the participants in the study were able to understand that application of hand hygiene
measures would be able to overcome the hygiene concerns in healthcare facilities due to

5INTERPRETING HEALTH RESEARCH
which morbidity and mortality rates are increasing worldwide. However, due to the presence
of self-reporting of the data, inclusion of bias in the results affected the authenticity and
reliability of the research article. Besides that lack of multiple healthcare organisations and
inclusion of participants from one facility affected the reliability of the research process, due
to which the process loses its authenticity. Besides this, the inclusion and WHO frameworks
and questionnaire for the identification of compliance level of the healthcare professionals for
hand hygiene was effectively mentioned in this research process (Cruz & Bashtawi, 2016).
Low, L. F., Venkatesh, S., Clemson, L., Merom, D., Casey, A. N., & Brodaty, H. (2018).
Feasibility of LifeFul, a relationship and reablement-focused culture change program in
residential aged care. BMC geriatrics, 18(1), 129. DOI: https://doi.org/10.1186/s12877-
018-0822-3
While the previous two research article included in this paper discusses about the
application of quantitative and qualitative research, this research process, discusses about the
application of conceptual or theoretical framework for the identification and analysis of
application of educational and training sessions with aged care professionals. The researchers
Low et al. (2018), mentioned that if the healthcare professionals working with aged patients,
includes custodial and task oriented processes in the healthcare facilities, then the wellbeing
and health of the patient’s decreases. Hence, to understand the aspect of this process, the
conducted the process in the aged care settings for 12 months and applied a reablement
program in residential aged care (Low et al., 2018). The theoretical framework used in this
research was developed on the analysis of the staff behaviour and connection between the
clinicians, nursing staff’s patients and healthcare professionals. Further, the Lifeful method
was developed on the pre and post method of the analysis and determines the fidelity,
adherence and acceptability of the nursing staff to the quality and safety issues selected for
the clinical application of aged care interventions. Hence, the aim of this conceptual

6INTERPRETING HEALTH RESEARCH
framework was to understand the way engagement and support of the healthcare
professionals helps the healthcare professionals to facilitate and develop organisational
change so that they can develop effective care for all the aged patients admitted in the
healthcare facility (Low et al., 2018). The researchers included more than 146 residents living
in the 69 aged care centres in Australia and then implemented the change management related
conceptual framework for 12 months so that the pre and post change measurements of the
healthcare professionals and their ability to compliance with the healthcare professionals
could be easily conducted. The participants that actually take part in the research process
were 105 of the 157 participants of the total number of participants and their ability to
comply with the national and international guidelines were assessed so that the barriers and
facilitators in the care process could be easily understood (Low et al., 2018). Hence after the
completion of the process, it was easily understood that participants that were able to take
educational and training session in the care facilities. Further, it was also seen that they were
able to identify the aspects due to which they were able to identify the barriers and facilities
that prevented them to comply with the guidelines or framework that is necessary for the
implementation of change in care process (Low et al., 2018). Hence, from this research
process, the researchers were to provide details about the application of theoretical
framework that helped the nursing professionals working in the aged care settings to
understand the application of the theoretical; framework so that all the complexities and
barriers of effective healthcare process could be identified and with the proper identification,
these aspects could be changed or modified (Low et al., 2018). However, the research could
have included a details of the training and educational session that was provided to the
nursing staff which helped them to successfully complete the process identify their aspects
that prevented them for complying with the healthcare aspects for safety and quality (Low et
al., 2018).

7INTERPRETING HEALTH RESEARCH
Cochrane, B., Foster, J., Boyd, R., & Atlantis, E. (2016). Implementation challenges in
delivering team-based care (‘TEAMcare’) for patients with chronic obstructive
pulmonary disease in a public hospital setting: a mixed methods approach. BMC health
services research, 16(1), 347. DOI: https://doi.org/10.1186/s12913-016-1592-2
Another research article, that should have been included in the annotated bibliography
related to the research question is the research conducted by Cochrane et al. (2016), as the
research discusses about the challenges that the healthcare professionals faces while
complying with the team based care in healthcare processes for patients affected with chronic
obstructive pulmonary disorder. As this research question discusses about the identification
of aspects due to which healthcare professionals are unable to comply with the processes and
guidelines for effective care of the patients and maintaining safety and quality of the
healthcare process, this research paper provides effective aspect for such analysis. As per the
guidelines of the COPD care, team bases care is an important aspect as holistic assessment
and management of care is an important aspect that should be followed by the healthcare
professionals. However, due to the lack of information, and educational as well as training
sessions nursing professionals are not aware of the strategies due to which it becomes
importance to comply with the healthcare guidelines. Hence, as per the researchers Cochrane
et al. (2016), the aim of their study was to understand the stakeholders views, as well as their
view about the inclusion of multi- disciplinary team for the care and management of COPD
affected patients. For the conduction of this research, the researchers selected a mixed
method study and as per the Australian guidelines of healthcare they developed the algorithm
for the COPD, with that they included COPD affected patients (Cochrane et al., 2016). These
patients were included as they were associated with healthcare facilities for 5 to 10 months
and they were asked to take part in the interview process so that their care process,
management status could be understood. The researchers included structured as well as semi-

8INTERPRETING HEALTH RESEARCH
structured interview in this research process so that feasibility, acceptability and management
of their COPD levels and their health management in those healthcare facilities could be
easily understood (Cochrane et al., 2016). Further, for the data analysis, all the data with their
data algorithm and data manipulation were transcribed, recorded and then with qualitative
thematic analysis. The research study clearly identified the fact that healthcare professionals
that were included in the care process and took part in the research process were not aware of
the motivation and health literacy for team based care process for critical illness that indicates
towards a major loophole in the development of care system in Australia (Cochrane et al.,
2016). Further, it was also seen that majority of the healthcare facilities, from which the
nursing professional’s assessment was conducted, lacked proper funding system to
implement multidisciplinary care process. Further, functional impairment, organisational
consideration are among the secondary aspects due to which, healthcare professionals
involved in the care process for COPD affected patients were unable to take part in the team
based or multidisciplinary care process (Cochrane et al., 2016). Hence, this research article,
with usage of mixed method analysis was able to identify the aspects due to which the
healthcare professionals were not being able to conduct the care process effectively and
required educational and training session so that they can comply with the guidelines and
principles of the COPD related educational sessions (Cochrane et al., 2016).
Wałaszek, M., Kołpa, M., Wolak, Z., Różańska, A., & Wójkowska-Mach, J. (2017).
Poor Hand Hygiene Procedure Compliance among Polish Medical Students and
Physicians—The Result of an Ineffective Education Basis or the Impact of
Organizational Culture? International journal of environmental research and public
health, 14(9), 1026. DOI: https://doi.org/10.3390/ijerph14091026
In this journal article the researcher had focused on the concept of hand hygiene and
prevention strategy related to healthcare-associated infection (HAI). The primary objective of

9INTERPRETING HEALTH RESEARCH
this study was to examine and evaluate the knowledge and understanding of medical students
and polish physician regarding the importance of hand hygiene in preventing the onset of
healthcare-associated infection (HAI). Three different methods were used to analyse the
understanding of the participants included in the study that comprised of quantitative method
using questionnaire method designed by the author, qualitative method using interview that
depend on the structured questionnaire and observation method that involved observing the
Ayliff hand washing procedure. The researcher used survey method that was anonymous
using author-generated questionnaire method that was completed by the new physicians who
had previously worked in different hospital setting. 100 participants were involved in the
study in which 28 participants were students, 18 participants were medical interns and 54
participants were physicians. Using the participants knowledge on the concept of hand
hygiene the researcher evaluated the result and accordingly published the result that stated
that ¾ of the medical students a d the physicians were not aware of the hand hygiene
techniques efficiently. From the response of the other participants it was observed that they
performed hand hygiene under certain situation like before performing any aseptic procedure,
before directly touching or contacting the patient, after directly touching the patient, after
exposure of the body fluids from the patient and after contacting or directly touching the
patient’s surrounding. The physician and intern involved in the research stated that effective
hand hygiene (HH) is the most significant method used for preventing healthcare-associated
infection (HAI) that will allow them to reduce the possibility of acquiring healthcare-
associated infection. Hence, it was established from the result analysis that the medical intern
and physician acquired sufficient knowledge regarding the beneficial effect of hand-hygiene
in controlling the incidence of high healthcare-associated infection. It was also established
from the result that the students who participated in the survey were not aware of the concept
and benefit of using hand hygiene technique to avoid healthcare-associated infection instead

10INTERPRETING HEALTH RESEARCH
were using gloves to cover their hands and were aware of the concept of using gloves to
reduce any risk of infection. The results were noted and evaluated from all the three methods
used in the study and accordingly it was concluded that the intensity of knowledge concerned
with hand hygiene was not sufficient or appropriate among the medical students and the
physician and they were not trained with the concept of hand hygiene. An extensive training
was recommended for the medical students and the physician that will train them on the
aspect of hand hygiene and how this procedure will help them to reduce the risk of
healthcare-associated infection. The training will be incorporated within their postgraduate
study. Hence, this research study gave a detail insight on the concept of hand hygiene (HH)
procedure and the requirement to train the medical student and the physician on this
procedure for preventing the condition of healthcare-associated infection (HIA) in their
healthcare practice.
Evaluative Summary
The prominence of decent inter-disciplinary approach and communication within
health care setting and the succeeding positive influence on patient health outcome were well
documented within the literature used for conducting the annotated bibliography that
involved the education training method to enhance the knowledge of the healthcare providers
within the healthcare setting. Primarily importance is given in highlighting the factors which
support good communication and knowledge and also focus on the identification or
documentation of communication let-downs that must be addressed and later used to improve
and develop effective teamwork. According to Cruz & Bashtawi (2016), hand hygiene is
crucial for preventing any kind of infection that will enhance the patient health outcome and
increase the patient safety from any infection. The paper provided greater emphasis on the
nursing student who are considered as the healthcare workers and are solely responsible for
maintain safe environment within the hospital setting for the patent. The primary aim of the

11INTERPRETING HEALTH RESEARCH
paper was to identify the conjecturers of hand-hygiene within the nursing student population.
The awareness regarding the concept of hand hygiene was established within the nursing
students by developing effective training and education program that will help the nursing
students to gain more information and knowledge on hand hygiene and its benefits.
Educational intervention technique was highlighted as the objective of the paper that focused
on the implementation of skilful knowledge among the nursing students towards the benefit
and concept of hand hygiene. Development of a good hand hygiene practice is essential for
preventing the condition of healthcare-associated infection (HIA). Therefore, the author
proposed effective hand hygiene seminars and trainings as educational interventions for
developing the knowledge and skill of the nursing students and adopting best hand hygiene
practice. According to Cochrane et al., (2016), chronic obstructive pulmonary disease
(COPD) is considered as the leading reason of mortality among people who are more than 40
years of age and the author had listed down the COPD guidelines that is recommended for
holistic management and assessment of the onset of disease. The author had focused and
explored the ideas of stakeholders that include healthcare team and the patient focusing on
the acceptability, feasibility and inhibitors to form a multidisciplinary and collaborative team-
based intervention that will aim to improve the overall health outcome of the patient suffering
from chronic obstructive pulmonary disease. The significance of conducting this study was to
improve the health literacy among the population and also enhance the healthcare associated
services that is required to improve the patient health outcome. Hence, the advantage of
developing an effective multidisciplinary communication with adequate clinical protocols
will assist the nursing students and the patent to improve the health literacy and patient
outcome. According to Low et al., (2018), the concept of reablement program was
highlighted for the residential age care patient in order to provide effective care and well-
being strategy to the residents. LifeFul was highlighted by the author in the study that was a

12INTERPRETING HEALTH RESEARCH
reablement program to improve the behaviour of the staff members under residential aged
care unit. The benefit of LifeFul was elaborated in the study that include supporting and
engaging the facility leaders to initiate and improve the organisational change and focusing
more on the improvement of the patient. Reablement program is defend as the conventional
care model that is primarily used to provide effective care and assistance to the patient and
improve their daily activities of life. According to Walaszek et al., (2017), the concept of
hand hygiene and prevention strategy related to healthcare-associated infection (HAI) was the
primary objective of this study and also to examine and evaluate the knowledge and
understanding of medical students and polish physician regarding the importance of hand
hygiene in preventing the onset of healthcare-associated infection (HAI). The author
conducted survey to analyse what proportion of medical students and physicians require
educational intervention that will facilitate the adoption of hand hygiene technique among
them. From the response of the other participants it was observed that they performed hand
hygiene under certain situation like before performing any aseptic procedure, before directly
touching or contacting the patient, after directly touching the patient, after exposure of the
body fluids from the patient and after contacting or directly touching the patient’s
surrounding. The physician and intern involved in the research stated that effective hand
hygiene (HH) is the most significant method used for preventing healthcare-associated
infection (HAI) that will allow them to reduce the possibility of acquiring healthcare-
associated infection. An extensive training was recommended for the medical students and
the physician that will train them on the aspect of hand hygiene and how this procedure will
help them to reduce the risk of healthcare-associated infection. The training will be
incorporated within their postgraduate study and hence the author gave more significance on
the educational intervention technique that will allow the physician and the medical students
to gain more knowledge and awareness of hand hygiene method of preventing healthcare-

13INTERPRETING HEALTH RESEARCH
associated infection. Tamilselvi and Srinivas (2016), also focused on the concept of
healthcare-associated infection and implementation of quality standard care in multispecialty
hospital that will improve the overall patient outcome. The author had highlighted that it is
essential to evaluate the quality system of the hospital that will provide better ways to
improve or modify the quality further that will help the hospital setting to reduce the risk of
infection and prevent healthcare-associated infection within the hospital setting. Three
different aspect was highlighted by the author that requires evaluation and improvement to
enhance the overall outcome of patient’s health such as better health facility, high manpower
qualification and enhanced competency. Hence, the author had provided a detail insight on
the quality care of the member present within the interdisciplinary team to enhance
implementation of quality system that can be monitored for general routine practice and high
quality of care and improve patient health care standard. The literature review had
highlighted the need of education intervention with appropriate training and campaign that
will help the health care professional or providers to deliver high quality of care and improve
patient health outcome. No literature had highlighted the need of training or education
intervention for the perioperative or postoperative nursing student instead highlighted the
general class of nursing students and the influence of proper training on them and the
multidisciplinary team.