University Nursing Practices: Hand Hygiene Evidence

This report provides an in-depth analysis of evidence-based practices in nursing, specifically focusing on hand hygiene and its role in infection control within acute care settings. The assignment utilizes a PICOT question to evaluate the effectiveness of alcohol-based hand sanitizers compared to soap and water in controlling nosocomial infections. A literature evaluation table is presented, summarizing six research articles that explore various aspects of hand hygiene, including adherence rates, the efficacy of different sanitizers, and interventions to improve compliance. The analysis includes the study's purpose, research questions, outcomes, methodologies, key findings, and recommendations, providing a comprehensive overview of current research in this critical area of healthcare. The report highlights the importance of hand hygiene in preventing the spread of infections and improving patient outcomes. This assignment is a detailed exploration of evidence-based practices in nursing, offering valuable insights for healthcare professionals and students. The report is available on Desklib, a platform that provides AI-based study tools for students.

Running head: Nursing Practices
Evidence-based practices in nursing –Hand Hygiene
Name of the Student
Name of the University
Author Note

1Evidence-based practices in nursing-Hand Hygiene
INTRODUCTION
Evidence based practice in nursing is significant for improving healthcare facilities of a
healthcare organization. In this assignment evidence-based practice related to infection control in
acute care will be discussed. Infection control in acute care facility includes hand washing,
isolation, control of outbreak, invasive device usage, issues related to housekeeping and food
preparation.
DISCUSSION
Here importance of evidence-based practice will be discussed with the help of PICOT
questions. The basic of infection control is to maintain hygiene. Hand hygiene is one o the most
important element of infection control activities. WHO took a global agenda-Clean Care is Safer
Care to promote hygiene as patient's safety programme (Cherian, and Burhan, 2019.). Growing
burden of health-care associated infections, multi drug resistant pathogen infection can be
controlled by practicing hand hygiene. Microbes are tend to colonized on hands and are
transmitted from one individual to another by skin (Chen, Fischbach, and Belkaid, 2018).
Healthcare workers specially nurses face infection very often during direct contact with patients
(Wistrand, Falk-Brynhildsen and Nilsson, 2018). Different kind of pathogens are colonized in
hands of health-care workers and contaminated through skin epithelial cells in bed-linen, bedside
furnitures, patient's cloths, immediate objects around patient. Highest rate of hand contamination
has been reported in critical care units through critical care unit (Tajeddin, et al, 2016).
In this assignment compliance of hand hygiene practice in aged care facility will be discussed.

2Evidence-based practices in nursing-Hand Hygiene
PICO question:
In patients admitted in hospital how effective is alcohol based hand sanitizer compared to soap
and water in controlling Nosocomial Infection or Cross Infection during the length of stay?
P (patient or population) patients admitted in the hospitals
I (Intervention)- Hand sanitizer
C(Comparison)- Soap and Water
O(Outcome)- Nosocomial infection or Cross infection
T(Time)- Length of stay

Running head: Nursing Practices
Literature evaluation table
Criteria Article 1 Article 2 Article 3
APA-Formatted
Article Citation
with Permalink
Sakihama, T., Honda, H., Saint,
S., Fowler, K. E.,
Shimizu, T., Kamiya,
T., ... & Mihashi, M.
(2016). Hand hygiene
adherence among health
care workers at Japanese
hospitals: a multicenter
observational study in
Japan. Journal of patient
safety, 12(1), 11-17.doi:
10.1097/PTS.000000000
Song, D., & Heacock, H. (2016).
Evaluating the Effectiveness
of Alcohol-based Hand
Sanitizers compared to
Alcohol-free Hand
Sanitizers. BCIT
Environmental Health
Journal. Retrieved from:
https://circuit.bcit.ca/repositor
y/islandora/object/repository
%3A329
https://
circuit.bcit.ca/
Luangasanatip, N., Hongsuwan, M.,
Limmathurotsakul, D.,
Lubell, Y., Lee, A. S.,
Harbarth, S., ... & Cooper,
B. S. (2015). Comparative
efficacy of interventions to
promote hand hygiene in
hospital: systematic review
and network meta-
analysis. bmj, 351,
h3728.retrieved from:
https://doi.org/10.1136/bmj.
h3728

1Evidence-based practices in nursing-Hand Hygiene
0000108
https://
journals.lww.com/
journalpatientsafety/
Abstract/2016/03000
/Hand_Hygiene_
Adherence_Among
_Health_Care_
Workers.2.aspx
repository/islandora
/object/repository
%3A329/datastream
/PDF/
download/citation.pdf
https://
www.bmj.com/
content
/351/bmj.h3728.short
How Does the
Article Relate to
the PICOT
Question?
The article is related to the
analysis the effectiveness of
alcohol based sanitizer to
prevent the infection among
patients of Japanese hospital
This article is an evidence for
analyzing efficacy of two different
alcohol based sanitizers on skin
Therefore, the article is associated
with the PICOT question.
The article is focused on
effectiveness of WHO compliances
of hand hygiene practices .Thus it
can be related to the PICOT
question .
Quantitative,
Qualitative (How
Cross- sectional study has been Quantitative study as t-test has been Qualitative study as systematic

2Evidence-based practices in nursing-Hand Hygiene
do you know?) executed. performed. review
Purpose
Statement
The purpose of the article is to
analyze hand hygiene practice in
a teaching hospital.
Determine the effectiveness of
alcohol-based
hand sanitizers and alcohol-free hand
sanitizers
To analyze the WHO-5 campaign
and other intervention for
promoting hand hygiene practice in
hospitals
Research
Question
What is the effect of provision of
hand hygiene training in
reducing hospital acquired
infection?
What are the evidence-based
guidelines concerning the withdrawal
of alcohol-based hand rubs?
How does the World Health
Organization 2005 campaign helps
to improve the efficacy of hand
hygiene in different healthcare
systems?
Outcome The comparative efficiency of
interventions, but nonetheless
provided evidence that WHO-5
is effective and that compliance
can be further improved by
adding interferences including
There was no significant difference
between the two kinds of hand
sanitizers. Both the alcohol-based
hand sanitizers and alcohol-free hand
sanitizers efficiently condensed the
Advancement of hand hygiene with
WHO-5 is operative at increasing
compliance in healthcare workers.
Addition of goal setting, reward
incentives, and accountability
strategies can lead to further

3Evidence-based practices in nursing-Hand Hygiene
objective setting, reward
encouragements, and
responsibility.
number of E.coli counts. improvements.
Setting
(Where did the
study take place?)
4 units of 4 different hospitals. Preparation of E.coli and hand
sanitizer was observed and effect of
hand sanitizer on negative control
group on pig's skin was observed.
The systemic reviews are based
hospitals.
Sample 3545 healthcare workers and
patients were observed in 4 units
of 4 different hospitals.
E.coli. colony and the two different
types of alcohol based sanitizers
3639 studies are retrieved however
41 paper met the criteria
Method Observational study Statistical analysis and empirical
study
systematic review and network
meta-analysis
Key Findings of
the Study
Hand hygiene practice rate is
lower in the hospitals of Japan
This research determines better
preventive measures among two types
of hand sanitizer.
Enhanced compliance to clinical
outcomes such as number of
infections prohibited would give
more direct evidence about the

4Evidence-based practices in nursing-Hand Hygiene
value of such interventions.
Recommendation
s of the
Researcher
Adherence of hand hygiene is
correlated to the physicians and
nurses is correlated. Different
hand hygiene practices can
influence higher rate of infection
rate in nurses compared to the
soap and water.
Hand sanitizers can be used in public
premises for reducing infections.
Different studies are associated with
the article has recommended that
goal setting, reward incentives and
accountability to WHO-5 hand
hygiene program can help nurses
for better situation in hand hygiene
practice
Criteria Article 4 Article 5 Article 6
APA-Formatted
Article Citation
with Permalink
Liu, S., Wang, M., Wang, G.,
Wu, X., Guan, W., &
Ren, J. (2017). Microbial
characteristics of
nosocomial infections
and their association with
Srigley, J. A., Furness, C. D., &
Gardam, M. (2016).
Interventions to improve
patient hand hygiene: a
systematic review. Journal of
Hospital Infection, 94(1), 23-
29.retrieved from:
Seo, H. J., Sohng, K. Y., Chang, S.
O., Chaung, S. K., Won, J.,
& Choi, M. J. (2019).
Interventions to improve
hand hygiene compliance in
emergency departments: a
systematic review. Journal

5Evidence-based practices in nursing-Hand Hygiene
the utilization of hand
hygiene products: a
hospital-wide analysis of
78,344 cases. Surgical
infections, 18(6), 676-
683.Retrieved from:
https://doi.org/10.1089/su
r.2017.037
https://
www.liebertpub.com
/doi/abs/10.1089/
sur.2017.037
https://doi.org/10.1016/j.jhin.2
016.04.018
https://
www.science
direct.
com/science/article
/pii/
S0195670
116300640 https://
www.science
direct.
com/science/article
/pii/
S0195670
116300640
of Hospital Infection.
Retrieved from:
https://doi.org/10.1016/j.jhin
.2019.03.013
https://www.sciencedirect.com/
science/article/pii/
S0195670119301471
How Does the
Article Relate to
The article focuses on the
effectiveness of usage of
The article compares usual care with
the hand hygiene intervention to
The article discusses about different
intervention related to the hand

6Evidence-based practices in nursing-Hand Hygiene
the PICOT
Question?
different hand hygiene products
is related to the incidence of the
nosocomial infection.
prevent the HAI which is similar to
the outcome of the PICOT question.
hygiene compliances among the
patients of Emergency Department
and PICOT question also focuses
on the hospital admitted patients.
Therefore it can be said that the
research article is related to the
PICOT question.
Quantitative,
Qualitative (How
do you know?)
Quantitative analysis Qualitative analysis Qualitative analysis
Purpose
Statement
The purpose of this study is to
analyze the microbial infection
characteristics in Asia-Pacific
region with the reference of the
occurrence of nosocomial
infection in Intensive Care Unit.
The aim of the study to find the rate
of infection occurrence in a health
care setting.
Purpose of the article is to find the
rate of infection rate among patients
of ED by calculating hand hygiene
indication, positive attitudes
towards HHC, monitoring and
providing feedback and other

7Evidence-based practices in nursing-Hand Hygiene
related factors.
Research
Question
How does the e incidence of
nosocomial infections associate
with the utilization of hand
hygiene products for preventing
microbial infection?
How proper hand hygiene
compliances are effective with respect
to the usual care to prevent the
infection in hospitals?
What are the effects of practicing
HHC in different factors of
infection control measure in
hospitals?
Outcome Higher utilization of hand
hygiene products are associated
with the declining nosocomial
infection.
The majority of hand hygiene
interventions are effective in reducing
the risk of infection from high to
moderate.
The result indicates that some
improvements are required for the
betterment of HHC.
Setting
(Where did the
study take place?)
78344 cases are included in the
study. several groups and sub
groups are segregated
Ten studies were included in the study
and then the risk assessment bias tool
was used
Twenty-four studies, which include
12 cross-sectional surveys and 12
interventional studies, were
included
Sample 78344 cases Ten studies Twenty four studies
Method Cohort study Systematic review Systematic review
Key Findings of Regression analysis presents that Interventions can improve patient The findings of the research

8Evidence-based practices in nursing-Hand Hygiene
the Study the higher rate of usage of hand
hygiene products are responsible
for reducing the nosocomial
infection
hand hygiene and may reduce the
occurrence of HCAIs with
enhancement of hand hygiene rates,
however the quality of evidence is
low.
suggested that HHC and factors
associated with the compliances are
need to be improved in some cases
Recommendation
s of the
Researcher
The study can help to develop
possible hand hygiene guidelines
in medical practice
The future researches will be helped
by the findings of this research for
assess the hand hygiene.
Future randomized controlled trials
are essential to establish which
intervention modalities are most
efficient and sustainable for HHC