HLT-362V: Article Analysis and Research Ethics Evaluation

This assignment provides a comprehensive analysis and evaluation of a healthcare research article focusing on hand hygiene compliance and its impact on hospital-acquired infections (HAIs) in an ICU setting. The analysis includes an examination of the problem statement, purpose, research questions, and variables used in the study. The assignment identifies the dependent and independent variables, data collection methods, and statistical analysis techniques employed. Furthermore, it summarizes the study's results, assumptions, and limitations. The core of the assignment involves an in-depth evaluation of the ethical considerations, including informed consent, confidentiality, and potential biases in data collection and analysis. The evaluation provides rationale and support for ethical concerns, referencing relevant literature to ensure the integrity and ethical conduct of the research. This study contributes to the understanding of research ethics in healthcare.

Article Analysis and Evaluation of Research Ethics
Article Citation and
Permalink
(APA format)
Article 1
Salama, M. F., Jamal, W. Y., Al Mousa, H., Al-AbdulGhani, K. A., & Rotimi, V. O.
(2013). The effect of hand hygiene compliance on hospital-acquired infections in an
ICU setting in a Kuwaiti teaching hospital. Journal of infection and public
health, 6(1), 27-34.
Point Description
Broad Topic Area/Title Impact of adherence to HH on HAI in ICU setting
Problem Statement
(What is the problem research
is addressing?)
This research is mainly aiming to address the issue of low adherence to hand hygiene
(HH) recommendation. HH practice related to hand washing or use of alcohol based
hand sanitizers is one effective method to prevent hospital acquired infection (HAI)
As no research in Kuwait has investigated about the effect of HH on nosocomial
infection rate, this study aimed to assess the benefits of HH on infection rates in ICU
hospital settings.
Purpose Statement
(What is the purpose of the
study?)
The purpose of the study was to evaluate rate of compliance to HH before and after an
educational intervention and observe its effect on HAI rates using WHO observation
method.
Research Questions
(What questions does the
research seek to answer?)
The research question mainly seeks to find whether indication, opportunity and
actions supporting HH practice can reduce the incidence of nosocomial infections in
hospital or not.
Define Hypothesis No hypothesis has been stated in the study. However, as per the variables used, it is
hypothesized that HH compliance and nosocomial infection will increase with the
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(Or state the correct hypothesis
based upon variables used)
implementation of educational intervention.
Identify Dependent and
Independent Variables and
Type of Data for the
Variables
The dependent variable in the study was the rate of HAI and the dependent variable
and the independent variable in the study included HH compliance and devices used.
The data were mostly quantitative data with HH compliance being recorded based on
number of actions, missed actions, opportunities and compliance rate. In addition, the
HAI rate was calculated based on overall HAI/1000 patient days. The calculation was
done separately for different stage of infection too.
Population of Interest for
Study
The population of interest for the study was HCWs in ICU setting.
Sample The sample for the study was medical team in the ICU consisting of 4 specialist
doctors, 2 registrars, an assistant matron, a head nurse and staff nurses
Sampling Method One of the drawback is that proper explanation regarding sampling style is missing. It
included 12 doctors and 26 nursing staffs members who took part in a Kuwait HH
Prevention Program
Identify Data Collection
Identify how data were
collected
In case of HH compliance, data was collected based on direct observation of health
care workers (HCWs) and compliance was measured by defining WHO’s five
moment of HH. All HCWs were unaware about the observation period. The data was
recorded based on job category. In addition, HAI rate was calculated using CDC
National Nosocomial Infection Surveillance (NNIS) System. Both device associated
infection and multidrug-resistance bacteria infection such as Clostridium difficile,
Escherichia coli, Pseudomonas aeruginosa and others were recorded. The HAI
calculation was done based on acquiring of infection post 48 hours of hospitalization
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Summarize Data Collection
Approach
This study mainly adopted direct observation as a method of data collection. The
advantage of this approach is that it is the more reliable method with low chance of
bias (Spradley, 2016). As staffs were unaware of the observation, this further
enhanced the reliability of the findings.
Discuss Data Analysis
Include what types of
statistical tests were used for
the variables.
The statistical analysis was done using a one-sided p-value with 95% confidence
levels. The statistical calculation was done using SAS System for Windows, version
9.1.
Summarize Results of Study The study recorded 1508 events requiring HH. The compliance rate was 43% for pre-
intervention and 61.4% for post-intervention. The reduction in rate of HAI was
significant too as HAI rate was reduced from 37.2% to 15.1% in the pre and post
intervention period.
Summary of Assumptions
and Limitations
Identify the assumptions and
limitations from the article.
Report other potential
assumptions and limitations of
your review not listed by the
author.
The article had no prior assumptions. However, the limitation of the article was that it
was done in an ICU setting and HH practice was not assessed according to procedural
risk. Other limitation is that it lacked evaluation on reduction in hospitalization
duration. This was necessary to get better insight about cost aspects of HH education
program.
Ethical Considerations
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Evaluate the article and identify potential ethical considerations that may have occurred when sampling, collecting data,
analyzing data, or publishing results. Summarize your findings below in 250-500 words. Provide rationale and support for
your evaluation.
The article by Salama et al. (2013) collected samples from a HH prevention program. However, no detail was given regarding
completion of informed consent process and maintaining confidentiality of information. Thus, potential consideration that was
necessary during the sampling process was to take consent from participants regarding the research process. According to Nijhawan et
al. (2013), informed consent is an important ethical requirement while conducting any research with human subject. This is necessary
to promote transparency and avoid conflicts during the process. As this research involved observation method, the researcher could
have considered informing participants about different types of risk as per the nature of research. Other consideration was to ensure
each HCWs that there information will be kept confidential (Resnik, 2018). This may have involved not revealing any data related to
their personal details like name and background. However, threat to confidentiality is high for the research as it used observation as a
method by which everything is revealed. This could have been managed by providing information related how their private data will
be safe guarded.
As the study used observation method of data collection and participants were not aware of the process, it may lead to ethical issues
too. This could have been managed by training observers not to reveal any private information of HCWs during data recording.
However, no such training to observers was provided in the study. This is one ethical action that was required during data collection.
The next important phase in research is data analysis and ethical consideration related to how the data will be published is mostly
important in this phase. At this stage, ethical considerations such as avoiding falsification of data can help to adhere to ethical norms
(Hoover & Buzdar, 2017).
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References:
Hoover, T. C., & Buzdar, A. (2017). Ethical Considerations in Human Subjects Research: Emerging Issues in Cancer Research.
In Ethical Challenges in Oncology (pp. 145-157). Academic Press.
Nijhawan, L.P., Janodia, M.D., Muddukrishna, B.S., Bhat, K.M., Bairy, K.L., Udupa, N. and Musmade, P.B., 2013. Informed consent:
Issues and challenges. Journal of advanced pharmaceutical technology & research, 4(3), p.134.
Resnik, D. B. (2018). Privacy and Confidentiality. In The Ethics of Research with Human Subjects (pp. 149-163). Springer, Cham.
Spradley, J. P. (2016). Participant observation. Waveland Press.
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