Research Critiques and PICOT Question Guidelines- Qualitative and Quantitative Studies
Healthcare-associated infections (HAIs) are a significant issue of concern in hospital settings that continuously threatens patient safety. HAIs directly lead to preventable patient harm and suffering, increase the patient’s length of stay, increase the cost of delivering care to the patient, and increase the risk of patient mortality (Serra-Burriel et al., 2020). HAIs are preventable with proper prevention and control (IPC) protocols within hospital settings. Hand hygiene is the most applied and effective IPC approach hospitals employ to prevent HAIs. However, the adherence to hand hygiene protocols among healthcare workers (HCWs) usually fades over time. This paper presents an updated PICOT question and provides a summary and comparison of four peer-reviewed articles that can help develop evidence to answer the PICOT question and help address the nursing problem identified.
Updated PICOT Question
In healthcare workers (P), does hand hygiene education (I) compared to regular hand washing protocols (C) improve adherence to hand hygiene protocols (O) over six months?
Background of Studies
The article by Douno et al. (2023) aims to develop qualitative insights on knowledge, attitudes, and practices on health hygiene among HCWs that support the planning and implementation of the WHO hand hygiene strategy in Faranah Regional Hospital, Guinea. The article identifies the gap in qualitative evidence on HCWs’ knowledge, attitudes, and practices of hand hygiene. The article presents a foundational qualitative study on the topic. The article is significant to nursing as it presents an in-depth assessment of HCWs’ knowledge, attitudes, and practices towards hand hygiene to develop suggestions on how to implement and improve compliance with the WHO’s hand hygiene protocols. The study has no clear research questions but employs observations and interviews for data collection.
In their article, Hammerschmidt and Manser (2019) explore the influence of individual and organizational factors on compliance with hand hygiene among nursing home nurses. The article aims to provide insights into the organizational factors that should be considered to improve hand hygiene in nursing homes. The article argues that despite hand hygiene being a major measure in preventing HAIs, nursing homes remain in compliance with set protocols. This article is significant in nursing as it focuses on various organizational factors that determine nurses’ knowledge behavior and influence compliance with hand hygiene, which can guide nurse managers to improve adherence to hand hygiene practices in nursing homes. The research questions used in the study explored the nurses’ and nursing managers’ hand hygiene knowledge, practices and compliance, and behaviors, as well as organizational factors influencing hand hygiene behaviors. For instance, “What knowledge do nurses have concerning hygiene management and infection prevention?” and “What are the perceptions of nurses and nursing managers of organizational structures and processes supporting hand hygiene?”
The article by Stangerup et al. (2021) explores changes in compliance with hand hygiene practices among HCWs with time, as well as the adherence trends before and during the COVID-19 pandemic. The article aims to identify factors and management approaches that influence the adherence to hand hygiene (HH) among HCWs. The authors argue that adherence and compliance trends to hand hygiene protocols differ during and after a pandemic. This article is significant to nursing as it identifies factors for changes in HH adherence among HCWs under various conditions. The study utilized three hypotheses focused on how termination of HH interventions makes HCWs less aware and compliant with HH during their clinical work routines, HH compliance during pre-pandemic and during the COVID-19 pandemic, and HH compliance during day and night.
In the article by Van Nguyen et al. (2020), the authors aim to determine how the knowledge and attitudes of HCWs influence their compliance with WHO’s hand hygiene protocols in a Vietnamese central general hospital. The authors argue that the levels of knowledge and attitudes of HCWs toward hand hygiene protocols influence their compliance levels. The article is significant in nursing and provides evidence of the relationship between knowledge of hand hygiene protocols and HCWs’ attitudes protocols to compliance with the protocols. It also highlights training as a solution to HH adherence issues. The article has no specific research question but utilizes the hygiene knowledge questionnaire for data collection.