Posted: November 7th, 2022
The Population and Quality Initiative Essay.
In Part A, you described the population and quality initiative related to your PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) statement. In this assignment, you will formalize your PICOT and research process.The Population and Quality Initiative Essay.
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Use the GCU Library to perform a search for peer-reviewed research articles. Find five peer-reviewed primary source translational research articles.
In a paper of 1,250-1,500 words, synthesize the research into a literature review. The literature review should provide an overview for the reader that illustrates the research related to your particular PICOT. Include the following:The Population and Quality Initiative Essay.
Introduction: Describe the clinical issue or problem you are addressing.
Methods: Describe the criteria you used in choosing your articles
Synthesize the Literature: Part A: Discuss the main components of each article (subjects, methods, key findings) and provide rationale for how this supports your PICOT; Part B: Compare and contrast the articles: Discuss limitations, controversies, and similarities/differences of the studies.
Areas of Further Study: Analyze the evidence presented in your articles to identify what is known, unknown, and requires further study.
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.The Population and Quality Initiative Essay.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Benchmark – Part B: Literature Review
Hospital-acquired infections (HAIs) refer to infections that occur during care provision to patients while there are in the hospital. HAIs remain a major concern across healthcare organizations because HAIs are allied to higher mortality rates, complications, readmissions, a longer period of hospital stay, and increased healthcare costs (Sharma, 2018). The efficacy of hand hygiene in preventing HAIs has been demonstrated. There are different hand hygiene techniques such as handwashing using soap and water; hand sanitizer/alcohol-based gels; or use of both techniques to prevent and reduce HAIs (Sharma, 2018). Therefore, the rationale of the project is to identify the most effective hand-hygiene method in reducing the rate of HAIs. The Population and Quality Initiative Essay.
The search for peer-reviewed research articles was performed through a detailed literature search on Grand Canyon University’s (GCU) library and databases like EMBASE, PubMed, Cochrane Library, and CINAHL. The PICOT question was utilized in the search and retrieval of the peer-reviewed research articles. The PICOT question used was “Among hospitalized patients aged 18 years or older (P), how does washing hands using soap and water (I) compared to using hand sanitizers(C), help to reduce incidences of HAIs (O) within 3 months (T)?
The inclusion criteria when choosing the research articles included: peer-reviewed research articles; research articles published after 2015 in order to make sure only the most recent evidence was used; articles published in English language; and lastly studies investigating interventions used to prevent and reduce hospital-acquired infections. The Population and Quality Initiative Essay.
The study by Alsagheret al (2018) aimed to compare the efficacy of hand-washing using soaps and alcohol-based hand rubs to decrease bacterial counts. There were 93 study participants from different settings who volunteered to perform hand hygiene techniques using alcohol hand-rubs, hand washing using antiseptic soap, and hand-washing using non-antiseptic soap. According to the findings of this study, hand-rubbing using alcohol gel was more effective than hand-washing using soap in decreasing bacterial contamination on the hands of the study participants (Alsagheret al., 2018). The findings support the PICOT in that they show that the use of alcohol-rubs or hand-sanitizers may be more effective to preventHAIs, particularly when there is no visible dirty or soiling of the hands. The Population and Quality Initiative Essay.
Murni et al (2015) conducted a prospective study with an aim of implementing amultilayered infection control program and evaluating the efficacy of the program on HAIs. Post-intervention findings indicated that the multifaceted infection control program was effective in lowering the rates of HAIs and increasing adherence to hand hygiene. These findings demonstrate the efficacy of proper hygiene interventions in decreasing HAIs.
James et al (2016) investigated the efficacy of a hand hygiene intervention program in reducing hygiene preventable infections among hospital workers. The study was a prospective, RCT that involved the implementation of alcohol-based hand sanitizers in strategic locations in the target hospital and educating the participants regarding hand hygiene. The findings of this study show that hygiene preventable infections significantly reduced and also adherence to hand hygiene among healthcare providers improved. Therefore, these findings provide evidence regarding the efficacy of hand sanitizers to prevent HAIs.
Kampiatu&Cozean (2015) conducted a controlled, crossover study to compare the effectiveness of a persistent sanitizer and handwashing alone in decreasing HAIs in a hospital setting. The study employed a controlled crossover study design and was performed in 3 hospital wards for three months. Persistent hand sanitizer and handwashing were used as the hand-hygiene techniques. According to the findings, hand sanitizer was significantly effective in reducing the rate of HAIs when compared to handwashing alone. In addition, the sanitizer was well-tolerated within the healthcare setting. The findings support the PICOT by providing evidence regarding the efficacy of sanitizer in reducing HAIs in comparison to handwashing alone. The Population and Quality Initiative Essay.
The study by Mandohet al (2018) aimed to determine the most effective hand-hygiene techniques used by healthcare providers and reduce HAIs. The study is a systematic review and a three-step search strategy was used to search and retrieve studies on hand-hygiene practices in a hospital setting. The search was performed in various health databases such as Cochrane Registry, PsycINFO, Medline, Medline, and CINAHL. The findings of this systematic review showed that the WHO multimodal hand hygiene approach and use of alcohol hand-rub led to reduced HAIs and increased adherence to hand hygiene. The findings from this study are relevant in the PICOT by providing evidence on the hand-hygiene approaches that are effective in reducing HAIs. The Population and Quality Initiative Essay.
The study by Murni et al (2015) is a multifaceted study and used a large sample size and hence increasing the reliability and validity result from this study. Additionally, multifaceted studies have been shown to be very effective in changing the behaviors of healthcare providers (Shaykh-Baygloo, 2010). Similarly, James et al (2015) had an adequate sample size and this increased the reliability of results. However, the study by James et al (2015) has several limitations that could have influenced the study’s findings such as exposing the control group to other individuals who might have inflections. The study by Alsagheret al (2018) is a prospective study and thus the data was collected over time and at regular intervals and this reduced the recall error and thus increases the reliability of the study’s findings. The study by Kampiatu&Cozean (2015)is a controlled crossover study that similarly recruited an adequate sample size and hence increased the reliability of the findings. Finally, Mandohet al (2018) is a systematic review that synthesized evidence from different studies and thus ensured high-quality of the findings from this systematic review. The Population and Quality Initiative Essay.
The findings from Mandoh et al (2018) demonstrated that alcohol run sanitizer was effective in reducing HAIs and improving compliance to hand hygiene among healthcare providers. These findings are supported by Kampiatu&Cozean (2015) whose findings indicated that the sanitizer had a higher efficacyin decreasing HAIs, when compared to handwashing alone. Murni et al (2015) takes a different note and provides that a multifaceted intervention consisting of the hand-hygiene campaign, and hand-hygiene techniques such as handwashing and use of alcohol-based hand rubs were effective in reducing the rates of HAIs in a hospital setting. According to Alsagher et al (2018), the use of hand sanitizers such as alcohol-based gel is more effective in killing microorganisms when compared to hand washing using soaps. These findings are supported by previous studies that provide that alcohol-based gels and sanitizers have higher efficacy in killing microorganisms when the hands are not visibly soiled when compared to hand-washing using soap. In addition,sanitizersand alcohol-based gels are more convenient to use and are well-tolerated on the skin, and hence there is more adherence to hand-hygiene when they are used. The Population and Quality Initiative Essay.
Areas of Further Study
The studies confirm the efficacy of sanitizers in reducing the rate of HAIs infections. However, sanitizers are not effective when the hands are physically soiled. Further research is required to identify the microbicidal effects of the sanitizers on specific microorganisms such as methicillin-resistant Staphylococcus aureus. Additionally, further research is needed to identify the impact of other factors, apart from hand-hygiene that are allied with HAI. Generally, there are numerous factors associated with hospital-acquired infections, and this presents a challenge of sorting out the independent impacts of specific variables, such as hand hygiene. Therefore, further studies investigating the effect of various hand hygiene techniques in reducing and preventing HAIs need to measure or control other factors likely to have an effect on the risk of infections. The Population and Quality Initiative Essay.
Description of the Population and Health Concerns
According to Adegboye et al. (2018), hospitalized patients are likely to get HAIs and the fact that they have a weak immune system worsens this risk. To add on, most hospitalized patients are deficient in the knowledge that their clinical status can deteriorate since each patient is diagnosed with a different condition caused by a different organism that can be transmitted from one patient to another. Instead, most patients are hopeful of improving and reuniting with family and loved ones or resuming their activities of daily life after receiving the appropriate medical care. The Population and Quality Initiative Essay.
The hands and skin of healthcare providers are colonized by pathogens such as multi-drug resistant gram-negative bacteria, clostridium difficile and MRSA. Moreover, there are many epithelial cells shed by the skin that have viable microorganisms, which can contaminate medical equipment in a patient’s immediate environment. Within the hospital setting, the surgical unit, critical care unit, intensive care unit and the emergency department are documented to have such high rates of hand contamination. Hands are contaminated when: a patient’s intact skin is touched, touching non-living objects surrounding a patient or when doing basic procedures such as taking a patient’s vital signs.
Adegboye et al. (2018) describe HAIs as infections that develop within 48 hours or more after admission in a healthcare setting or 30 days after receiving care. Hospital-Acquired infections are of public health significance since they contribute to mortalities, morbidities, increased costs of care, prolonged admissions and pose a threat to the safety of patients. Poor practices of hand hygiene among medical staff are the major contributor to high incidences of HAIs (King et al. 2016). Also referred to as nosocomial infections, HAIs have captured the attention of key players in the health sector, healthcare providers, policymakers, the federal and state governments, not because it causes significant morbidity, mortality and increased healthcare costs, but because it is a preventable health issue. The Population and Quality Initiative Essay.
Impact on Population Health Management
Based on the statistics provided by the CDC, every year, more than 2 million patients are hospitalized and get hospital-acquired infections when receiving treatment for other conditions (Adegboye et al., 2018). Out of the 2million, an estimated ten thousand die from nosocomial infections. Therefore, to provide high-quality care that guarantees the safety of patients in resource-rich and resource-limited settings, it is important to prevent these infections. More specifically, in the US, one out of 136 patients gets seriously ill because of HAIs. This equates to 1.7 million cases annually causing additional costs of between US$ 4.0–5.0 billion and an estimated 90 000 deaths (Haverstick et al., 2017).
Currently, existing research enlists several reasons to explain why HAIs are increasing at an alarming rate in this century. First are surgical and medical procedures that extend beyond the body’s natural protective barrier, second is a gradual increase in the number of sick patients admitted in hospitals and healthcare providers who move from one patient to another when giving care creating a channel for transmitting pathogens (Haverstick et al., 2017). Besides, although most hospitals have hygiene protocols that explain how to sterilize medical equipment, their implementation is poorly done and this makes them ineffective. This explains the need for the leadership of healthcare institutions to ensure that hygiene protocols are adhered to through proper implementation to prevent HAIs. Healthcare organizations with limited resources such as water increase the risk of HAIs. Therefore, health facilities should have an adequate supply of clean water to reduce this risk. The Population and Quality Initiative Essay.
There is immense progress in healthcare in pursuit of understanding the pathology of communicable diseases and how multi-drug resistant infectious diseases are spread from one person to another in hospitals. There is also evidence to support that the hands of healthcare providers are the main source of HAIs among critically ill patients (Fox et al., 2015). This finding promotes the need to conduct further research on how to prevent HAIs in hospitals by observing basic hygiene principles.
In most hospitals, handwashing is the most important and effective infection control procedure that prevents transmission of pathogens from person to person. According to the findings by the WHO, handwashing with soap and water has a scientific basis and the most appropriate intervention that reduces the transmission costs of pathogens and the rates of HAIs (Haverstick et al., 2017). When combined with other infection control strategies, handwashing produces better results. The Population and Quality Initiative Essay.
Clinical Question/PICOT Statement
Among hospitalized patients aged 18 years or older (P), how does washing hands using soap and water (I) compared to using hand sanitizers(C), help to reduce incidences of HAIs (O) within 3 months (T)?
As highlighted by King et al. (2016), the CDC published revised guidelines and policies in 2002 on handwashing practices in healthcare settings that all healthcare organizations are required to adhere to. The guidelines strongly recommend that healthcare providers use hand rubs and alcohol sanitizers to decontaminate hands between each non-soiled patient and wash hands using clean running water and soap for visibly contaminated or soiled hands. The Population and Quality Initiative Essay.
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