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NUR342 Evidence Based Health Research And Practice

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  • Course Code: NUR342
  • University: Charles Darwin University
  • Country: Australia


This is the post that You have to repy to:


Clinical problem in a health care setting:

A clinical problem that I have identified is the compliance and knowledge of health care workers (HCWs) regarding the use of disinfectants and proper hand hygiene to reduce the rate of infections in an intensive care unit (ICU).

Why I have chosen this problem and this setting:

For every HCWs, following proper hand hygiene routine is necessary to prevent hospital-acquired infections. The contaminated hands of healthcare professionals are one of the main reasons behind the transmission of potentially pathogenic organisms to vulnerable patients (Oyapero & Oyapero, 2018). The reason for me choosing this problem and this setting is because of my own experience. I was once admitted to ICU post-surgery of my leg and noticed some nurses were not following proper hand hygiene routine while contacting with different patients. I want to work on these units someday and I personally feel that negligence in hand hygiene has always been the most crucial factor for the transmission of diseases, especially in ICU where acutely ill patients are admitted.

Clinical research question using the PICO (quantitative format):

Does following proper hand hygiene procedure by health care workers reduces the risk of hospital acquired infections?

P (problem): risk of hospital-acquired infection due to the negligence in hand hygiene by HCWs.                     

I (Intervention): proper handwashing and regular use of disinfectants.

C (comparison): compares the effects of correct and incorrect hand hygiene procedure in a health care setting.

O (outcome): Reduction of disease transmissions and infections.

 Article 1:

In article one, Musu et al. (2017) conducted an observational study in six intensive care units and observe the adherence by health care workers to standard precautions and hand hygiene during their clinical practices. Different compliances rate with hand hygiene procedure was found among HCWs where hand hygiene before and after direct contact with the patients were 38.4% and 55.1%. This article states that HCWs shows considerable compliance in hand hygiene process and suggests that implementing adequate procedure can help in reducing infection risks in patients. Overall, the research has shown that non-compliance with hand hygiene is the main problem in-hospital care, but most of the hospital-acquired infections are preventable by fostering a correct adhesion to hand hygiene.

Article 2:

In this article, Salama et al. (2013) state that, the main challenges to health care system are hospital-acquired infections and to reduce the transmission of pathogens in hospitals, compliance with effective hand hygiene practices is the best strategy. A study was conducted to discover the hand hygiene compliance rate among HCWs and its effect on the hospital-acquired infection rate in the ICU. Education about hand hygiene techniques to HCWs was provided, and pre and post interventional period were compared to determine the overall effect. The rate of hand hygiene compliance by HCWs increased from 42.9% pre-intervention to 61.4% post-intervention, and the rate of overall healthcare-associated infections fell from 37.2% pre-intervention to 15.1% post-intervention. Hence, this study suggests that the reduction in hospital-acquired infections is directly related to the improved rate of hand hygiene practices by HCWs.

Overall, the two articles mentioned above identifies that following proper hand hygiene routine minimises the rate of hospital-acquired infections.


Detailed reply to peer

Detailed rationale for selecting peers work

Inclusion of own thoughts/opinion on topic

2 or more relevant and current journal articles identifies.

Detailed description of how articles address peers clinical research question



Hello, your assessment is quite informative since it highlights a universal remedy that can lower disparity in the ICU setting.   Honestly, I am enlightened by how you have expressed your ideas. Please check out my reply below.

I chose to reply to your post on how to minimize infections using disinfectants in a hospital setting. The health outcome is in the intensive care unit of a hospital in Australia (Allen et al., 2018).  I have chosen the topic since I have experienced people suffer acquired infections while receiving treatment in the intensive care unit in a hospital in Australia.  During the regular visits to the facility, I have witnessed people’s conditions worsen every day. Agonizingly mortality and morbidity rates are escalate due to infections.  The rate of hospital readmissions is also high due to the attack of the diseases (Allen et al., 2018).  I feel that the primary cause poor hygiene little knowledge about the use of disinfectants and hygiene among the nurses within the healthcare setting.

To my knowledge, I feel that acquired infections are preventable through proper hand hygiene. Typically, patients and practitioners must continually wash off microbes in their hands with disinfectant (John & Armstrong, 2017). The action lowers the microbes’ load that prevent infections

I utilized the articles below; I hope they will make your assessment weighty.

In the first article, Sickbert-Bennett, et al. (2016) conducted a longitudinal analysis of a hospital facility and the adherence of the practitioners to precautions of hand hygiene. The article primarily explored the behavior of the care providers in North Carolina hospital.  The researchers identified that the procedure reduced infections with a high margin since the practitioners were openly involved in direct contact with the clients.  The authors suggest that practitioners had higher compliance with the hand hygiene process. The article also says that non-compliance leads to increased acquired infections that increase suffering on the clients (Sickbert-Bennett, et al et al., 2016). A continuous cessation program makes regular cleaning of hands a culture of the employees leading to improved quality of care. The unique part of the article is that it identifies the covariant variables that other care related precautions could have caused decreased infections. However, there was no robust infections at the time.

Secondly, Grayson et al. (2018) evaluated the efficiency of NHHI, a program in Australia    healthcare system that aimed at controlling infections. Grayson et al (2018) declare that compliance with hand hygiene is the best alternative has seen great success since its invention in the Australia.  The principal objective of the research study was study how NHHI had impacted the country and its impact on the acquired infection rates in the intensive care unit. Grayson et al et al (2018) provided some education on the techniques of lowering to the practitioners before and after the intervention period.  

The results showed a positive increment of compliance of over 84·3% of the total 398(private) and 598 hospital facilities under research lens (Grayson et al., 2018). The researchers concluded that improved hand hygiene among the practitioners that reduced the prices of hospital-acquired diseases.  The article provides some evidence that practitioners completed NHHI programs.



Allen, J., Rey-Conde, T., North, J. B., Kruger, P., Babidge, W. J., Wysocki, A. P., & Maddern, G. J. (2018). Processes of care in surgical patients who died with hospital-acquired infections in Australian hospitals. Journal of Hospital Infection, 99(1), 17-23.

Grayson, M. L., Steward son, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., ... & National Hand Hygiene Initiative. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. The Lancet Infectious Diseases, 18(11), 1269-1277.

John, K., & Armstrong, M. (2017). Non-compliance and hospital-acquired infection: Using design methodologies to improve hand hygiene practices. Infection, Disease & Health, 22, S13.

Sickbert-Bennett, E. E., DiBiase, L. M., Willis, T. M. S., Wolak, E. S., Weber, D. J., & Rutala, W. A. (2016). Reduction of healthcare-associated infections by exceeding high compliance with hand hygiene practices. Emerging infectious diseases, 22(9), 1628.

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