Summary
The adoption of evidence-based practice in the healthcare sector is vital for the achievement of better healthcare in the country. Evidence-based practice helps with the identification of efficient medical techniques that health professionals should use in their daily activities. The focus of the paper has been on the use of hand hygiene protocol as an intervention of nosocomial infections in ICU’s. Nosocomial infections or HAIs are caused by the transfer of bacteria pathogens between patients, and nurses are the largest agents of transmitting the infections to the patients. In recent years, the transmission of HAIs has been on the rise leading to high mortality and morbidity rates. Moreover, the patients are forced to bear the high cost of medical care, while hospitals suffer from a bad reputation and high inefficient levels. Therefore, it is important to introduce evidence-based practice emphasizing on the importance of appropriate hand hygiene.
Introduction
Translating evidence into practice is the last step in the adoption of the best evidence-based practices in healthcare organizations. Essentially, knowledge translation encompasses all the processes involved in communicating knowledge or information generated through robust clinical research to healthcare workers to promote safer and efficient delivery of health services (Curtis et al., 2017). Critical components of translating evidence into practice include the production of evidence, practical application of knowledge, and usage of effective knowledge dissemination process. The primary focus of this paper is translating the evidence collected from the PICOT question “How does the observation of hand hygiene among healthcare workers help in reducing the prevalence of nosocomial infections among hospitalized patients in the ICU?” into practice.
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The significance of the PICOT Question in Nursing Practice
Arguably, nurses’ have a significant role in preventing the transmission of nosocomial infections in hospitals. Nurses’ have a lot of contact with patients during the administration of bedside care in organizations. Most times the nurses attend to multiple patients at once, thus there is a high probability of transmitting hospital-acquired infections (HAIs) to patients. Therefore, it is important for nurses’ to learn and implement effective techniques to reduce the rate of nosocomial infections reported in organizations.
Although many nurses are aware of their role in reducing the rates of new nosocomial infections, they face numerous challenging adhering to the recommended prevention techniques. The acute shortage of nurses in organizations means that these professionals are forced to work longer shifts and have a heavy workload. Moreover, research suggests that many nurses suffer from high burnout and stress levels that affect their ability to perform their work effectively. Consequently, the nurses often overlook the hospital protocol created to control HAI, thus they contribute to the rising infection rates. Therefore, it is important to remind the nurses about the importance of practicing hand hygiene regardless of the amount of pressure faced in organizations as a technique for lowering the nosocomial infections.
Literature Review Findings
The synthesis of the vast literature on the role of hand hygiene in preventing nosocomial infections reveals several interesting facts. Foremost, nosocomial infections contribute to the high mortality and morbidity rates among patients admitted to the Intensive Care Unit (ICU). The high risk of HAIs among these groups of patients is attributable to the type of medical procedures performed during their stay in hospital (Salama et al., 2013). For example, ICU patients go through many surgical procedures and the wounds are possible entry points for bacteria responsible for the development of nosocomial infections. Nurses act as HAIs transmission agents through their hand; for example, touching a patient with their hands is enough to pass on an infection. Since many ICU patients tend to develop resistance to antibiotics, it is difficult for healthcare professionals to guess the right combination of antibiotics to treat the HAIs (Fox et al., 2015). Consequently, a significant proportion of ICU patients die from nosocomial infections.
There is a general consensus that hand hygiene is the most effective and simplest method of controlling nosocomial infections. The results of the cross-sectional studies investigating the relationship between hand hygiene and nosocomial infections found that there was a significant drop in the rates of infections within days. Nurses’ are required to follow the World Health Organization’s hand hygiene protocol for maximum results. There are two primary methods of observing hand hygiene including washing with soap and water and applying disinfectant antiseptic, and it is important for health professionals to follow the right approach depending on the situation.
Nursing Practice Supported by Evidence
The critical care practice is supported by the evidence in the literature review. The role of critical care nurses is to take care of critically ill patients in the ICU. As earlier said, critically ill patients are more vulnerable to nosocomial infections compared to all the other groups of patients in hospitals. The patients are heavily dependent on critical care nurses to meet their everyday needs such as dressing, bathing, eating, taking medicines, and completing medical procedures. According to Salama et al (2013) hand hygiene leads to a fall in the rate of nosocomial infections in the ICU.
Fox et al (2015) confirmed the findings that the observance of hand hygiene protocol prevents the spread of HCAs in the ICU, and also suggested that nurses should help the patients to observe hand hygiene. The work of critical care nurses is complex and involving, and they are prone to forgetting to observe the right-hand hygiene procedures. However, by observing hand hygiene the critical care nurses will lead to lower nosocomial infections and mortality rates in organizations.
Advantages of Hand Hygiene Protocol
The advantages of observing the hand hygiene protocol cannot be understated. Arguably, the biggest advantage is reducing the transmission of nosocomial infections among patients in the ICU. Moreover, the patients’ recovery process will be faster because they are not exposed to other types of illnesses, and their overall medical fees will be manageable compared to individuals treated for HAIs. It is important to note that lower morbidity corresponds to low mortality rates.
Besides, the reduction of nosocomial infections will increase the level of organizational efficiency and effectiveness. As a result, the hospital will have a higher capacity to attend to new patients as the incidences of dealing with secondary infections. Moreover, the hospital will record a high patients’ satisfaction level, and its brand equity in the market will improve. Furthermore, hand hygiene also helps to create a positive and safe working environment for the employees.
Negative Potential Outcome of Failing to Adopt Hand Hygiene
Failure to adopt the hand hygiene protocol will have significant negative effects on healthcare organizations. The challenges include high mortality and morbidity rates, high medical costs, lower efficiency rates, and reduced employees’ safety that is attributable to the high rates of nosocomial infections. Moreover, the health care workers will have a heavy workload as they try to manage the resistant HAIs. Cumulatively, all the negative effects of low hand hygiene will lead to the development of bad organizational reputation due to poor customer satisfaction rates.
Dissemination of Information
Additionally, it is important to disseminate the information to the nurses’ practitioners particularly the critical nurses working in the ICU. The first step of disseminating the information in selecting the study site, in this case, the ICU. The findings of the research will be communicated through the use of journal articles due to their wide reach to nursing professionals worldwide. Moreover, the journal articles will be published online to give people unlimited access to the information, hence more nurses will learn how to apply the evidence-based practice in their work (Curtis et al., 2017). Moreover, the journal article will be submitted to healthcare conferences making it a major point of discussion among healthcare professionals. As a result, the information will be effectively disseminated to the target population.
Implementation of Evidence-Based Practice in Organization
Disseminating information is not enough for the adoption of evidence-based practice, it is important for organizations to go a step harder to implement the changes. The goal of the change implementation state is to change the nurses’ perception and attitude, and to in turn influence them to practice hard hygiene (Bonham et al., 2014)
Different approaches can be used to implement the evidence-based practice. One is the use of visual cues to remind nurses’ of the hand hygiene protocol in the hospital. Two is using seminars to educate health care workers about the importance of hand hygiene, and how to overcome the challenges that are encountered to wash their hands. Moreover, it is important to develop a clinical guideline that will be used to facilitate the effective implementation of the hand hygiene protocol as an intervention of nosocomial infections.
However, the implementation of the hand-hygiene evidence-based practice will be affected by different barriers. Examples of these barriers include lack of knowledge, role strain, education gap, and lack of adequate time to introduce the changes to the people (Curtis et al., 2017). The strategies for overcoming the implementation barriers include starting conversations about the evidence-based practice in an organization to show the urgency of dealing with the problem. Moreover, it is important to engaging the educators and other professionals in the healthcare sector to identify the best solution to the problems.
References
Bonham, C. A., Sommerfeld, D., Willging, C., & Aarons, G. A. (2014). Organizational factors influencing the implementation of evidence-based practices for integrated treatment in behavioral health agencies. Psychiatry journal, 2014.
Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2017). Translating research findings to clinical nursing practice. Journal of clinical nursing, 26(5-6), 862-872.
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., ... & Bader, M. K. (2015). Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses’ hand washing. American Journal of Critical Care, 24(3), 216-224.
Khammarnia, M., Haj Mohammadi, M., Amani, Z., Rezaeian, S., & Setoodehzadeh, F. (2015). Barriers to implementation of evidence-based practice in Zahedan teaching hospitals, Iran, 2014. Nursing research and practice, 2015.
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.
