World Health Organization Guidelines for Hand Hygiene in Health Care - Essay Example

? DOES HAND HYGIENE COMPLIANCE INCREASE AMONG STAFF MEMBERS AWARE OF A POPULATION OF IMMUNOCOMPROMISED PATIENTS? Identification of, and Rationale for, the Research, Including a Brief Critical Review of Appropriate Literature: Recognizing a worldwide need to develop hand hygiene in health care services, the World Health Organization (WHO) introduced its rules on Hand Hygiene in Health Care. These international consensus rules reinforce the require for multidimensional policies as the most capable process to assist hand hygiene. “Key elements include staff education and motivation, adoption of an alcohol-based hand rub as the primary method for hand hygiene, use of performance indicators, and strong commitment by all stakeholders, such as front-line staff, managers and health care leaders, to improve hand hygiene” (Gooding 2011). This Challenge is an international reality: no clinic, no hospital, no health-care system, no health post and no dispensary can presently say that compliance with hand hygiene suggestions is not an issue. “WHO Guidelines for Hand Hygiene in Health Care prepared with the help of more than 100 international experts, are in the testing and implementation phases in different parts of the world. Pilot sites range from modern, high-technology hospitals in developed countries to remote dispensaries in resource-poor villages” (World Alliance for Patient Safety: Who Guidelines on Hand Hygiene in Health Care (Advanced Draft); A Summary 2005, p. 5). In October 2005, the World Health Organization (WHO) launched the campaign for hand hygiene importance worldwide, with the theme “Clean Care Is Safer Care” (Patient Safety 2012) as part of the Hand Hygiene Health Care draft. This program has already caused many people and organizations to participate, the Ministries of Health from 124 countries agreed to collaborate to lower infection due to poor hand hygiene and support the efforts of WHO. (Allegranzi et al. 2009). Most pathogens transmitted by the hands of health care workers. (Doebbling et al. 1992). All patients on the department develop a side effect of they’re treatment called neutropenic sepsis. Neutropenic sepsis is defined as drop in the white blood cell count, which are the bodies major defense against infections. As some research has found that as little as 47% compliance of hand hygiene in health care workers (Randle et al. 2010). Identification of Research Question/Objectives/Problem/Hypothesis: The research question to be focused on this paper is: “Does hand hygiene compliance increase among staff members aware of a population of immunocompromised patients’’? Selection and Rationale for the Research Methodology: There are Two Methods of Research: By definition quantitative research deals with quantities and relationships  between attributes; it involves the collection and analysis of highly structured data in the positivist tradition (Bowling 2002). Whereas qualitative research can be described as a study of people in there natural social settings and to collect naturally occurring data (Bowling 2002).   Design Method Used: The researcher proposes to utilize the method of quasi experimental design , the method is, nevertheless, a very useful method for measuring social variables. (Parahoo 2006). The inherent weaknesses in the methodology do not undermine the validity of the data, as long as they are recognized and allowed for during the whole experimental process. Firm statistical analysis can be very difficult due to the lack of proper controls (Polit and Beck 2008). Quasi-experimental design includes choosing groups, upon which a variable is tested, with no any random pre-selection procedures. “For example, to perform an educational experiment, a class might be arbitrarily divided by alphabetical selection or by seating arrangement. The division is often convenient and, especially in an educational situation, causes as little disruption as possible” (Quasi-Experimental Design 2008). Differences of Quasi Experiment and a True Experiment: “Quasi-experiments are sometimes called natural experiments because membership in the treatment level is determined by conditions beyond the control of the experimenter (subjects are already in the box). An experiment may seem to be a true experiment, but if the subjects have NOT been randomly assigned to the treatment condition, the experiment is a quasi- experiment (quasi = seeming, resembles)” (Types of Experiments, n.d.). Advantages: Especially in social sciences, where pre-selection and randomization of groups is often difficult, they can be very useful in generating results for general trends. In addition, without extensive pre-screening and randomization needing to be undertaken, they do reduce the time and resources needed for experimentation. (Poilt and Beck 2008). “It is now commonly accepted that the best environment in which to test a demonstration is within the agency that would administer the program if it were adopted on an ongoing basis” (Bawden & Sonenstein n.d.). Disadvantages: Without proper randomization, statistical tests can hold less validity. ‘true experiments are not possible. (Poilt and Beck 2008) “In situations where it is known that only a small sample size will be available to test the efficacy of an intervention, randomization may not be a viable option” Harris et al. 2006).  Randomized control trials are the best way to compare the effectiveness of different interventions. The British Medical Journal (BMJ) (1996). Glasziou et al (2003) describes randomized control trials as the key to the structure of experimental research designs to evaluate effectiveness of interventions. Proposed Method of Data Collection and Rationale: Target group of the study is group of nurses in the hospitals. The objectives of the study are to identify whether hand hygiene compliance increase among staff members aware of a population of immuno-compromised patients. The methods of the study used survey, questionnaire and observation. Analysis of Method and Design Collection: “Hand hygiene is an essential component of hospital-associated pneumonia reduction. Evidence-based guidelines have been published for general hand hygiene7, 8 as well as specific hand hygiene measures related to respiratory care. Excellent evidence exists that alcohol hand rubs effectively reduce the transmission of potential pathogens from health care workers’ hands to patients” (Kleinpell et al . n.d.). For hands that are not clearly dirty, alcohol hand rubs are extra efficient than hand washing with antimicrobial or plain soap. “A number of educational and training strategies have been employed to increase hand hygiene compliance. Most have been work-based rather than classroom-based and many have incorporated practical demonstrations.” (Gould 2007, p. 14). Evaluated with education, training is inexpensive and is greatly less resource-intensive, but its influence is expected to be short-lived and prejudiced by nurses revenue and scarcity as health workers are trained to start a cyclic group of activities relatively than to believe imaginatively in narrative conditions. Hand hygiene fulfillment is necessary in the following four circumstances: Before primary patient contact. Before an aseptic method (a process that includes the manipulation or touching of a patient's body or enveloping device that could effect in infection). After probable revelation to bodily fluids. After environment/patient contact. Data Collection and Storage: All data will be anonymised to ensure confidentiality in accordance with the Nursing and Midwifery Council Code of Conduct NMC (2008). Sample Group: Sample Size: Sampling can be defined as the selection or choosing of the some division of an aggregate on the basis of the judgment or the inference about the aggregate or the totality is made. Sampling is done mainly on the assumption that the data will be much useful in enabling various parameters in the study. The sample is a vital part in the study of population and the analysis of them. All items in any field of the research consist of a universe or the population and the complete details of every items in the population is identified as the enquiry or the analysis in the research data. Sample size is the size of the sample we use to collect the information from the target people. To measure the same,the sample size collected from the customer of various levels is 17. It was proposed that each member of staff is observed once ,the samples have to be checked mainly with the 17 nursing staffs and how they take up the seriousness of the same. The Sample size helps to increase the certainty of the information. But at same time; it increase the cost associated with it. Identification of Relevant Ethical Issues:   In 2007 the National Research and Ethics Service (NRES) was set up this committee coordinates research over a number of sites any one thinking of undertaking a research proposal can contact the committee for advice of whether there are ethical issues that need to be sought before the research commences. Gaining informed consent is at the centre of ethical research, and the national and international governance frameworks which– include the World Health Organisation’s Declaration . Consideration of Quality of the Proposal: Reliability refers to the consistency of a particular method in measuring or observing the same phenomena which is rigorous and systemic in its approach (Parahoo 2006). To ensure reliability and robustness of the survey the tool being used is founded on the plan prepared by the world health organization. “WHO Guidelines for Hand Hygiene in Health Care prepared with the help of more than 100 international experts, are in the testing and implementation phases in different parts of the world. Pilot sites range from modern, high-technology hospitals in developed countries to remote dispensaries in resource-poor villages” (World Alliance for Patient Safety: Who Guidelines on Hand Hygiene in Health Care (Advanced Draft): A Summary 2005, p. 5). Validity is the degree to which a test events what it assert to calculate. It is very important for a test to be applicable in order for the consequences to be exactly functional . Validity isn’t understood by a single statistic, but by a remains of research that show the relationship among the test and the behavior it is considered to measure. “A test has construct validity if it demonstrates an association between the test scores and the prediction of a theoretical trait. Intelligence tests are one example of measurement instruments that should have construct validity” (Cherry 2012). The validity is how greatly we can speak the trial is open from flaw that could have subjective to our results. as quasi-experiments require fundamental control mechanism they normally have few validity then a accurate experiment but additional than a simply correlation learning. The validity is the amount we are be able to simplify outcome to other condition or diverse people. If we cannot simplify our results they are not important to study. Again we will be capable to simplify from a quasi experimental plan more than we will from a merely correlation lessons but less than we would from a prohibited experiment. Discussion of How the Results will be Analysed and Presented: The results will be analysed by using simple descriptive statistics by looking at the number of members that carried out hand hygiene as set by Trust guidelines. By getting help from a staistition these results can be calculated using a software package e.g. Statisical Package for the Social Sciences (SPSS) to look for a statistical significance, does the intervention change behavior and compliance, or is there no change. To clearly illustrate the findings will be displayed as Bar Charts as, it is the simplest chart than can present nominal data. “chi-square is the sum of the squared difference between observed (o) and the expected (e) data (or the deviation, d), divided by the expected data in all possible categories” (Fisher & Yates n.d.). In statistical testing testing, the p-value is the possibility of getting astatistic test at least as farthest as the one that was really experimental, supposing that the hypothesis which is null is true. One frequently "discards the null hypothesis" when the p-value is fewer than the level of significance which is often 0.05. Descriptive Data: For data dealing out to be winning, it is necessary to have an general image of your information. Descriptive data uses the method can be used to recognize the characteristic property of your data and emphasize which data principles should be cared for as sound or outliers. Thus, we frst initiate the basic concept of expressive data summarization previous to receiving into the tangible mechanism of data giving out technique. The charts are shows at the end to understand the frequency of the same. The chart below shows the opinion of the 17 samples taken for the study. 1 point is given to the agreed statement and the 0 is given for non agreed statements. Inferential Sats: Statistical inference is the procedure of arriving at the conclusion from information topic to random dissimilarity, for example, scrutiny errors or sampling difference.More considerably, the conditions statistical inference are utilized to explain systems of events that can be used to sketch conclusions from datasets beginning from system affect by random variation. Discussion/ Consideration for Patient Care: Hand washing for hand cleanliness is the act of cleaning the hands with or with no the use of water or a different liquid, or with the use of soap, for the reason of removing dirt, soil, and bacteria. “Hand washing is the single most important procedure for preventing health care associated infections” (Hand Washing and Hand Hygiene for Health Care Facilities n.d.). Medical hand cleanliness is relevant to the hygiene practices connected to the administration of medical and medicine care that minimizes illness and the dispersal of disease. “The big advantage of these cleansers is that you don’t need water or a towel, so you can use them anywhere. But alcohol doesn’t kill everything. That’s why it shouldn’t be the only cleaner available in health care settings” (News from Harvard Health Publications 2000). This is particularly significant for people who handle work or food in the medical field, other than it is also a significant practice for the common public. There are mixtures of interferences that can be implemented to raise compliance to hand cleanliness and ensure that hands and often handled tools remain as clean as probable in the hospital. “An antiseptic hand wash is the same but with the inclusion of an antiseptic solution that may be included in the soap itself or added as a separate element” (MRSA in Veterinary Practice n.d.). WASHED HANDS USING 5 MOMENTS ROLE OF STAFF WASHED HANDS USING 5 MOMENTS ROLE OF STAFF Opp.Obs. Opp.Obs. 1 16 2 17 3 18 4 19 5 20 6 21 7 22 8 23 9 24 10 25 11 26 12 27 13 28 14 29 15 30 APPENDIX 1 DATA SURVEY SHEET Compliance % = Actions x 100 Opportunities Staff ID: Staff Nurse-1 Medical Student-4 Pharmacist-7 Other-10 Medical Staff -2 Physiotherapist-5 Radiograher-8 Dietician-3 Domestic-6 Housekeeper-9 Opp. Obs.- Opportunity Observed Descriptive Statistics: References Allegranzi, B and Pittet, D (2009) Role of hand hygiene in healthcare-associated infection prevention. Journal of Hospital Infection vol. 73.pg.305-315. Bassett, C and Bassett, J (2003) Quantitative and Qualitative Research. British Journal of Perioperative Nursing. Vol. 13. No.3. pg 116-117 Bowling, A (2002) Research Methods in health, investigating health and health services. 2nd edition Buckingham. Open University Press British Medical Journal (1998) Understanding controlled trials: Why are randomised controlled trials important? Vol. 316. pg.201 Doebbeling, BN et al. (1992) Comparative Efficacy of Alternative Hand-Washing Agents in Reducing Nosocomial Infections in Intensive Care Units. New England Journal of Medicine. Vol. 327 pg. 88-93. Glasziou, P Del Mar, C Salisbury J (2003) Evidence Based Medicine Workbook. London: BMJ Books. Nursing and Midwifery Council Code of Professional Conduct (2008) Parahoo, K (1997) Nursing Research. Principles, Processes and Issues. Basingstoke, Palgrave Macmillan. Parahoo, K (2006) Nursing Research. Principles, Processes and Issues 2nd edition. Basingstoke, Palgrave Macmillan. Polit, D and Beck, C (2008) Nursing ressearch: generating and assessing evidence for nursing practice. Philidelphia, Lippincott. Randle, J, Arthur, A and Vaughan, N (2010) Twenty-four-hour observational study of hospital hand hygiene compliance. Journal of Hospital Infection. Vol.76. pg.252-255 Research Ethics: RCN Guidance for Nurses (2004) London, Royal College of Nurses. Tarling, M and CroftS, L (2002) The essential researchers handbook for Nurses and Health Care Professionals 2nd edition. London, Bailiere Tindall. Reference List Bawden, D.L. & Sonenstein, F.L. (n.d.). Quasi-Experimental Designs. The Urban Institute. Available at [Acessed on 25 April 2012] Cherry, K. (2012(. What is Validity? About.com. Available at [Acessed on 25 April 2012] Fisher, R.A. & Yates, F. (n.d.). Chi-Square Test. Statistical Tables for Biological Agricultural and Medical Research. Available at [Acessed on 25 April 2012] Gooding, K. (2011). Proper Hand Hygiene and Education Vital. The Barbados Advocate. Available at [Acessed on 25 April 2012] Gould, D. (2007). Hand Hygiene Compliance. Infection Control. European Infectious Disease. Available at [Acessed on 25 April 2012] Hand Washing and Hand Hygiene for Health Care Facilities. (n.d.). NSW Infection Control Resource Centre. Available at [Acessed on 25 April 2012] Harris et al. 2006. The Use and Interpretation of Quasi-Experimental Studies in Medical Informatics. American Medical Informatics Association. Print. Kleinpell et al. (n.d.). Chapter 42Targeting Health Care–Associated Infections: Evidence-Based Strategies. NCBI. Available at [Acessed on 25 April 2012] MRSA in Veterinary Practice. (2011). Veterinary Nurse Training Online. Available at [Acessed on 25 April 2012] News from Harvard Health Publications. (2000). Harvard Health Publications. Available at Read More