NURS 6052: Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change

Assignment: Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change

This paper systematically and thoroughly examines four research studies to identify their value, relevance, and trustworthiness in addressing whether hand hygiene, like hand washing among healthcare workers effective compared to hand sanitizer, effectively reduces the spread of Coronavirus during their stay at the hospital. It entails a literature evaluation table and a brief discussion that suggest the best practice that emerges from the four reviewed research articles. For nurses to ensure hand sanitizer and hand hygiene effectiveness and prevent the spread of the virus, reliable and valid information is required on the best practice.

 

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Full APA formatted citation of selected article. Article #1 Article #2 Article #3 Article #4
Greenaway, R. E., Ormandy, K., Fellows, C., &Hollowood, T. (2018). Impact of hand sanitizer format (gel/foam/liquid) and dose amount on its sensory properties and acceptability for improving hand hygiene compliance. Journal of Hospital Infection, 100(2), 195-201

 

 

Yeasmin, D., Dutta, N. C., Nizame, F. A., Rahman, M. J., Ashraf, S., Ram, P. K., … &Unicomb, L. (2021). Could Alcohol-Based Hand Sanitizer Be an Option for Hand Hygiene for Households in Rural Bangladesh? The American Journal of Tropical Medicine and Hygiene, tpmd200755.

 

Prince-Guerra, J. L., Nace, M. E., Lyles, R. H., de Aceituno, A. M. F., Bartz, F. E., Arbogast, J. W., … & Leon, J. S. (2020). Both Handwashing and an Alcohol-Based Hand Sanitizer Intervention Reduce Soil and Microbial Contamination on Farmworker Hands during Harvest but Produce Type Matters. Applied and Environmental Microbiology, 86(18).

 

Cure, L., & Van Enk, R. (2015). Effect of hand sanitizer location on hand hygiene compliance. American journal of infection control, 43(9), 917-921
Evidence Level *

(I, II, or III)

 

Level I: Experimental study Level II: Combination of experimental study and meta-analysis Level IV: Respectedauthorities’ opinions, was used to make a clinical decision based on scientific evidence

 

Level III: Qualitative, qualitative systematic review with meta-synthesis
Conceptual Framework

 

Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**

 

The effectiveness of alcohol-based hand rubs such as foam, gel form, and liquid type on sensory features and acceptability, including its impact on health workers hygiene (Greenaway et al., 2018).

 

The Impacts of hand sanitizer as an alternative approach to water and soap among low and high-income countries enhance hand hygiene practices (Yeasmin et al., 2021). How to hand hygiene interventions, especially handwashing with water and soap is critical for minimizing the spread of germs and virus, including health-associated infections (Prince-Guerra et al., 2021). How hand-hygiene using hand sanitizer dispenser is the essential intervention in preventing infections in the healthcare setting.
Design/Method

 

Describe the designand how the studywas carried out (In detail, including inclusion/exclusion criteria).

A clinical practice guideline based on qualitative approach A descriptive sensory examination created key sensory differences on the ten market-emerging alcohol-based hand rubs (three gels, two liquids, four foams, and one aerosol foam). The differences and effectiveness were reinforced from the focus group (Greenaway et al., 2018). The alcohol-based hand rubs that did not fall under the modern market selection criteria were excluded from the study. Used a combination of quantitative and qualitative study, including randomized control trial, in which a total of 120 households from the designated groups or clusters were randomized to diverse clinical intervention (Yeasmin et al., 2021). The promoters issued free alcohol-based hand sanitizers and installed handwashing stations. It entails phases one and two, in which the initial phase, promoters recommended handwashing with water and soap to be effective compared to hand sanitizers. A survey was conducted, including in-depth interviews for phase two, and respondents suggested using both interventions. This study used a quantitative method, in which the hypothesis on handwashing and hand sanitizer was evaluated using correlation coefficients and level of significance. There was an analysis of data and the sample from farmworkers. According to Prince-Guerra et al. (2021), after 30 to 90 minutes before they engaged in handwashing, they were given hand sanitizers. Then, they rinsed their hand to measure the soil amount and indication of bacteria. The research used the quantitative method in a cluster-randomized study (Cure and Van Enk, 2015). Different databases were also searched for meta-analysis review. There were usability and standardization of a sanitizer in twelve inpatient participants. The healthcare examined the compliance of workers using hand sanitizer quality enhancement and effectiveness program. A regression model was used to determine the relationship between compliance of both intervention methods.
Sample/Setting

 

The number andcharacteristics of

patients,attrition rate, etc.

The top ten market-leading leading alcohol-based hand rubs (three gels, two liquids, four foams, and one aerosol foam). These were reinforced with the focused group in Acute care settings (Greenaway et al., 2018). A total of 12 households were enrolled from three rural villages in rural Bangladesh (Yeasmin et al., 2021). Three hundred twenty-six farm workers were recruited in the study and were randomly selected during harvesting time in Acute care settings. The study included 12 participating inpatients units. It was conducted in Midwest, 404-bed private hospital with different 15 inpatient care units, including other ambulatory units (Cure and Van Enk, 2015).
Major Variables Studied

 

List and define dependent and independent variables

The independent variable was sensory differences among the alcohol-based sanitizers. The dependent variables were three gels, two liquids, four foams, and one aerosol foam. The independent variables are alcohol-based hand sanitizers, installed handwashing places (soppy bottle water, bucket with a tap, stand, and basin) (Yeasmin et al., 2021). The dependent variable was acceptability, perceptions, and compliance with handwashing and hand sanitizer. The dependent variables were handwashing using water and or two-step alcohol-based hand sanitizer (Prince-Guerra et al., 2021). The independent variable was interventions to minimize bacteria and soil on farmworker hands. The dependent variable was the effectiveness of sanitizer dispensers and their compliance with staff in using them in a hospital. The dependent variable was compliance and usability of the intervention.
Measurement

 

Identify primary statistics used to answer clinical questions (You need to list the actual tests done).

Compliance to hand hygiene and safety guidelines from various clinical intervention and WHO (Greenaway et al., 2018). Deductive qualitative data coding related to dimensions and levels in systems of IBM-WASH. Standard deviation and mean were used for progressive survey responses. The confidence level was applied. 95% confidence intervals were derived for each group. It was then merged across diverse research data reports using random-effect meta-analysis.

 

Statistical analysis was used in which (p = .0046) was considered adequate for usability, and p= 0.003 was for visibility. While P= 0.37 was for compliance. The level of significance was determined, and a conclusion between correlations or relationship was made.
Data AnalysisStatistical or

Qualitativefindings

 

(You need to enter the actual numbers determined by the statistical tests or qualitative data).

The vital desirable qualities of hand sanitizers were not sticky, absorption rate, moisturized/soft hand feel, low smell, and clean feeling. Statistical inferences were made. The initial phase included N=89 of 120 (74%). The mean household sizes were 5.4 individuals. In the second phase, the respondents’ average age was 29 and 25, N=87 (69%) (Yeasmin et al., 2021). Phase 1 recorded a high number of the respondent that recommend handwashing as an effective intervention.  The confidence level of 0.95% was used, and alcohol-based sanitizer was considered under (P < 0.0001), Enterococcus sp under (P = 0.003), and coliforms under (P = 0.002) (Prince-Guerra et al., 2021). All were summed as effective under(P = 0.4) or allowance of (P = 0.3) Meta-regression analysis was used.

·         Usability = (P= 0.0046)

·         Visibility p= 0.003

·         Compliance P= 0.37 (Cure and Van Enk,2015)

Findings and Recommendations

 

General findings and recommendations of the research

The research found out that foam and gel sanitizer formats were practical compared to liquid. They were compared to the liquid because they were absorbed, soft/moisturized hand quickly, trigger clean feel, not sticky, and have a low smell (Greenaway et al., 2018). This study recommended the effectiveness of hand-based sanitizer in reducing the spread of the virus. Household members preferred hand sanitizer use on their potential during the COVID-19 pandemic. Participants also stated that water and soap removed dirt from hands, and hand sanitizer effectively kills germs. The study found that the two-step alcohol hand-based sanitizer method was the same as handwashing with water and soap in reducing germs on participants’ hands (Prince-Guerra et al., 2021). Therefore, both interventions should be considered when maintaining hygiene and prevention viruses. Total usability, accessibility, and visibility of alcohol-based sanitizers on participants were statistically linked with a higher observed compliance rate. However, standardization did not have a significant impact on practical compliance. It implied that hand-based sanitizer is not still considered effective in terms of standardization by P=0.31.
Appraisal and Study Quality

 

 

Describe the general worth of this research to practice.

 

What are the strengths and limitations of study?

 

What are the risks associated with implementation of the suggested practices or processes detailed in the research?

 

What is the feasibility ofuse in your practice?

Adherence methodologies are of specific importance or significance for sensory differences between ten market-leading alcohol-based hand rubs. The study did not include a detailed sample size. Extensive eligibility criteria were incorporated in the research, and the question was clearly addressed and reviewed.

Additionally, The study adds to the nursing knowledge on how to prevent various infections in the clinical setting (Yeasmin et al., 2021).

The use of the FDA’s Produce Safety Rule in the study provided safety measures and compared the interventions with usual care significantly reduced bacteria, viruses, and germs that cause infections like COVID-19.  Further, a significant strength is that the study used a broad study sample, and the results can be applied to extensive population settings. However, the substantial random study sample increases the validity, reliability, and applicability of the products. The research study is highly feasible in my practice. Participants in the study had their strength, balance, and mobility examined upon referrals for the study program and then again before discharge.

The research study is highly feasible in my practice.

 

 

 

Key findings

 

 

 

Foam and gel-based sanitizer are effective compared to liquid (including handwashing with water and soap). It because they are absorbed, soft/moisturized quickly, and trigger a clean feel (Greenaway et al., 2018). Washing hands with soap and water is the best decontamination method compared to alcohol-based hand sanitizer in preventing the spread of the virus. Handwashing with soap and water safeguarded the participants from bacteria and germs during harvesting time compared to the use of hand sanitizer after harvesting. The hand sanitizer dispenser was not effective in terms of standardization in reducing the spread of the virus. Thus, handwashing using soap and water is preferred.
 

 

Outcomes

 

 

 

According to Greenaway et al. (2018), alcohol-based hand rubs in the form of gel and foam gave a smoother, cleaner, more moisturized feel is considered an effective intervention. Handwashing with water and soap reduced the spread of the virus among low and high-income countries, enhancing hand hygiene practices (Yeasmin et al., 2021). Handwashing with soap and water prevented the spread of bacteria and germs among farmworkers after harvesting (Prince-Guerra et al., 2021). A hand sanitizer dispenser was used, but the participants did not comply with the intervention because it lacked proper standardization (Cure and Van Enk,2015).
General Notes/Comments Low level evidence

 

 

 

 

 

High level evidence High level evidence Medium level evidence

 

 

References

Cure, L., & Van Enk, R. (2015). Effect of hand sanitizer location on hand hygiene compliance. American journal of infection control,         43(9), 917-921

Grant, C., &Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your” House”. Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.

Greenaway, R. E., Ormandy, K., Fellows, C., &Hollowood, T. (2018). Impact of hand sanitizer format (gel/foam/liquid) and dose          amount on its sensory properties and acceptability for improving hand hygiene compliance. Journal of Hospital Infection,       100(2), 195201

Prince-Guerra, J. L., Nace, M. E., Lyles, R. H., de Aceituno, A. M. F., Bartz, F. E., Arbogast, J. W., … & Leon, J. S. (2020). Both    Handwashing and an Alcohol-Based Hand Sanitizer Intervention Reduce Soil and Microbial Contamination on Farmworker            Hands during Harvest but Produce Type Matters. Applied and Environmental Microbiology, 86(18).

The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing dvidence-based practice: appendix C: evidence level and quality guide. Retrieved October 23, 2019 from https://www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide.pdf

Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. Retrieved October 23, 2019 from https://academicguides.waldenu.edu/library/conceptualframework

Yeasmin, D., Dutta, N. C., Nizame, F. A., Rahman, M. J., Ashraf, S., Ram, P. K., … &Unicomb, L. (2021). Could Alcohol-Based Hand Sanitizer Be an Option for Hand Hygiene for Households in Rural Bangladesh? The American Journal of Tropical       Medicine and Hygiene, tpmd200755.

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