Reflect on the knowledge and skills that you have gained throughout this course. What do you see as having the most impact on your role as a healthcare administrator/leader? Be sure to support your thoughts with at least two current, evidence-based sources.
some things from this course I attached below
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Hand Hygiene Interventions, a Mixed-Methods Analysis of Healthcare Worker
Compliance
Dania Atieh
Southern New Hamphsire University
Journal 4
2
Hand Hygiene Interventions, a Mixed-Methods Analysis of Healthcare Worker
Compliance
The choice between quantitative and qualitative research approaches in addressing the research
topic of enhancing hand hygiene compliance among healthcare professionals is determined by the
nature of the inquiry. “In healthcare workers, how does the implementation of hand hygiene
interventions compared to no intervention or standard practice influence hand hygiene compliance
rates?” suggests the need for a mixed-methods approach that incorporates both quantitative and
qualitative elements.
Quantitative Approach
A quantitative method would be useful for measuring and interpreting numerical data
pertaining to hand hygiene compliance rates. To measure the efficacy of various initiatives,
surveys, observations, and statistical analysis might be used. For example, quantifiable data from
compliance rates before and after hand hygiene programs may paint a clear picture of the impact.
Chen et al.’s (2023) study demonstrates how quantitative data may be used to assess the influence
of healthcare delivery complexity on hand hygiene compliance.
Qualitative Approach
At the same time, a qualitative approach is required to dive into the complexities of
healthcare personnel’ experiences and views of hand hygiene initiatives. Interviews or focus group
conversations with healthcare professionals using qualitative methodologies might reveal
contextual variables impacting compliance (McKim, 2016). Understanding the issues, attitudes,
and beliefs of healthcare professionals around hand cleanliness, as shown in Patwardhan and
Patwardhan’s (2019) study, might provide useful insights.
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Mixed-Methods Integration
By combining both approaches, a more comprehensive understanding of the issue emerges.
Qualitative data can provide depth and context, while quantitative data offers statistical evidence
of the interventions’ impact. This mixed-methods strategy aligns with the integrative review’s
nuanced goal of not only assessing success or failure but also understanding the practical
consequences of interventions in real-world healthcare settings.
In conclusion, the integration of quantitative and qualitative approaches is crucial for a
holistic exploration of hand hygiene interventions’ impact. The quantitative aspect provides
measurable outcomes, while the qualitative component captures the rich context of healthcare
workers’ experiences, ensuring a robust and well-rounded analysis of the research problem.
4
References
Chen, W., Tseng, C.-L., & Tseng, C. (2023). The impact of healthcare delivery complexity on
practices for clinical quality improvement: A case of healthcare workers’ hand hygiene
compliance. Service Science, Advance online publication.
https://doi.org/10.1287/serv.2023.0323
McKim, C. A. (2016). The value of mixed methods research. Journal of Mixed Methods
Research, 11(2), 202–222. https://doi.org/10.1177/1558689815607096
Patwardhan, N., & Patwardhan, S. (2019). Hand hygiene compliance among healthcare workers
in a superspeciality Tertiary Care Hospital. Journal of Patient Safety and Infection
Control, 7(1), 5. https://doi.org/10.4103/jpsic.jpsic_4_19
Tschudin Sutter, S. (2018). The impact of hand hygiene technique on hand hygiene compliance
and microbiological efficacy. Isrctn.Com/. https://doi.org/10.1186/isrctn45923734
1
6-2 Milestone Three HCM440, article analysis
Dania Atieh
Module 6
Milestone 3 HCM440
2
6-2 Milestone Three HCM440, article analysis
Introduction
Hand hygiene is a critical component of infection control in healthcare settings, and
numerous research studies have been conducted to understand and improve compliance among
healthcare workers. This paper aims to provide a critical analysis of the research methodologies
employed in six peer-reviewed articles on hand hygiene. The chosen articles encompass diverse
research methods and approaches, reflecting the complexity of studying and enhancing hand
hygiene practices in healthcare.
Research Methods
Alshammari et al. (2018) utilized a cross-sectional research methodology. This approach
involved the collection of self-reported data through questionnaires and direct observations using
a checklist. The cross-sectional design allowed for a snapshot of hand hygiene practices among
healthcare workers. Bishop et al. (2020) adopted a quasi-experimental design. The study compared
hand hygiene compliance with and without automated reminders, providing insights into the
effectiveness of this intervention. This design facilitated a practical evaluation of the reminder
system.
Chen et al. (2023) employed a correlational design. This approach allowed the researchers
to explore the relationships between quality improvement practices, healthcare delivery
complexity, and hand hygiene compliance among healthcare workers. Park et al. (2021) utilized a
retrospective design. By analyzing data from a South Korean referral hospital, the researchers
aimed to establish the minimum number of observations required for accurate hand hygiene
compliance assessment. Tschudin Sutter (2018) employed a retrospective and comparative
approach. The researchers compared the effectiveness of different hand hygiene techniques,
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assessing microbiological efficacy through statistical analyses such as t-tests.Lastly, Wahab (2023)
did not involve primary research but synthesized evidence from various studies. While not
employing a specific research design, this review method is valuable for summarizing existing
knowledge on the effectiveness of nudges in improving hand hygiene compliance.
Data Collection and Statistical Data Analysis:
Alshammari et al. (2018) utilized a 16-item checklist for direct observations and statistical
analyses to compare self-reported and observed hand hygiene compliance. Bishop et al. (2020)
conducted statistical analyses to compare compliance with and without automated reminders,
employing a quasi-experimental design. Chen et al. (2023) employed correlational analyses to
explore relationships between healthcare delivery complexity, quality improvement practices, and
hand hygiene compliance. Park et al. (2021) used statistical calculations to determine the minimum
number of observations required for accurate hand hygiene compliance assessment. Tschudin
Sutter (2018) applied statistical analyses, including t-tests, to compare the microbiological efficacy
of different hand hygiene techniques. Wahab (2023), being a narrative review, did not involve
statistical analyses but synthesized evidence from various studies on nudges as an intervention.
Gaps and Inconsistencies
1.
Gaps in Study Locations, Settings, and Time Periods: The literature reflects
variations in the geographic locations, healthcare settings, and time periods of the studies. This
diversity influences the generalizability of findings. For instance, Alshammari et al. (2018)
conducted research in MERS-CoV endemic regions, and the specific characteristics of these
settings may limit the broader applicability of the study’s conclusions.
2.
Inconsistencies in Sample Sizes, Demographics, and Cultural Factors:
Differences in sample sizes, participant demographics, and cultural factors across studies
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contribute to inconsistencies. The study by Wahab (2023) specifically addresses nudges as an
intervention, but the varying cultural contexts in different healthcare settings may impact the
effectiveness of nudges, introducing potential inconsistencies in the findings.
3.
Standardization Issues in Measurement Tools and Definitions: Standardization
issues arise from variations in hand hygiene measurement tools, definitions of compliance, and
observational methodologies. Tschudin Sutter (2018), in examining hand hygiene technique and
microbiological efficacy, may face challenges in aggregating results due to potential differences
in how microbiological efficacy is measured and defined across studies.
The identified gaps and inconsistencies highlight the need for greater standardization in
study design, measurement tools, and definitions within the field of hand hygiene research.
Addressing these issues will enhance the reliability and applicability of findings across diverse
healthcare contexts.
Conclusion
The critical analysis of the methodologies used in the six hand hygiene studies reveals a
diverse range of research approaches. Each study’s methodology was appropriate for its research
question, providing valuable insights into hand hygiene practices among healthcare workers.
However, the identification of gaps and inconsistencies highlights areas for improvement,
including increased standardization, advanced statistical methods, and consideration of contextual
factors. Future research in hand hygiene should build on these insights to enhance the validity and
reliability of findings.
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References
Alshammari, M., Reynolds, K., Verhougstraete, M., & O’Rourke, M. (2018). Comparison of
perceived and observed hand hygiene compliance in healthcare workers in MERS-COV
endemic regions. Healthcare, 6(4), 122. https://doi.org/10.3390/healthcare6040122
Bishop, S. M., Heishman, C., Oppy, L., & Scott, L. (2020). Impact of an automated hand
hygiene reminder alert on healthcare worker hand hygiene compliance. American Journal
of Infection Control, 48(8). https://doi.org/10.1016/j.ajic.2020.06.027
Chen, W., Tseng, C.-L., & Tseng, C. (2023). The impact of healthcare delivery complexity on
practices for clinical quality improvement: A case of healthcare workers’ hand hygiene
compliance. Service Science. https://doi.org/10.1287/serv.2023.0323
Park, S. Y., Park, S., Lee, E., Kim, T. H., & Won, S. (2021). Appropriate Number of
Observations for Determining Hand Hygiene Compliance among Healthcare Workers.
https://doi.org/10.21203/rs.3.rs-659400/v1
Tschudin Sutter, S. (2018). The impact of hand hygiene technique on hand hygiene compliance
and microbiological efficacy. Http://Isrctn.Com/. https://doi.org/10.1186/isrctn45923734
Wahab, M. T. (2023). Nudges as a suitable and effective intervention to improve hand hygiene
compliance among healthcare workers in Patient Care Settings: A narrative review.
International Journal of Infection Control. https://doi.org/10.3396/ijic.v19.22762
1
Annotated bibliography, Impact of Hand Hygiene Interventions on Hand Hygiene
Compliance among Healthcare Workers
Dania Atieh
Milestone Two
HCM440
2
Comparing Perceived and Actual Hand Hygiene Practices in MERS-CoV Regions (2018)
This article delves into the crucial issue of hand hygiene practices among healthcare
workers in countries endemic to MERS-CoV. Employing a cross-sectional research approach, the
study contrasts self-reported hand hygiene behaviors gathered through questionnaires with direct
observations utilizing a 16-item checklist based on guidelines from the CDC, WHO, and Boyce
and Pittet. Conducted in outpatient examination rooms and emergency departments of Saudi
Arabian hospitals, the study reveals a substantial gap between healthcare workers’ perceptions and
their actual behaviors. This underscores the imperative for interventions to enhance hand hygiene
compliance in MERS-CoV endemic areas. Notably, the study highlights disparities between the
self-reported hand hygiene practices of physicians and nurses, prompting further exploration of
these differences. The comprehensive methodology, spanning various healthcare settings and
employing statistical analyses, offers valuable insights for infection control strategies in endemic
regions.
Impact of Automated Reminders on Hand Hygiene (2020)
This study investigates how automated hand hygiene compliance systems can assist
healthcare professionals in improving their hand hygiene habits. The authors aim to assess the
impact of a real-time reminder warning sequence on an automated hand hygiene system on
healthcare worker hand hygiene compliance. Over a 14-day period, the research compares hand
hygiene compliance on days when the alarm is active versus days when it is deactivated in selected
inpatient units. The findings indicate that the use of the automated system’s real-time reminder
alert sequence leads to sustained total hand hygiene compliance of ≥90%. Deactivating the alert
results in an average hand hygiene compliance drop to 74%, affecting both entry and exit
compliance. Upon reactivating the alert, total hand hygiene compliance returns to ≥90%. The
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conclusion underscores the effectiveness of automated hand hygiene systems, particularly those
with real-time reminders, in achieving and maintaining high compliance rates among healthcare
workers. The research supports the incorporation of real-time reminders in the design and
implementation of such systems to enhance overall hand hygiene compliance.
Complexities in Healthcare Delivery and Hand Hygiene (2023)
Wenlin Chen et al.’s paper explores the relationship between quality improvement (QI)
practices and healthcare worker (HCW) hand hygiene compliance while considering the
complexity of healthcare delivery. Analyzing data from 320 HCWs at a Taiwanese university
hospital, the study reveals that contextual complexity influences the effectiveness of QI practices,
while provider complexity determines their efficacy. Implementing numerous QI procedures
simultaneously does not always yield better results; the key lies in selecting the appropriate
approaches. The study provides insights for healthcare institutions to develop successful QI
methods tailored to clinical quality improvement in the context of the complexity of healthcare
delivery.
Optimizing Observations for Hand Hygiene Compliance (2021)
Se Yoon Park et al.’s article (2021) focuses on determining the minimum number of
observations needed to evaluate hand hygiene (HH) compliance among healthcare workers.
Conducted in a South Korean referral hospital from January to December 2018, the retrospective
study used the World Health Organization’s six-step approach to calculate HH compliance rates.
The study reveals that a minimum of five observations is required to calculate ideal HH compliance
with 30% absolute precision and a 90% confidence interval, utilizing a method that considers the
overall mean value, absolute precision, and confidence interval.
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Exploring Hand Hygiene Technique and Microbiological Effectiveness (2018)
This study delves into the correlation between hand hygiene technique, compliance, and
microbiological efficacy among healthcare workers. Despite numerous efforts to improve hand
hygiene compliance, it often falls short in preventing healthcare-associated infections. The study,
registered and completed retrospectively, examines the efficacy of a three-step hand hygiene
technique in comparison to the standard six-step technique outlined in WHO guidelines. The
research aims to evaluate healthcare workers’ compliance and the reduction in bacterial load on
hands using both techniques. The study’s conclusion provides potential insights into refining hand
hygiene practices for better infection control.
Utilizing Nudges to Enhance Hand Hygiene Compliance (2023)
Muhammad Taufeeq Wahab’s narrative review explores the potential of nudges as
interventions to boost hand hygiene compliance among healthcare workers (HCWs). Hand hygiene
plays a crucial role in preventing healthcare-associated infections (HCAIs), yet challenges persist
globally with low compliance rates. Nudges, defined as interventions that influence judgment,
choice, or behavior without restricting options or altering economic incentives, are examined for
their suitability in fostering professional handwashing habits. The review encompasses 19 primary
studies, including 10 from a systematic review, investigating the isolated impact of nudge
interventions on HCW hand hygiene compliance. While some evidence indicates the effectiveness
of performance feedback, methodological heterogeneity calls for cautious interpretation. The
review advocates for future research with robust designs, automated auditing systems, and
consideration of structural constraints when evaluating nudge interventions.
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References
Alshammari, M., Reynolds, K., Verhougstraete, M., & O’Rourke, M. (2018). Comparison of
perceived and observed hand hygiene compliance in healthcare workers in MERS-COV
endemic regions. Healthcare, 6(4), 122. https://doi.org/10.3390/healthcare6040122
Bishop, S. M., Heishman, C., Oppy, L., & Scott, L. (2020). Impact of an automated hand
hygiene reminder alert on healthcare worker hand hygiene compliance. American Journal
of Infection Control, 48(8). https://doi.org/10.1016/j.ajic.2020.06.027
Chen, W., Tseng, C.-L., & Tseng, C. (2023). The impact of healthcare delivery complexity on
practices for clinical quality improvement: A case of healthcare workers’ hand hygiene
compliance. Service Science. https://doi.org/10.1287/serv.2023.0323
Park, S. Y., Park, S., Lee, E., Kim, T. H., & Won, S. (2021). Appropriate Number of
Observations for Determining Hand Hygiene Compliance among Healthcare Workers.
https://doi.org/10.21203/rs.3.rs-659400/v1
Tschudin Sutter, S. (2018). The impact of hand hygiene technique on hand hygiene compliance
and microbiological efficacy. Http://Isrctn.Com/. https://doi.org/10.1186/isrctn45923734
Wahab, M. T. (2023). Nudges as a suitable and effective intervention to improve hand hygiene
compliance among healthcare workers in Patient Care Settings: A narrative review.
International Journal of Infection Control. https://doi.org/10.3396/ijic.v19.22762
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