The section includes a systematic review of literature on the PICOT question, “whether hand washing by health providers when on duty helps to reduce hospital-related infections.” The study applies three empirical articles that relate directly to the topic of study. It is aimed at establishing the impact of hand hygiene as a strategy to prevent hospital-acquired infections. In essence, it is a comparison of sources in terms of research questions, sample populations, and limitations of the study.
A Comparison of Research Questions
The research questions from the three empirical studies correlate with the topic, “the effect of hand hygiene in the prevention of hospital-acquired infections.” Barnes, Morgan, Harris, Carling, and Thom (2014) conducted a quantitative study in a 20-patient ICU to investigate the importance of hand hygiene and a clean environment in the prevention of hospital-acquired infections. The research question for the study included the integration of two approaches to preventing infections in hospitals. In a similar quantitative study involving 1007 ICU patients, Martínez-Reséndez et al. (2014) investigated the impact of chlorhexidine (CHX) bathing and hand hygiene (HH) compliance in the prevention of HAIs in the intensive care unit. The two studies differ in their research question because the second study focused on hand hygiene and included the substance used in the process. Marimuthu, Pittet, and Harbarth (2014), in a systematic review of previous studies, explored the question of the relationship between improvement of hand hygiene and the control of methicillin-resistant infections in hospital settings. Notably, the three studies are similar in their approach to hand hygiene in the prevention of hospital-acquired infections. However, they differ in their focus on hand hygiene because some, such as Barnes et al. (2014) included an additional strategy for infection control.
A Comparison of Sample Populations
The three studies focused on particular research to establish the impact of hand hygiene in the prevention and reduction of hospital-acquired infections. Barnes et al. (2014) and Martínez-Reséndez et al. (2014) conducted their studies in intensive care units. The settings are commonly affected by infections because of the treatment mechanisms such as catheterization. Martínez-Reséndez et al. (2014) conducted the study in two adult intensive care units (ICUs), where 1071 patients were admitted during the 18-month study period. Similarly, Barnes, Morgan, Harris, Carling, and Thom (2014) carried out their study in a 20-patient intensive care unit. However, the sample of the two studies differed because the latter included 175 parameter-based scenarios, involving patients in the intensive care unit. Marimuthu, Pittet, and Harbarth (2014) performed a completely different study from the other two articles. Their research was a systematic review of previous studies on the impact of hand hygiene improvement on the control of nosocomial MRSA.
A Comparison of the Limitations of the Study
Although all the three studies provided support for the use of hand hygiene in the control of infections in hospitals, they had limitations that were unique because of differences in their design and data collection, among other aspects of research. The study by Barnes, Morgan, Harris, Carling, and Thom (2014) had several limitations: the parameter selection limited to available literature; otherwise, the researchers used unpublished data; varied admission prevalence of MDROs as well as hand hygiene baseline values; and the sole focus on terminal cleaning following a discharge of a patient. The study by Marimuthu, Pittet, and Harbarth (2014) had limitations emanating from the use of a review of previous studies instead of primary research. One of the limitations was a delay in the hand hygiene compliance improvement and the evaluation of the impact on the rate of hospital-acquired infections. The study lacked a clear incremental benefit of hand hygiene on the reduction of hospital-acquired infections. The study did not have clear evidence of the effect of contact precautions in areas with low rates of infections. Notably, the research conducted by Martínez-Reséndez et al. (2014) was limited by the use of two strategies because it was difficult to determine the actual impact of hand hygiene in isolation. Another limitation is that hand hygiene evaluation was conducted by directly observing the process during the morning and afternoon schedules.
As it is evident from the analysis, the three sources reveal a positive effect of proper hand hygiene in the prevention and reduction of hospital-acquired infections. They all acknowledged that health care providers should comply with hand hygiene practices to prevent different kinds of infections acquired during the caregiving process. However, the limitations of the studies indicate the need for further research. One of the recommendations is to isolate hand hygiene practices to provide objective evidence of the impact of the exercise alone instead of combining with additional strategies such as environmental hygiene. Further research is also necessary to establish the connection between compliance with hand hygiene and the reduction of infections in hospitals and other settings outside the intensive care unit. Therefore, additional research should include exploration of the impact of hand hygiene practices in various types of infections, such as VAP and CAUTI.