Johns Hopkins Nursing Evidence-Based Practice Appendi 809266

Johns Hopkins Nursing Evidence Based Practice Appendix G Individual E

Johns Hopkins Nursing Evidence-Based Practice Appendix G: Individual Evidence Summary Tool Johns Hopkins Nursing Evidence-Based Practice Appendix G: Individual Evidence Summary Tool EBP Question: What are the barriers and importance of adherence to performing aseptic technique to decrease hospital acquired infections (HAIs) for medical-surgical nurses in an ER setting?

Paper For Above instruction

Introduction

Hospital-acquired infections (HAIs) pose a significant challenge in healthcare settings, particularly in emergency rooms where rapid and often complex care is administered. Adherence to aseptic technique is a critical factor in reducing the incidence of HAIs, which are associated with increased morbidity, mortality, and healthcare costs (Concha-Rogazy et al., 2016). Understanding the barriers that impede adherence and the importance of strict aseptic practices can inform strategies to enhance compliance among medical-surgical nurses in ER environments.

The purpose of this paper is to synthesize existing evidence regarding the barriers to aseptic technique adherence and its importance in decreasing HAIs in ER settings. Drawing from a range of research designs, the review highlights critical findings and offers informed recommendations for practice improvement based on a robust appraisal of the evidence.

Summary of Evidence

Evidence from various levels of research demonstrates that both systemic and individual factors influence adherence to aseptic protocols. A systematic review by Concha-Rogazy et al. (2016) provided compelling evidence that low infection rates (

Nevertheless, multiple barriers have been identified across studies. Tambe et al. (2019) highlighted healthcare resource limitations, such as inadequate supply of sterile equipment and financial constraints faced by patients, as significant obstacles to compliance. Nurses are generally knowledgeable about aseptic techniques but often encounter challenges translating this knowledge into practice due to resource scarcity and workload pressures.

Qualitative studies by Lin (2019) and Towell (2020) elucidated barriers related to awareness and motivational factors. Nurses often lack clarity on when and how to implement aseptic precautions, especially differentiating between clean and sterile gloves. Additionally, barriers such as lack of awareness, environmental factors, peer pressure, and management directives influence adherence. The studies also pointed out facilitators, including online training modules, hospital-wide handwashing initiatives, and organizational culture that promotes safety and autonomy (Lin, 2019; Towell, 2020).

Further, Mohsen et al. (2020) underscored the significance of continuous education, training, and curriculum updates to embed infection prevention into routine nursing practice. Lack of preparation, time constraints, and environmental contamination serve as to barriers to strict adherence. Sameer et al. (2018) concurred that improper aseptic practices directly relate to increased contamination and subsequent infections, emphasizing the need for standardization and better environmental controls.

More broadly, systematic reviews synthesized data on barriers, highlighting inconsistent definitions of aseptic practice as a major cause of variability and increased infection risks (Suvikas-Peltonen et al., 2017). These inconsistencies can lead to confusion, poor risk assessment, and variability in practice, underscoring the necessity for standard practices and ongoing competency assessments (Clare & Rowley, 2018).

The importance of adherence is reinforced in case studies, such as Johnson (2018), who demonstrated that organizational efforts, including root cause analysis and staff engagement, significantly reduced HAIs. Integrated policies based on evidence and shared accountability foster a culture of safety, emphasizing that strict aseptic technique is vital to patient safety, regulatory compliance, and cost containment.

Synthesis of Evidence

The collected evidence consistently indicates that barriers such as resource limitations, lack of awareness or training, environmental factors, and organizational culture impede adherence to aseptic techniques (Tambe et al., 2019; Lin, 2019; Towell, 2020). The facilitators include organizational policies, education programs, and a safety climate that encourages self-autonomy and peer support (Mohsen et al., 2020; Clare & Rowley, 2018).

Most high-level evidence (Level I and II) supports that proper aseptic technique, when adhered to, significantly reduces HAIs (Concha-Rogazy et al., 2016). Moderate-quality evidence suggests that addressing barriers through targeted education, resource availability, and organizational culture can improve compliance (Lin, 2019; Towell, 2020). Lower-level evidence points to persistent misconceptions and variability in definitions as ongoing challenges.

Overall, the synthesis indicates a strong connection between adherence to aseptic protocols and decreased HAIs. Effective strategies should focus on standardization, continuous education, resource provision, and fostering a safety-oriented environment.

Translation Pathways and Recommendations

The synthesis provides strong evidence supporting practice change. Implementation of multifaceted interventions—such as staff training, resource allocation, and organizational culture initiatives—is warranted. The evidence suggests that a combination of education, environmental management, and leadership support can create sustainable improvements in aseptic practices (Concha-Rogazy et al., 2016; Mohsen et al., 2020).

Recommendations should be compatible with the organizational culture, priorities, and resources. Feasibility includes secure administrative support, stakeholder engagement, and resource investment. Fidelity to evidence-based guidelines, ongoing competency assessments, and routine audits are essential components of successful implementation.

In conclusion, addressing the barriers to aseptic technique adherence through targeted, evidence-based strategies can significantly reduce HAIs in ER settings. A comprehensive approach involving education, resource management, leadership support, and organizational culture change is vital for sustained improvement in patient safety outcomes.

References

• Clare, S., & Rowley, S. (2018). Implementing the Aseptic Non Touch Technique (ANTT®) clinical practice framework for aseptic technique: A pragmatic evaluation using a mixed methods approach in two London hospitals. Journal of Infection Prevention, 19(1), 6–15.
• Concha-Rogazy, M., Andrighetti-Ferrada, C., & Curi-Tuma, M. (2016). Aseptic techniques for minor surgical procedures. Revista médica de Chile, 144(8).
• Johnson, S. (2018). A case study of organizational risk on hospital-acquired infections. Nursing Economics, 36(3), 128–135.
• Lin, F., Gillespie, B. M., Chaboyer, W., Li, Y., Whitelock, K., Morley, N., & Marshall, A. P. (2019). Preventing surgical site infections: Facilitators and barriers to nurses’ adherence to clinical practice guidelines—A qualitative study. Journal of Clinical Nursing, 28(9/10).
• Mohsen, M., Riad, N., & Badawy, A. (2020). Compliance and barriers facing nurses with surgical site infection prevention guidelines. Open Journal of Nursing, 10, 15-33.
• Suvikas-Peltonen, E., Hakoinen, S., Celikkayalar, E., Laaksonen, R., & Airaksinen, M. (2017). Incorrect aseptic techniques in medicine preparation and recommendations for safer practices: A systematic review. European Journal of Hospital Pharmacy, 24(3), 175–181.
• Tambe, T. A., Nkfusai, N. C., Nsai, F. S., & Cumber, S. N. (2019). Challenges faced by nurses in implementing aseptic techniques at the surgical wards of the Bamenda Regional Hospital, Cameroon. Pan African Medical Journal, 33, 105.
• Towell, B. A., Slatyer, S., Cadwallader, H., Harvey, M., & Davis, S. (2020). The influence of adaptive challenge on engagement of multidisciplinary staff in standardising aseptic technique in an emergency department: A qualitative study. Journal of Clinical Nursing, 29(3/4), 459–467.